Business Musings: Writing with Chronic Health Problems
This morning, I got a piece of well-intentioned advice from someone I’ve never met. I get advice often. I also get great tips and links from you readers, notes about my math errors and typos (of which there are far too many), and all sorts of marvelous things.
I also get well-intentioned, if wrong for me, advice. This particular piece of advice is one I get monthly, sometimes weekly.
It goes like this: At your age, it’s time to stop running and do low-impact cardio. (Or swim, or go to the gym, or lift light weights, or do yoga.)
The implication is that running is bad for me and my health, based solely on my age, and maybe on the fact that I’ve injured my knee in the past.
The knee injury, according to several doctors, had nothing to do with running. And, for the record, the knee injury occurred when I was standing still.
Lots of studies show that running is the best exercise for any age, period. And that knee thing? That low-impact thing? All myths. Here’s a bunch of studies about the good things running does for a person.
It is, by far, the best exercise you can do (and the cheapest).
But that’s not what’s important to this blog. What’s important to this blog is this: Running is the best exercise I can do.
Because I do it.
The best exercise for you is the one you’ll actually do. The one you look forward to. The one you enjoy.
I loved swimming, but it took 3 hours out of my day—getting to the pool, socializing (introvert me hates that), showering before and after, getting home and oh, yeah! Swimming. Plus the chemicals just aren’t good for me, and I don’t live in a climate that allows me to swim in the lake year-round.
I had a gym membership that I used for years and years. I still gained weight. I hated the workout, hated the TV set on some stinky cable news channel (I don’t care which one—they’re all stinky), hated the boredom, which I fought by listening to audio books. I did my low-impact workouts, I got an award-winning short story out of my spinning class (aptly titled, “Spinning,”), and I was diligent.
I went cycling with a friend for two years and rode in my first (and only) century. That ended when I set my bike down fast rather than hit a car blowing a stop sign, and broke my elbow. (Got a story out of that one too, when I could type again.) In cycling, it’s not if you fall. It’s when. My first bike accident (at 9) knocked out my front teeth and left me with permanent scars. This last one left me with an elbow that complains every time it rains.
I still gained weight. I still felt crappy. I still had all of my chronic health problems, so I missed a lot of scheduled exercise events because I was ill.
It wasn’t until I got a Fitbit on a lark that exercise became do-not-miss for me. Why? Because I can hit my 10,000 steps even when I’m sick. I shuffle around the house like the walking dead, determined to hit that magic number, because I’m anal, and because finishing my steps every day before midnight is something I can control.
The knee injury got in the way. I made my doctor give me a schedule and benchmarks so that I wouldn’t start up again too soon, but also so that I would start as soon as I could. He thought I was nuts, but he did it. And I followed it, even though I didn’t want to. (I wanted to hobble around the house to hit that magic 10,000 steps.) Even with an injured knee, I got 3,000-4,000 steps per day (using crutches), because I really can’t sit down for very long.
It drives me crazy.
So why am I telling you all of this? This is a writing blog, right?
Because dozens of you have asked me, both privately and in comments, how I write with a chronic health condition.
There really is a trick to the writing while chronically ill. But the trick is personal, and it’s tailored to each individual person.
So, more personal stories—and then tips.
I have many many many allergies. It’s taken years to identify them, particularly the food allergies. I’m deathly allergic to perfume and soaps (particularly anything with manmade glycerin) and that causes more problems than I can say. It’s also the allergy that’s forcing me to rethink travel.
The worst health problem I have, though, is chronic migraines. From the age of 19 on, I got migraines so severe and long-lasting that I would lose weeks to them. By the time I reached my mid-thirties, I would have migraines 21-25 days per month.
And yes, those were the years I was building my career, and editing The Magazine of Fantasy & Science Fiction. I was working at an international level career, traveling (even though it made me sicker), and was horribly ill through much of it.
