Surgery Day

We checked in with a secret yellow card they hand you and went straight to pre-op.

At pre-op, we took out my contacts, shaved the area, took blood and vitals and then the relatively long wait for the surgery.

Vitals were really good.  Blood pressure was normal and heart rate was under 60bpm. 

We arrived around 9am, and the surgery was scheduled for 11:15.  For unknown delays, 12:51 was the official start time.

I remember waiting in the real pre-op for a while.  I had expressed concerns about my anesthesia on the last surgery, so they assigned the actual anesthesiologist to do the procedure.  I spent a while chatting with him and his assistants.  I remember meeting a couple of them and discussing how the last spinal block should not have failed.

The anesthesia prep people talked about how I'd be asked to bend over where they'd give me the spinal while I sat relatively upright.  But I don't remember any of that.  It's really odd- because they say you're lucid.  The drug they use must have some type of short-term memory loss that goes with it, which is kind of scary.

I'm not sure what the delay was in getting to my surgery, but I do remember meeting the doctor and asking if he was "warmed up", because I know he had other surgeries scheduled that day.

The surgery apparently took just under two hours.   Comments made to us afterwards were pretty somber:

• There was no chance it could have healed.
• No sign of healing.  None.  No callus, no scar tissue.
• The hardware was loose.  It wasn't my 'muscles going over hardware' that caused the pops, I felt, it was just moving bone.
  
• The loose hardware had shaved out the inside of the femoral head.  It was a shell.
• The femoral head was dead.
• I had signs of arthritus

Surgical Anticipation

Tomorrow's the big day.  I get a hip replacement.

It's been a long and honestly painful journey.  I still haven't come up with a reason that all this happened- no striking 'life lesson' to share.  I do have one I've been tossing around, but I'll wait until I recover to write it up.

I go into the hospital at 9:15 with the surgery scheduled to start at 11:15.  My doctor told me it would be a two-hour operation.  Add in the pre- and post-operative stuff and I figure I won't be back to my room until the early evening. 

They're going to open me up and take out the old hardware.  Then, my damaged femoral head will be removed.  They'll ream out my acetabulum and insert a metal cup. They'll trim the top of my femur and insert a stem.  They'll test the new components for range of motion and sew me up.  Two hours- it'll be busy, I'm sure.

Hopefully by the end of this week, I'll be able to walk without my walker.  Slowly.  Carefully.  But I'll walk for the first time since September 4th.

The technology of hip replacement

Even before I was resigned to having a hip replacement done, I was already reading up on them.  I had heard that they only last a certain amount of time before they wear out.  Apparently those estimates were on the low side- the original ones lasted about double what they thought.  And with the newer technology, I was told that mine will last upwards of 25 years, even with my high level of activity.

The prosthetic I'll be getting is this one: a J&J (DePuy) Pinnacle.

The issues in the past with hip replacements is that they used a small ball which limited the range of motion.  It also had a smaller surface area- yet the same amount of force, which causes higher wear.

Newer designs use a large ball, trying to approximate the original femur.  The Pinnacle design isn't the largest one, though it is pretty big.  The Pinnacle socket is a two-piece. There's a titanium cup which is put in the pelvis, and a liner.   That's the selling point of the pinnacle- the liner (and ball) can be swapped out.  The have balls in metal and ceramic, and liners in plastic, ceramic and metal, giving the surgeon a lot of choice.  Ceramic has fallen out of favor because some squeak after time.  Plastics are popular, but they don't wear as long as metal.   Metal has concerns because metal on metal causes ions of the metal to be released with some uncertainty as to what happens over time.   This new joint is design to have much lower wear because it allows the synovial fluid to lubricate the joint as if it would a normal joint.

The other half of the joint is a stem which goes into the femur and the ball on the end.  As I mentioned earlier, the ball is a relatively large diameter at 36mm or so (compared to the early balls which were 24mm), but not as large as the original femur which is around 54mm.  I did some searching on studies, which found that head sizes >32mm had a huge improvement in range-of-motion and lessened the chance of dislocation.

So, I'm satisfied with the choice of component.  And its modular design will allow the liner to be changed (I assume) at some point if the materials wear or there's a problem.

Preop is done

I just back from hours that the hospital getting ready for the next operation.

Besides all the paperwork, I spent a lot of time with the anesthesia department because I was concerned about the October surgery.  It was supposed to be a spinal block like the first surgery- and something went wrong.  What it was I was never told.  So the anesthesia interview nurse had me meet with the head of anesthesiology.  He was a great guy and told me it was likely one of two things- occasionally a medication will be less than effective and they end up sending back the whole lot.  The other one is what I suspected is that a nurse anesthetist student was working with the doctor and did the procedure.  Or failed at it.  In any case, the doctor promised me that only one of his doctors on staff would do the procedure.

I met with my surgeon and he was sharp.  I had a list of tough questions to ask him and it was almost like he was ready for me. Now that I think about it, maybe he had been warned after my extensive talk with the trauma specialist.

• Will the existing hardware cause complications?  No, it will need some additional time, but it should come out easily.
• What kind of hardware is it?  It will be a metal/metal titanium prosthesis with a textured surface for new bone to bond to.
  
• Will a new cut need to be made?  No, the line of the fracture is appropriate for where the new hardware will go.  
• What diameter is the ball going to be?  36mm most likely. 

I also spent time with the physicians assistant, who was very sharp.  We talked about recovery (staples out in 10 days, 6 weeks for full motion, 8 weeks full recovery) and also looked at my x-ray.  It was pretty scary what had happened since my last x-ray.  The top of the hardware is loose and moving around in my femur.  There's a black area that looks like it has been 'wiped' by the hardware moving back and forth.  It wasn't there the week before- no wonder my pain got so bad so quickly.

In any case, the paperwork is done.  Next Tuesday morning I'll be back at the hospital for the third time this year.

Primary Care Mellowness

I met with my primary care doctor yesterday.  It was really just serendipitous that I had an appointment with him.  He stays very busy but an opening for my yearly physical popped open and it happened to be during 'exam week'.  I really welcomed it because he's very laid back.  I'm in kind of a rush with trying to get surgeries scheduled and such before the end of the year, and he's one to give me a check as to if I'm doing the right thing.

The good news is that I'm in great health- other than the leg.  My heartrate is 54, my BP was 112/78.  And that's while being in constant pain (which often raises it).

My doctors says I need to inform my regular doctor about what I'm going to do.  I'm somewhat dreading that call.

I'm not a candidate

I just got back from Duke, meeting with a trauma specialist.

The doctor I met last week was unhappy with my surgeries and said I won't heal.  He referred me to a trauma specialist to see if he thought I could be repaired.

