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Another Personal Update and Changing Plans

We’d been hoping to be done with chemo and moving toward a bone marrow transplant for my wife. Unfortunately, the scan eight days ago showed several masses in my wife’s abdomen. So we’ve spend most of the past week in the hospital, where they worked on pain management, hit the cancer with radiation, and began a new chemotherapy regimen.

Chemo will continue for approximately two months. This type of chemo attacks the cancer differently, so the hope is that while the cells may have developed some resistance to the prior chemo, this new type will wipe them out.

If all goes well, the doctors are talking about maybe using CAR T-cell therapy after chemo. Ideally, we’re hoping this would be the new “finishing move” against the cancer.

It’s been a difficult and scary week. I’m so grateful to friends and family who’ve been helping out and providing so much support while we try to cope with everything. We were able to get Amy out of the hospital yesterday afternoon, which is good. Now … now we’re back to waiting and hoping.

I don’t know how active or responsive I’ll be online. I hope the next one of these updates comes with better news.

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Cool Stuff Friday

Friday is off to a slow start today.

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Cool Stuff Friday

Friday is starting a petition to rewrite Monday.

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Geese! (And one not-a-goose)

Last night, I took the camera and visited the ponds by our high school, where the geese have been raising a new crop of cute little poop-monsters.

I posted a few of these pics on Facebook and Twitter, but wanted to share more of them here.

I think somebody spotted me.

Snacking on some yummy dandelion.

I love this family photo.

Just hanging out with the bigger birds…

Pregnancy and Biology 101

I originally titled this “Pregnancy 101 for Guys,” but given the state of sex education in the U.S., I suspect many of us need some additional learning regardless of gender. But I’m mostly looking at my fellow guys with this thing, especially with all of the recent debate and discussion. Some of this is information I wish I’d learned sooner. Hopefully it will be helpful to others.

This is a very incomplete list. Factual corrections are appreciated. And if you’ve encountered additional myths that need busting, feel free to add them to the comments. (I considered just turning comments off, but I’ll leave them open for now and we’ll see what happens.)

Periods can’t be turned on and off like a tap.

I don’t even know what to say to this one, which came from a Twitter thread. But, um…

  • Periods happen when the uterus sheds its lining, resulting in bleeding from the vagina.
  • Periods generally happen about once a month, and last for about 5 days. Neither of these numbers are exact.
  • For some people, periods are relatively regular and predictable. For others, not so much.
  • No, it’s not like peeing. You can’t just “hold it.” WTF is wrong with you, man?

Fertility is cyclical.

About halfway through the menstrual cycle, the ovary releases an egg into the fallopian tube. That egg lives about 12-24 hours after leaving the ovary. If it’s not fertilized, the egg dissolves, and the cycle continues.

This doesn’t mean there’s only a 12-24 hour window when sex can result in pregnancy. Sperm can survive up to five days in the fallopian tubes. If you and your partner have sex, and your partner ovulates two days later, that’s when sperm and egg would potentially meet. In other words, fertilization would occur two days after you had sex.

(This should also help explain why some emergency contraception works by preventing ovulation after sex.)

Conception isn’t instantaneous.

“It can take anything from 45 minutes to 12 hours for a sperm to reach your fallopian tubes, which is where conception usually happens.” (Source)

And once the sperm reaches the egg, “it takes about 24 hours for a sperm cell to fertilize an egg.” (Source)

“X Weeks Pregnant” isn’t the number of weeks from conception.

“Gestational age is the common term used during pregnancy to describe how far along the pregnancy is. It is measured in weeks, from the first day of the woman’s last menstrual cycle to the current date. A normal pregnancy can range from 38 to 42 weeks.” (Source)

In other words, someone who is “six weeks pregnant” has not actually been pregnant for six weeks.

Pregnancy tests don’t work instantly after conception.

“If you are pregnant, your body needs time to develop detectable levels of [human chorionic gonadotropin (HCG)]. This typically takes seven to 12 days after successful implantation of an egg.” (Source)

Healthline advises waiting until the week after your missed period for an accurate pregnancy test result.

