Amazing Insights into Happiness - Top 5 Regrets People Have As They Are About to Die

A palliative-care nurse shared very thought-provoking insights from her life's work of caring for patients who were about to die. Scary to think that almost everyone regrets working so much....it definitely provokes self-reflection.

1. I wish I'd had the courage to live a life true to myself, not the life others expected of me.

"This was the most common regret of all. When people realize that their life is almost over and look back clearly on it, it is easy to see how many dreams have gone unfulfilled. Most people had not honored even a half of their dreams and had to die knowing that it was due to choices they had made, or not made. Health brings a freedom very few realize, until they no longer have it."

The overall theme here definitely seems to be authenticity. What a powerful sentiment! So many of us spend our entire lives subconsciously (or consciously) trying to conform to societal expectations of how we should look, what kind of work we should do, and certain standards of living we should strive for.

2. I wish I hadn't worked so hard.

"This came from every male patient that I nursed. They missed their children's youth and their partner's companionship. Women also spoke of this regret, but as most were from an older generation, many of the female patients had not been breadwinners. All of the men I nursed deeply regretted spending so much of their lives on the treadmill of a work existence."

3. I wish I'd had the courage to express my feelings.

"Many people suppressed their feelings in order to keep peace with others. As a result, they settled for a mediocre existence and never became who they were truly capable of becoming. Many developed illnesses relating to the bitterness and resentment they carried as a result."

4. I wish I had stayed in touch with my friends.

"Often they would not truly realize the full benefits of old friends until their dying weeks and it was not always possible to track them down. Many had become so caught up in their own lives that they had let golden friendships slip by over the years. There were many deep regrets about not giving friendships the time and effort that they deserved. Everyone misses their friends when they are dying."

5. I wish that I had let myself be happier.

"This is a surprisingly common one. Many did not realize until the end that happiness is a choice. They had stayed stuck in old patterns and habits. The so-called 'comfort' of familiarity overflowed into their emotions, as well as their physical lives. Fear of change had them pretending to others, and to their selves, that they were content, when deep within, they longed to laugh properly and have silliness in their life again."

That is why these nuggets of wisdom are so powerful; for those near death, the societal constraints they have been subjugated under are laid bare, and core principles come through. Prioritize family, friends, and a positive outlook. Of course work is important (and in many cases quite meaningful), but it needs to be correctly contextualized within the overall framework of your life.

Recovery Days 5-7 - Post-op fasciotomy - Surgery Fights Back with Swelling and Numbness

While days 1-4 went relatively peachy, 5-7 encountered myriad issues that warranted a couple calls to my surgeon's office in order to find out what constituted "normal". Moral of the story was, unless something is really fucked up, it's probably within normal variations of recovery.

The first problem arose the night of day 5. On day 4, I had accidentally knocked the inside of my right lower shin/ankle pretty hard, sending a strange sensation up my leg. I thought nothing of it, however, until numbness came on in the exact spot about 24 hours later. The numbness basically encompassed the upper half of my ankle bone, extending for a swath of about three square inches upward until one of my incisions. I knew numbness was one of the side effects of surgery, but I was under the impression that if numbness had happened, I would know right away post-surgery. This numbness, however, had taken me by surprise 5 days down the road. Worried, I called the office and spoke to a fellow. She explained that while it is somewhat unusual for the numbness to come on five days after, it's not unheard of and not too worrisome. If the numbness was actually caused by the hit to my ankle I sustained, feeling in that area could come back rather quickly, but if it had nothing to do with it and was a natural outcome of the surgery, sensation in the area could take anywhere from 4 months to a year to fully be restored. What was reassuring, however, was the doctor's assurance that the numbness in that area does not hinder recovery at all, and the numbness that doctor's worry about pertains to the foot, which thankfully so far, I do not have.

Days 6 and 7, however, brought a new challenge - moderate swelling in my right foot. Along with the numbness that I also experienced in the right lower leg, it was also apparent that my two legs were simply not recovering at the same rate, which I also found worrisome. The pain in the calf (which is what hinders one from doing strong heel to toe strikes) was strongly persisting in the right leg while quickly waning in the left. Cue another call to the fellow at the surgeon's office. She explained that the swelling in the foot is the most common and very expected, as it is the primary weight bearer, and that a combination of icing, elevation, and compression stockings would help alleviate the symptoms. And in terms of one leg recovering faster than the other, she added that it is the most common complaint from patients, and is simply natural - eventually they will catch up to each other.

I also had one more overall complaint for the doctor - It almost felt as I had regressed from Days 1-5, and I was not as comfortable on my feet nor proficient at ankle pumps as I had been earlier. Once again, the fellow dexterously assuaged all my doubts by saying that as patients feel more comfortable on their feet, they probably push their limits too far, causing the legs to stiffen up temporarily and recover.

