Halfway thru year 4

June 2026

Still experiencing significant pain when moving. There is severe pain when first moving up and away from chair after sitting. This seems related to post traumatic arthritis. It subsides a bit after walking a few steps.

Other pain is when weight bearing and using quadriceps. Stair climbing is quite painful. Removal of the screw on left leg (August 2025) has not reduced the pain on the outside of the knee as expected. Right leg quadriceps and quadriceps tendons are producing as much or more pain than ever.

I am now convinced that pain and inflammation are due to irregularities in bone around fracture and significant scar tissue. This particular serious related to the gnarly fracture sight on the right femur. I think the compression is complete with my right leg now a full 1 inch shorter than my right.

In addition to rough area of the fracture, o believe there are issues with the femoral nerve.

According to literature and physician discussion, it appears that this long term chronic pain is “normal” and expected considering the extreme damage. The recommended treatment is PT exercises, massage and pain medicine.

Here is a quote from a recent study regarding unexplained pain after a femur fracture:

“What are the causes of prolonged disability? The time course of recovery is poorly understood, and the sources of disability are similarly unclear. There is general agreement that knee pain is a substantial functional problem following fracture of the femoral shaft. Ricci and colleagues9 reported knee pain in up to 36% of patients with fractures of the femoral shaft, but the severity and clinical importance of this knee pain remains unknown. Causes of knee pain are generally poorly understood. Various theories propose that intra-articular pathology, intraosseous hypertension, prominent hardware and muscle deconditioning may be the primary sources of knee pain following fracture of the femoral shaft.10–16 Hip pain is also reported after intramedullary nailing. About 10% of patients report hip pain.9Sources of hip pain include damage to the abductor musculature related to nail insertion.17,18”

I have settled into a regimen of 325mg aspirin and 300mg Gabapentin twice daily-taken with food. Occasional substitution of Ibuprofen or Naproxen for the aspirin. I take 1.2 oz of alcohol in Bourbon whisky (3 oz of 40%) each night for sleep. No kidney or liver issues indicated in my recent blood work. Long term use of NSAID’s is risky but my dose is relatively low. I have been following this regimen now for 3 years. 

Recently I have added topical application of Diclofinac (Voltaren) twice daily. Another NSAID but with less risk and possible positive interactions with aspirin in that it tends to reduce the risk of bleeding caused by the aspirin.

In addition I am getting Stem Wave treatments twice weekly  for 6 weeks. Efficacy is yet unknown,

I selectively use a stabilizing knee brace about 30% of the time-when quadricep tendon seems to have a higher pain level. It helps sometimes-sometimes not.

My daily use of the racing simulator is a serious workout with continuous bending and force applied to the ankles, calves and quads. It does not seem to increase my pain. I do notice that the rapid application of throttle with my right leg does occasionally induce pain in the quadriceps.

I have recently purchased a sophisticated powered “lift” chair that has back massage and heat therapy. This, my exercise and occasional use of my Teeter inversion device seems to have solved my back pain.

My Primary Care Physician and my Orthopedic Surgeon have recently reviewed my condition. X-rays indicate bones have healed and are slowly remodeling. Both physicians more or less indicated there was nothing to do for me other than PT. Attempts to contact Neurosurgery PA and DPT have been frustrating and unsuccessful. I feel I am in a situation where nobody knows how to cure my pain-it appears to be accepted as “sometimes the outcome is less than ideal” after the trauma. 

My main avenue now is to pursue aggressive self help using exercises and massage in the hope that breaking up scarcities and strengthening muscles may reduce pain.

I go in and out of severe depression. My relationship with Jesus and continued prayer is the only effective treatment. Chronic pain without the hope of recovery is a very tough scenario.

44 Months of “Recovery”

 Written August 13, 2026

For more than 3 years, I lived with the hope of "getting better".  Not naive enough to believe I would be able to do all the things I did before the accident, but hope of a reasonably "normal" live for a 75 year old man with arthritis and a bit of spinal stenosis. 

Something puzzleing happened over the past few months. I got worse! More pain. A lot more pain when walking. 

As mentioned in my previous post, my PCP and Ortho both kind of offered little hope of getting better. I did manage to meet with the Neurologist and Physical Therapist. The Neurologist offered little help and suggested that I continue my approach of using massage to achieve "myofascial release" of scar tissue tugging on the femoral nerve. She did increase my dose of Gabapentin to three pills per day, up from two.  The PT suggested some new excercises and continuation of my past/present exercise regimen but with the use of weights.

I concluded that while exercise and continued stenghtening of my right leg was important, the excess pain from using the cane all of the time and climbing stairs at home was not helping. I was avoiding the pain by limiting my movement. IF I was to improve, then exercise and massage would be key, but using all the tools necessary for reasonable pain free mobility was rational focusing on controlled exercise, without creating too much inflammation.

So, we installed a Harman 300 stair lift and I bought two wheel chairs.

My first wheel chair was a lower cost NOVA Aluminum chair with non removable wheels-35 pounds. A nice chair but heavy and the "tires" were hard urethane "slicks" with no traction. With a seat width of 18" and an overall width of 25.5" it was useful but not ideal.

My goal was to end up with an alloy aluminum "professional grade" chair below 30 pounds, with removable wheels and a 17" seat width, hopefully less than 25" overall width. For a while I considered a "fixed" design but in order to exit thru the garage in between both vehicles, I settled on a "folding" design. New in the range of $2300, I was lucky to find my Motion Compisites (Built in USA-NY) Helio A6 that met my specs for much less. (See pic above)

Now I use the chair most times but also the cane sometimes as the cane is required when taking out the dog for her "business" multiple times per day. I also use the cane while moving about on the second floor. 

The stair lift is fantastic. The fear a falling down stairs because a momentary loss of leg function is gone!

I am at peace with my situation. I attended a wedding a reception in the DC area using the chair and cane at the wedding, reception and hotel without problems. I sat in the chair for hours. Pain was manageable and I was comfortable. I am quite able to use the wheelchair for moving long distances indoors and out over 3-4" curbs/thresholds and reasonable inclines. Loading and unloading into and out of my pickup is not difficult. (I can make the Helio A6 light as necessary by removeing wheels.  If this is my life, and God's Will for me, I am at peace.

I do think the strategy is working to produce some improvement. The myofacsial release is helping. The strengthening of the right leg is helping. I am using my Assault Bike to stress my right quadracepts. I push for two minutes with my right leg only trying to stay above 25 RPM. 

The PT's "theory" and my own research indicates he is correct. My pain is in part due to my right leg being weak. Literature indicates that pain breeds a rational reaction to limit the muscle's use, leading to atrophy and more pain. This could in part explain why I have not improved and even regressed. So I am exercising and "pushing thru" the pain.

I am sure that I will be handicapped for life, but do have hope than pain will be less severe over time.