If the average menstrual cycle is 28, and gestational age is measured from the first day of the last menstrual cycle, this means you’re already considered to be a minimum of five to six weeks pregnant by the time you get an accurate result from your pregnancy test.

Conception =/= Pregnant.

“Conception doesn’t always mean that a pregnancy will occur and be carried to full term.” (Source)

The American College of Obstetricians and Gynecologists notes, “Fertilization, the union of an egg and a sperm into a single cell, is the first step in a complex series of events that leads to pregnancy.” (Source, Emphasis added)

It takes around a week, give or take, for the fertilized egg to implant in the uterine lining.

Whether you agree or disagree — and I have no doubt people will continue to argue this one — the ACOG has stated that “pregnancy begins upon the implantation of a fertilized egg into the lining of a woman’s uterus. This typically takes place, if at all, between 5 and 9 days after fertilization of the egg – which itself can take place over the course of several days following sexual intercourse.”

What is ectopic pregnancy?

In some cases, the fertilized egg implants outside of the uterus, most often in the fallopian tube. “The fertilized egg can’t survive, and the growing tissue may cause life-threatening bleeding, if left untreated.” (Source)

The incidence of ectopic pregnancy is 1-2% in developed countries. (Source)

Ectopic pregnancy is treated with either medication or surgery to prevent the development of the fertilized, implanted egg, in essence terminating the pregnancy.

Pregnancy can be dangerous. Especially in the U.S.

“With an estimated 26.4 deaths for every 100,000 live births in 2015, America has the highest maternal mortality rate of all industrialized countries—by several times over.” (Source)

“African-American, Native American and Alaska Native women are about three times more likely to die from causes related to pregnancy, compared to white women.” (Source)

We have got to do better with health care, people…

In Other News, Cancer Still Sucks

We found out yesterday that a friend of Amy’s passed away last week from complications of leukemia/lymphoma. From everything Amy says, this was an incredibly good-hearted and compassionate person. So we’ve got the grief over losing a good person, as well as all of the fear this stirs up for our own situation.

Not much has really changed since last month. Amy finished up another round of chemo on Monday, so she’s pretty wiped out. There are some cumulative effects, so the exhaustion and stuff gets a little harder each time, but she’s getting through it.

The next step is another round of scans to see if she’s in remission and decide whether we can move on to the bone marrow transplant. We had a consult with the bone marrow transplant director in Detroit a week or two back. There are still a fair number of unknowns — not only the scan results, but whether her bone marrow is healthy enough for an autologous transplant. That’s where they use the patient’s own stem cells rather than getting a donor, which is what we’re hoping for. (Faster recovery, no rejection issues.) But her younger brother will be getting tested to see if he’s a match, just in case.

We meet with the oncologist again tomorrow. Hopefully we’ll get things scheduled soon, because all this waiting and uncertainty sucks.

Inigo Montoya - I hate waiting

I’ve been continuing to work to get the house ready. Chemo suppresses the immune system, and bone marrow transplant does the same, so there’s a lot of worry about potential infections and such. We’ve got people ripping out the gross carpet in the basement today, replacing it with vinyl laminate that should be a lot more sanitary. I’ve done a lot of dusting and cleaning and decluttering. It’s never going to be hospital-level sanitary, but we’re making progress.

I think we’re all feeling a bit burnt out by everything, but we’re getting through.

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I managed to make it out to see Endgame on Sunday 98% spoiler-free! Good timing, too. Later that night, I stumbled across at least three different spoilers on Twitter and Facebook.

General impression: I liked it better than Infinity War. Nothing about Endgame really shocked me, but I had fun, and it’s an impressive capstone to a decade of storytelling over 22 movies.

All right, spoiler stuff beyond the cut tag…

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Cool Stuff Friday

Friday only needs to dodge spoilers for another two days!

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Cool Stuff Friday

Friday is a spoiler-free zone.