I ranked the migraines by severity. I could work through a mild migraine. It was just pain, after all. If I could think relatively clearly, I could read. I could write both fiction and non-fiction with a “mild” migraine.
The mid-range migraine—the kind where I couldn’t see anything around me clearly, the kind where I didn’t feel safe driving—I could still read when I had it. Or write nonfiction, with a lot of spellchecking. But I couldn’t do close work or go over a copy edit or line edit anything.
I could also teach and speak in front of a group with a headache that bad, as long as I was talking about something I knew. Giving a prepared speech, with a text and a teleprompter? Impossible. But off-the-cuff? Easy, easy, easy. Just as long as no one expected me to remember the details the next day.
The bad ones were truly bad. I couldn’t get out of bed for some of them, could barely speak, certainly couldn’t think. I’d have 5-7 of those per month, and if I managed them right, the worst of it would last about six hours. If I managed them wrong, I might have that level of migraine for days.
So…how did I work with all of that? Mostly, I didn’t. That’s the odd thing. If I had a nine-to-five day job, I would have had to go on disability, like so many of my friends in similar situations. Either that or have a truly understanding boss, one who knew I wasn’t faking when I said I couldn’t come in until the afternoon—and maybe not even then.
With the exception of one job I had with a truly understanding boss, I never worked traditional hours. When I had day jobs, I had unusual ones, the kind with flexible hours or the kind that were performance based. (If I finished all my work, I could go home.)
So, as we’re talking about working through chronic health problems, keep in mind that as writers, we’re in control of our own schedules. We figure out how to manage the day-to-day business.
The word management is the key. The other key is acceptance. (I have a tougher time with the second one.)
Notice, I can still give you, years later, the schedule of my migraines. I didn’t always know when they would arrive or how long they would last, but I could manage my response to them. I could avoid triggers—changing time zones, for example. Changing air pressure. Stress.
Over time, I learned what foods aggravated the migraines. Eventually, I realized that the food allergies existed (I thought it was a migraine problem, not that the migraine came from the allergies), and cutting all the things I was allergic to out of my diet reduced the migraines by several a month.
Working with my doctor helped as well. I found the right doctor, and I gave her my headache chart. I’d kept a chart on my calendar to prove to myself that I wasn’t a slacker. If I failed to get work done, it was because of a migraine, not because I was lazy.
That habit proved effective when I started working with this excellent doctor who helped me manage the migraines, and bring them down to only 14 or so a month.
But still, 14 a month is roughly half the month with a migraine. I could have given myself permission not to do anything at all during that period of time, but I’m not built that way.
So I evolved around the migraines.
Here’s what I realized I could control:
- I could control the triggers—and avoid them.
- I could exercise. The migraines got better if I exercised. And I could run (or walk) with a migraine and, magically, the migraine often got better.
- I could divide my work days according to the migraines. Remember, I told you that I could work through some migraines. The key for me was to try to do the actual work I wanted to do. If that wasn’t possible, then I would move to “easier” work. If that wasn’t possible, then the couch it was for me for the rest of the day, so I could work the following day.
- I could prioritize everything. Rather than try to do all of the work all the time, I could divide the work into things that I absolutely couldn’t miss to the things I could let slide. (Filing, I’m looking at you.)
Even though it’s fourth on the list, prioritizing was absolutely the key to everything I did.
I examined my life and set my priorities. I don’t have children, and I have a writing spouse, who understands. (Thank heavens. More on him later.) I saw Dean every day, often for hours. We work at home, so we spend more time together than many other couples do. He’s a priority, but we don’t have limited time, so I didn’t have to schedule my time with him.
Therefore, some of the priorities most people have—family obligations, day jobs—are not the kinds of priorities I have.
Still, I came up with a list.
I needed to:
Write Every Day
Exercise Every Day
Manage My Food Intake
Get Enough Sleep
Sounds simple, right? But simple was what I needed, what I still need.
