Ten Years. Ten long years. Ten slow years. Ten years of being thankful to still be alive. Ten years of watching my friends slowly die off of illness related to their work in the toxic plume in the wreckage of the collapsed World Trade Center (WTC). Ten years of lobbying our government to do the right thing and embrace the medical issues that “The Heroes” are now riddled with. Ten years of families still waiting for DNA to connect thousands of bodily remains so that they can bury or inter some piece of their lost family member as opposed to having nothing or no place to go. Ten years.

On September 10, 2001, I was a happy, healthy new York City firefighter looking forward to the next morning and what excitement the day would bring. as we all know “that day” turned out to be a day that would change the face of the world, fracture its security, and redefine “terrorism” as a worldly concern for the U.S. as opposed to it happening everywhere but here. The world’s most televised event happening right in front of us. either standing on West Street or standing in front of your television, we witnessed horror at a level unimaginable to the American people. Firefighters and police officers running in while everyone else was trying to get out. Regular folk refusing to leave his or her fellow friends or coworkers to find their own way down. Acts of selflessness that define bravery and humanity amidst the greatest travesty and disregard for human life that anyone could think of.

The Big One

That morning as I drove across the Brooklyn Bridge, I knew what my destiny in life was. I was going to what we called, “The Big one.” I and my comrades knew that this would indeed be our last day. It was the first thing I said as we turned off the approach and were mid-span on the bridge. The officer in charge sitting across from me, a two- time Vietnam vet, cancer survivor, and 30-year veteran of the Fire Department of new York (FDNY) sat quiet and simply muttered, “This is very bad, Bobby.” I on the other hand was a bit more expressive in my words, “Holy shit, Ed! look at that! We’re gonna die.” He agreed, and we both knew that people were in dire need of rescue. to put it simple, there were twenty floors of fire over a thousand feet in the air, and we were in deep shit from the onset. People were flying out the windows from above, exploding in the street, and there was nothing we could do to stop it. as we pulled up to the foot of the WTC property on Liberty Street, everyone’s attention was suddenly drawn to a loud sound coming from the south. I looked straight up to catch a glimpse of the tail section of United flight 175 sinking into Tower 2. “This is the end of the world,” I thought. Ed and I were immediately swept into a stampeding swarm of people running for their lives.

The rest of the morning went as we all know—thousands dead, an American icon of building construction and freedom now in a smoking pile with bodies everywhere. Hell had come to earth and taken up residence in lower Manhattan. little did any of us working there realize, we all took this hell home with us…both physically and emotionally.

Many are now ill and tragically many have also died from their exposure to what then EPA Director Christine Todd Whitman called “air that is safe to breathe.” Lung cancer, heart disease, sarcoidosis, colon cancer, brain cancer, and the list goes on. Many, including myself, have an extremely diminished lung capacity, a condition called RADS or Reactive Airway Disease. It kind of feels like you were under water too long; like you’re inhaling glass shards. Sinus conditions, numerous bouts with chronic bronchitis, sleep apnea, and skin conditions. The numbers of “exposed” are in the thousands and most of us have that thought in the back of our heads, “Wonder when it’s going to be me.” no drama. no nonsense, it’s something we are now living with and will undoubtedly shorten our time on this planet and our time with family and friends.

Best Laid Plans

My plans were to be in the fire business for thirty years and retire as a captain with a group of young men that I would lead into battle and be respected for my compassion, leadership, and experience. I was in the process of transferring to Special Operations Company, which is kind of the like getting asked to play for the Yankees even though I’m a Mets fan. Something wasn’t right. I wasn’t sleeping, and to be honest I haven’t slept a solid night in ten years now. I was drinking coffee by the gallon, and I was having some pretty wicked dreams and flashbacks of people jumping from those windows. I was dreaming of my dead friends talking to me, begging me to come and get them out of “The Pile.” I was waking up soaking wet and in a panic. I tried to ignore these symptoms and just go back to work. I went to a bunch of fires, and I was most definitely on edge. I was not looking forward to going to work as I had. in fact I was actually fearing it. when I’d drive home following the end of my tour, I’d be saying, “Okay, Bobby, you lived another day.” that was not normal by any means. Eventually these daily conflicts had consumed my life, and it was time to acknowledge them. I reached out to the FDNY Counseling Unit to simply get a few weeks off so I could recharge my batteries. to the contrary and to my surprise, those “two weeks” became the rest of my life. I was eventually diagnosed with Acute Chronic Post Traumatic Stress Disorder. “What? me? PTSD? that only happens to those Vietnam guys.”