The doctor today said he was excited to read the notes from last week because he looks at this kind of operation as a challenge and one that rewards him because he can get someone back on their feet with their own bones.

He took lots of x-rays and we sat and talked for a long while.  I had heard good things about this guy from his own staff and they were right.  I've never had so much personal time with a senior doctor like this.  We went over everything, from the original surgeries to the current prognosis.

I'll cut to the chase and repeat that he said I'm not a candidate to salvage my bone.  The problem is that the femoral neck has shortened to the point that even if it were to be operated on, there's not enough neck for the joint to function properly.  My leg is already much shorter than it should be, and even though the operation could take a wedge out of my femur to make it straighter, it still wouldn't be long enough.  So, taking the reduced neck, shortened leg, the fracture site has shifted and what isn't in contact with bone would have to be reworked.  So he summarized that it just wouldn't work.  He said he'd also get a referral from the senior doctor in the practice (joking that it meant he had more gray hair).  I got the followup call this afternoon, and it was as he expected- that neither of them thinks it can be saved.

I've now had six MDs tell me it won't heal, with a couple more by the end of the week.  I haven't heard a dissenting opinion other than those who did my surgeries.   Which means a hip replacement.  I've been reading on them for a while,lots of options out there- and it's not surprising because there are 400 thousand of them done a year.   Next week I plan on researching doctors and their availability. 

Atrophy

My leg is getting weaker and weaker.  The past few weeks it must have looked a lot smaller because several doctors have commented on it as they manipulated it.

I don't know what's happening- maybe from the pain I'm not even trying to move it anymore.  In fact, I just can't.  I can no longer lift my leg on my own.  For example- to get in and out of the car, I have to pick up my leg and move it in.  It's not the pain- I just don't have any strength.

It's not like I had huge thighs to start with, but this is getting ridiculous. 

Exam week

I've got many tests and operations this coming week.  I'm going to get a third opinion, I'm going to see my regular practitioner, I'm supposed to get a CT scan, and see a 'trauma' specialist.  I also see my current orthopaedist in the middle of the week.  The big event will be the highly recommended hip specialist for whom I had to wait several weeks to get an appointment.

The pain is really bad in the morning.  Once I'm up and about, I can manage, but I dread going to bed- because the transition both going to bed and getting up is terrible.

I'm trying to reconcile that I'll be convalescing one way or another during the winter months, so spearfishing won't be so tempting, as the water is cold, and the fishing restricted because of the spawning season.

But I was talking with my daughter today about snowboarding and recalled that I had tentatively planned a trip out West with my buddy in Salt Lake City.  I have a feeling that's not going to happen- but maybe they'll get a late season for me in April or something.

Hopes Dashed

I couldn't sleep last night- the conversation I had with Charlie and others had me excited- and alongside a midday nap made me well rested.  At 3:45am I decided to take an ambien.  That stuff works- and when I got up I could still feel its odd effects on my perception.

The exciting news for the say was to visit an independent doctor for a second opinion.   This physician was very matter of fact- and not at all hopeful.

"Very little chance of it healing."
"If it does heal you'll have a leg an inch shorter than the other."
"The first surgery was going to fail because the screws didn't have the right separation."
"The second surgery was going to fail because it didn't have a proper reduction."

Not words I wanted to hear, but that's why I got the second opinion.

The part I'm confused about is what's the next step.  He said I needed to see a trauma specialist and I was given the name of one.  Unfortunately, that guy was booked until March!  So I was given a backup, whom I initially though was very junior since he had an opening next week, but has an impressive pedigree as well.

Next week is very busy with a physical, a referral, another 2nd opinion, a CT scan, and a visit to my doctor's office.

A glimmer of hope?

I collected my xrays as I left my doctor's office to send to a friend who is a radiologist.  He's been very interested in my injury and recovery and was one of the first to offer a fresh perspective on my fracture.

He was pleasantly surprised by my latest xrays.  He agrees that the ball looks good, but he thinks that there has been a reduction of the gap in the fracture. Furthermore, he thinks there is some new bone forming on part of the facture.

This may be because I had started to put some weight on the leg the past few weeks.  Maybe that little bit of pressure forced two bones together with the nail acting as a guide.

The long term question (besides AVN) is if it heals this way, will it be strong enough to support my weight and activities?  The fracture itself is about as bad as it can get- it is vertical- aligned with the forces of my body upon it.  So, an incomplete healing will mean it is weak- maybe able to support my body weight standing- but jumping or lifting?  In the long term, my titanium hardware will stay in and help support as well.  There's always the fallback of a replacement if it fails.

Stuck in limbo

I went to the doctor today and got more x-rays done.  Things looked about the same as last week.  The femoral head looks solid.  No progress and no failure of the hardware.  The doc keeps saying that the hardware will fail eventually, so the body's healing needs to take over before that happens.

From reading about bone healing, if new bone doesn't form, scar tissue can form isntead.  For low-stress bones, you might not even know, and eventually it can calcify.  That won't work on a femur.  So, it really needs to be growing bone, or something else needs to be done.

The something else is either a total hip replacement (doc didn't think a half-replacement would last more than 5 years with me), or a much more invasive procedure.  The invasive procedure would be to go in and clear out the scar tissue, debride (debreed?) the bone and re-pin it.  Of course, he mentioned that doing it again could result in the same failure as the first time.

I really prefer my own bone- the body maintains it for life.  So if there's a chance of it working I want to go with that. But, the issue all along is will the femoral head live?  The doctor has set me up for a CT scan this week and another appointment next week.

With the CT scan, we'll be able to see a 3-dimensional view if the bone is really aligned and how well.  Then we can make a better decision.

Psychosomatic

I called my doctor today.  He gave me his cellphone number and actually answers it.  That's very cool in my book.  I think this is only the second time I've called him and I can't remember the first time (I assume it was close to a surgery and I probably wasn't lucid).

I told him I had more pain and that I was worried about my prognosis.  He said he wanted to take a look at my x-rays, but he was out of town.  He then offered to send me to the local clinic for x-rays and he'd view them remotely.  I went to the clinic and got the x-rays done- he had called and they knew all  about me.  But he wasn't able to view them at his remote office because of some data transfer issue.  But, my other doctor viewed them, and said as well that he was going by the office and he could see me.

It was really nice of him, we went over all my concerns and he thought the x-rays were definitely not worse (and my own viewing made me think they've improved).

I'm not sure what it is, but maybe the little bit of putting weight on my leg has kick started the healing again, I don't know.  I felt a lot better after the appointment.  I'm still in pain, but I'm not quite so worried.

A big step backwards

My pain has been increasing.  A lot.  To the point that I had to take a percocet.  This sucks.

