Medical Mondays: Chemo in my garden

I've had a few requests to do more herbal medicine/toxicology posts. Here's one I love.

Does this look familiar to you?

Photo credit 

Vinca, or periwinkle, is a commonly used a decorative ground cover. It's native to Europe but found in North America, parts of Africa, and Asia. It has ever blooming periwinkle-colored flowers with waxy, drought-resistant leaves. In some places, it has a bad name because it can get quite invasive. 

Whenever I see it, I think "pretty." Then I think, "chemotherapy." 

There are many active compounds in the Vinca species. In the Catharanthus roseus species, the chemicals vincristine and vinblastine have been extracted and are commonly used to treat leukemia and lymphomas today.

Catharanthus roseus can be pink, white, or a combination

Photo credit

In traditional Chinese medicine, it has been used to treat diabetes, Hodgkins disease (a type of lymphoma), and malaria. 

If the plant is ingested orally, it is VERY dangerous. It can be hallucinogenic, and may cause kidney and nerve damage.

Vincristine and vinblastine work by inhibiting the rapid division of cancer cells. Jargon alert!-->Specifically, it polymerizes microtubules needed to allow mitosis to occur.<--Jargon alert over! Unfortunately, it also effects other cells that divide rapidly in healthy human tissues, such as the cells of hair follicles. Hence, many patients on these medication will have chemo-induced hair loss. 

Other side effects include neuropathy (numbness and tingling of the limbs), low sodium levels, and constipation, among others. 

Vinca is so pretty and so fascinating, isn't it? Can you take a moment and imagine how you could use Vinca in a story?

If you've got a fictional medical question, let me know! Post below or email me at

All I ask is that you become a follower and post a link on your blog when I post your answer. This is for fictional scenarios, only. Please check out the boring but necessary disclaimer on my sidebar --->

Also, don't forget to stop by Laura Diamond's Mental Health Mondays and Sarah Fine's The Strangest Situation for great psychiatric and psychological viewpoints on all things literary. :)

Now follow Medical Mondays on Twitter! #MedMonday

My Goodreads Freak Out

I joined Goodreads a few years ago, but I'd been horribly stagnant. After all, I can barely handle Facebook, Blogging, and Twitter. Google+ has become an odd country where (mostly) strangers add me to their little Google crop circles daily. (And thus I run farther and farther way. Might as well call it Google negative bajillion, at this rate.)

Anyway, sometime in the last two weeks, my book mysteriously popped up on Goodreads. I didn't put it there. My reaction?

I stared at the "book cover image not on hand" icon. Then I twitched and proceeded to dive for the safety of my comforter.

Holy freaking macaroni, my book is up on Goodreads. 

So then, I did what any normal person would do. I visited my book on Goodreads, like, forty times that day to make sure I wasn't hallucinating. Then, another weird thing started to happen.

People started adding it to their to-read list.

What the--?

I know, I know. You're thinking, "Lydia, be reasonable. Some people actually might want to read it."

But "to-read" possessed way more of a "will-check-out-your-underwear-drawer-and-medicine-cabinets" kind of vibe.

Anyway, after I unstuck myself from the bedding, I put up a blurby short something about the book (90% of which is taken directly from my original query--so yeah, if you ever wanted to see my query, that's pretty much it, minus one paragraph with spoilers), started adding friends that I should have added a million hours ago, and began Goodreads obsessing.

THE FOUNTAIN is on the YA Novels of 2013 list, and it's hovering at #50. What qualifies for the buoyancy of 50, rather than 150, or 5? Apparently a mathematical equation that involves voting it up, and how many people want "to-read". However, I'm convinced that the Goodreads fairies came up with this far more accurate equation to determine ranking:


[(# marked "to-read") + (#votes up)]  ÷ [(facial pore size / general anxiety level)]
- [(time spent driving over speed limit) ÷ (probability of showering by noon that day)]  = RANK

Oh yes. You know it's right.

All I know is, Goodreads is going be the death of me. 

So I am vowing to stop the madness. It's cutting into my writing time, adding unnecessary stress to my life, and making what little hair I have fall out.  No more checking GR forty times a day and no more looking at ranks.  

