mstreet2379
03-17-2009, 12:45 AM
My God, I'm so greatful to have found this site with so many people that have gone through the OATS procedure on their ankles. I'm having the OATS procedure on 4/23/09 and have many questions that my OS gives me very vague answers on, but rightfully so, as everyone recovers differently. I've had an arthroscopy already and thought I may need another one (about 3 years later) so I saw my initial OS... but he diagnosed the OcD and stated I'd need a more specialist MD to handle my care... So I was referred on. I've been informed that I have "a very advanced stage of Ocd", and that if we don't try this first, by next year I'll need a total ankle replacement due to it's progression. Aaand... even OATS may not work and I'll still need total ankle replacement.
I have chronic pain very regularily... and have gone through various pain killers to get me through until surgery (not covered under FMLA til end of March)... Ibuprofin (total 1600 mg daily), Flector patches (does NOTHING), Injections, Vicodin, Vicoprofin, and Oxycontin... developing high tolerances to all of the above.
So, here's my scoop... I'm a 26 year old mother of 2 young children. I damaged BOTH ankles working as a C-5 jet mechanic in the USAF. I really need to know how to care for my 6 and 2 year old... My questions are: HOW LONG WILL I BE HOSPITALIZED? WILL I NEED A WHEELCHAIR? HOW PAINFUL IS IT POST-OP? WHAT DOES THE PAIN FROM THE BONE GRAFT FEEL LIKE? WILL I BE ABLE TO DRIVE AFTER, SAY, 1 WEEK? (DAD WORKS OVER THE ROAD... SO I'M ON MY OWN HERE...) WILL I BE ON CRUTCHES IN SEPT? (I'M STANDING UP IN MY BEST FRIENDS WEDDING) WILL I BE ABLE TO DANCE @ HER WEDDING? WILL I EVER BE ABLE TO RUN AGAIN? HOW BIG OF AN ISSUE IS IT IF I SKIP PT FOR 1 OR TWO WEEKS 8 WEEKS AFTER SURGERY... (GOING TO SEE MY HONEY OVER THE ROAD WITH THE KIDS) YADDA YADDA... SO IF ANYONE HAS BEEN THROUGH THIS... PLEASE COMMENT, OR BETTER YET...
THANK YOU ALL IN ADVANCE FOR YOUR HELP.
And beleive me... no e-mail can be too long or detailed regarding this issue for me.
I have chronic pain very regularily... and have gone through various pain killers to get me through until surgery (not covered under FMLA til end of March)... Ibuprofin (total 1600 mg daily), Flector patches (does NOTHING), Injections, Vicodin, Vicoprofin, and Oxycontin... developing high tolerances to all of the above.
So, here's my scoop... I'm a 26 year old mother of 2 young children. I damaged BOTH ankles working as a C-5 jet mechanic in the USAF. I really need to know how to care for my 6 and 2 year old... My questions are: HOW LONG WILL I BE HOSPITALIZED? WILL I NEED A WHEELCHAIR? HOW PAINFUL IS IT POST-OP? WHAT DOES THE PAIN FROM THE BONE GRAFT FEEL LIKE? WILL I BE ABLE TO DRIVE AFTER, SAY, 1 WEEK? (DAD WORKS OVER THE ROAD... SO I'M ON MY OWN HERE...) WILL I BE ON CRUTCHES IN SEPT? (I'M STANDING UP IN MY BEST FRIENDS WEDDING) WILL I BE ABLE TO DANCE @ HER WEDDING? WILL I EVER BE ABLE TO RUN AGAIN? HOW BIG OF AN ISSUE IS IT IF I SKIP PT FOR 1 OR TWO WEEKS 8 WEEKS AFTER SURGERY... (GOING TO SEE MY HONEY OVER THE ROAD WITH THE KIDS) YADDA YADDA... SO IF ANYONE HAS BEEN THROUGH THIS... PLEASE COMMENT, OR BETTER YET...
THANK YOU ALL IN ADVANCE FOR YOUR HELP.
And beleive me... no e-mail can be too long or detailed regarding this issue for me.
