I write and I erase the outline. We’re in a transitional scene, which is pretty well crossing maps, so there’s about as much put in as taken out, so that’s why the graph doesn’t advance appreciably. We are now into the main action of the book.
Todd Lockwood is doing the cover for the next book to come out. He and I turn out to be at opposite ends of the state, both fanatic backyard gardeners.
Jane’s back took another spasm last night, but the fact it’s now in line means she thinks it’s going to behave. We’re staying off the ice today: Jane doesn’t need to have her back catch and take a fall on it to boot.
We had one heckuva blow last night, tropic-style rain coming in curtains on a 40-50 mph wind. Our trees stood fast and we’d battened down the patio furniture, but now the nights are going to be 34 degrees for the next several days: this is an Arctic front. We’re just real glad we’re not at 500 more feet of elevation, because at about 2000 feet, we’re that close to snow. The higher parts of the Cascades apparently got hammered yesterday.
I got my thyroid prescription upped just a tad; I take 2 minipills on Sundays. Apparently it’s slow to leave the system, so this way works. I dunno, I may take the double dose on Mondays. Everybody can use more pep on Monday morning. I’m the doc’s ongoing science project—I’m in the middle of the ‘old’ good range, but the low end of the ‘new’ good range for thyroid function, and boy! does a microdose make a huge difference for me. He’s quite happy with the changes in my well-being. I’m the classic case of somebody who could chalk up the myriad effects of low thyroid to just age—but hey, I skate, I have strong bones, I haul dirt—why should I be getting tired with no reason? I just tire easily, can get depressed, and have days when it’s physically hard to put one foot in front of the other, plus insomnia—and it (and a few other symptoms) mean, yep, I have the constellation of problems that mean the ‘new’ range is where I really, really want to live. Oh, it’s made such a difference. Ten years’ worth of difference. I like feeling good!
Hurrah for feeling good! (and being into the main action…!)
More storms last night and woke up this morning to find we’d had a power outage sometime or other. As usual, the sirens across the street drowned out the TV yesterday evening. Nothing happened here except for over 2 inches of rain in less than an hour and the usual high winds.
And did you look at the jetstream yesterday? Swooped way down over your area and then up nearly to Canada before coming back down towards the south east.
I think it did it at ground level. More trees down in Spokane. Fortunately this one wasn’t on a house.
I’m glad you’re sorting out the medication. Any tips on writing transitions while you’re at it?
Hurrah for levothyroxine. My doc keeps me a the low end of good, but I was diagnosed about 12-15 years ago well over the old hypo range. I was lucky to have a GP doc who understood the thyroid range and believes in what feels good to be the right dose. The right dose makes an astonishing difference in function. I’m glad you are getting what you need – life at hypothyroid levels is not fun.
Worth knowing, too, what I’m told not all MD’s may have read yet—quite recently the endocrinology (Grant’s favorite word) profession bumped the range in which one may reasonably consider there could be a thyroid problem. Falling technically within the old ‘safe’ range cost me no end of grief, ten years of my life that was like slogging uphill while suffering every clinical effect of low thyroid: all the symptoms, none of the readings that would let me get help. That has now changed, I now fit the criteria, and funny thing, I’m having to have the dosage bumped just a micro-bit. I’m being treated by a really good endocrinologist, and it’s wonderful. I’m told one day the thyroid will just kind of quit (Hashimoto’s), but the nice little pills will just slowly increase to take care of that and I’ll still be happy.
Writing transitions: the best transition is to TELL your story before writing it, (often called an outline, but lacking all ABC’s and 123’s and bearing no resemblance to Mr. Smith’s 3rd grade classwork.) You just tell it in plain words. When you go back to WRITE your story with all the whistles and bells you will run into these spots in which nothing much happens, but that are necessary. I would advise you not imitate the guy whose hero was stuck in a pit of vipers with poison gas and rising water—end scene. The next scene starts with “Joe really hated snakes. But he had to feel sorry for those particular vipers. The poison gas overkill was just a mistake.” Readers want to kill you for that.
The main rule is—don’t cheat the readers of something they’ll want to see, but spare them the mind-numbing routine. You don’t have to tell everything. “Wheels down for landing,” covers the airport scene, what Joe did on the plane, how he got his ticket, and “soggy day in Boston” covers where he is. Your initial outline has already id’ed the plane ride as a no-event transition, so you just burn past it as painlessly as possible.
Homer was the first guy on record who tried to portray the speech of a really humorously boring old man (Nestor) with actually including Nestor’s excruciatingly long (when I was a boy I walked uphill to school both ways)…speech. The problem is, the reader’s boredom is not an illusion, and not helpful. In spite of the adage, Show, don’t tell, there are some points where you should pan the camera and show the drowsing audience rather than feeding us Nestor’s speech.
Howzzat for an explanation.
That’s very nice — including the tip on knowing where you are going because of pre-writing, so that you don’t lovingly detail the really boring bits. This bit of info is the answer to part of why I took up my dabbling with writing — I wanted to figure out the mechanics of transitions. Thank you.