I soon learned that many of us were suffering from the same emotional injuries that combat vets suffer from. Now looking back I understand that we were in a battle that morning; a battle that became known as the first battle in “The War on Terror.” We didn’t carry rifles or wear camouflage. We wore fire helmets and fire gear. We were injured and some of us died. under all that gear though, we were human just like everyone else. We feel pain and regardless of how much you are taught in the fraternal aspect of the fire service to “not feel,” these feelings get inside of you, and they simply don’t go away. just the opposite; they stay inside of you and bounce around like a razor blade that chews you up.

Over the past twenty-five years, I’ve been told I was a “very good fireman.” I was told I was “one of the toughest guys” people had met with my ability to embrace death, blood, guts, sadness, and pain. It is what we strive for in the fire business—being that “go to guy” who gets it done. I did, and I did it well. however, having to adjust to the fact that I had become a “victim” of this attack and that I had to now care for the caregiver was not easy, and I still struggle with it ten years later. I’ve been in some form of cognitive therapy for seven years now. I retired from the FDNY in October of 2006, and my expectation of being that cranky old captain with thirty years of service? unfortunately that will remain a dream.

Never Forget

Ten years later, I am now addressing all walks of life with regard to our emotions and that we take a lot home with us. Cops, firemen, nurses, teachers, security agencies, you name it, I’m spending some time with them to expand their awareness to “emotional injury.” I’ve written articles for a number of emergency services magazines and websites. I recently finished my first book titled, Beyond Surviving, and most recently began recording podcasts and a radio forum called, “It’s okay Not to be Okay” with a renowned clinical psychologist, Dr. Mark Lerner.

I had a choice to make at a point in my “recovery.” I had to do something with what happened to me. I felt the need to teach others that we are all human and that we all feel. Most of all, I had to pass on the message that life is “one day at a time” and that we are allowed to heal. Firemen, cops, and military; we all have a tough time embracing that one. when they meet me or read an article, they can’t say, “That guy has no clue what we go through. Who is he to tell me about my emotions?” I worked for the best fire department on this planet. I worked in the busiest neighborhood and in a respected company. all validating marks that can’t be dismissed. I’ve been there and done it. Thankfully, they acknowledge that for their own well being and embrace taking care of themselves so they can continue to take care of others.

Take a moment this September 11th and those that follow to watch an American flag blow in the breeze. be thankful that you live in a country that allows you to read whatever book or magazine you want, watch whatever TV channel you choose, and either walk into or pass by the house of worship of your choice. Thank a veteran for their service and realize that tomorrow has no guarantees. Make the difference today.

NEVER FORGET. 343 37 23

BALTIMORE — Mere inches made all the difference in Lonnie Chisenhall’s rapid recovery from a frightening fastball.

The Indians’ rookie was back in the starting lineup Monday, manning third base and batting ninth. on July 7, Chisenhall was struck on the right side of his face by a pitch from the Blue Jays’ Carlos Villanueva.

Fortunately for Chisenhall, the baseball glanced off his helmet first.

“You have to be thankful that the ball got the helmet,” Indians manager Manny Acta said. “I don’t think that if it would’ve got him square in the face he was going to be able to come back this fast. He went through all those tests and took batting practice.”

Chisenhall noted that he has taken batting practice with no issues for the past four or five days. He also stepped to the plate during a simulated game Thursday against sidelined Indians starter Fausto Carmona. With no concussion-like symptoms and his vision fine, Chisenhall was cleared to play.

“He’s good to go,” Acta said.

On Thursday, the white of Chisenhall’s right eye was red and he had bruising on his upper cheek — results of a sinus fracture. the third baseman will be sporting a specialized helmet, which has an earflap that extends over the cheek and jaw, for the next six weeks or so while the bone heals.

Chisenhall entered the opener with the Orioles hitting .267 (8-for-30) with one home run, three doubles and two RBIs in nine games with Cleveland this season.

Carmona works out quad with no problems

BALTIMORE — Fausto Carmona did not like being placed on the disabled list, but the Indians starter feels rested, recovered and ready to rejoin the rotation after a bout with a strained right quadriceps.

Carmona logged three innings during a simulated game Thursday at Camden Yards before testing his leg in a series of sprint and agility drills in the outfield. Barring a setback, Carmona is expected to be activated from the 15-day DL on Monday for a road start against the Twins.