Sponsor
krisj5kids
03-17-2009, 06:56 AM
So, here's my scoop... I'm a 26 year old mother of 2 young children. I damaged BOTH ankles working as a C-5 jet mechanic in the USAF. I really need to know how to care for my 6 and 2 year old... My questions are: HOW LONG WILL I BE HOSPITALIZED? It depends. My dr. said he usually sends people home the same day, BUT most stay about 3 days and I did too. I recommend it if your insurance will pay.WILL I NEED A WHEELCHAIR?No, probably not. HOW PAINFUL IS IT POST-OP? Honestly, worse than childbirth. It was very painful, thus the reason to try and be in the hospital for 3 days or so.WHAT DOES THE PAIN FROM THE BONE GRAFT FEEL LIKE? WILL I BE ABLE TO DRIVE AFTER, SAY, 1 WEEK? I did, but don't tell anyone. Seriously, what ankle is it? The right, then probably no, the left, you can probably manage.(DAD WORKS OVER THE ROAD... SO I'M ON MY OWN HERE...) WILL I BE ON CRUTCHES IN SEPT? NO, unless you hurt it again(I'M STANDING UP IN MY BEST FRIENDS WEDDING) WILL I BE ABLE TO DANCE @ HER WEDDING?In Sept? Probably WILL I EVER BE ABLE TO RUN AGAIN? I've been running since 4 mos post op, so yes, the idea is that you will be able to run again. Abby runs too.HOW BIG OF AN ISSUE IS IT IF I SKIP PT FOR 1 OR TWO WEEKS 8 WEEKS AFTER SURGERY...NOt that big of a deal at all as long as you do your exercises on the road. (GOING TO SEE MY HONEY OVER THE ROAD WITH THE KIDS) YADDA YADDA... SO IF ANYONE HAS BEEN THROUGH THIS... PLEASE COMMENT
THANK YOU ALL IN ADVANCE FOR YOUR HELP.
And beleive me... no e-mail can be too long or detailed regarding this issue for me.
Good luck and ask away. There are many of us who have been through this. Also, do a search here for OATS and Mosaicplasty and read previous posts and you'll get lots of info that way too.
THANK YOU ALL IN ADVANCE FOR YOUR HELP.
And beleive me... no e-mail can be too long or detailed regarding this issue for me.
Good luck and ask away. There are many of us who have been through this. Also, do a search here for OATS and Mosaicplasty and read previous posts and you'll get lots of info that way too.
kimberp
03-17-2009, 12:15 PM
HOW LONG WILL I BE HOSPITALIZED? 3 days is the norm, I was in a lot of pain and was kept for 4 days.
WILL I NEED A WHEELCHAIR? Depends how comfortable you are with using crutches. Some people feel more comfortable with a wheelchair or a walker especially earlier on when you are on more pain meds and feeling a bit 'fuzzy.' I think we've all taken a tumble on crutches so if you'd be more comfortable and stable with a wheelchair, I'd say go for it.
HOW PAINFUL IS IT POST-OP? Not to scare you, but the first 2 weeks for me were excruciating, then it just turned off like a light switch. Be prepared for the worst and hopefully you'll be one of the ones with minimal pain.
WHAT DOES THE PAIN FROM THE BONE GRAFT FEEL LIKE? My overall pain was just in my ankle, kind of like a truck drove over it and stayed parked on it. Pain was horrendous, although my knee felt great. No pain, just stiffness.
WILL I BE ABLE TO DRIVE AFTER, SAY, 1 WEEK? Absolutely not especially since it's your right foot. You won't start to feel normal and not 'foggy' for a few weeks after the surgery, even if your not on pain meds. Plus you will have pain just from the vibration from the car and just having your foot down for more than 5 minutes after 1 week.
WILL I BE ON CRUTCHES IN SEPT? 5 months after surgery? Probably no crutches by then but I wouldn't plan on walking normally or without a limp by then. Usually it is 12 weeks non weight bearing and then gradually back to full weight bearing. Things will be stiff when you first start to walk.
WILL I EVER BE ABLE TO RUN AGAIN? Minimal activity isn't recommended until at least 6 months out and my OS as well as Abby's (who is running now) said not until 9 months or so. Honestly, you can run or do activities as soon as you want, but all you would be doing is compromising this surgery, risking another (or worse) and reducing effectiveness of this surgery. As my OS said, OATS could last me 10 years, 20+ years or 5 years ... all depends on how I treat my ankle from this point on and given the recovery for this is so important as the plugs incorporate into your talus, I am not sure why anyone would want to rush back to normal activities. No activity is important enough to make me go through this or another ankle surgery again.