It also makes me know that I'm not getting better; worse in fact.

I'm going to call my doctor tomorrow and see what his gut tells him.  I am not happy.

Reading to distraction

I've been getting bad reports on my x-rays lately.  A radiologist friend sent them to some ortho friends of his and they both came back with opinions that the fracture would not heal and that I'd need a hemiarthroplasty- which is a half-hip replacement.

So, off to google to read up on it.  I can't get a clear view as to if I should get a hemi- a full replacement, or if I should continue to get a surgery and try to save the existing bone.

This was a cool video- similar to the French one I posted a few weeks ago.

http://www.youtube.com/watch?v=Ng4Avx7rjpo

Whatever happened to that light

at the end of the tunnel?

Today has been very depressing.  I'm thinking that the bone isn't healing and have gotten some confirmation.  Both from my own attempts at putting weight on it and having a radiologist friend take a look at my x-rays.

In the walking experiment, I attempted to put weight on the leg.  It feels solid.

I then attempted to walk along with my walker and 'walk' by putting  a little weight on the bad leg.  It worked, but every step I felt something move around in my leg and do a bit of a twist.  That feeling is what made me go to the hospital when I first broke my leg.  That it wasn't solid.  And that's what I'm starting to imagine is happening- my bones have kind of healed over and the support is coming from that big nail.  If that is right, it is likely never to heal.

Thinking that my next appointment is two weeks away, and no where to go but.. down makes me want to get an earlier appointment.  I'm waiting to hear back from a few friends who are in the business and get their opinions.  If the same results come back (nonunion), then I'll call my doctor next week and try to speed up whatever comes next.

Progress?

I'm still trying to figure out what the doctors were trying to figure out.  They probably have a better idea by now, and it happens that my daughter is going to visit the doctor for a sore shoulder.  While there, I'm sure my wife will chat him up about his thoughts on my recovery.  She missed the last appointment, which is too bad, because she has a good rapport with the entire staff.  I'm sure she'll get some information today.

The other things I'll get are the x-rays.  I spoke to the technician who will make a CDROM to give to my wife.  I'm very interested in comparing my x-rays over time and will add posts in order to show them.   I'm very interested in the latest set since it caused so much discussion last week.

Physically, I feel better than I did a couple of days ago.  I woke up this morning with a lot of stiffness/pain, but it has subsided.  Every once in a while I still get the intense 'knee' pain which still confuses me if it is really the knee. 

The doctors had me try to stand on my leg last week- and I somewhat chickened out.  It had been so long that I put weight on it that I was scared of falling.   So I've been doing a few attempts at putting weight on it.  It seems solid, but I haven't put my whole body weight on it yet.  I think I need a bar to hang from to really avoid the fear of falling instead of pushing down on my crutches or walker.

Hello pain, my old friend

Am I psychosomatic?

What I am is unable to sleep because of pain.  Thursday was an active day, but Thursday night was as well.  I tried to go to bed early- at 11, but woke up at 1am and spent until 6am tossing and turning.  I slept in until about 9, but wasn't well rested.

The pain has been back as well.  And it is much sharper than it has been recently.  And, it feels like it is deep.

Which is crazy, because only a couple of days ago I told the doctor I felt fine.  And now, the pain is bad.  Bad enough that I used to take an oxycontin because it hurt so much.  I'm not going to take those anymore if I can help it.  Which means, when the leg isn't moved or under stress, there's no pain.  Moving it does hurt though. 

Am I imagining it because the last exam wasn't great?  Was I pretending it wasn't bad because I was thinking I was getting better? 

Who knows, but if it keeps up, I'll be making an appointment sooner than the 3-weeks out I'm looking at so far.

The pool is still closed

I had high expectations going to the doctor today.  The last time I met with him, he was joking and happy that I was off pain medications.  He told me then "3 weeks, more x-rays, then 3 weeks after that we take a look and  you start walking."

It started off the same way, we met before I had x-rays done and he asked about pain as he manipulated my leg and how the pain compared to the last time.  I told him it was about the same.

After the x-rays, it was not so good.  I watched him as he looked at the x-ray and he was not happy.  He immediately sent me in for more x-rays, then again a third time.

X-rays are 2-dimensional representations of 3-dimensional structures.  So is TV.  Depending on the angle you take a shot, it can make things appear out of whack, especially with spherical structures.  Your mind interprets them as a circle being bisected by a line (the head of my femur with the nail going into it), but because it is 3-dimensional (and the hip rotates so easily) the view can seem dramatically different... or maybe I'm being hopeful.

He was looking at it and said "the ice cream is off the cone."  I didn't understand at first, but what he meant was that the ball of the femur didn't appear to be in-line with the femur.  Which was very odd, because I wasn't in any pain.  He said he never had a patient that was getting worse in the x-rays feel better.  So we went back for x-rays several times.  He really wanted to get some angles that showed if it was in line.  The other pictures made him happier, but it seemed a bit forced to me.   He called a couple of other doctors over who reviewed them with him, and the one x-ray they all agreed wasn't good, but the others were.  So I guess the question is "which one is correct?"  He postulated that the head was attached, but a bit off center, which is why the one picture looked so bad.

Looking at it myself in the office, I thought the nail had moved from the center of the head to further 'up'.  But after getting home and looking at the last surgery, I don't think it has.  It may have backed out a bit more, causing the muscle pain I'm feeling.

The docs really were a bit freaked- they kept asking how I felt, and had me put weight on it as well.  Furthermore, a not-good sign was that the fracture was well-defined.  The hope is that as it heals, the edge will start to 'soften', and that apparently wasn't happening.  The doc also said "if it pops and you're in intense pain, you have my cellphone", and "nope, I'm not thinking about hip replacement now."   I'm reading a lot into this, and there were many more words of confidence given, but I think he is not pleased.

I did go ahead and ask if I could start swimming, and I was told "let's take a look again in three weeks."

The pool is still closed.

No fun on a day like today

It is an absolutely beautiful day today.  At least from what I can see out the window.

The weather lately has been terrible.  Cold, rainy.  A buddy of mine just got back from London and said there was no difference.   What I realized is that when it is bad that you wouldn't want to go out... you don't want to go out.

But today... I'm hating it.  I've been sitting in front of the PC, and will be watching a movie later.  Which is great stuff when the weather sucks- but I'd be diving, or climbing, or riding my motorcycle, or playing disc golf with the kids... *something* on a gorgeous fall weekend.  I hope I have days like this in December!

Another good bit of news- three days now without any sleep aids.  If you don't call staying up really late a sleep aid!  I think I don't need ambien anymore.  I sound like a burned out rock start claiming I'm 'chemical free'.  But it is a milestone for me.  I've never liked taking any drug, and after 10 weeks, I'm not taking any.