I am not a number.

I'm going to use Goodreads for the good things. I've been cataloging my TBR pile so I can access it when it's time to buy a new book. If you have written a book that I haven't added, please let me know. 

And it's been fun finding my Goodreads friends (er, mostly you guys, my bloggy friends) and seeing what you guys are reading. That is muy awesome and I'm finding new books to read that way.

So. Do you do Goodreads? How much of your online life does it occupy?

p.s. I don't do reviews on GR. I'll explain this behavior in another post someday.
p.p.s. I vow to never respond to good or bad reviews, on GR or anywhere else.

Interview!

Mindy McGinnis, whose debut NOT A DROP TO DRINK (Katherine Tegen/Harper Collins) is coming out in 2013, has kindly interviewed me on all things blogging and writing.

Pull up a chair.

Have a virtual cup of latte, on me.

And thank you much for the visit, if you do drop by. :)

******

Please take a moment to visit Deb's Sisterhood of the Traveling Blog post on Wednesday, when she answers this question: "Where do your expectations for your writing (career/skill/quality/achievements) come from? Is the source internal, external, or both? And how do you cope when you don't meet them?" Check out recent answers by Laura, me, and Sarah! 

Medical Mondays: Prions from Outer Space

A while ago, Krispy at A Nudge in the Right Direction asked me a question about picking out a slow disease to attack a character.

One of the diseases I considered were prion diseases. First off, the name "prion" sounds sci-fi, and as you'll see below, they are like no other disease you've ever encountered.

What's a prion? Prions are proteins that are folded in an abnormal state. They have no DNA or RNA, like most living things. They are difficult to destroy and are infectious. 

How do they multiply? Prions propagate themselves by causing nearby, normal proteins to fold abnormally like them. Once those proteins misfold, they too cause other nearby normal proteins to misfold, and on and on. (Kind of like the Borg and their assimilation).

How do you destroy prions? With a lot of effort. The normal way we disinfect things to destroy viruses and bacteria often don't work on prions. High, prolonged temperatures, high concentrations of formaldehyde or caustic solutions are needed.

Is it animal, vegetable, mineral, or alien? Prions are not technically alive, in that they do not need food, or respond to their environment. They defy the biological definition that living things have nucleic acids (the building blocks of DNA). However, they replicate. They spread. And their very existence appears to have one effect--to make more of itself. Sounds alien to me.

Where did they come from? Okay, okay. They probably didn't come from another planet. There is a gene in humans on chromosome 20 for a similar prion protein that is a normal protein in humans. Mutations in this gene have cause inherited diseases with prions, like Creutzfeld-Jacob disease (CJD), Gerstmann-Straüssler-Scheinker syndrome, and Familial Fatal Insomnia (Death by Insomnia).

Can human immune systems fight prions? In a word, no.

What other diseases in humans are caused by prions? Mad Cow Disease (or bovine spongiform encephalopathy) has been theorized to have been transmitted to humans and causing variant CJD. Kuru is found in a native population of New Guinea that practiced cannibalism. There are several diseases that affect animals too, such as scrapie and of course, mad cow disease.

Symptoms? All prion diseases are neurodegenerative. They are slow diseases that primarily effect the neural tissues (brain, spinal cord). The symptoms can range from progressive dementia, difficulty walking or standing up, jerking of the limbs and tremors. Familial Fatal Insomnia causes...well. The name says it all.

Is there a cure? No. They are uniformly fatal.

Why aren't we all dead from prions, if they are so hard to kill and there's no cure? When cows are infected, there are low levels of prion in milk and meat, and it's not easy to absorb by eating. You also can't get prions from other people through casual contact. You'd need to be exposed to brain or spinal fluid tissues, or though organ donation.

How common are these diseases? As of 2011, there have been a total of about 211 cases of variant CJD worldwide. As for random, non-inherited, non-Mad-Cow related cases of CJD? 1 in a million cases worldwide, per year. Basically, pretty rare.

Did I just hear a collective sigh of relief?