I think I’ll see if my “MD” (Doc in a Box) will read up on the Endo. I am in the “TSH normal” range but I’m not feelin’ the love…
Thanks for posting about that.
Excellent article written in layman’s terms about the TSH controversy — includes citations:
http://thyroid.about.com/od/gettestedanddiagnosed/a/tshtestwars.htm
That is the best article I have found on the problem. I particularly don’t like being handed lab results with ‘normal’ instead of numbers.
I’d say everybody who doesn’t feel up to snuff and has had low energy for some time should take a look at the symptoms (WebMD) for low thyroid or Hashimoto’s (is it Syndrome? or Disease?) —and if you exhibit a majority of those symptoms (I had everything but osteoporosis) it is time to have a talk with your doc with a copy of this article in hand.
From the doc’s point of view some patient comes in saying, “My hair’s getting thin,”—he says, “well, you’re getting older.” The patient comes back a year later and says, “I just feel tired.’ “Well, you’re getting older.” And six months later says, “I feel depressed,” and they say, “Here, have some Zoloft.” …you get the picture.
But if the same patient comes in waving this article and says “I have 90% of this group of symptoms, and I want a blood test,” the answer could be different.
Here’s the list of symptoms:
http://www.webmd.com/a-to-z-guides/hypothyroidism-symptoms
One of the most significant things in that article of OSG’s imho is that the LABS are insisting on sticking to the old standard, and that some of the doctors are refusing to go beyond that because of exposure to malpractice.
I think anybody who is exhibiting a significant proportion of these symptoms should take a look at their numbers, not just a ‘normal’, and talk seriously with their doctor.
Thank you, reading….
Fast question about the outline: you say that you are shooting for 209 pages. How does that translate into “book pages”? I can’t recall any 200 page books in recent memory.
There’s no straight transition: it depends on the font the publisher picks. But I write single-spaced and page-wide, 330 words-per-page. When you put it in doublespace, it’ll go 400 pages, about 70,000-80,000 words. Gate of Ivrel is 80,000. Books are getting slowly shorter again. The old standard was 80,000. The new one became 120,000, which is the size of most Foreigner books, but not all. I am a strong believer in stopping a story when it’s over. 😉 I’m betting on 120,000-130,000 words for this current ones.
Off topic:
Carolyn, what has happened to my avatar pic here??? Not loading! Everyone else’s seems to be — at least that’s what I’m seeing.
That’s a first, osg! My guess is that the source has become corrupt. See if you can re-upload your avatar to wherever you had it embedded. If you have to re-establish your account, I can change somebody’s username or password, add or delete a user, but I have no way to control the avatars.
I don’t see you either, OSG; thought you had had a sudden attack of shyness! 😉 Thanks for the link on thyroid. I attribute many of my problems to recurrent Lyme. Could it possibly be thyroid? Have an appt. coming up, and will definitely ask about this.
Carolyn, thanks. I’ll re-load The Green One.
Smartcat, consider requesting that your vitamin D levels be checked. There are several blood tests for it but “Vitamin D 25-hydroxy” (Vitamin D 25-OH) is the one you want.
My yield on this has been shockingly high: easily 70% of my patients have been positive for insufficiency or deficiency. It should be at least 30, & I’m happiest when my patients hover around 50. My pt with “my” all-time record was **7**. I kid you not. Granted, it has been winter & we live in a northern latitude — but still…!
Simple over the counter or prescription replacement is working miracles for my patients, I kid you not. It’s not just my observation either: my personal physician is experiencing the same jaw-dropping numbers & results with his patients. His “patient all-time low was **3**. We speculated on how how his patient was even ambulatory with that severe of a deficiency.
We now return you to your regularly scheduled programming.
It’s not working, OSG. I’m getting a prolonged “waiting on gravatar.com” notice on my load of the page in my browser, and for a while I got the little dummy icon for a pic inaccessible. Then that went away and I have only a white square.
CJ observed: “One of the most significant things in that article of OSG’s imho is that the LABS are insisting on sticking to the old standard, and that some of the doctors are refusing to go beyond that because of exposure to malpractice.”
Yes, the labs cite only the “old” reference range. Key point: TSH stands for Thyroid STIMULATING Hormone, so the numbers are “backwards” from what you might expect. The higher the TSH, the more sluggish the thyroid: it is needing more *stimulation*. Please remember TSH reference ranges are still not only controversial, but also far from everyone has heard of the controversy, especially those not in specializing in endocrinology.
How I handle this controversy:
If a patient’s TSH is >2.0 or so, I explain the controversy & offer the patient the option to try a very low dose of Levoxyl for 6-8 weeks, with labs to be done at the end of that period. (It is critical labs be monitored because you really hurt someone by giving them too thyroid medication.) Documented is that I discussed the controversy with them & offered the option. Furthermore, I do not prescribe for more than 2 months of Levoxyl in these situations, to ensure adherence to obtaining needed labs. No labs = no refill.