A sleepful night

A friend of mine had been on ambien for months and decided to quit.  He told me yesterday that he had made it three days in a row and was able to fall asleep.

That inspired me, so I did it myself.  And it worked.  It took a little longer to fall asleep, but I did it.  I woke up tired, but it's better than being dependent on a drug.

I'm really looking forward to my recovery.  I plan on asking the doctor next week if I can start swimming.  I hope so- it's got to be low impact, and I need to do some kind of exercise.

Catching up to the 4yo crowd.

I'm still in pain.  Worse than I think I should be. For some reason, it seems like it is my knee that hurts- just south of the kneecap. Hopefully, it is just that- and not 'referred pain' from something going wrong with the healing.

I hope it is simply from lack of any real use.  It seems worst with sideways motion, such as being on my side- or lifting my leg into bed.  I had severe pain from that move as well before my first surgery.  But it was definitely at the hip then.

I'm sick of being a cripple- and treated like one.  So I did something I haven't done in nine weeks.  I tied my shoes.  If I was a 4 year-old, I'd be thrilled!  

Scorn for the disabled?

This is one of those times that you realize what happens to other people when it happens to you.

I think long term care is typically associated with older folks, or disabled or special needs people.  Basically, you know things aren't going to get better.  You have to guard yourself at looking down on them because they're needy.  And you have to realize (and they as well) that not everyone can be perfect in their behavior towards them.

When you're injured and know you're going to get better- and then get treated with scorn or discounted it really hurts.  Because you know you're going to get better and they would never treat you like that were you up and about and walking around. 

It's different in that you expect to be treated the same as if you were healthy- and it is the same in that bad behavior toward someone who isn't fully functional is a terrible thing to do.

Weight gain and loss

I found that I lose my appetite when I was taking the ocycontins. I would eat a very small serving of dinner and virtually no breakfast or lunch.

I've been off those for several weeks now. I still don't have an appetite at breakfast- I think it due to the Ambien perhaps?

But I'm very hungry at dinner (my wife is an excellent cook), and worse- it is Halloween time (lots of candy lying around the house), followed by the upcoming Thanksgiving, cookies, and Christmas eat-fests.

I had lost 20 pounds at my lowest point- most of it muscle I'm sure.  I am slimmer as well.  But now, the pounds are creeping back (slowly, only 3 so far), but I'm going to need to do something.

The problem is that I can't find any kind of cardio that works for me with a bad hip/leg.  I am able to do pushups.  I tried doing pullups, but I've lost a lot of strength.

So now I'm trying to limit my eating until my recuperation catches up.

If the nail fails

Here's a great video (in French) about how hip replacement has advanced. About halfway into it, it gets a bit graphic, so be warned.



As I've mentioned my fear is AVN, the head of the femur not getting enough blood and then failing. If it fails, it requires a hip replacement. What I've read is that they'll typically do a 'half' replacement of just the head. This video shows a full replacement on a hockey player. Very high tech.

The one pill I can't shake

I was up until 5am. 

I was exhausted, but couldn't sleep. Welcome to dependence on Ambien.  I was so tired last night that I figured I'd fall asleep on my own.  After all, I don't need a sleep aid when I take my frequent naps- why at night.

I don't know, but if I'm to get any sleep, I'll need to take the Ambien in the meantime.

Convalescing

It was a relatively slow weekend- I carved pumpkins with the kids and that ended up being a bit painful. And I sat out on the street passing out candy with the neighbors (the whole cul-de-sac meets at the top of the street).  It was rough- I'm only taking ibuprofin and aspirin for pain now. 

But the last couple of days have been better- I'm not going to bed in pain or waking up in pain, thankfully.

Pain is back

I'm not sure why, but I've had a lot more hip pain since the appointment on Wednesday. It started when I was on the x-ray table, having to splay my legs for one of the poses.  At that point, there was a sharp pain, and it has been with me ever since. 

The pain is bad enough that I'm considering taking the pain pills again, which I terribly want to avoid.

Doc says I take my first step in 6 weeks

I think it was a really good day.   Today was the appointment some 7 1/2 weeks after the initial accident, and almost 4 weeks after the second surgery.

My doc was happy with the x-ray, because really- it didn't change.  The nail hadn't moved and- at least to me- the fracture looked good- almost as if there wasn't one.

In fact, it was so good that my doc thought it was a good time to play a joke on another doctor- the one who had seen me originally.  He asked an attendant to bring in the doc because he wanted a second opinion.  He introduced the x-ray as I had been complaining of recent pain (somewhat true because I am off the pain meds and actually feel things now).  The 2nd doc nervously looked at the xrays, clicking between views and finally said "I don't see anything." At which point my doc guffawed and said he didnt' think so either- maybe he should give me some more pills.  Doctor humor I suppose.

Since trochanteric nail fixation usually has the patient walking right away, I asked about why the time before I could be weight bearing. And he said my fracture was definitely femoral neck- and not a trochanteric fracture and therefore quite different as far as recovery.

My biggest fear is AVN- the death of the femoral head.  It is because the blood to the head is mainly from the neck of the femur.  Here's a great diagram- there are actually three sources of blood- the middle one is the one I'm worried about.  You'd think the top one is key, but apparently it might not even be present in 20% of the population. Hopefully mine is.

I asked again about the bone graft procedure and avoiding AVN and got a couple of different answers since both docs were present.  My original doc said that AVN was decided the day I had the accident.  My new doc again indicated it wasn't his type of surgery.  Does this mean I should get a second (3rd) opinion, or was the time for the graft when I was getting the fracture repaired?

Now the good news.  My doctor said I don't need to see him for THREE weeks, and that if that is good (as he expects), there will be another followup three weeks after that- and then I start 'recovery.'

"Recovery?" I asked.  He said (smiling) there is no recovery.  You just start walking (maybe with one crutch).

So, I finally have a light at the end of my tunnel.

A relatively good day

I awoke this morning...  refreshed.  I managed to get some coding done, fixed a serious bug, did some reading.  Then got tired and tried to nap.  But, hey- that's one of the better days I've had lately!

I'm really excited about the doctor's visit tomorrow.  They called to remind me of the appointment, and I was like "I'm not going to forget!"

I've got a lot of questions for him about my recovery, chances to avoid AVN, limits as to what I can do, etc.  I've been doing a lot of reading on my particular surgery and apparently usually you can walk on the leg immediately.  I'm concerned about why the 'nail' moved to start with.  It had a grooved head that should not have backed out, because its purpose was to prevent the joint from twisting. 

I'd also like to get some of the newer xrays to post up.

Hoping for a good night's sleep!