“I’m not anticipating any issues,” said Indians manager Manny Acta. “I think he’s ready to start on Monday.”

Carmona injured his right leg during a hard fall while running out a bunt in the third inning of an Interleague game against the Reds on July 2. Earlier in the game, Carmona had the webbing between the index and middle fingers on his right hand cut by a grounder off the bat of Homer Bailey.

Neither injury presented a problem during Thursday’s workout.

Carmona worked through 50 pitches, throwing 20 in his first simulated inning followed by 15 in each of the next two frames. Cleveland hitters Lonnie Chisenhall, Luis Valbuena, Ezequiel Carrera and Shelley Duncan each stepped in to face the big right-hander.

In the outfield after his pitching session, Carmona simulated fielding places, running in all directions after going through his delivery motion. Carmona, who is 4-10 with a 5.78 ERA in 18 starts this season for the Tribe, said that the running drills were more important for testing his leg strength.

“It’s OK,” Carmona said. “I threw on the mound like normal in a game. After that, I did some running. I feel good. I’m ready to go. Throwing on the mound, I felt very good. I was throwing strikes. My leg is strong.”

The Indians have a day-night doubleheader Monday against the Twins at Target Field. It is not immediately clear which game Carmona will start. Acta indicated that Cleveland will announce Monday’s second starter on Sunday night. the top candidates appear to be lefty David Huff and righty Zach McAllister, from Triple-A Columbus.

For now, the Indians are more concerned with Carmona’s health.

“He looked good,” Acta said. “He had no issues. He threw the ball very good and he’s all set to go. He did some running and all that and, probably in the next day or so, we’re going to have him do some agility work around the mound just to make sure everything checks out OK.” Acta gets great memories from HR Derby

BALTIMORE — Manny Acta would have been forgiven for taking a day off from throwing early batting practice to his hitters. Giving up 31 home runs to Red Sox slugger Adrian Gonzalez in Monday’s Home Run Derby took a toll on the Indians manager’s arm.

On Thursday afternoon, though, Acta took the mound at Camden Yards and willingly threw fastballs to a group of Cleveland batters. the home-run output was considerably lower during this particular session.

“Different hitters,” joked Indians closer Chris Perez, who was a member of the American League All-Star team. “He performed. He got A-Gone in the finals. He represented us well. I’m sure that’s a great memory he’ll have.”

Gonzalez finished as the runner-up to Yankees second baseman Robinson Cano in the Derby with Acta as his personal thrower. Acta noted that he and the Boston first baseman had no prior connection. It was a random turn of events that led to the Tribe manager helping Gonzalez reach the Derby finals.

“He didn’t have anybody to throw,” explained Acta, who was on the AL’s All-Star coaching staff. “I was just sitting at my locker eating and reading. I heard him telling his dad or somebody that was with him that he didn’t have anybody to throw to him.

“It was only like 20 minutes until that whole thing started. I turned around and told him if he wanted, I could throw to him. It was a great experience — a hurtful one.”

It did not take long for Acta to become impressed with Gonzalez, either.

“He’s an unbelievably focused guy,” Acta said. “I’ve never seen anybody so focused on a Home Run Derby. He was in it to win it. we went to the cage and right away we were doing some coaching in there. He was telling me where he wanted the ball and all that kind of stuff.

“Then, in between rounds, we went in and hit again before it was his turn. He was very, very serious about this. I learned a great deal about why he’s such a great player.”

Cano eventually defeated Gonzalez, 32-31, for the Derby crown. His father, Jose Cano, served as his Derby thrower. Acta and the elder Cano were Minor League teammates in the Houston Astros organization.

“I’ve known little Robinson since he was like six years old,” Acta said.

Quote to note

“I got a bunch of tweets about it. I told them all that I’m practicing a backflip for next year.” – Reliever Vinnie Pestano, who sprints in from the bullpen, on San Diego closer Heath Bell’s sprint and slide to the mound during Tuesday’s All-Star Game. Smoke signals

• Right-hander Jeanmar Gomez was with the Indians in Baltimore on Thursday. It has not been officially announced, but Gomez is the planned starter for Sunday’s game against the Orioles. He still needs to be officially recalled from Triple-A Columbus, where he has gone 9-3 with a 2.40 ERA in 14 starts.

