On May 13th, after a glorious 30 mile bike ride in Central Park, Dr. Hoffman's bike hit a pot hole not 20 feet from his apartment building. The wheel turned and Dr. Hoffman fell hard on his left side, breaking the trochanter--the upper part of the femur. http://www.maitrise-orthop.com/corpusmaitri/orthopaedic/mo65_trochanteric_fracture/a2_3bis.jpeg
When he couldn't get up, he knew something was terribly wrong and the staff at his apartment called 911. The FDNY ambulance was there in minutes and did a wonderful job of stabilizing his left leg and taking him to New York Cornell Weil Hospital.
The emergency room team there is so professional and so well rehearsed that watching them assess and care for this injury was similar to watching a professional ballet company.
Surgery was performed by Dr. Dean Lorich of Hospital for Special Surgery and New York Hospital early on Sunday May 14th. A 15 inch titanium rod was placed inside his thigh bone.
Dr. Hoffman's "breakaway" pants were designed for knee replacement and hip injury/replacement clients. They are manufactured by http://www.spirited-sisters.com
This innovative company is at the cutting edge of hospital and rehab attire.
Rehab began early Monday morning on May 15th.
Dr. Hoffman returned to his apartment on Thursday May 18th and broadcast his WOR radio program Health Talk on Friday.
Besides working with a physical therapist twice or three times a week, Dr. Hoffman exercises on his own, variously walking on the treadmill, doing specific strengthening and flexibility exercises, stationary bicycling and swimming. He takes a supplement program which he designed for himself. The pdf at the bottom of the page is available for download. He also received IV infusions of vitamins and minerals for 21 consecutive days after his discharge from hospital, which were initially brought to the apartment by his staff. He continues to receive them several times a week at the Hoffman Center
Dr. Hoffman graduated from a crutch to a cane the week of May 30th and returned to the office the first week of June.
The cane arrived on time and Dr. Hoffman recounted that he felt like he had take possession of a brand new Lexus, he was so excited to graduate from crutches to cane.
Upon leaving the hospital he was given a goody-bag filled with helpful appliances to put on socks; pinch and grab things that normally would require bending down; a 30 inch shoe horn among other things. He has outgrown all of these now and celebrated the morning he could bend down to pick up the Wall Street Journal at his front door.
The week of June 9th was yet another milestone when he returned to the gym to ride the stationary bike; work out on the Nautilus equipment; and best of all to swim laps in the pool. He has a new friend at the Y with a transplanted meniscus and they compare notes on their progress.
Dr. Hoffman's diet of organic red meat has paid off in blood counts that improved rapidly, normalizing in just two months.
He freqently is heard to ask "Where'd I put my cane?"--a good sign, since he's forgetting to use it! The task at hand is to build strength and balance so that he can normalize his gait.
Dr. Hoffman continues to go to the YMCA to swim, ride the stationary bike and use the weight machines. Most recently, he set up his new triathlon bike on a trainer and gets a workout while watching the news or the Yankees. He also does strengthening exercises in his apartment. To maintain core body strength and to help with alignment, he does 200 abdominal crunches per morning as well as back exercises.
At his 6 week check up Dr. Dean Lorich told Dr. Hoffman that his xrays look great and the bone is healing well.
As July ends, Dr. Hoffman is able to climb stairs without holding the rail, but still has some difficulty going down. Now that his strength and balance have returned, he just moth-balled the shower-chair that enabled him to climb into the shower safely the first few weeks after the accident.
On August 1, Dr. Hoffman attained a milestone by undertaking his first plane flight since the injury. He was called upon to provide the keynote address to over 300 managers of The Vitamin Shoppe at their annual professional education meeting in Orlando. There, he introduced Vitamin Shoppe personnel to his new MD Select line, which will be exclusively offered in Vitamin Shoppe stores this fall. Stay tuned for details . . .
Dr. Hoffman extends his thanks to The Vitamin Shoppe and to American Airlines for facilitating his air travel. Thanks to great logistics, Dr. Hoffman was whisked from curbside to gate and through security with a minimum of wear and tear to his sore hip. Amazingly, with a large piece of titanium hardware implanted in his leg bone, he didn't trip the metal detector! He missed only one night of live radio broadcasts while overnighting in Florida, and arrived back fresh to continue his busy schedule of seeing patients at the Hoffman Center.
Dr. Hoffman isn't ready to return to running, but he was surprised and delighted to regain a previously-cherished exercise option: he's back on the Stairmaster, albeit for short periods of time, but it's a start.
Dr. Hoffman's latest milestone was riding the subway for the first time on August 22nd. The stairs at Grand Central Station proved no serious impediment, and Dr. Hoffman rocked in a car stuffed with morning commuters. Just commuting to work in New York City requires a certain degree of fitness!
Milestones for September: Walking upstairs is easy. But walking downstairs involves placing forces equal to up to five times your body weight on your lower extremities. Dr. Hoffman reports that he is now able to descend stairs normally!
