James Samiany learned to live alone after losing his wife and two sons in a fiery crash in Colorado more than 35 years ago.
But now, the retired engineer was lying on the floor of his bedroom, wondering whether he could pick himself up.
He had been putting on his pajamas at the edge of his bed when he slid off the silk comforter and fell on his face.
He had just returned home from back surgery, his spine supported by two steel bars running from his neck to lower back, and any attempt to raise himself caused excruciating pain.
Samiany, then 79, grabbed the blankets in an effort to lift himself onto the bed, but everything he pulled came down on the floor.
That night of Feb. 15, 2006, he crawled on his belly around his apartment until sleep overcame him. He spent the next five days on the floor with no food or water. He had no nurse or family members who checked on him and was unable to yell loud enough to summon a neighbor in the condominium complex.
When emergency personnel finally broke the door open, they found the apartment covered in his urine and feces. "It was a like a cesspool," said Samiany, who is now 81.
As an avid walker and a regular at the Modesto YMCA gymnasium, Samiany was better equipped than most seniors to prevent a life-threatening fall.
But he needed an operation two years ago to correct a previous surgery on a bulging disc in his spine.
His mobility was limited after the February 2006 procedure at a Sacramento hospital, and he lives alone, so he didn't have anyone to assist him.
"When you are recovering from surgery, especially a knee or hip replacement, that is an exceptional time when you are at risk of falling," said Jill Erickson, a manager with Stanislaus County Aging and Veterans Services.
The county agency is part of a coalition that is trying to reduce the number of fall-related injuries among seniors.
After falling to the floor, Samiany spent most of his waking hours trying to get on his feet. It was painful to raise his arms and he could barely grab the side of his coffee table. He tried to latch onto a stand holding his stereo, but it fell on top of him.
He would crawl the floor looking for other hand holds, become exhausted, pass out and wake up again.
"You are helpless; that is the sense that comes over you," he said. "You start thinking about your life, your past. I was thinking, 'What a way to die.' "
The son of a Russian father and Greek mother, he was born in Iran when his father was working in the old fields of that country. The family moved to England, where Samiany finished high school at age 15. He promptly left home to escape his hard-drinking, abusive father, he said.
His grades got him into the University of Cambridge, where he studied history and the social sciences. He had to work nights in a steel mill to pay bills, he said.
After earning a degree, he worked for the United Nations in New York in 1949 and 1950, but felt the organization was ineffective and quit.
Earning a civil engineering degree at the University of Illinois, he worked for firms in different states and was raising two sons with his wife, Rosemary, when his life took a tragic turn about 1970.
His wife and children were killed when the car she was driving crashed into a power pole in Colorado. He became demoralized and avoided emotional attachments after their deaths, he said.
He worked on projects in Victorville, Tracy and Modesto before retiring here in 1991.
After spending five days on the floor, he had almost given up when an idea popped into his head.
He crept over to his desk and found the telephone cord underneath it. When he pulled on the cord, the phone fell from the desktop, struck a chair and landed on the carpet. The body of the phone was broken, but he was able to dial 911.
He's still embarrassed that he didn't think of that before.
"I was disoriented for a long time," he said last week. "I had my mind set on finding some way to get up. I don't like to ask for help if I can help myself."
When emergency personnel arrived, they told him to back away from the door and then broke the door open. Samiany's injuries included bruises on his face, severe dehydration and a dramatic loss of weight. He was taken to a hospital and then transferred to a Kaiser Permanente hospital in Fremont.
He spent more than two months in hospitals and Garden City Health Care Center in Modesto, where he was put through exercises to regain his strength.
Samiany, who now uses a cane, has adopted measures to keep from falling again.
He uses equipment designed to assist seniors with daily living, such as elastic strength bands to build muscles in his arms and legs and a device for putting on his socks.
He walks two to three miles a day and likes to take the bus to downtown Modesto to get to the post office or library.
He has five telephones in his apartment, as well as 3-foot-long grabbers for picking up items, so he doesn't have to bend down. He remains active as a county election volunteer.
Although he might have "the strongest legs anyone can have at my age," he watches his step and avoids sudden movements that could disturb his balance. In addition, his landlord and people from the Area Agency on Aging call to check on him occasionally.
"I saw the shadow of death pass over me," he said last week. "I am very careful not to do stupid things."
Erickson said Aging and Veterans Services receives requests for in-home assistance when seniors are discharged from hospitals. It's important to assess the home environment for fall hazards and discuss what assistance the person will need during recovery, she said.
It also helps to have support from family or friends. "A lot of people don't reach out to their family," Erickson said. "They think they can do it all."
Bee staff writer Ken Carlson can be reached at email@example.com or 578-2321.