HOW BIG OF AN ISSUE IS IT IF I SKIP PT FOR 1 OR TWO WEEKS 8 WEEKS AFTER SURGERY Movement is important after this surgery to help healing as bloodflow to the area will not only help move the fluids that have collected (reduced swelling = reduced pain) but will also help avoid any nerve issues such as RSD which are a concern after any surgery. If you can, I would at least go to PT the first time to see what you should do and then do it on your own, but at least knowing what you can/can't do would help you get through those first few weeks.
I hope this helps ... there are a lot of conversations about OATS on here .. go to "Advanced Search" above and put in the terms "OATS", "OCD" and search the foot forums and you'll see probably more detail than you'd like, but you'll be better prepared.
Kim :)
WILL I NEED A WHEELCHAIR? Depends how comfortable you are with using crutches. Some people feel more comfortable with a wheelchair or a walker especially earlier on when you are on more pain meds and feeling a bit 'fuzzy.' I think we've all taken a tumble on crutches so if you'd be more comfortable and stable with a wheelchair, I'd say go for it.
HOW PAINFUL IS IT POST-OP? Not to scare you, but the first 2 weeks for me were excruciating, then it just turned off like a light switch. Be prepared for the worst and hopefully you'll be one of the ones with minimal pain.
WHAT DOES THE PAIN FROM THE BONE GRAFT FEEL LIKE? My overall pain was just in my ankle, kind of like a truck drove over it and stayed parked on it. Pain was horrendous, although my knee felt great. No pain, just stiffness.
WILL I BE ABLE TO DRIVE AFTER, SAY, 1 WEEK? Absolutely not especially since it's your right foot. You won't start to feel normal and not 'foggy' for a few weeks after the surgery, even if your not on pain meds. Plus you will have pain just from the vibration from the car and just having your foot down for more than 5 minutes after 1 week.
WILL I BE ON CRUTCHES IN SEPT? 5 months after surgery? Probably no crutches by then but I wouldn't plan on walking normally or without a limp by then. Usually it is 12 weeks non weight bearing and then gradually back to full weight bearing. Things will be stiff when you first start to walk.
WILL I EVER BE ABLE TO RUN AGAIN? Minimal activity isn't recommended until at least 6 months out and my OS as well as Abby's (who is running now) said not until 9 months or so. Honestly, you can run or do activities as soon as you want, but all you would be doing is compromising this surgery, risking another (or worse) and reducing effectiveness of this surgery. As my OS said, OATS could last me 10 years, 20+ years or 5 years ... all depends on how I treat my ankle from this point on and given the recovery for this is so important as the plugs incorporate into your talus, I am not sure why anyone would want to rush back to normal activities. No activity is important enough to make me go through this or another ankle surgery again.
HOW BIG OF AN ISSUE IS IT IF I SKIP PT FOR 1 OR TWO WEEKS 8 WEEKS AFTER SURGERY Movement is important after this surgery to help healing as bloodflow to the area will not only help move the fluids that have collected (reduced swelling = reduced pain) but will also help avoid any nerve issues such as RSD which are a concern after any surgery. If you can, I would at least go to PT the first time to see what you should do and then do it on your own, but at least knowing what you can/can't do would help you get through those first few weeks.
I hope this helps ... there are a lot of conversations about OATS on here .. go to "Advanced Search" above and put in the terms "OATS", "OCD" and search the foot forums and you'll see probably more detail than you'd like, but you'll be better prepared.