Additionally: Cane? What cane? The cane is rapidly becoming a fixture of the past, as Dr. Hoffman is increasingly abandoning it for all but the most daunting urban hikes. He is going back to taking the subway to work. Gym workouts continue, as do bike rides (using a trainer that holds the bike upright). As cooler weather looms, Dr. Hoffman is trying to capitalize on those last fall weekends for getaways to the beach for long open water swims . "In the water, I can get a complete workout without worrying about my leg," he reports.
As of October 13, Dr. Hoffman reached the 5 month post-accident milestone. He has retired the cane completely, and not only can take the subway to work, he can even walk to work. There is some residual aching and stiffness, but mobility is no longer restricted.
Dr. Hoffman's workouts now include deep-water running, a technique used by runners to rehab injuries. Dr. Hoffman uses an Aquajogger Water Floatation Fitness Belt (Excel Sports Science, Inc., 800-922-9544)for frequent pool running sessions at the nearby "Y".
On Monday, October 16, Dr. Hoffman visited his orthopedic surgeon, Dr. Dean Lorich, for his 5 month follow-up. After X-rays, Dr. Lorich pronounced his hip "beautifully-healed". To Dr. Hoffman's question, "What can I do now, are there any restrictions?" Dr. Lorich replied "There are none."
Encouraged by his clean bill of health, Dr. Hoffman surprised himself by running, albeit at a slow pace, on a treadmill, and plans to ramp up the pace and duration of his running gradually.
In December, Dr. Hoffman began working with a personal trainer at the "Y". The focus is flexibility and strengthening of the injured leg. To this end he is performing sliding lunges foward , backward, and sideways.
Additionally he is cultivating balance with a device called a BOSU ball .
His strength training regimen includes use of Universal machines to perform squats, quadriceps, calf, hamstring, and hip flexor and extensor exercises.
In January of 2007, Dr. Hoffman was pleasantly surprised when he took a bicycle spinning class and had a pain-free, high performance spin, with no residual soreness. This bodes well for a full comeback in 2007! Spinning classes have become part of his weekly exercise regimen.
Nine months after his accident, Dr. Hoffman achieved a milestone by running a mile on the treadmill. He experienced no soreness after this feat, so with warmer weather around the corner, could he be making a spring running comeback? Stay tuned!
March 2007: While sidelined from long-distance running these past few months, Dr. Hoffman undertook a different challenge: Swimming around the island of Manhattan! Not literally--unlike Kramer in that famous episode of Seinfeld, Dr. Hoffman has been swimming regularly at the Vanderbilt YMCA, accumulating a total of 2094 laps--the equivalent of the 26+ miles that comprise a swim circuit around Manhattan via the Hudson, East River, and Harlem River! He's proudly sporting a new T-shirt that says: "I swam Manhattan at the Vanderbilt YMCA!"
ECSTASY! With the advent of warm weather, Dr. Hoffman felt he was ready to get back on the bike. You'll recall that he injured his hip the very weekend he was to test-ride his new custom Serotta "Nove" carbon and titanium bike! The new bike has been a part of his rehab, but only while mounted on a stationary trainer in front of the TV in Dr. Hoffman's study. Over the winter he got used to the feel of the new bike without ever having taken it on the road. Even "Meet the Press" seemed bearable while practice-riding!
On March 31, with the spring weather beckoning, Dr. Hoffman took the new bike off its stand and suited up for a road ride. The first few steps were a little tenuous as Dr. Hoffman accustomed himself to the feel and balance of the new bike. He assiduously practiced getting in and out of the toe clips and rehearsed some emergency dismounts. There definitely was a fear element to conquer, but soon Dr. Hoffman was climbing hills, negotiating turns, and ripping through straightaways, enjoying the lightness and maneuverability of his new dream riding machine.
Best of all, the hip did not complain. This is a great portent for the spring and summer months ahead, which promise lots of happy riding opportunities. The smooth ride of his new "Nove" should prove a great incentive for Dr. Hoffman to recover his pre-accident riding form.
May 12, 2007: The one-year anniversary of Dr. Hoffman's accident. Dr. Hoffman commemorated it while attending ACAM's scientific conference in Chicago, where he tried out his new running prowess on Lake Shore Drive. He was delighted to log a 3 mile run, albeit at a slow, cautious pace, beside beautiful Lake Michigan.
As of July, 2007, 14 months after the accident, Dr. Hoffman is routinely running four miles at a time, albeit at a slightly more leisurely pace, and biking 30-40 miles per weekend. Swimming and kayaking are part of Dr. Hoffman's summer routine at his home by the water on the East End of Long Island. Dr. Hoffman considers each outing a supreme benediction after being laid up all of last summer.
On August 31, 2007, nearly sixteen months after his bike accident, Dr. Hoffman began the final phase of his recuperation. In a one hour operation at New York's Hospital for Special Surgery, Dr. Dean Lorich removed the intertrochanteric nail that was used to patch Dr. Hoffmanęs broken hip. The lightweight titanium device had served its purpose: over the last year, it had served as an internal scaffold around which Dr. Hoffman's hip bone had healed.
Why remove the device at all? Dr. Hoffman was already returning to peak performance, running several miles at a stretch, and was bicycling almost up to his pre-fracture form. In fact, in most individuals over 65 who have hip fractures due to osteoporosis, the metal is left in to reinforce the bone and prevent future fractures.