So, what's the conclusion? First of all, that this fellow I spoke to should definitely be employed in some sort of suicide prevention program. I could have called in saying both my legs had fallen off, and she probably would have found a way to calm me down and make me feel that it was a normal process of recovery post-surgery. In all seriousness though, it made me realize that post-op recovery is not going to be a linear progression, and I need to be emotionally and physically prepared for the ups and downs that are coming. I just hope that at the end, I'll be back to where I want to be....

Days 1-4 post-op fasciotomy - Recovery Begins

For the first 4 days, everything was going alright. I was slowly able to progress from barely being able to lift my feet off the ground to being able to do some nice heel to toe strikes. On day 3, I was told that I was allowed to switch from the four-point crutch gait to the two point, which allowed for much greater mobility. Whenever I was laying down, (which I probably was 90 percent of the day), I would have my feet steeply elevated and be icing. After my second night sleeping on the first floor, I moved up to the second, and while a flight of stairs is certainly not easy, there wasn't any major problems or pain from doing it.

Starting on Day 3 -Three times a day, for about 5 minutes, I alternatively lift both legs in the air and do a couple sets of twenty ankle pumps, but quite lightly, as I was told it is important not to push anything, as the body is recuperating. By day 4, I was moving around the house without crutches, and even was able to drive to the post office to mail something. The doctor said that on walks that are longer than those one would typically take around the house, crutches should be used until day 7-8.

In terms of physical therapy, my surgeon told to me that under no circumstances should I begin any kind of PT before my post-op appointment on April 12th.
So far, no swelling or numbness to report, and I keep ace bandages on both legs tightly wrapped - Step by step, my recovery is taking shape.....

Fasciotomy Pre-Op Appointment - Cautiously Optimistic

Finally it came to the day I was looking forward to for a couple weeks. When I got called at the office, a fellow who works with the surgeon came in to take my history, and ask if there were any problems, etc. I explained to him that over the last couple weeks I had started to feel the effects of CS even when I was not exercising, as it manifested itself in a sort of uncomfortable, not getting great circulation feeling in my legs. He explained that this was not crazy, and sometimes is how compartment syndrome progresses.

Then the surgeon came in. He explained to me that even though I had only three compartments test positive for compartment syndrome, he thought it would be best to release all 4 on each leg. I asked him the reasoning for this, and he explained his reasoning: 1. I had explained to him that most of the pain I felt during running was actually in the lateral area, and thus he thought it would be foolish to leave the compartment alone and 2. He told me that there have been lots of cases where people get 1,2, or 3 compartments released and then are symptomatic later on for the fourth and have to have surgery all over again, so it was safer to release all 4 compartments in this case.

I was worried, however, that this would make the procedure a little more risky, just from the logic that the more compartments you mess around with, the more random things can go wrong. He responded that the releasing of the lateral compartment did not significantly compromise the success of the surgery, and that the benefits of doing so far outweighed the risks.

Then, on to success rates. The doctor told me that 90% of his patients experience full recovery, meaning they are able to achieve athletic performance levels that are commensurate with how their performance levels were pre-onset of exertional compartment syndrome. While in the grand scheme of things, that is not as high as I would like, after reading the literature and looking at online forums, it unfortunately seems that that is the best you are going to get. Plus, I would like to think that since I am still relatively young, my chances will be good.

In terms of a recovery timetable, my surgeon said at 4-6 weeks I could begin to do cycling, 6-8, running, and at about 10-12, I should be nearing full recovery. While that is a substantial amount of time, I really don't care in the slightest if I will finally be able to do the things I love for the first time in a long while.

The surgeon also said he would be sending me for an MRI just to rule out vascular restriction in my legs, as apparently that sometimes causes compartment syndrome-like symptoms. With that, I thanked him profusely, and barring a rare case of vascular restriction, was set to go under the knife!

Choosing the right surgeon for compartment release

Once I had decided that I was going to need surgery, it was time to find a qualified surgeon - easier said than done. While almost any orthopedic surgeon will offer to do the fasciotomy (compartment release), it must be taken into account that compartment syndrome is still a relatively rarely diagnosed condition, and therefore, there are not a lot of surgeons out there who have done the procedure enough times to be truly considered experts.

So when speaking to a prospective surgeon, DO NOT be embarrassed to ask how many compartment releases the surgeon has done in the past year. While this might be a somewhat awkward question to ask, as it implies a certain distrust of the surgeon's abilities, it nonetheless must be asked. I first went to a highly respected surgeon (for those Sox fans out there, he was part of the surgical team that did the famous suturing of Curt Schilling's ankle in the 2004 ALCS against the Yankees). Unfortunately though, he told me that he only did about 1-2 fasciotomies a year. That just wasn't going to cut it. Even if his office walls were adorned with the autographs of the entire '04 sox championship team.