• Right-hander Alex White, who is on the 60-day disabled list with a right middle finger injury, is also in Baltimore. White is slated to throw a bullpen session at Camden Yards on Saturday and is scheduled to complete four mound sessions before advancing to simulated games. White could begin a rehab assignment within the next two weeks.

• the Indians made it known on Wednesday that they planned on recalling outfielder Ezequiel Carrera from Triple-A Columbus after placing righty Mitch Talbot (back strain) on the 15-day disabled list. on Thursday, Cleveland made the move official. “He could see limited action here,” Indians manager Manny Acta said. “He could probably pinch hit, pinch run, or something like that. or, cheerleader — you name it.”

• the Indians announced promotions of staff members Bob DiBiasio and Curtis Danburg on Thursday. DiBiasio, whose previous title was vice president of public relations, has been named the senior vice president of public affairs. DiBiasio has been with the organization for 33 years. Danburg, who has been with the organization for 16 years, has been promoted from director of communications and creative services to senior director of communications.

Bone loss drugs in the class of bisphosphonates have, again, been linked to bone fractures of the femur (thigh bone). Web MD said that a recent, large review of over 200,000 post-menopausal women found that those taking bisphosphonates—drugs sold under the names Fosamax, Fosamax Plus D, Actonel, Actonel with Calcium, Boniva, Atelvia, and Reclast, as well as generics—for over five years experienced a two-fold likelihood of suffering fractures, versus women taking these drugs for briefer periods.

Fractures occurred in about one of every 1,000 women who took bisphosphonates for five years or more, one of the researchers told WebMD. The study appears in the February 23rd issue of the Journal of the American Medical Association.According to recent studies, about half of all women over the age of 50 will suffer a bone loss-related fracture, and about one in every five of these women will die within a year, noted WebMD, noting that bisphosphonates are taking by millions of patients in the U.S. In addition to their use in preventing osteoporosis fractures, bisphosphonates also help to reduce hip, spine, and other fractures related to weakened bones.

Despite this, reports began emerging in recent years about long-term bisphosphonate use and femur fractures, prompting the FDA to mandate a label change on the medication to include a warning of “possible risk of atypical thigh bone fracture” in long-term users, said WebMD. “While it is not clear whether bisphosphonates are the cause, atypical femur fractures … have been predominantly reported in patients taking bisphosphonates,” FDA officials noted in a news release issued at the time, quoted WebMD. According to the FDA warning, the severe musculoskeletal pain associated with bisphosphonates may occur within days, months, or years after starting treatment. some patients have reported complete relief of symptoms after discontinuing the bisphosphonate; others have reported slow or incomplete resolution.

In the emerging study, the researchers identified 205,466 women at least in their late 60s who began taking an oral bisphosphonate between 2002 and 2008; the group was studied until the spring of 2009, said WebMD. at that time, 716 women required hospitalization for femur fractures. The 716 cases were matched to the nearly 3,600 women who did not suffer a femur fracture, said WebMD.

Women taking the bone drugs for the five-year period or more experienced a 2.7-fold increased likelihood for fractures versus women taking them under 100 days. A secondary review found that women taking the drugs for three years or more experienced a 24 percent risk of osteoporosis-linked breaks than the under-100 day group, added WebMD.

Bisphosphonates are also approved for a variety of other indications, including other bone diseases such as Paget’s disease, and are given to cancer patients for the prevention of fractures due to bone metastases.

Over the past several years, bisphosphonates have been associated with a number of side effects, including Osteonecrosis of the Jaw/Dead Jaw Syndrome, Esophageal Cancer, Fractures, Atrial Fibrillation, and Severe Musculoskeletal Pain. Osteonecrosis of the jaw (ONJ), or dead jaw syndrome is a condition in which the bone tissue in the jaw fails to heal after minor trauma such as a tooth extraction, causing the bone to be exposed. The exposure can eventually lead to infection and fracture and may require long-term antibiotic therapy or surgery to remove the dying bone tissue. In 2005, the FDA ordered that the label for Fosamax and other bisphosphonates be updated to include warnings about ONJ.

This is a very thorough site. cancer.gov/cancertopics/facts…

Good luck to you. take care.

Depends on which one. Usually the presenting symptom is pain, because it has fractured, and by that time is probably a metastasized from another organ. another sign is a spontaneous fracture with out a predisposing factor, usually " I was walking and it suddenly broke" Apart from that it is almost impossible to find or diagnose beforehand