Winning the war

My wife is convinced that this withdrawal problem is false- that I wasn't on the painkillers long enough to have any sort of dependency.  She's very smart, so maybe she's right.

But, I've never had a problem sleeping- though I have a lot on my mind right now.  And certainly not two nights in a row.   I'm also fighting nausea, which is unusual.

In any case, I'm not going to take the painkillers any more.  I don't have pain per-se.  I have some serious discomfort- and maybe jabs of pain here and there.  But I've been out of commission for almost two months.  My muscles are out of shape, and even sitting upright is relatively new.

Today has been rough on the nausea side.  I eat ginger, which helps, but it's not like I'm going to blow chunks.  It's just a general malise- feeling poorly and a lack of hunger. 

I did get a nap this afternoon- without medication- so I think I'm getting past that.  Doc visit is in two days.  I'm so hopeful.

Sleep victory

Again, it took about an hour, but I got some sleep last night.  I took both a tylenol PM and an ambien.  I'm not sure which one is helping (or maybe it is time), but I awoke this morning having not moved all night.  Sweet.

Depressed

I managed to get some sleep last night; I needed it because it has been two days without it.  Even so, it was not satisfying- it took an hour to get get to sleep, and when I awoke, I wasn't refreshed; I was exhausted from bizarre dreams.  Somehow incorporating technology from Dollhouse, scuba diving and motorcycle racing allowed me to sleep.. or wake.  Pretty freaky.

And this description of oxycontin withdrawal is much closer to home:

Withdrawal related side effects

There is a high risk of experiencing severe withdrawal symptoms if a patient discontinues oxycodone abruptly. Therefore therapy should be gradually discontinued rather than abruptly discontinued. People who use oxycodone in a hazardous or harmful fashion are at even higher risk of severe withdrawal symptoms as they tend to use higher than prescribed doses. The symptoms of oxycodone withdrawal are the same as for other opiate based painkillers and may include "anxiety, nausea, insomnia, muscle pain, fevers, and other flu like symptoms."^[20]

And this:

• Insomnia:  Individual may be very restless in the days after he stops taking OxyContin.
• Depression and anxiety:  The two most common psychological effects of detox from OxyContin.

I've been feeling like I'm coming down with something; haven't been able to sleep; soreness in some muscles, etc.  And I also read you're supposed to not go cold-turkey, but just decrease the dose.  Ooops.  Well, if you're reading this blog because you're in the same state as I am, take my experience to heart.

And the bad news...

symptoms most commonly begin in the 4-8 hours after the last dose of OxyContin and last generally for about a week. 

Horrible night

Still  not taking the pain pills, but I have a feeling it's not as easy as I hoped.  I was unable to sleep Friday night; stayed up until 5am again and just dozed fitfully in the morning.  Had a big day as my sister invited me to her house to watch some football, but it was very taxing. 

The monkey counterattacks

Going cold turkey is certainly the fastest way to get over a 'habit'. It is likely the most intensely painful.  Total pain will be less than systematic withdrawal.  I really don't know- I'm just integrating the 'pain' over an extended period of time versus a short amount of time and guessing.

One of the side effects is 'restlessness'.  I had a relatively busy day, and not much sleep last night, and no naps to speak of.  You'd think I'd be exhausted- and I am.  But here it is almost 3am and I've been unable to sleep for three hours.  I'm guessing that other forces are at work.

I'm not a quitter, however, and I'm not going to give in.  Wish me luck tonight.

A rough anniversary

Seven weeks ago today I had my accident in which I broke my hip.  Today has been lousy.  It started with last night. I didn't get to sleep until 5am.  I'm guessing it is because I slept most of the day yesterday and had caffeinated soda relatively late last night.  Or it could have been revenge of the monkey.  Either way, it made for a lousy day as I've been tired all day but not really able to sleep soundly.

Seven weeks since I've been able to walk.  I'm not sure how many more until I get to take my first step.

Screw you monkey

Big day today, though I barely stirred.

I made it all night without any pain medication.  I went from three oxys to Zero.  Not even an ambien.  I awoke a few times, but not in any pain.  This morning I was exhausted and couldn't get out of bed until noon, then slept again most of the afternoon.  I slept again early this evening.   No pain meds.

But, it looks like I've avoided getting addicted to opiates, which frequently happens without careful monitoring.  Here are the withdrawal symptoms:

Sudden stoppage of oxycontin can result in serious withdrawal symptoms. The withdrawal syndrome may be characterized by restlessness, lacrimation, restlessness, anxiety, rhinorrhea, yawning, perspiration, chills, myalgia, and mydriasis. Other symptoms also may develop, include irritability, vague pain, weakness, abdominal cramps, insomnia, nausea, anorexia, vomiting, diarrhea, or increased blood pressure, respiratory rate, or heart rate.

Extremely tired doesn't seem to be on the list.  36 hours so far, if I make it to 72, I'll be happy.

It's only Fair

Today the family went to the State Fair.  It's a big deal, they go almost every year.  But I didn't go this year; but I can't complain too loudly because I was in perfect shape last year and chose not to go.

One thing I did notice is that it was very lonely being hurt and all by myself.  I am very thankful for my wife and family; I don't know what I'd do if I had to suffer these weeks by myself.

The best news is that I made it through the day without any pain pills!  I'd love to get off these day and night.

Bath Day

It has been a long time since I took a bath.  I took several of them after my first surgery since it was recommended to help blood flow.  But, it is also what made us realize I wasn't getting better since the sideways movement of my leg over the edge of the tub hurt to the point of tears. 

Tonight's bath was great.  Very relaxing, and none of that pain from before.  Stef is concerned about me falling, but we were very careful getting in and out. 

I managed to get a little work done, which was nice.  I've got to get some code done- and it keeps the brain working, though the body is getting atrophied.

It really seemed theraputic on the leg, having the water suspend it.  I hope to use that excuse when it comes time for rehab and getting me back scuba diving!

Friends

If you get seriously injured you're going to find out a lot about your friends. I've been pleasantly surprised by some who came out of nowhere to help. While others I thought were good friends haven't even called to check up on me. It's weird- and I think adds to the notion of 'true friends.'

I can't blame some of them, no one wants to see a friend in pain or hobbling around. But that person who is hurt is likely dying for company. One of the best things that people did for us is bring us prepared meals. This was especially important right out of the hospital when we were getting used to the routine. Those meals saved so much stress and meant so much- it wasn't a lot of time on the givers part, but it helped many times more for us.

Those who visit you in the hospital are also going the extra step. A hospital is an 'inhospitable' place (rimshot?). The journey in there goes a long way to making the patient feel better.

