-10 attack, -10HP, +5d6 damage?
Alright, add:
• lady's gambit (6hp for +3 to attack and damage)
• Masochism (+1 to a bunch of things, including attack, per 10 taken, until the next turn) +1 attack :-/
• Reckless Attack (May subtract up to BAB from AC and add that value to damage instead. x2 with two-handed weapons.) -6 AC, +12 Damage
• Unerring Strike (Reverse Power Attack) -6 damage, +6 attack
Now we have +0 attack, -16 HP, -6 AC, +(5d6+9) damage, with only 4 more damage taken to get a +1 attack.