I went to see an orthopedist last Friday, 7/11, and again for x-rays last Monday 7/14. He's a cyclist, local, referred by another friend who's a rider. Nice guy. I gave him the CD with x-ray and fluoroscope images from before and after my femur surgery, and contact info for the surgeon who did the work in UT.
He explained that there is in fact a pretty solid risk of avascular necrosis (AVN), because the break is right where some critical blood flow happens. He said that the x-rays look like things are beginning to heal well, and that no bolts or screws were displaced. He told me that, unlike some femur breaks, mine is going to need six weeks of no weight on the left leg, because the metal is just holding the bone in place, and like a wire coat hanger, could easily fatigue or displace. Some breaks and their repairs benefit from some weight sooner than others. This one is the kind that does not benefit from it. There's shear force from body weight on the fracture, and that's not good. He said that after six weeks, I can gradually start putting weight on it, a little more each week, and that I can start to ride after that. Riding is about seven to eight weeks in my future, or late September at this point.
He explained that if AVN occurs, I have to have a hip replacement, which will be as bad as my most recent experience or worse. And he cautioned me that crashing on a replaced hip is an even worse event.
He recommended that I keep the metal in place, but suggested that one of the bolts - the upper one, without the plate, could potentially be removed, if it bothered me. He also said that I should remain at home, and not try commuting to work for another two weeks. I'll see him and get x-rays again on 7/28, and at that point he may clear me to go into the office. He suggested I take calcium and vitamin D supplements, twice a day. He said most Northern Californians are vitamin D deficient. I've been taking them.
I have been feeling really blue; depressed. I am an active, capable guy. I do things. I go places. I move under my own power. I eat and expend energy and move through space and love the feel of wind on my skin. I like to sweat and walk fast on busy streets and travel from my home to a big city where my co-workers and I do interesting work, and then travel home again on a ferry filled with interesting people and ride my bike up the hill. These things I can't do right now, and won't be able to do for a while. There have been stretches of days where I haven't left the house, but just alternated between one spot on my couch, and sleeping in my bed. The pain was worse before, now it's not so bad. That's partially because I'm healing, and partially because I've been actively avoiding putting weight on it, doing certain movements that I know will hurt. I am on crutches when I'm not on my butt or my back. I am still taking painkillers, but less of them, just evenings and and when I go to bed. The most pain and discomfort come when I try to sleep.
I am working from home, but to be honest I'm not doing a great job right now. Being depressed and remote aren't a great combination. Luckily I can work remotely, and I'm contributing in a small way to my company's success right now. My co-workers have been good about it, and some are even going to come to my house and work with me next Monday. I'm looking forward to that. :)
I also have this problem where my heart sometimes beats funny; atrial fibrillation. For some reason I've had it happen a couple times since I broke my femur. I figured it might be the calcium supplements. There does seem to be a link. I got some magnesium supplements and I've been taking them as well. So far no afib since I added the magnesium. Man, the combination of afib and a broken femur was depressing!
My family has been very helpful and supportive, as much as they can be. It's been a tough time. I can drive and I've started being more helpful, but I can't carry anything with crutches, and even going down and up the twenty one steps to our driveway, and getting into and out of a car can be onerous. It's frustrating to feel better but not be able to use my body.
I read this quote recently, from Henry David Thoreau about skunk cabbage, and it seemed fitting to my situation:
He explained that there is in fact a pretty solid risk of avascular necrosis (AVN), because the break is right where some critical blood flow happens. He said that the x-rays look like things are beginning to heal well, and that no bolts or screws were displaced. He told me that, unlike some femur breaks, mine is going to need six weeks of no weight on the left leg, because the metal is just holding the bone in place, and like a wire coat hanger, could easily fatigue or displace. Some breaks and their repairs benefit from some weight sooner than others. This one is the kind that does not benefit from it. There's shear force from body weight on the fracture, and that's not good. He said that after six weeks, I can gradually start putting weight on it, a little more each week, and that I can start to ride after that. Riding is about seven to eight weeks in my future, or late September at this point.
He explained that if AVN occurs, I have to have a hip replacement, which will be as bad as my most recent experience or worse. And he cautioned me that crashing on a replaced hip is an even worse event.
He recommended that I keep the metal in place, but suggested that one of the bolts - the upper one, without the plate, could potentially be removed, if it bothered me. He also said that I should remain at home, and not try commuting to work for another two weeks. I'll see him and get x-rays again on 7/28, and at that point he may clear me to go into the office. He suggested I take calcium and vitamin D supplements, twice a day. He said most Northern Californians are vitamin D deficient. I've been taking them.
I have been feeling really blue; depressed. I am an active, capable guy. I do things. I go places. I move under my own power. I eat and expend energy and move through space and love the feel of wind on my skin. I like to sweat and walk fast on busy streets and travel from my home to a big city where my co-workers and I do interesting work, and then travel home again on a ferry filled with interesting people and ride my bike up the hill. These things I can't do right now, and won't be able to do for a while. There have been stretches of days where I haven't left the house, but just alternated between one spot on my couch, and sleeping in my bed. The pain was worse before, now it's not so bad. That's partially because I'm healing, and partially because I've been actively avoiding putting weight on it, doing certain movements that I know will hurt. I am on crutches when I'm not on my butt or my back. I am still taking painkillers, but less of them, just evenings and and when I go to bed. The most pain and discomfort come when I try to sleep.
I am working from home, but to be honest I'm not doing a great job right now. Being depressed and remote aren't a great combination. Luckily I can work remotely, and I'm contributing in a small way to my company's success right now. My co-workers have been good about it, and some are even going to come to my house and work with me next Monday. I'm looking forward to that. :)
I also have this problem where my heart sometimes beats funny; atrial fibrillation. For some reason I've had it happen a couple times since I broke my femur. I figured it might be the calcium supplements. There does seem to be a link. I got some magnesium supplements and I've been taking them as well. So far no afib since I added the magnesium. Man, the combination of afib and a broken femur was depressing!
My family has been very helpful and supportive, as much as they can be. It's been a tough time. I can drive and I've started being more helpful, but I can't carry anything with crutches, and even going down and up the twenty one steps to our driveway, and getting into and out of a car can be onerous. It's frustrating to feel better but not be able to use my body.
I read this quote recently, from Henry David Thoreau about skunk cabbage, and it seemed fitting to my situation:
If you are afflicted with melancholy at this season, go to the swamp and see the brave spears of skunk-cabbage buds already advanced toward a new year. Their gravestones are not bespoken yet. Is it the winter of their discontent? Do they seem to have lain down to die, despairing of skunk-cabbagedom? “Up and at ’em,” “Give it to ’em,” “Excelsior,” “Put it through,” — these are their mottoes. Mortal human creatures must take a little respite in this fall of the year; their spirits do flag a little. There is a little questioning of destiny, and thinking to go like cowards to where the “weary shall be at rest.” But not so with the skunk-cabbage. Are these false prophets? Is it a lie or a vain boast underneath the skunk-cabbage bud, pushing it upward and lifting the dead leaves with it? They rest with spears advanced; they rest to shoot! …
See those green cabbage buds lifting the dry leaves in that watery and muddy place. There is no can’t nor cant to them. They see over the brow of winter’s hill. They see another summer ahead.
Here's another useful quote:
“All of humanity’s problems,” the French scientist and philosopher Blaise Pascal wrote in 1654, “stem from man’s inability to sit quietly in a room alone.”
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