If you've got a fictional medical question, let me know! Post below or email me at

All I ask is that you become a follower and post a link on your blog when I post your answer. This is for fictional scenarios, only. Please check out the boring but necessary disclaimer on my sidebar --->

Also, don't forget to stop by Laura Diamond's Mental Health Mondays and Sarah Fine's The Strangest Situation for great psychiatric and psychological viewpoints on all things literary. :)

Now follow Medical Mondays on Twitter! #MedMonday

Blogging: The WHAT Factor

Today is Part Two of a series on blogging.

See here for Part 1, on Why Did You Start Blogging?

When I started, I figured I would blog about writing. I was deep into my second novel, trying to get an agent, and I figured I needed it for platform. Also, to vent! (Carefully, mind you.)

Early on, I decided to tackle a huge paranoia I had. I feared that other writers would shun me because I had this whole other career as a doctor. I wanted my blog to focus on the writer part, but I felt like a sham. I thought, maybe embracing it would be a better idea.

And so, Medical Mondays was born, along with Mental Health Mondays with Laura Diamond, who uses her skills as psychiatrist for writerly questions too. Sarah Fine came on board later on, to add her knowledge of psychology (specifically, child psychology). It's been a trifecta of goodness.

I am so glad I took that shaky step! Not only do I get a chance to help others, I also learn something fact-checking and doing research for every single post. As for that paranoia of mine? Poof. It disappeared when I realized people embraced these different sides of me and were okay with it. The icing on the bloggy cake is that Medical Mondays garners the most page views and sends the most strangers to my blog from search engines.

The Wednesday blog chain started soon afterwards. The Sisterhood of the Traveling Blog has changed a few members, but every month we're challenged to answer our own question. Deb, Sarah, and Laura have been great sisters, and great supporters.

I added other themes, like Plot Devices. Deus Ex Machina (after I got the spelling right) was illuminating for me. I also found out what a MacGuffin was (not a slobbish, overweight MacGyver. Who knew?)

Then weird science-related things that caught my attention. The Zombie Ants post was a runaway hit. The Luna Moth one still takes my breath away.

In August, I started doing some Author Spotlights on Fridays. That has been fun, and it came at a time where I was running out of fun things to blog about. Lately it's died off a bit, mostly because I slacked off on finding authors, plus I wanted to blog on Fridays for myself again. BUT if you want to be spotlit for a Friday, email me. I'd be happy to have you. :)

I guess after doing this for two years, I figured out a lot.

• Sometimes taking a chance on content can pay off big (personally, and in page views)
• Be willing to change and experiment. It's your blog, after all.
  
• Make your own rules, and stick to them. For me, I stay away from cussing, religion/spirituality, and politics. I do not do book reviews. I don't post my own fiction here, not even snippets. I don't show pictures or names of my family members, and obviously, I don't blog about specifics from my day job. (Can you say HIPAA violation???)
  
• Be yourself. On my blog, I'm silly. I doodle cartoons. This is what I'm like, on a personal level. Yes, my patients and my boss can probably see this stuff, but people and patients I work with know I keep my work sphere very distinct from this one. I've decided I have different facets, and I choose when to show those facets. I am not all things at all times. I am complicated, and I'm okay with that.

One big upcoming question will be about self-promotion. I will have a book coming out on 2013. Yes, I will make announcements on exciting stuff. But no, I will not be shoving my book in my reader's faces on every post when the time comes. I don't like reading that on other's people's blogs, and I won't have it on mine.

My blog, myself, my decisions.

So. How did you decide what kind of content to have on your blog?

Turning laziness into good stuff

Theresa Milstein came up with a great idea recently. She wanted to be inspired to write whenever possible. Every day, in fact. But what about making those down times productive too?

So we collected ourselves into a little Facebook group (Hi Sharon and Susan and Crystal and Ann and Robyn!) called Write On to Build On.

For every day we don't write, we donate a dollar to a worthy cause.

After a bit of searching, we chose buildOn.

"buildOn runs after-school youth programs that mobilize urban teens to lift up their communities and change the world through intensive local service and by building schools in some of the poorest countries on the planet. We are a movement of students, educators and communities. Through our programs, people inspire people across neighborhoods, across cities, and across continents to reach and think beyond their realm of possibility."