But orthopedists give young active patients the option of having the metal removed from their hips, because it allows a more natural feel. While not painful, Dr. Hoffman had noted the slight protrusion of the internal device interfered with complete freedom of motion and felt "foreign". So, with the encouragement of Dr. Lorich, out it came.
After Dr. Hoffman woke up in the recovery room, one of the nurses handed him his freshly removed "hardware" in an autoclave bag. "It was awesome holding that fifteen inch piece of metal in my hands," Dr. Hoffman reported. "After over a year embedded deep in my body, it felt strange to run my fingers over the smooth metal surface, imagining it a few hours earlier in contact with my own muscle, tendons, bone, and marrow. I came to appreciate even more the technological mastery and surgical skill required for its design and accurate implantation. This was truly an example of the triumph of medical ingenuity over chaos and calamity."
After his second surgery, Dr. Hoffman is finding "Advanced Systemic Enzymes," one of the new supplements he has developed as part of his MD Select line with the Vitamin Shoppe, to be particularly helpful for reducing pain and swelling. "Within just a day of taking three Advanced Systemic Enzyme capsules three times a day away from meals, as I now recommend to my patients for post-operative recovery, my leg swelling was down by at least 50%."
Dr. Hoffman will require a few more days of rest and pain medication, but should be back to work by mid-week. Then he will gradually ramp up his exercise and try out his "new" hip.
Two weeks post-surgery: With stitches out, Dr. Hoffman was a spectator at the Mighty Hamptons Triathlon, September 16. Still sporting a cane, Dr. Hoffman rooted for former Trisports-mates Rowan Mestecky and David Cowan, who had great races.
Dr. Hoffman's consolation: Outdoor BBQ-ing and his first post-surgery swims in Shinnecock Bay. "In the water," he says, "I feel almost normal." Next stop: the pool at the "Y" for some deep water "aqua-jogging".
Fast-forward to December 31st, 2007: Weeks of swimming, stationary bicycling and strength-training at the Vanderbilt "Y" have paid off. Dr. Hoffman even skips the "F" train and walks to and from his office to prep his leg for the final stage of his recovery: getting back outside and running.
Bliss! Dr. Hoffman puts on his winter wear running togs, long lying fallow in his drawer, to test his legs on the mean streets of New York. He opts for his traditional route up Sutton Place to the beautiful East River Drive, up to 96th St. and back.
The temperature is in the 40's and a light breeze ripples the swirling East River on the last day of 2007. While a little rusty from months off the running course, the leg feels good as Dr. Hoffman takes year-end "test-drive".
Music booms in on the Ipod, and Dr. Hoffman feels a surge of emotion as he listens to the driving beat of Albert Cummings' blues song "I'm Free":
"It's been so long since I went out on my own
I can't believe how much time has gone. . .
Now I'm free
Free at last
Free at last
Now I'm free from my past!"
Four miles, and the hip felt great! The trial run portends a comeback on the running circuit for Dr. Hoffman.
May you, too, achieve your personal goals in 2008, and may God and Nature, the bestowers of recovery, grant you a healthy and vibrant new year!
Dr. Hoffman has been reading nearly a book a week during his recuperation. Below is a partial list which will be updated periodically:
A World Undone: The History of the Great War, by G. J. Meyer
The Constant Gardener, by John Le Carre
Magical Thinking, by Augusten Burroughs
The Terrorist, by John Updike
Grapeshot and Shamrocks: A Historical Fiction of the Civil War, by Doc J. McNiff
The Poe Shadow, by Matthew Pearl
The Pirate Coast, by Richard Zacks
Mayflower, by Nathan Philbrick
Middlesex, by Jeffrey Eugenides
When Bad Things Happen to Good People, by Harold S. Kushner
The Looming Tower: Al-Qaeda and the Road to 9/11, by Lawrence Wright
The Tortilla Curtain, by T.C. Boyle
Blood and Thunder, by Hampton Sides
Silent Victory: The U.S. Submarine War against Japan, by Clay Blair, Jr.
Rubicon: The Last Years of the Roman Republic, by Tom Holland
Ghost Soldiers: The Epic Account of World War II's Greatest Rescue Mission, by Hampton Sides
Roma: The Novel Of Ancient Rome by Steven Saylor
The Rising Tide: A Novel of World War II, by Jeff Shaara
Generation Loss, by Elizabeth Hand
Unanticipated Side Effects, by Augusten Burroughs
Exit Ghost, by Philip Roth
The Gravedigger's Daughter, by Joyce Carol Oates
Tree of Smoke, by Denis Johnson
The Day of Battle:The War in Sicily and Italy, 1943-1944, by Rick Atkinson
The World Without Us, by Alan Weisman
Where I'm Calling From by Raymond Carver
Shattered Sword: The Untold Story of the Battle of Midway by Jonathan Parshall and Anthony Tully
Dr. Hoffman wishes to extend his thanks for the many wonderful cards and e-mails from well wishers who have provided him with encouragement in his comeback from hip fracture. He was heartened that so many people cared.
Check back for frequent updates about his progress.