Notice what’s missing from the list? No email, no website work, no promotion. Those weren’t my priorities, and still aren’t. Those things can—and often do—wait.
Writing first. Exercise second. Food and sleep and reading. (Socializing with Dean is as natural as breathing, so it’s not even on the list: it’s assumed.)
It became critical to have food in the house, in case I couldn’t drive. On my good days, when I was the primary chef (Dean has taken that over for reasons to do with his health), I would cook extra food and freeze it for the days when I couldn’t cook.
I never beat myself up for sleeping too much. I got sicker if I had less than six hours of sleep, so if I occasionally had nine, I figured that was fine. I slept when I needed to.
When I got the Fitbit and started the 10,000 steps per day, I had to put exercise ahead of the writing. If I had to choose writing or exercise in the hour between 11 P.M. and midnight, I chose exercise. I finished those damn steps.
One reason I started running was because I could get my steps faster when I ran. That was all. It takes me a minimum of two hours walking to get my (these days) 11,000 steps. When I run, it takes 30-40 minutes. That’s a lot of writing time. I take two days off per week on running, and those days I’m always annoyed at the fact that walking takes so bloody long.
But the writing…note that in that list above, it’s first. Because I didn’t allow myself to do anything (besides eat breakfast) before I started writing. With those headaches, I might only have a few good hours in a day, and often they were in the early part of my day. Better to get to the writing first, because if I waited—for any reason—I might not be able to write at all due to my health.
In 2012, a vitamin supplement I was taking changed the added ingredients (the coating, essentially) without noting that change on the label. (This company was later sued by others and settled out of court.) The change added something I’m extremely allergic to, and I was poisoning myself by small doses daily. I got sicker than I have ever been, before or since. (I figured it out on my own, realizing that I got sicker after I took my vitamins, and I just quit taking vitamins entirely.)
Those days were so bad that I could barely get out of bed, barely function. I would stagger to my writing office, manage about 1,000 words, and be done for the entire day.
Looking back, I’m astonished I managed that much. I could barely heat up food. Yet I managed to write.
Because I had put into place that set of priorities. Write first, everything else second. I knew, without thinking about it, how to plan my day.
Get up, eat something, write. Repeat. Rest if necessary. Exercise when possible.
When I’m healthy, I can write 4-5,000 words per day on most days, with time left over for living, cooking, exercise, relaxation, and all the other things that normal people do.
So 1,000 words per day seems like nothing to me. Yet I can still remember just how hard those words came, and how important they were.
Because 1,000 words per day adds up. That’s 365,000 words per year—more than three novels worth. It was a heck of an accomplishment, and I’m still proud of it, because I know how hard fought and precious those words were.
So, I managed my days, down to the hour. I gave myself permission to rest. I also knew that I would lose days whether I wanted to or not.
Those “lost” days weren’t really lost. They were me taking care of myself, getting rested, making sure I didn’t lose more days by pushing too hard.
The migraines have eased, because I’m older (migraines decrease with time), because I know the triggers, and because I no longer eat the foods that I’m allergic to. I still have 4-6 migraines a month, but only 1-2 days of severe migraines, which is just heavenly.
And what I’ve learned was that something else happened in the down time. Not just rest (which I’m having to relearn how to accomplish when I’m feeling healthy), but thinking.
Apparently, I did a lot of creative thinking when I was down. Making connections that I wouldn’t have made otherwise, having weird realizations because my brain was scrambled. I’m a lot more original when I’m resting than I am when I’m pushing hard on something.
More to learn.
I didn’t just manage my days. I managed my month, and sometimes my year.
I had to be honest with myself about what I could accomplish. I couldn’t guarantee that I would get 5,000 words per day, nor could I guarantee 1,000. But I could guarantee that I could write as much as possible.
What I did was this: I averaged my writing output. I figured some days I would get 5,000 words, some days I would get 1,000. So I averaged my output as I planned my year. I figured I could manage 3,000 words per day. That wasn’t exactly true. But if I wrote four days in one week, got 5,000 words on two of them, and 1,000 words on two of them, then I would get 12,000 words—or the same as 3,000 words every day for four days.