Kim :)
akirka
03-17-2009, 03:05 PM
Mstreet,
Really glad you found this site because this is an unusual surgery and it really helps to talk to others who have been through it. Do you have help from another relative or friend while your husband is away? I think with 2 little kids help is going to be essential for at least 3-6 weeks. I agree with Kim that you cannot drive for at least 3-4 weeks so you need to start planning transportation for you and your family. If you're going to do this surgery, you got be serious about it - this is your future mobility and it sounds like you have a severe injury. If you take it easy and follow all Dr. instructions (no shortcuts) you will definitely improve your chances of a good outcome and no ankle repalcement! I had crutches and a Roller-Aid (scooter), but also a wheelchair. The wheelchair was a godsend when I needed to transport things, carry my dinner, laundary, etc. And it reduces the chances of falling on the surgery foot. I was in the hospital for 2 days and they really drug you out! :dizzy: I was different from the other gals, my knee/donor site hurt worse than my ankle. At 5 months I was walking slowly, no crutches, had stiffness and aches but was rapidly improving. You'll be able to stand in the wedding but maybe not boogey all night on the dance floor! Probably no high heel shoes either so I would warn your friend! I wore cute Crocs sandals at my friend's wedding and it was like walking on marshmallows. Skipping some PT is fine, you can do exercises on your own, but definitely go back! I would say that my true running days are over. I used to run 4-5 miles a day, on hard surfaces, up hills, on rocks, but no more. You have to learn to be happy that you can walk pain-free. I 'run' some but it's only on a flat, soft surface and no more than 2 miles; once or twice a week. It's just not worth ruining my foot to do more. So that's my 2 cents. I'm 14 months out from surgery and feel WAY better! Write with any questions
Abby :)
Really glad you found this site because this is an unusual surgery and it really helps to talk to others who have been through it. Do you have help from another relative or friend while your husband is away? I think with 2 little kids help is going to be essential for at least 3-6 weeks. I agree with Kim that you cannot drive for at least 3-4 weeks so you need to start planning transportation for you and your family. If you're going to do this surgery, you got be serious about it - this is your future mobility and it sounds like you have a severe injury. If you take it easy and follow all Dr. instructions (no shortcuts) you will definitely improve your chances of a good outcome and no ankle repalcement! I had crutches and a Roller-Aid (scooter), but also a wheelchair. The wheelchair was a godsend when I needed to transport things, carry my dinner, laundary, etc. And it reduces the chances of falling on the surgery foot. I was in the hospital for 2 days and they really drug you out! :dizzy: I was different from the other gals, my knee/donor site hurt worse than my ankle. At 5 months I was walking slowly, no crutches, had stiffness and aches but was rapidly improving. You'll be able to stand in the wedding but maybe not boogey all night on the dance floor! Probably no high heel shoes either so I would warn your friend! I wore cute Crocs sandals at my friend's wedding and it was like walking on marshmallows. Skipping some PT is fine, you can do exercises on your own, but definitely go back! I would say that my true running days are over. I used to run 4-5 miles a day, on hard surfaces, up hills, on rocks, but no more. You have to learn to be happy that you can walk pain-free. I 'run' some but it's only on a flat, soft surface and no more than 2 miles; once or twice a week. It's just not worth ruining my foot to do more. So that's my 2 cents. I'm 14 months out from surgery and feel WAY better! Write with any questions
Abby :)
demogoat
03-17-2009, 11:05 PM
Mstreet,
I think everyone has pretty much hit your questions but I want to add that YES, you want a wheelchair. I have three kids (4, 6, and 8) and it was a huge help in the kitchen because I could do a few things and keep my foot elevated (an absolute must for pain control) while also getting things to and fro in my lap without having to negotiate crutches. So unless your little ones are self sufficient, get the wheelchair - you will appreciate it when you are drugged out! Good luck and post more questions if you have them.
Margaret
I think everyone has pretty much hit your questions but I want to add that YES, you want a wheelchair. I have three kids (4, 6, and 8) and it was a huge help in the kitchen because I could do a few things and keep my foot elevated (an absolute must for pain control) while also getting things to and fro in my lap without having to negotiate crutches. So unless your little ones are self sufficient, get the wheelchair - you will appreciate it when you are drugged out! Good luck and post more questions if you have them.
Margaret
krisj5kids
03-18-2009, 02:06 PM
I would like to add that my dr. okay'd running for me at 3 mos. I wouldn't have run if he didn't tell me it was okay. I know many have said 6 mos, but I was following dr.'s orders and he said he was aggressive with rehab and getting back into activities. I have no done anything I was not supposed to do. I agree that following rehab schedule is important. I saw my dr. today and he didn't say anthing about me not running or that I ran too early. He knows how often and how far I run and he was okay with it.
mstreet2379
03-18-2009, 08:37 PM
Thank you all so much for all your answers! And as a response... no, I won't have much help post-operativly. My significant other can't come home until late August. So far, all I've got arranged is the kids staying with the grandparents for the first week, and planned on playing it by ear from there... but if I'm not going to be able to drive for over 3 weeks, I need to clearly research more options for help with my kids.