Based on the follow-up labs and how the pt feels at the end of the 6-8 weeks, we then plan from there.
(I hope I’m not hijacking this thread.)
Vitamin D3 is making the news a lot lately. I don’t take it every day but when I do it is 8-10K IU in an gel cap – oil base. I am the only person in my office who hasn’t been Officially Sick this winter at work. Had some allergy kick ups and some sinus infection as a result, but my immune system has Dealt. I have been telling anyone who’ll listen they need to consider D if they want to stay well. I read one doctor talking about how his patients, who are all encouraged to be Well Sufficient in D, have super-fast recovery if they break bones. I wonder if it would help with soft tissue injury as well. Anyway.
On the topic of vitamins, I believe D is a fat soluble vitamin and as a result when I saw “Fat Free Vitamin D Milk” in the grocery I really had to scratch my head. Now if I could just find the thyroxine black market…
OT: Carolyn, Ysabel is now visible but I still have only the white square. I also can’t figure out how to upload a new pic, even when I went to my profile page.
If you are not able to see Ysabel (I can) I am wondering if the problem does not lie within gravatar.com, a server issue, or some such. Thus far you are the lucky only person thus afflicted!
Thanks, OSG, you have provided a memory jog. I take vitamin D with my calcium and in a combo A&D and a multi vitamin to total about 1000 iu a day. For various reasons have not taken the last two since Christmas. A quick trip to CVS has taken care of that. Thanks again. 🙂
Thank you, CJ, for the space to communicate. 😀
Vitamin D is critical for your body to absorb and utilize calcium, so most calcium comes with it as an added bonus. However, one of the best ways to get vitamin D is to simply go our for a walk in short sleeves. One news blurb I remember said 15 minutes a day is enough — and usually you won’t get a burn in that short of time [unless you live in the southwest]. Probably one of the biggest problems with recent years insisting that sunlight-bad-and-you-better-be-wearing your-sunblock-and-have-hats-and-glasses-and-long-sleeves-etc-etc, is that as a population we’re becoming vitamin D deficient [although polariod sunglasses will help protect against cataract development]. You can still protect against the sun under worse-case scenarios, but you really need some to be healthy.
I’m definitely going to check into the thyroid issue more. I think there’s a link with what’s going on with me, but so far several doctors and an endocrinologist insist there’s nothing wrong. What about the adrenal system? How can that play into things?
It looks like I’ve hijacked our thread, Carolyn!
Oh, the adrenal system! Now THAT’S a time bomb, and too complicated for any of us mere mortals to understand. As a cardiologist friend told me, “Endocrinologists are *much* smarter than the rest of us”. I agree! Of course, cardios only need to deal with plumbing and electricity, right? 😉
I had an ‘interesting’ endocrinology encounter 2 years ago. As background, at that time I was *the* provider holding down a high-volume, high-acuity rural hospital ER basically single-handedly for 48 hours a week — plus seeking an average of 20-30 family practice / urgent care patients IN ADDITION to that because of short-staffing. I’ll spare you the Lurid Details, but it was very typical to go without ANY sleep for 24+ hours. My personal record was 37 hours. I wish I was kidding. It was NOT safe.
Anyway, my orthopedist sent me to an endocrinolgist on an unrelated matter. To cut a long story short, labs indicated I had a pheochromocytoma, a rare adrenal gland tumor. Pheos are typically benign but very dangerous as they surge high levels of adrenaline. You can guess how healthy this is.
I was picking out a surgeon and arranging time off work for surgery when my endocrinologist decided, after repeating my labs 2 more times and consulting with the medical director of the lab, that I didn’t have a pheo after all. Whew!
You know what I’m certain was really going on, & why my labs were abnormal & somewhat confusing? The Dreaded ER. I was under such extreme stress and so sleep deprived that it threw my catecholamines (“fight or flight” stress hormones) totally out of whack.
The moral of the story is how skewed your labs can get and falsely indicate a very serious problem when unbearable stress it is the actual problem.
BTW, I left the Dreaded ER shortly thereafter.
http://en.wikipedia.org/wiki/Catecholamine
Thank goodness! We still think the current place works you too hard—but that’s another story! At least you’re not 37 hours without sleep.
BTW, your avatar shows in the admin area, in the admin version of comments, in the user area of admin, etc. Only on the public version of comments is it missing.
Carolyn, I can figure out where / how to reload it. On Jane’s C&L, it shows up fine. When I click the pic on C&L it takes me to a photo gallery. When I click my “white box pic” on your site — nothing. Dead in the water!
I can only believe that your registration problem on this site is due to a stray neutrino from a long-dead sun…
I can delete your membership and you can reregister, which may restore it. I can ‘attribute’ all your comments to your other name, then delete THAT name once you’ve reregistered as OSG with your proper avatar and attribute all the comments to OSG again.
That’s all I can think of.