We were inspired too!

In the process of picking an organization, we used Charity Navigator to evaluate the accountability and transparency of charities and help us pick a highly-rated charity that would put the majority of our donations directly to good use.

Do you have plans to give back, however small, this year? And I'm not just talking about money. Mentoring a new writer, volunteering, supporting others...how will you do it?

****

Please take a moment to stop by Sarah Fine's blog, where she answers her own Sisterhood of the Traveling Blog question: "Where do your expectations for your writing (career/skill/quality/achievements) come from? Is the source internal, external, or both? And how do you cope when you don't meet them?" Check out recent answers by Laura, me, and next week with Deb!

Medical Mondays: Nearly Ready for the Apocalypse

I tend to daydream about surviving horrible situations. Well before Survivor or Lost aired on TV, I would sit in the subway car in New York and think: What would happen if these ten passengers and I all got stuck together, for a month, trying to survive? Who'd rise above the situation and be the leader? Who'd become friends, when normally they'd never ever talk? Who'd be in charge of getting food? Who'd steal it?

As a child, I imagined trekking through the woods, wearing a coat bearing fifty pockets. In those pockets? My beloved stuffed animals, first-aid kits, fire-making materials, food and water. This was a fun daydream for me.

I know. It's odd. Or rather, I'm odd.

But one thing always stopped those survivalist/disaster daydreams in their tracks. My vision problems.

Here's how bad it was: When I held a book about eight inches away from my face, the text was too blurry to read. Without contacts or glasses, I was seriously disabled. Contacts can be swept out of one's eyes by a single rogue wave in the ocean. Glasses shattered by one wayward behind, sitting down.

So on Friday, I got laser vision correction, after thinking it over for a decade.

After 5 mg of Valium, I was ready to go. I asked my hubs to try to scare me, to see if it was having an effect yet. When he asked, "Are you scared of the surgery?" I laughed at him. "Okay. It's working," he decided.

The surgery itself was quick, but not quite painless. There was intense pressure and burning and the feeling like they were playing hockey with my eyeballs for a while. When they were done, I could see the clock on the wall, but everything was foggy, like I had a film on my eyes. I was cautiously optimistic.

(If you really want to see what I went through, here's a YouTube video. It is NOT for the squeamish!)

That night, my eyes burned so badly and the light was so excruciating I could barely open them for the intensive eye drop treatments I needed. I had (still have) big hemorrhages on the whites of my eyes.

The next morning, I woke up to see the fine branches on the trees outside my bedroom window.

I almost cried.

Now it's Sunday, and though I'm still seeing halos around the lights, I can now see the tips of the branches three houses away.* There's no guarantee it'll stay this good, but for now, I'm beyond thrilled.

I'm ready for that Apocalypse now.**

*Keep in mind, every patient's experience with laser vision correction may be different. I am not promoting this, only discussing my own experience. It's a very, VERY personal decision!

**Actually, I'm hoping that since I'm prepared for it, it won't happen, ha ha.

If you've got a fictional medical question, let me know! Post below or email me at

All I ask is that you become a follower and post a link on your blog when I post your answer. This is for fictional scenarios, only. Please check out the boring but necessary disclaimer on my sidebar --->

Also, don't forget to stop by Laura Diamond's Mental Health Mondays and Sarah Fine's The Strangest Situation for great psychiatric and psychological viewpoints on all things literary. :)

Now follow Medical Mondays on Twitter! #MedMonday

Tough Time Troubles

I have a post on The Lucky 13's on how to get through some writer tough times as a writer. Also, I answer the question of whether or not published authors can produce sunshine and rainbows out of their rear end.

Check it out, if you can.

Today, I am getting my eyeballs lasered, so if I don't comment on your blog, you'll know why. I've finally decided to fix my myopia so I won't be left behind during the upcoming Apocalypse.

I'm joking. Sort of.

Have a great weekend!