Figuring things that way made the math easier.
Then I had to be honest about how many days I was down. That’s really hard for me (see acceptance, below). But I figured I’d have at least four days when I couldn’t write at all, and four more when I couldn’t write or read or do anything.
Or…you know…I could say I didn’t work weekends, for the sake of my planning. Five days per week, 50 weeks per year (two weeks of travel or extreme sickness or vacation).
With those numbers in mind, I would then figure out how much I could write and how fast.
In the days when I worked to a traditional publishing deadline, I’d start with the do-not-miss deadline, and then subtract a month. That was my real deadline.
(For example, if the drop dead was July 31, then my real deadline was June 30.)
That system built in some time in case I had a particularly bad period leading into it, and also gave me a reputation for being early or on time with most of my projects.
Using the real deadline, I would then analyze how long it would take me to write the project at 3,000 words per day. So, if I had a 90,000 word novel due, I had 30 days of writing ahead of me. At five days per week, that would take me six weeks. I added a seventh week for yet another cushion, added an eighth week for first readers and cleanup, and found my personal drop-dead start date.
I would try to start sooner than that, depending on the deadline.
So…let’s say that July 31 project was a 90,000 word novel. I needed to have it done by June 30. Factoring in all of that, I would need to start the novel no later than May 8. But May 8 is a weird number, so I would start the book on something easy to remember, like May 1.
I would often finish by my real deadline. Occasionally, I would get too close to the drop-dead deadline for my comfort. I would let my editor know I was running a little late. Even then, I usually made my deadline on time, but I still built in cushion.
I didn’t push any harder than I could. I didn’t set unreasonable expectations. I made sure I took care of myself, and part of taking care of myself is writing as much as I possibly can.
Because I love it. Just like I found a form of exercise I like.
Necessary stuff, and stuff I still do. Because just going to the grocery store can knock me flat for days if someone shows up wearing too much perfume and gets too close to me for an extended period of time. If I have an allergic reaction to that person’s perfume, I’m down for the count for hours to days. And I still have to build that stuff in. You can’t plan for it (As in: I will have an allergy attack on January 3, at 5 p.m.). You can only cope with it once it happens. And it still happens way more than I like.
Dean also has chronic health issues. (He gave me permission to discuss that.)
Because he suffered several incidents of heat stroke in his years as a professional athlete, he is extremely sensitive to heat. And he had a stroke five-and-a-half years ago that left him partially blind in one eye. He has high blood pressure, which he wasn’t managing well at the time of that regular stroke (due to extreme stress and a decision he and his doctor had made on plans that changed overnight).
Dean has to deal with all of those things, and they’re tied together.
First, he has to manage the actual health part. He has to eat right, and exercise, and take medication for his high blood pressure. He has a blood pressure cuff at home, and he uses that whenever he’s feeling like the blood pressure is spiraling out of control (or when he’s under a lot of stress).
He too has travel restrictions, mostly due to the heat stroke in his past. He has to be very, very, very careful not to overheat, which isn’t just about hot summer days. It’s also about overheated rooms in the winter, and not paying attention when he’s getting hot.
He has to be aware of his circumstances at all times, make sure he’s getting enough fluid, and cool his body down immediately if he’s at all worried about overheating.
The eye, though, that’s the one that has the greatest impact on his writing. Because he is very aware that he only has one eye left, and if he loses sight in that eye, everything changes. Writing will still be possible, but he’d have to learn a whole new skill set, which he emphatically does not want to do.
How does he manage? He micromanages his day, with an emphasis on resting his eyes.
He limits his computer time to 30-40 minutes per session. During that session, he makes sure he looks into the distance several times, and focuses on something far away.
He then leaves the computer and closes his eyes for at least five minutes in a dark area, easing eye strain.