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The Umbrella Academy (Spoilers)

I finally got around to watching The Umbrella Academy on Netflix, after hearing lots of mostly-positive comments and reviews. Naturally, I must now share ALL OF MY OWN COMMENTS AND REVIEWS. Such is the nature of the internet…

I mostly enjoyed it, though the ending felt empty and unsatisfying.

Details behind the spoiler cut…

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Another Personal/Family Update

We have a slightly more concrete plan for the coming weeks, with the understanding that plans can change from day to day based on test results, scheduling issues, the whims of the insurance companies, and more.

Amy’s currently going through her third round of R-EPOCH chemotherapy (her fifth or sixth total round of chemo, depending on how you count them.) The goal is to do one more round the first full week in May, then do another CT scan. If she looks cancer-free at that time, we’ll move on to the bone marrow transplant step.

I got choked up the first time the phrase “cancer-free” came up. There’s so much hope and fear wrapped up in those two words, and in the results of that scan a month or so from now. We know she’s responded well to treatment so far, but there’s so much unknown…

We got to spend some good family time together for my birthday weekend, which was nice. I ate way too much, which was also nice 🙂

I’d like to believe the end is in sight, and we’re starting to move toward the next steps of her recovery and rebuilding our new normal. The whole family is pretty damn tired of cancer and chemo and all the rest. This crap gets old pretty quick.

We learned something exciting this week, though. Amy’s been using an infusion pump that delivers her chemo cocktail over the course of 3-4 days. But the tubing has sprung a leak at least three different times, all in the same spot. It looks like the chemotherapy meds are actually eating through the air filter in the line. These are the chemicals they’re pumping into my wife’s body…

Well, if they eat through filters, hopefully they’ll gobble up cancer cells even better.

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U.S. Health Insurance: It’s a Trap!

Let me preface this post by saying, thanks to a clause in the ACA and a significant amount of luck, we’re all right.

The default in the United States is that you’re supposed to get insurance through your employer. The employer picks up some/most/all of the cost, and that coverage is considered one of the benefits of employment.

As you may recall, back in December, my wife was diagnosed with an aggressive stage 4 lymphoma. She spent about six weeks in the hospital, and if everything goes well and the chemo and bone marrow transplant both work, she might be able to go back to work at the end of the summer.

Fortunately, we have relatively good health insurance coverage. According to the benefit statements, her treatment has cost somewhere between half a million and a million dollars so far. We’ve only been responsible for a very tiny fraction of that cost.

Jump to last week, when we got a letter from a benefits management company. Because my wife hadn’t been working since late November, her benefits were being cancelled. The official reason was “reduced work hours.” Our options were to either pay for COBRA coverage to continue on the plan we had, or we could go to the Health Exchange to find a new plan. Either way, we were now responsible for the full cost of our health insurance. In addition, if we chose a new plan, we’d be responsible for any new deductibles.

Here’s where the luck kicks in. Back when I tried to quit my day job a few years back, they created a part-time position for me, one I could do mostly from home. And as a result, I could continue to receive health insurance (but not vision or dental) through that job.

The benefits management letter was telling us our family’s dental and vision insurance were no longer covered by my wife’s company. But we still have health insurance.

COBRA costs to continue dental and vision are about $150 a month for our family. We can handle that. What would have been a lot harder would be paying probably $1000-$2000 per month so we could continue getting health insurance through COBRA.

Cobra Commander

Think about it.

  1. You get health insurance through your employer, just like you’re supposed to.
  2. You get really sick. Fortunately, you have health insurance! Well done, you!
  3. Because you’re sick, you can’t go to work. A few months later, you lose your health insurance.
  4. Surprise! Not only are you on reduced income from not working, you’ve got to cover a couple thousand dollars of new expenses every month!

We’ve designed a system that abandons people when they need it the most. Is it any wonder we see hundreds of thousands of families declaring bankruptcy every year because of medical expenses?

Ackbar: It's a trap!