Eventually, I found my guy, who does tons of them, and came highly recommended (If anyone would like names, please contact me).

Now it was time for the pre-op appointment...

Rolfing (ouch!), Physical Therapy, Stretching - Helpful for some things, but not exertional CS

I now faced a decision - Do I decide to go under the knife right away, or do I try to convince myself that with a little alteration of activity and different forms of massage, I can live with the condition? Obviously the latter is a little less daunting, so I quickly devoted myself to all forms of alternative treatment.

First up - Physical Therapy - Went about six times (Over the course of this entire saga, I did feel partly guilty for taking advantage of the fucked up healthcare system we are all so privileged with in the U.S.) The physical therapist admitted that she had not seen anyone be able to actually overcome symptoms of compartment Syndrome, but she would give it a try. She did all different sorts of ankle, shin, and calf massages/manipulations, but over the two and a half weeks that I attempted treatment, there was simply no progress, and I decided to move on.

Second - Rolfing - While I had not heard of rolfing until I read this article in the NYTimes (http://www.nytimes.com/2010/10/07/fashion/07rolfing.html), it is a treatment that many people I now know swear by. Why it interested me particularly for Compartment syndrome, though, was the fact that rolfing is completely devoted to resetting all the fascia in the body. And what do you know? Compartment Syndrome is fascially based! I went to a rolfer that came highly recommended, and while he did say that he has seen people afflicted with CS overcome the disorder through rolfing, it was not a high percentage. I decided to give it a try (and at about 125 a session, it was not an easy choice). Now, granted, I was warned beforehand by many a rolfer devotee that rolfing was painful - but nothing, I mean nothing, can prepare you for the actual experience - Plain and simple, it fucking hurts. Thankfully, though, my rolfer was laid back, and thus didn't mind me lashing out at him into my pillow with language that most would not approve of. I went to five sessions with him, and while I sometimes did see small improvements, it was never substantial enough to allow me to conclude that the rolfing did actually help. My rolfer did however explain how my back pain could be connected to the Compartment syndrome, as he showed me quite a startling picture of someone's fascia cut out of their body, and it really is ALL connected.

During both the PT and the rolfing, I also tried doing at-home stretches that I found on the internet that I thought might help, but I really did not see any marked improvements (although by this time I was also extremely discouraged). A couple weeks post-rolfing, and my CS had progressed to where I could not even play an hour game of basketball comfortably, and the daunting realization that surgery would be the only option if I wanted to continue my athletic pursuits slowly began to set in.

It was time to tuck my tail between my legs and, with my test results in my hand, consult a surgeon :(.

Compartment Syndrome Blog - Let's Get To The Bottom Of This (Pre-op, Post-op, Fasciotomy Details)

Wow...where to begin. The last year has probably been the most frustrating physically I have ever encountered, and it's entirely possible that it all stemmed from one condition; Exertional Compartment Syndrome. When I was first told I might have the condition bilaterally, I did what most people looking for answers do - went on the internet and attempted to find out as much about the condition as possible. It was quite disheartening, though, when I slowly realized that this was still a rare (if not rare, then at least under diagnosed) syndrome, and there was a significant dearth of helpful information on the subject.

Basically, I felt that the exertional CS content on the web consisted of two different but equally flawed sources of information: 1. Summaries about the condition on sites like wikipedia, mayo clinic, emedicine etc. that would give the standard physiological background, list of symptoms, and then treatment options. Many sites would actually claim (incorrectly) that most cases of CS could be resolved non-invasively through PT and the like.

The second source of incomplete information were sites like runners forum.

These, in my opinion, were more helpful than the standard info sites, but still lacked the specificity and detail that I would have liked to see in order to more accurately assess my options.

There were, however, a couple blogs about the entire process, and it was these that I found the most helpful, as one could actually see if progress was made post-surgery (and if so, what exercises/PT was instrumental to the progress), or if complications arose.

Unfortunately, though, I found comprehensive CS blogs few and far between, so I promised myself that after surgery I would try to blog my progress, and in the process, maybe allow a couple readers (if there will be any) to glean a little more information about it, and also, possibly attract fellow post-op CS patients who could share any nuggets of information they deem helpful. I got my surgery yesterday, and my first blog post will merely just detail the last year of my life as pertaining to CS, and then I will provide periodic updates, which will be as detailed as possible about my recovery.

A lot of stretching is done after surgery!

But what I feel is of paramount importance is for this really to be interactive. Even if I detail every thing about my CS process, that is still only one experience; what will make this blog truly helpful is if people who have had any sort of CS ordeal to detail their respective challenges and successes in DETAIL. Don't be afraid that by going into too much detail you will begin to bore readers. Believe me, people who have made the effort to come to a site like this want all the information they can get.

Much love to all,

John