He takes a ton of breaks when he’s reading on paper, for the exact same reason. And when he drives somewhere (also causing eye strain), he stops the car and walks around a lot.
Even in periods of extreme deadlines and high stress, he does not vary these routines, because to do so would harm his health worse.
So do I.
The key to management, though, is…
I love to think that I can do anything. And then I remind myself, as those of you who read this blog regularly, that I will never play professional basketball. Even if I had been born after the WNBA was formed, I would never have played professional basketball. I’m not tall enough and I’m not fast enough to compensate for being short. Wouldn’t have happened, no matter how much I wanted it to.
When the migraines were at their worst, I struggled mightily with the limitations they placed on me. Dean would sometimes have to remind me that rest now equaled a good day later.
I am struggling right now with the limitations that the perfume allergy (which has grown worse over time) has placed on me.
But only through accepting that I have this issues can I plan for them. I could easily have promised books to my traditional editors on 30-day deadlines, thinking I would be able to write 5,000 words every day for 30 days.
I would have been wrong, and angry, and frustrated.
Knowing—and accepting—my limitations made my writing possible.
Knowing—and accepting—my limitations made my career possible.
Rather than focusing on what I couldn’t do because of my health, I focused on what I could do.
Did (and do) I have days when I feel sorry for myself because I can’t do something? Sure. But the key isn’t focusing on the negative. The key isn’t really focusing at all.
The key is doing.
I can’t dunk a basketball. I’m not a professional athlete. But I’ve been running long enough now that 3 miles is not tiring or even that unusual. (I kinda miss that extreme effort: I like the challenge, and now I have to ramp it up.) That makes me an athlete of sorts. Which is weird, considering where I started.
I might not be able to write as much as my husband. He can write 3-5,000 words after working eight hours on other stuff. But I’m consistent, and I get a lot done anyway.
Because I’ve learned to accept the chronic health problems. I live with them. They’re as much a part of me as my bone structure.
The main thing about chronic health issues is accept them, then manage them. Work to keep them from impinging on your life too much. When they do impinge (and they will), accept that’s part of who you are.
And realize you’ll struggle. We all do.
I do, weekly. I really do hate rules and regulations, even when I put them on myself. But I keep my eye on the goal as much as I can.
The goal for me is to share the stories in my head. So I have to figure out how to do that, with all of my personal challenges.
The thing is, those challenges are no different from the challenges that people who have day jobs face or people who have toddlers or people who have sick parents. We all have things that get in the way of our writing.
We just have to figure out our priorities and figure out where the writing falls in the scheme of our lives.
That’s so easy to write, and so hard to do.
And now, I’m signing off, because I still have 6266 steps to achieve before midnight—and this is not a running day.
Those of you who get the blog posts early on Patreon will notice a pile up of blogs in the next week or two. I have a workshop coming up, and I’m planning ahead—managing my time. I will have a migraine when the workshop ends, and the migraine will fall on my usual blog writing day. So I’m planning for that, plus the lost time that I will spend in the workshop itself.
Managing, managing, managing.
It’s kinda fun to write a lot of blogs at once.
You’ve helped with that, by giving me suggestions and helping me focus on what to write. Thank you! And thank you for the comments, forwards, links, and shares. Much appreciated.
I set up a Patreon account late last year because so many of you asked for it. You wanted to support the blog, but not on PayPal. So, if you want to support the blog on a regular basis, use Patreon. If you want to contribute to this post only, the PayPal donate button remains on the site. If you go that route, please include your email address in the notes section, so I can say thank you.
Back when I was having the worst of the health problems, that constant dripping deadline of the blog got me to the computer when nothing else would. Thank you all for that, and for reading this week in and week out.
Thanks so much!
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“Business Musings: Writing With Chronic Health Problems,” copyright © 2017 by Kristine Kathryn Rusch. Image at the top of the blog copyright © 2017 Can Stock Photo / prometeus