DO YOU THINK THAT IF I HAVE THE KIDS IN DAYCARE 8 HOURS A DAY I'LL GET BY?
Also, I WONDERED WHAT THEY USE FOR POST-OP PAIN MANAGEMENT. I've already been on Oxycontin for chronic pain due to this, but taken off due to my high tolerance level(s). So, we need me to be off of the Oxycontin until surgery to try to prevent my tolerance from going any higher, so we still have options for pain control. IS MORPHINE AN OPTION IF THE "NORMAL" DOESN'T WORK? I'm so use to the narcotic pain releivers, as nothing else really works... I can function at 110% while on them. Sad to say, I know. Sometimes I feel like I can be a better mom when I do need to take them, because there seems to be no pain, no inflamation, no aching... AND, as superficial as this may sound, it seems as though I've got more mobility while the medication is active in my body. In addition to that, when I'm not in pain, I'm not irritable... even my daughter has made the comment on my "flare up" days when I medicate... "Mom, you're being super nice today! AND you're even playing really fun games with us!"
Yea, this condition really bites... I felt so horrible when my daughter said that to me.
Another question... how much weight did ya'll gain post-op? Really, that's the least of my worries, but hey, I am a female and we all worry about our "girlish figures". :-) My goal is to lose 15lbs. pre-op, so that if I do gain weight, I should be right back around where I started when all is said and done. Ideally, I'd like to con't to lose weight, as thats just less weight on my ankle/foot during recovery.
DO YOU THINK THAT IF I HAVE THE KIDS IN DAYCARE 8 HOURS A DAY I'LL GET BY?
Also, I WONDERED WHAT THEY USE FOR POST-OP PAIN MANAGEMENT. I've already been on Oxycontin for chronic pain due to this, but taken off due to my high tolerance level(s). So, we need me to be off of the Oxycontin until surgery to try to prevent my tolerance from going any higher, so we still have options for pain control. IS MORPHINE AN OPTION IF THE "NORMAL" DOESN'T WORK? I'm so use to the narcotic pain releivers, as nothing else really works... I can function at 110% while on them. Sad to say, I know. Sometimes I feel like I can be a better mom when I do need to take them, because there seems to be no pain, no inflamation, no aching... AND, as superficial as this may sound, it seems as though I've got more mobility while the medication is active in my body. In addition to that, when I'm not in pain, I'm not irritable... even my daughter has made the comment on my "flare up" days when I medicate... "Mom, you're being super nice today! AND you're even playing really fun games with us!"
Yea, this condition really bites... I felt so horrible when my daughter said that to me.
Another question... how much weight did ya'll gain post-op? Really, that's the least of my worries, but hey, I am a female and we all worry about our "girlish figures". :-) My goal is to lose 15lbs. pre-op, so that if I do gain weight, I should be right back around where I started when all is said and done. Ideally, I'd like to con't to lose weight, as thats just less weight on my ankle/foot during recovery.
krisj5kids
03-18-2009, 09:50 PM
Yeah, you'll need to research the driving part. I know someone who has driven with their right foot in a cast, but if you ever got in an accident....
For the pain, I had this GREAT thing called an OnQ. It was a nerve block with the anesthetic in a ball that I could wear. It numbed my leg and so I took no pain medicine at all when I had the OnQ. When it wasn't working (for the a 24 hour period in the hospital it didn't work) I was on morphine and dilutid sp? which was horrible and made me puke. So I just did morphine. But the nerve block, if it is available, it is great. I even was able to wear it at home.
I did gain weight. My first surgery I gained 20 lbs so I made a concious effort to not gain weight this time. I did okay until we went to Hawaii on vacation and Christmas came along. So I ended up gaining about 10 lbs. I've lost most, but not all of it.
For the pain, I had this GREAT thing called an OnQ. It was a nerve block with the anesthetic in a ball that I could wear. It numbed my leg and so I took no pain medicine at all when I had the OnQ. When it wasn't working (for the a 24 hour period in the hospital it didn't work) I was on morphine and dilutid sp? which was horrible and made me puke. So I just did morphine. But the nerve block, if it is available, it is great. I even was able to wear it at home.