If my employer hadn’t really wanted to keep me on – so much that they created a new position for me,  and if the ACA hadn’t allowed me to continue receiving health insurance through them, I would currently be A) panicking like a cat in a cucumber field, and B) looking into GoFundMe and other ways of making sure we can continue to afford to keep my wife alive.

That we put people in this position when they’ve done everything “right” in terms of finding a job and working for years for their benefits – hell, the fact that we put anyone in this kind of position, period – is obscene. The whole for-profit approach to health care in this country is literally killing people.

My family is very fortunate in many ways, and we’re all right for now. But as a country, we have got to do better.

Writing Advice, Part 1 of [Shrug Emoji]

Over on Goodreads, someone asked me for advice for people who want to be authors. That’s a pretty broad question, and comes up in one form or another pretty routinely. So I’m gonna break it down into bite-sized chunks and post stuff as I have time and inspiration.

1. Why are you asking me?

I’m not saying you shouldn’t ask me for advice, but why are you? Do you know anything about my career or what I write, or are you taking a shotgun approach and asking anyone and everyone you can find? My advice will be based on my experiences and my goals, which won’t be the same as yours. Recognizing those differences can help you know when to follow — or not follow — my advice.

2. Ask around, but avoid the “Preachers.”

Every author’s career path is different, so it’s good to ask around. Follow other authors online, read their blogs and learn about their experiences. Lots of us are very open about this stuff. But be very careful about anyone who insists they know the One True Path to publishing success. There isn’t one. If someone sounds like they’re on a Crusade, just smile and nod and back away.

3. It’s okay to write crap.

In the early part of my career, perfectionism was killing my productivity. Very few authors can produce publishable first drafts. I had to shut off the editor brain and just write. Once I had something on the page, I could go back and make it better, but you can’t revise a blank page. And if you spend all your time trying to make the first page perfect, you’ll never write page two.

4. Stock up on patience.

One way or another, writing and publishing tend to be slow. DAW published Goblin Quest more than five years after I’d finished writing it. Finding an agent was a multi-year endeavor. And the writing itself…some of these books take me more than a year to write. Being a writer is a long-term thing, not an overnight transformation.

5. What are your goals?

Do you want to see your book in bookstores? Do you want to write one book or many? Do you want to make a living at this? Do you want to write fanfiction or tie-in fiction or original stuff or all of the above? What’s driving you to write in the first place? Figuring out exactly what you want will help you figure out how to get there.

6. Read in your genre.

Read older stuff so you know what’s been done and how the genre has changed. Equally or more important: read new stuff so you know what’s being done today. Hint: publishers aren’t buying the same stuff they were buying fifty years ago, or even ten years ago.

7. Read outside of your genre.

I’ve found this to be a great way of learning new techniques and tricks for compelling storytelling. Read poetry to learn about word choice and imagery and rhythm. Read romance to learn about writing engaging relationship conflicts and resolution. Read comedy to learn humor. Read scripts to study dialogue.

8. Write.

This is the big one. If you want to be a writer, write. Get some words on the page, good or bad, and then write some more. Write what excites you. Write what makes you laugh or cry. Write what knots your guts up with fear. Write gorgeously. Write crap. Write your stories.

Cool Stuff Friday

Friday will be DMing “The Lost City” for his son’s slumber party tonight.

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Bounding Into Comics vs. Fonda Lee

I got to meet and hang out with author Fonda Lee at the Launch Pad Astronomy Workshop a few years back. Recently, Lee was at Barnes and Noble and observed:

“This is what modern fantasy writers are up against. In my local B&N, most authors are lucky to find a copy of their book, super lucky if it’s face out. There are 3.5 shelves for Tolkien. 1.5 for Jordan. Here’s who we compete against for shelf space: not each other, but dead guys.” (Source)

Her Tweets got a lot of attention, leading to an article by John Trent at Bounding Into Comics that derides Lee and accuses her, among other things, of criticizing Tolkien. Not that Lee ever did this. Her second Tweet in that thread said, “Before you @ me about the importance of classics, I love LOTR too, okay?” One might almost suspect Trent’s comment, “Lee isn’t the first person to criticize Tolkien,” of being an attempt to stir up shit.