Me and My Critic Fairies

Me and my Critic Fairy Critters

This month's Sisterhood of the Traveling Blog question comes from Sarah, who asks:

"Where do your expectations for your writing (career/skill/quality/achievements) come from? Is the source internal, external, or both? And how do you cope when you don't meet them?"

Oh the pressure.

My expectations for my career come from me. What I want out of a writing career has changed from a spastic "I WANNA WRITE A BOOK!" to a more refined, "I would love a successful, lifelong career in YA fiction writing."

Defining success is a very personal, individual thing. I'm still figuring it out. Good reviews? A certain number of books sold? Both? Just being published (which is already huge for me)? Just writing the stories I want to write? We'll see.

As for the skill and quality of my writing? External or internal? I'd say both.
For me, the external sources of pressure include:

• future readers
• my crit partners
• my agent
• my editor
• other YA books that blow me away with their story lines and prose

The internal sources of pressure come from me trying my hardest to write a page of a novel that I can read and say, "Wow, this is good. How did I do that?" Something I can be really proud of.

Now, the last question: How do I deal when I don't meet my expectations?

For my career? Ask again later, says the Eight Ball. It's too early.

For my writing, it's revise, revise, and revise. Revision has been the key to my writing skills improving. I hate doing them, but I also love them because they make me a better writer. I set the bar very high for myself. I'm used to reading my writing and knowing when it sucks lemons. Because at the end of the day?

I am my harshest critic.

Medical Mondays: My Armadillo Gave Me Leprosy

It's one of those days. I woke up and decided to do a post on leprosy. *shrugs*

Leprosy is a very misunderstood disease. People think of sick beggars with fingers and limbs falling off left and right, severe deformities of their face and body, and of course, a horribly contagious disease without any treatment.

Not so! So let's learn some leprosy stuff.

What is it?
Leprosy (also called Hansen's Disease) is caused by a bacterium, Mycobacterium leprae.

How common is it?
In 1985, there were 54 million cases worldwide. In 2010, there were less than 300,000. In the U.S., there were 205 new cases in 2010.

Where is it most commonly found?
In developing countries, like Bangladesh, Brazil, Nigeria, for example. Most of the U.S. cases are from immigrants or those traveling to developing countries.

How do you get it?
It's usually spread through respiratory droplets, similar to the flu or colds. Some cases have been reported after contact with armadillos. Yes! The pill bugs of the animal world!

Do the armadillos suffer from leprosy too?
Most armadillos don't live long enough in the wild to manifest the disease. But in captivity, they do. Up to 20% of the armadillo population is probably affected. They probably got it from humans centuries ago! Yep, OUR fault.

How contagious is it?
Most people exposed to leprosy do NOT get the disease.

What are the symptoms?
Leprosy affects the skin and the nerve endings of the body.
After an exposure, it usually takes 3-5 years before any signs show up.

• Skin lesions that can look like circular burn marks, target lesions, thickened reddish patches
  
• Numbness within those skin lesions
• Tingling or numbness of the hands and feet
• Lumps and nodules on the face and earlobes
• Loss of eyebrows and eyelashes
• Dryness of the cornea (the clear covering over your iris), abrasions and ulcers
• Only in advanced disease, when the numb fingers and feet allow people to get trauma and infections, are there limbs falling off--not directly due to leprosy, but the secondary infections that happen.
  

Factoids:

• The leprosy bacterium grows better in cooler environments, which is why it has a tendency to affect the skin and respiratory tract and armadillos (cooler core body temperature than other animals).
• It tends to infect men more than women
• It's relatively slow growing
• The nerve damage can cause disability to the legs, arms, and eyes can be permanent and cause permanent disability, which is why early treatment is very important.
  

Is there a vaccine?
Yes. The BCG vaccine (Bacillus Calmette-Guerin) which is usually used outside of the U.S. to prevent tuberculosis, is also over 50% effective in preventing leprosy. Because leprosy is so uncommon in the U.S., this vaccine isn't used here.

What is the treatment?
Antibiotics. Dapsone and rifampin, and sometimes a third agent clofazimine, are used for anywhere from 12 to 24 months of treatment. These medications are highly effective, meaning it's pretty easy to cure leprosy.