I did gain weight. My first surgery I gained 20 lbs so I made a concious effort to not gain weight this time. I did okay until we went to Hawaii on vacation and Christmas came along. So I ended up gaining about 10 lbs. I've lost most, but not all of it.
dizzizzi99
03-18-2009, 10:38 PM
Mstreet,
I would plan on 3 days hosp. Also a chair FOR SURE. on crutches you will not be able to carry anything plus all the kitchen work too. Also I have both ankles mssed up and the constant crutching on a leg that is also sore or messed up will be difficult. So to help keep the other leg healthy I say get a chair. I actually did not have so much trouble with the pain at first. The cast making my staples dig into my leg was the worst but then you get booted and you can get relief from that. I say at first cause it gets worse as theropy starts in my opion. AS far as driving it is not legal to drive with a cast or boot on in most states so check on that. By Sept you will be without crutches and may limp You are fortunate to have age on your side and my heal faster than some of us. If both of your legs have issues still keep in mind that it will take a long time to heal. Rushing any of the recoop usually results in a even longer time. Taking a LONG year to heal is not as bad as loosing the ankles for ever. So try and take your time, listen to the doc, err on the side of caution. I wish you the best. Watch the meds on your stomach I ended up in the hosp with messed up stomach and esophagus lining.
Diane
I would plan on 3 days hosp. Also a chair FOR SURE. on crutches you will not be able to carry anything plus all the kitchen work too. Also I have both ankles mssed up and the constant crutching on a leg that is also sore or messed up will be difficult. So to help keep the other leg healthy I say get a chair. I actually did not have so much trouble with the pain at first. The cast making my staples dig into my leg was the worst but then you get booted and you can get relief from that. I say at first cause it gets worse as theropy starts in my opion. AS far as driving it is not legal to drive with a cast or boot on in most states so check on that. By Sept you will be without crutches and may limp You are fortunate to have age on your side and my heal faster than some of us. If both of your legs have issues still keep in mind that it will take a long time to heal. Rushing any of the recoop usually results in a even longer time. Taking a LONG year to heal is not as bad as loosing the ankles for ever. So try and take your time, listen to the doc, err on the side of caution. I wish you the best. Watch the meds on your stomach I ended up in the hosp with messed up stomach and esophagus lining.
Diane
tijean
03-22-2009, 10:41 AM
I see on this thread the subject of weight gain pre and post op is a real topic. I actually lost 15 lbs throughout this ordeal. I was so freaked about gaining weight and having the cast even tighter than it was. I know my injury is different from some, but the break was severe...my ankle was pointing east and my foot was pointing west, not a sight I ever want to see again.
I looked up foods and supplements that promote bone growth....Spinach, Sweet potatoes, Broccoli, Almonds, Onions, Soy, Tomatoes, Salmon, Apples, Grains etc (no junk food, Chinese food... ever, it makes you feel crappy and retain water)...and have been taking supplements...Multi Vitamin, Chondroitin, Magnesium, Glucosamine, Calcium, Omega 3 and Silica Gel, religiously.
I know it has helped. My nails look better than ever and I was in an air cast boot in 5 weeks and 2 days...rather than the predicted at first, 6 or 7 weeks. My biggest problem now is getting the boot to a manageable level of comfort.
It's two weeks now since my cast has come off and the swelling is really down...color is good...almost normal looking and my range of motion is surprising. My physio guy said I will not be in the boot for another 4 weeks as was also predicted. I guess I have approached this recovery like a project at work...researching and diligence in execution. Focusing like that has helped keep the "creepiness" at bay as well.
I looked up foods and supplements that promote bone growth....Spinach, Sweet potatoes, Broccoli, Almonds, Onions, Soy, Tomatoes, Salmon, Apples, Grains etc (no junk food, Chinese food... ever, it makes you feel crappy and retain water)...and have been taking supplements...Multi Vitamin, Chondroitin, Magnesium, Glucosamine, Calcium, Omega 3 and Silica Gel, religiously.
I know it has helped. My nails look better than ever and I was in an air cast boot in 5 weeks and 2 days...rather than the predicted at first, 6 or 7 weeks. My biggest problem now is getting the boot to a manageable level of comfort.
It's two weeks now since my cast has come off and the swelling is really down...color is good...almost normal looking and my range of motion is surprising. My physio guy said I will not be in the boot for another 4 weeks as was also predicted. I guess I have approached this recovery like a project at work...researching and diligence in execution. Focusing like that has helped keep the "creepiness" at bay as well.