An effective attempt, it seems. Lee has been barraged by Tolkien Defenders over on Twitter.

Trent opens his article with the claim, “Science Fiction and Fantasy author Fonda Lee, the writer of the Green Bone Saga, decried Barnes & Noble for stocking popular fantasy authors J.R.R. Tolkien and Robert Jordan.”

Nowhere does Lee say B&N shouldn’t stock Tolkien and Jordan. She’s complaining that these two authors get 4-6 shelves in the B&N SF/F section, which means other authors are left with little or no space at all.

Back to Trent:

“Fonda then explains the business that Barnes & Noble is in. She describes it as as ‘a place of discovery.'”

Lee’s actual Tweet:

“If you think a bookstore should be a place of discovery, who goes into B&N and ‘discovers’ Tolkien? Do they figure people want another 5 copies of LOTR and aren’t interested in all the other work out there?”

Lee isn’t booksplaining the business Barnes & Noble is in. She’s talking about one aspect of bookstores — discoverability. Nowhere does she say that’s the sole purpose of B&N.

And she’s not wrong. For readers looking to discover new books and new authors, 4-6 shelves of two dead fantasy authors is a hindrance. It also makes things harder for other authors trying to get their own work out there.

All in all, Trent’s article seems less about accurate reporting and more about distorting someone’s comments to sic the trolls on her and stir up a game of, “Let’s you and her fight.”

Numerous commenters are happy to take his bait, attacking Lee as an author, claiming she doesn’t write well and she should try “not to suck.”

Let’s see here… Fonda Lee won the World Fantasy Award, the Aurora Award (twice), had her work named a Best Book of 2017 by NPR, SyFy Wire, and — oh yes — Barnes & Noble. She’s been a finalist for the Andre Norton Award, the Nebula Award, and the Oregon Book Award. She won the Oregon Spirit Book Award, and was a YALSA Top Ten Quick Pick for Reluctant YA Readers.

Reader, I wish my writing could “suck” as well as Lee’s!

Now, there is a valid point buried in the article and comments. Bookstores are a business, just like publishers and all the rest. Their goal is to make money, and that means stocking books they believe will sell the best. Tolkien and Jordan sell a lot of books.

But there’s also some chicken-and-egg logic to untangle here. All other factors being equal, an author with a three-shelf display is going to sell a hell of a lot better than an author with one or two books squeezed spine-out on the shelf. Bookstores and publishers choose which books to promote, which books to put face-out, which books to put on table or end cap displays, and so on. All those things help to sell books.

Writing a good book helps a lot too, but let’s not pretend that’s the only factor in a book’s commercial success.

The emphasis on these books also sends a message about what kind of customer B&N is targeting. Lee notes that her store had:

  • 18 copies of Lord of the Rings
  • Only 1 copy of the Nebula- and Hugo-award winning The Fifth Season
  • Only 1 copy of Lee’s own World Fantasy Award-winning Jade City

Three titles isn’t enough to make any statistically sound conclusions. But this doesn’t suggest that B&N is interested in a broader, more diverse range of customers, or that they want customers who are looking to discover newer, exciting authors. It feels like “more of the same” marketing. “If you liked this dead white guy’s fiction, you might also like this other dead white guy’s fiction.”

Barnes & Noble knows books by Tolkien and Jordan are reliable sellers. They’re safe.

It’s a choice. B&N has the right to make whatever choice they want about who to feature and how to fill their shelves. Lee’s comments simply point out that this choice hurts discoverability for both authors and readers. She also thanks independent bookstores, which are often more willing to take risks, to customize their selection for their local readers, and to focus on more than just the safe same-old.

I wonder if that’s one of the reasons for the resurgence in independent bookstores

In the meantime, Lee’s book Jade City has been sitting in my TBR pile for a while. I may need to bump it to the top.

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Jim C. Hines
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