And finally, you'll find the well-meaning, but .. I'm not even sure of the word.. basically, friends who say they're going to do something, come by, help out... and then you never see them. I'm sure other things came up, but it puts it into perspective those who say and those who do.

Anyway, today was a good day in that a buddy of mine took me out to lunch. It's a pain taking out the cripple (to the cripple also), but I get out so rarely that it was a nice change. Thank you!

Out of the house

Today is the first day I've left the house post-surgery that wasn't some kind of appointment. My sister invited me over for dinner. It was great. I took a couple of pain pills before I left and we were there for about 3 1/2 hours and it worked out well. A delicious meal and the kids all playing made it fun. I watched a little TV and chatted, so it was a good evening all around.

It is frightening going down stairs. Stairs to and from garages seem to be the same three wooden steps without a railing. Doing them is simply terrifying. The crutches don't support me in three dimensions- so going up or down is very uncertain. I usually try to grab onto a door frame or something to get a solid feeling as I move a single crutch down, then the bad leg, then the good. I'm looking forward to when I can put weight on the leg without this fear.

Depression sets in

I don't know if it has 'set in', but it is certainly bothering me today.

I had another great night's sleep- 7+ hours before waking- and then a few more this morning.

This is a Saturday in the early fall. A beautiful day- the sun is shining, the weather crisp. The kids are outside right now, and I'd have my choice of going to the racetrack as some of my friends are, or going diving off the coast with a charter I know, or going climbing at Looking Glass with a buddy of mine.

Instead, I'm inside typing on the computer. Which is what I do all week, I don't resent it. But the weekend is supposed to be special- a change from the drudge of coding. Instead, as NIN says, "Every day is always the same". I might get some work done for 'work'. I don't know. I've got 'big plans' this weekend. Some people are bringing over dinner and a movie- and Brian might come by as well. And tomorrow, my sister has invited me for dinner.

But I'm still depressed. In the normal scheme of things- I have such busy weekends, I turn away activities- now I eagerly await them.

Sucks.

A terrible part of the evening

I had a good day- it was nice having friends over, and my daughter had a big night going to homecoming dance. Some friends brought over dinner and a movie and it was to be a big evening.

However, the following happened. I've put it in ROT13 because it is horrible and I'm going to shield it from normal viewing. If you need to see it (meaning that you've actually just broken your hip and want to know what to expect) you can figure out how to decode it with a modicum of searching.

Crepbprg naq bklpbagva unf bar fvqr rssrpg- pbafgvcngvba. Sreebhf tyhpbangr nyfb pnhfrf vg. Vg gbbx zber guna n jrrx orsber V jnf noyr gb unir zl svefg objry zbirzrag. Fhecevfvatyl, gur ubfcvgny qvqa'g ernyyl znxr nal zragvba bs vg ng nyy- whfg na nfvqr gung gurer pna or pbafgvcngvba. Hayvxr gur cncrejbex jvgu bgure qehtf gung gurl tnir zr furrgf bs vasbezngvba, abguvat ernyyl rzcunfvmrq gur pbafgvcngvba vffhr. Gur cbfgf jurer V qb V unir znexrq jvgu 'oz' fb lbh trg na vqrn bs gur gvzryvar (cbfg frpbaq bcrengvba naljnl).

V'z n 'erthyne' thl. Zrnavat V gnxr n fuvg nobhg rirel qnl. Ohg gurfr qehtf unir orra fgbccvat zr hc. Gurl jrer pnershy va gur ubfcvgny gb nfx vs V fgnegrq cnffvat 'tnf' orpnhfr unq V abg, gung pbhyq unir orra n pbzcyvpngvba jvgu fhetrel. Fb gurl jrer unccl naq V jrag ubzr.

V jnf jnearq n pbhcyr bs gvzrf nobhg gur rssrpgf bs gurfr qehtf ba objry zbirzragf- ohg orpnhfr V nz fb erthyne V svtherq gung univat vg yrff bsgra jbhyq or n orarsvg- rfcrpvnyyl pbafvqrevat gung jvgu n oebxra uvc, vg vf uneq gb znarhire bagb gur gbvyrg. Naq vg jbexrq. Fbzrjung.

Gur svefg penc V gbbx jnf qvssvphyg- zl ... gheq (guvf vf EBG-13'q, fb V svther V pna or pehqr) jnf uneq nf n ebpx- V zrna, nf vg pnzr bhg, vg oebxr bss vagb uneq cvrprf. Gung pna'g or tbbq sbe gur cvcrf.

Fb V nqqrq n fgbby fbsgrare gb zl qbfr bs zrqvpvar. Vg urycrq orpnhfr gur arkg qhzc jnf fbsgre.

Ohg, gur 'onpxvat hc' xrcg tbvat. V unq orra rngvat snveyl jryy, nqqvat fnynqf gb zl qvrg- V fgebatyl erpbzzraq lbh qb gung.

Gur cnfg srj qnlf V'ir orra rngvat cbbeyl- va gung abg serfu sbbqf, ohg jryy-cercnerq zrnyf. Sbbq jryy pbbxrq zrnaf qvrgnel svore vf nyernql oebxra qbja fb gurer'f abguvat gb fpeho gur flfgrz.

Gbavtug- jvgu thrfgf bire- V fcrag bire na ubhe ba gur fuvggre. V jnf va grnef. Vg uheg fb onqyl gung V unq gb gnxr crepbprg gb trg bire gur cnva juvyr V jnf fuvggvat.. orpnhfr bs gur crepbprg. Gung'f n ivpvbhf plpyr vs gurer rirel jnf bar. Vg jnf fb onq gung V npghnyyl unq gb ernpu gb zl nahf naq gel gb uryc trg gur zbirzrag bhg. Vg gbbx sberire naq znqr zr anhfrbhf. V frevbhfyl fcrag bire na ubhe qbvat guvf. Vg jnf greevoyr. V gevrq gb fgbc naq jnvg hagvy yngre, ohg vg jnf fb sne 'qbja' gung gurer jnf ab tbvat onpx. V cebonoyl uheg zlfrys gelvat gb trg vg bhg. Vg svanyyl pnzr bhg ovg ol ovg ng svefg, gura svanyyl n ehfu. V unq gb xrrc syhfuvat gur gbvyrg gb znxr fher vg qvq abg pybt. Naq V sryg fb qvegl nsgrejneqf V gbbx n fubjre nf jryy.

V jnf jnearq gb nqq Zvenynk gb zl ebhgvar- naq gung vf svefg ba gur yvfg sbe gbzbeebj. Gur cbbe jvsr unq gb urne zr fhssre naq guvf vf abg tbvat gb unccra ntnva.

