Writing Hiatus and Other Changes

There’s no real news on the cancer front. If all goes well, Amy will get the next dose of chemo on Monday and Tuesday. But we have to wait a bit longer to see if and how well this is working. We’re also waiting on insurance approval for the CAR T-cell procedure she needs. In the meantime, she’s still pretty weak, but her pain is better managed, which helps a lot.

This last round – discovering the masses in her abdomen after six months of chemo and treatment – flipped a switch in my brain. Before, I’d been struggling to make time to write, squeezing in anywhere from 200-500 words a few times a week. But with this setback, I just stopped.

I’m not quitting forever. Terminal Peace is still under contract, and I’ve got an idea for a contemporary fantasy I want to do next. But…priorities, you know? I need to spend time with my wife. I need to be there for the kids. And I need to stop pushing myself to do ALL THE THINGS, and to stop beating myself up for not being able to do everything.

My editor has been incredibly understanding. So much love for Sheila and DAW! The longer gap between books two and three of this trilogy is going to suck, but c’est la vie. I just can’t worry about that right this minute.

Another change I’ve started looking at involves the day job. Back in 2015, I mostly quit my full-time job with the state. The ended up creating a 10 hour/week job I could do mostly from home, which gave me a nice, modest income and provided a little structure to my weeks. But Amy’s not going to be well enough to go back to her job in the near future. We’re trying to get her long term disability straightened out, but so far it’s been “under review” for three weeks. And we’re paying for COBRA coverage for dental and vision right now.

All of which has me looking into going back to work full time. I’ve started having that conversation with my bosses, and it sounds like we should be able to figure something out. I don’t know what it will look like, exactly, but it should hopefully be enough for me to support my family.

It wouldn’t have been my first choice, but at least I have the choice. I don’t know exactly when I’ll make the change, either. I’ll be giving up some of that time with my wife and kids, which means I want to put it off as long as I can. But I might be able to continue telecommuting for at least some of it, which would help a lot. And I still have some sick time and FMLA I can use, if necessary.

Most of my books were written while working 40+ hours/week, so I know I can continue to do both, once things settle down a bit. For now though, we’re just gonna keep going one day at a time…

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.

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.

Jim C. Hines