Not sure if you're going to run with this and write about leprosy in your next book, but if you do, do me a favor and stick an armadillo in there, okay? :)

If you've got a fictional medical question, let me know! Post below or email me at

All I ask is that you become a follower and post a link on your blog when I post your answer. This is for fictional scenarios, only. Please check out the boring but necessary disclaimer on my sidebar --->

Also, don't forget to stop by Laura Diamond's Mental Health Mondays and Sarah Fine's The Strangest Situation for great psychiatric and psychological viewpoints on all things literary. :)

Now follow Medical Mondays on Twitter! #MedMonday

Please! Help a Writer Out.

I don't do this very often, but Candace is a dear writing friend and she's proud and brave as can be. It took a lot for her to ask for help.

Stop by her blog and if you can, help out.

From the bottom of my heart, if you do, I thank you.

The Medical Humanities: Where to Submit

I've been helping to develop a Medical Humanities presence where I work as a primary care doc.

Healthcare can unfortunately be a spirit-draining endeavor. I started writing non-fiction narrative pieces as an outlet early on in my career.

Writing narrative non-fiction was startlingly therapeutic for me, and eventually lead to writing poetry. And that lead to writing fiction.

So I owe a lot to the medical humanities.

If you ever write poetry, fiction, or narrative non-fiction that explores the human condition or the intersection between medicine and life, here is a list of places that might accept your submissions.

For most of these, you don't need to be a doctor or be working in the healthcare environment to submit. Many of these journals also accept photography and artwork, along with poetry, fiction, and narrative non-fiction.

Consider it. The world would be a better place if everyone could share your stories!

Why Did You Start Blogging?

I've been blogging for nearly two years now. Lately I've been thinking a lot about what role blogging plays in my world as a writer. I'm going to explore this topic a bit more this year, so bear with me. (That phrase is funny. Bear with me. I feel a doodle coming on...)

I started blogging on a whim. People said you need to blog to become a writer, for an agent/publisher wouldn't pick up a writer without a strong online presence.

BUT I was also as freaked out as a kid taking the SAT test with no pencil and no clothes. Yep. Like that. I assumed blogging meant no more private me, showing everyone what a silly person I was, how sadly unpublished and woefully unprepared I was for all things blogging. Still, I dove in with post #1.

So a day after I started blogging, I decided to quit.

But then I thought, "I should blog about wanting to quit blogging" and then post #2 was born. And it kept going, and going...

So how about you? When and why did you start blogging?

**********

This week's Sisterhood of the Traveling Blog question comes from Sarah Fine, who asks:

"Where do your expectations for your writing (career/skill/quality/achievements) come from? Is the source internal, external, or both? And how do you cope when you don't meet them?"

Great question, Sarah! This week, Laura will answer and next week, I'm up!

Medical Mondays: I'm Telekinetic! Almost.

Hey all, and Happy New Year!

I find the idea of telekinesis fun but faulty. How is it scientifically possible? I'm willing to make allowances for fiction, but in real life, I'm not a believer.

Then I saw this game called MindFlex. Looks like Mattel got a leg up on the paranormal universe, heh heh.

So you wear this headband with electrodes attached to your ears and around your head. Supposedly, it reads electrical brain activity and translates that to powering up a tiny fan in the console. Thus, the ball levitates.

We got if for the kids for Christmas. Okay, um. We got it for us too, since we've played it more than they have! I couldn't get it to work for the longest time (not enough caffeine, maybe?). Finally, I started babbling random things to see what would happen.

Check out what gets my mind totally focused and unfocused!



Mental power is full of electricity and magic, I tell you. Use it to good effect for a very productive 2012!

If you've got a fictional medical question, let me know! Post below or email me at

All I ask is that you become a follower and post a link on your blog when I post your answer. This is for fictional scenarios, only. Please check out the boring but necessary disclaimer on my sidebar --->

Also, don't forget to stop by Laura Diamond's Mental Health Mondays and Sarah Fine's The Strangest Situation for great psychiatric and psychological viewpoints on all things literary. :)

Now follow Medical Mondays on Twitter! #MedMonday