Ubcrshyyl ernqvat guvf- lbh jba'g yrg vg unccra gb lbh. Vs lbh'er ba n erthyne ebhgvar bs crepbprg be bklpbagva-onfrq qehtf (ybgf bs oenaq anzrf naq sbezhynf) nofbyhgryl gnxr n fbsgrare naq ynkngvir. Lbh jbhyq gunax zr- ohg whfg gnxr zl jbeq.

Okay, got the sleep formula

It's the same one the doc gave me originally. It is a stout application of oxycontin, a single application of ambien, and I took a percocet before bed as well because I had some pain from having a relatively busy day.

I awoke 8 hours later, with dry mouth, but fully rested!

Stitches out

I don't think I mentioned that I got my stitches out yesterday. My wife usually takes out my stitches, but there was an assistant at the office who did it. Considering how badly it hurt, Stef was glad she wasn't the one pulling them out. The doc used an unusual stitch that had very few knots in it, but it made for a lot of pulling to get the suture out.

Shower!

Today was huge in that I got a shower. First time since the accident- six weeks.

Not that I haven't bathed- I took baths after I got my stitches out and got a sponge bath after this last operation.

But a real shower....Aaaaaah. We set up the 'potty chair' that is used to raise the level for the toilet in the shower. It is heavy steel and able to support my weight so I backed my walked up to the shower stall and slid backwards into the chair.

Washing hair... rinsing... did I mention "aaaaah."

I think I might do this more often!

Elusive sleep

Even though I had a good doctor's visit, I didn't get a good night's sleep. Stef prepared the three oxycontins for me, but no ambien since I really don't have problems getting to sleep.

It didn't work. I work up every couple of hours and had to take additional pain medication. I don't know what's going on. Tonight we'll try the oxy and the ambien both and see if that does it.

Doctor is hopeful

Went to the doctor today and got xrays. The good news is that it appears that the new hardware is working. There doesn't appear to be any movement, so the bone can finally start healing. We were pretty surprised last week that we had a centimeter of movement where the nail was coming out of the head and consequently extending out of the rod in my femur. The big question was, "is it going to continue moving?" and the answer is "no." That's good because as it moved the head closer to the rest of the femur it meant the leg was shortening up. The doc said "it wants to heal." I'm not sure what that means medically, but he seemed happy. My original doctor took a look at the xrays and agreed that it was looking good.

I was told I need a few more weeks of 'paranoid careful.' He said the only thing that can go wrong at this point is if I take a big fall or something and pop the hardware out. A few more weeks after that and we can start my rehabilitation.

Something interesting that my wife told me that I forgot was that he might have to go back in and replace the nail because it is sticking out so much that it might interfere with my muscles around the bone (and I suppose could cause a wound if I fell on it).

My long term concern is that of AVN which can be an issue because the blood supply has been interrupted to the head (breaking it off will do that). I asked the doctor about an alternative surgery I heard about that uses a sliver of fibula and a vein graft to insert into the head where it will grow and get blood to flow. The doctor said he knew of it but that I was getting way ahead of where we were. I'm concerned in that by the time we get there it may be too late, so I'm hoping at the time of when he considers taking out the nail that we replace it with this bone sliver instead.

A couple of other positives- I don't go back to the doctor for *two* weeks. So, I must be well enough that we don't need to keep a constant look at it (which I think would have helped determine the hardware failed early in my first operation). And no new meds- I've got enough to last until the next appointment- and maybe longer since I've cut back on opiates during the day.

Building a better day

I stayed up late and took a single oxycontin, two percs and one ambien. I had to get up a few times, but being actually tired helped.

I feel much better- and less mean- today. Stef is getting the oxycontin for tonight.

A bad day

Today just was bad- I think it stems from the lack of sleep. Also, I'm out of oxycontin because of the increased dosage I had been taking at night. My wife tried to go get more today (you have to get prescriptions in person) but the doctor was out. He'll do it tomorrow (doc is great).

Because of the pain, I was in a bad mood all day, and didn't get any coding- or any-thing done. I managed to nap for a few hours this afternoon- which probably won't help for tonight. I also didn't have much appetite.

Here's hoping tonight works out.

Well that didn't work.

The experiment about cutting back meds for bedtime was a failure. I got up every two hours last night. It could have been because it was on top of not taking any pain meds during the day, but I'm not going to risk it again. Sleep is too important because it sets the tone for the next day, and honestly, is when the most healing takes place (horizontal, not moving).

Beam me up, McCoy

Okay, I'm mixing metaphors, but I stayed off the pain meds today. The only one I had was the percocet just before 8am. Nothing since. As we're in the evening, I'm also cutting back. Two oxycontin and one ambien and one percocet.

We'll see if I wake up if I end up with something like:

"By golly, Jim... I'm beginning to think I can cure a rainy day!" -- McCoy (The Devil in the Dark)

or...

"He's dead, Jim" (multiple episodes)

Sleeping Three-peat

Yet another good night's sleep. Even though I stayed up late, I slept for a long uninterrupted time. The combination seems to be three oxycontin about an hour before bed, followed by a single percocet, then the ambien. I woke up at 7:45, grabbed another percocet and slept until 10.

During the day I have cut way back on everything- obviously my morning routine still has me taking all the supplements, but I only take one oxycontin for my waking hours.

I slept on my stomach from the 7:45 until 10am interval. I was able to do it by hanging my feet off the edge of the bed. One thing I noticed between this and when I took a nap later in the day is that my feet were still swollen compared to sleeping on my back. On my back, the swelling goes down almost completely.

Bombs away

Okay, if you're on the same meds as I, you'll figure out what this means.

Daily meds restriction

During the day I'm able to deal with the pain a lot better. I think the full night's sleep not only allowed me to be rested, but also gives more chance to heal.

During the day today, I'm down to 3 doses of percocet. I was double that just a few days ago. Here's hoping I can manage the pain.

Another white hip-hop guy

I didn't think it would be this obvious this early, but my leg is definitely going to be shorter.

Just sitting down I see that one knee extends further than the other. When I lie down flat, there's about a 1.5cm difference in leg length when measured at the heel.

Looks like I'm going to have one of those hip-hop 'pop' walks. Or maybe not- I've always been a toe-walker which means that the first hit is based on muscle instead of skeleton (heel) and should be easier to compensate. It still sucks either way.

Sleep is goooood

I slept until almost 10am this morning and awoke refreshed. I did have to get up some time and use the bathroom, and I remember taking a percocet sometime around 7am, but at 10 I awoke and feel great! I could use every day like this!

Swelling looks like it has gone down on the leg. I'm doing my toe-presses as instructed to keep the circulation up. It seems like my tendons on my thigh are very tight, so I went ahead and took a skelaxin this morning. I've massaged them, but I'm not sure why they suddenly tightened up.

Will I sleep?

Hoping for a second night of sleep. Trying the same combo of meds the doctor recommended that worked yesterday.

Oh, this isn't the kind of thing I'd normally publicize, but had the 2nd BM in a week. Synthetic morphine does a number on the digestive system. If you're having to take these pain medications, be sure to take a stool softener. There. I said it. Bleh.

My pharmacy

I'm the guy who never took anything- in the hospital I was asked what medication I took regularly... nothing. Well, I'm supposed to be taking fish oil to offset future problems with cholesterol, but we eat so much fish that I haven't bothered. I also have no allergies. But it turns out that I also don't respond to a lot of medicines.

Because of the pain I've been having with the surgeries- and in some cases getting worse, I've been through a lot of medications.

Here's a current view of all that I'm taking...

• Calcium Supplement (extra calcium)
• Ferrous Gluconate (iron blood level)
• Fish oil (cholesterol)
• (another fish oil)
• Aspirin (blood clots)
• Stool softener (opaiates cause severe constipation)
• Skelaxin (muscle spasms)
• Oxycontin (daily pain relief)
• Percocet ('breakout' pain relief)
• Ambien (sleep medicine)

That's just swell

One of the dangers post-surgery is swelling. Which apparently isn't bad initialy. It's a body defense mechanism. It's also where leaking fuilds end up going if they don't ooze out of a cut.

The doctor told me that my swelling at this point (6 days after surgery) was because he has my leg wrapped up around the incisions because there had been some bleeding post-operation. And during the operation, I apparently lost a good amount of blood. So at the time of the checkup visit, he assumed it was the bandages preventing the swelling from going down.

This is two days later- and my foot is still swollen. In fact, it swells up and down (but never completely down) based on how I sit. I assume the more vertical I am, the more likely blood is to go down and have trouble coming up past the injuries.


This morning I asked the doctor and he told me a second possibility which we need to look out for are blood clots. He has recommended lots of 'toe presses' and keeping my foot elevated, as well as continuing my daily aspirin dose.

5 hours of sleep is a record

After experiementing with different combinations of pain medication we finally stumbled on a good combination. I take 3 oxycontins for my evening interval, then 3 percocets at midnight, as well as an ambien. I still had some pain waiting to fall asleep, but nothing like before... plus, I slept past 5am- which is a new record.

Sleep will be good for me.

My pill collection

This comes from someone who answered 'no' to about every question when I checked in from 'no allergies', to 'not smoking' to 'not taking any medications.

Doc says I need to be careful

I went to the doctor today, 6 days since my surgery.

It was xray time, and though he seemed happy, I wasn't. The bone had collapsed another 10mm along the new screw they put into the femeral head- or the main part of the bone moved up- I'm not sure which.

No showers- due to the danger of falling.

Nailed and pinned

Here are the xrays immediately after my operation. This is the second operation, 31/2 weeks after the first that was with stainless screws.

This operation is called a Trochanteric Fixation Nail.

It involves a long titanium rod (to just above my kneecap) and a nail set in a sliding groove which goes into the femeral head to keep it from twisting.

Screwed. Literally.

My accident was on a Friday evening, but it wasn't until Saturday afternoon that my stubborness wore off enough to go to the hospital. They saw that it was a hip fracture (that's what they call it, even though it is the femur) and called the doctor who saw me and scheduled an 'emergency' operation for Sunday morning.

Here are the xrays from the operation. I'm writing this article fairly late, but I'll go back and fill in the details as I remember.

An introduction

My name is Frederick.  And I'm not a thrill seeker.

I am a married father with children.  A geek who designs and writes software.   I have bad vision- without my contacts.  I'm a bit shy in large crowds.   I've been told I'm likely to be a 'highly sensitive person'.  I analyze everything I hear and see.  And just now analyzing that article, I'm far too removed from many of the symptoms to believe I'm so easily categorized.  Nothing really startles me- I believe that I anticipate almost everything in advance.  I am sensitive to pain- when I'm not ignoring it (read ahead when in the ambulance, my BP went to 215/135 and I responded that my pain was '7/10'- I was only asked because of my symptoms, not my demeanor.  I'm told I'm ridiculously competitive.  I'm not drawn to the arts- but I appreciate anything well done- music, art, or an algorithm.  Then again, when I watch a movie, I notice minute detail- and can match up faces of obscure actors to movies I have seen years before- and then launch into a critique of the movie involving plot, acting and inconsistencies. 

The reason I mention this to counter the opening statement is that people who don't know me assume that I am some kind of thrill seeker.  My current passion is spearfishing.  Okay- no biggie- it's just scuba diving and bringing home a few fish.  But I dive in shark-infested waters and have had to fight off sharks- and have never given up my catch.  My last passion was rock climbing- an excellent sport that has me hanging 800 feet over a sheer drop on a 10mm rope.  And during the 90s I decided I wanted to race motorcycles- and went from the guy who always got lapped to the guy who always won- culminating in a national championship- and even time on TV holding up one of those giant checks.

The reason I'm not a thrill seeker is that all those 'dangerous' activities were well-reasoned.  Motorcycle racing has excellent protective gear, and you really only fall in the corners- where you are then swept off the track from centripetal force.  The 'fall' is about twenty inches, followed by a lot of sliding.  I have fallen many times while racing- and other than an unusual broken thumb from improper equipment, never got hurt.  I took class after class of racing instruction until I felt ready to 'push' it and start winning.  Rock climbing is far more likely to result in injury because of the potential energy release.  But rock climbing has developed techniques and equipment which ensure safety.  I've never even taken a fall that scared me.  I made sure I was well trained before I attempted anything beyond my skill level.  Again, never hurt.  Scuba diving by its very nature is relying on equipment to keep you alive in a hostile environment- you can't breathe water- and if you surface too quickly you'll hurt yourself badly.  Add in the stress of hunting and keeping the other predators at bay, and it is a 'dangerous' sport.  But, I built up my skills over many years and listened and watched experts, and learned their techniques and adopted their equipment.  I dive with redundant air supplies.  If anything happens to my main equipment- tank, regulator.. anything- I have a complete backup.  I volunteered for diving experiments- partially because I was able to be locked into a room with a leading researcher of dive medicine for hours on end.

I hope I've explained myself.  I love doing exciting things- but only when I'm sure there's not excessive danger.  I don't think I could ever skydive- at least the 'freefall' type- because the reliance is totally on equipment.  You might think it is similar to rock climbing- but rock climbing only relies on the equipment after you fail.  If you don't fall, you don't use the equipment.   You skip that first part in sky diving.

I made a huge mistake that starts this saga.