Archive for August, 2015

Brief update on Kate

Just a brief update to let you know what’s happened with Kate since she got out of the hospital on Sunday August 16.

First the bad news: while I was at Worldcon, Kate tripped and fell on an uneven bit of sidewalk near the library. Her face and knee got pretty banged up, and they gave her a CAT scan to make sure nothing was wrong inside her head. She also had to have some teeth splinted; the splints will stay on for 6-8 weeks and there might be more dental work needed after that. I have to emphasize that this was nothing Marc could have prevented, and I’m sure it would have gone down exactly the same way if I had been there.

Now the good news: Marc and Kate were kind enough to not call me about the fall until they knew she was stable and I wouldn’t have to come home early from the con. Kate is healing up nicely; the stitches have come out, and the bruises on her face are almost all gone.

She has done very well learning to monitor her blood sugar and give herself her own insulin shots. Her blood sugar numbers are pretty much under control now, and the various symptoms of high blood sugar are almost completely gone. She is definitely done with chemo! And we just got the results of her most recent MRI, and what’s inside her head is stable or somewhat improved (one spot of enhancement we’d been keeping an eye on seems to be gone). From here it’s just a matter of taking it easy and healing, with MRIs every two months to make sure everything is okay.

Thank you to everyone for your support, both practical and psychological. You have no idea how much you have helped already, and continue to do so.

My Worldcon schedule

Following several days of thinking that the Worldcon was increasingly unlikely for me, followed by the unhappy certainty that I would not be able to make it, a generous friend has stepped forward and I can attend the convention after all (though without Kate). And I got back to the program committee before they deleted me from the schedule, so here is where you can find me at the con:

The Best Writing Advice I Was Ever Given
Wednesday 12:00 – 12:45, Bays 111A (CC)
What writing advice have you received that you’d share with others? How did it help make you a better writer?
Bobbie Benton Hull (M), David Gerrold, P. C. Hodgell, David D. Levine, Derryl Murphy

Autographing – Elizabeth Bear, Patricia Briggs, Wesley Chu, Tanglwyst de Holloway, David D. Levine
Wednesday 14:00 – 14:45, Exhibit Hall B (CC)

Reading – David D. Levine
Thursday 13:30 – 14:00, 303B (CC)

Steampunk: Aesthetics vs. Content
Thursday 15:00 – 15:45, 302AB (CC)
Steampunk is known for being pretty, but what about real content? Is it that dramatically different from other genres? Or are most steampunk stories like one genre with a veneer of steampunk?
David D. Levine (M), Matthew Dockrey, Sarina Dorie, Grá Linnaea

Writers Workshop section 05
Friday 13:00 – 16:00, 201A (CC)
Fifty-plus entrants submitted speculative fiction manuscripts in advance to be constructively criticized by industry professionals. In this section, a few of these entrants go on the hot seat to hear what the pros have to say. All workshop sections are closed to non-participants.
David D. Levine, Madeleine Robins, Diana Pharaoh Francis

Kaffee Klatche – David D. Levine
Saturday 13:00 – 13:45, 202B-KK3 (CC)
Join a panelist and up to 9 other fans for a small discussion. Coffee and snacks available for sale on the 2nd floor.

Game of Thrones: Expectations of Gender and Sexuality
Sunday 12:00 – 12:45, Bays 111A (CC)
After five seasons, we have expectatons of Game of Thrones as having a lot of female nudity and graphic violence. But, at the same time, it has some very strong female characters, and, among some of the characters, a more modern view of sexuality. Do these contrasting views work against the show or enhance it? What are some of the bigger surprises?
Perrianne Lurie (M), David D. Levine, Lauren Roy, Valerie Estelle Frankel

Update on Kate – no Worldcon for us (ETA: I can come!)

STOP PRESS: I WILL BE AT WORLDCON!

Extremely generous friend Marc Wells has just stepped forward to take care of Kate while I take his wife Patty to the convention, saying “you and Patty need to be there, I don’t.” Marc has the experience to help Kate with her insulin and I trust him completely.

This is so overwhelming I am in tears. But I will be at the convention.

Original post follows:

The short version: Kate spent four days in the hospital last week, coming home Sunday, and we won’t be able to attend the Worldcon.

The long version: This started over a week ago, with tummy troubles that came and went. Thursday at 1am it was back, even worse, to the extent that I called 911 at 5am; paramedics came, gave her an intravenous drug for nausea, and took her to the ER.

At the ER she got more intravenous drugs and a CT scan, which showed some bowel irritation but nothing major. With the drugs she perked up pretty quickly, but the doctors decided to keep her overnight for tests and observation. They also gave her injections of insulin to bring her steroid-induced high blood sugar down. (We had just started metformin, an oral blood sugar medication. As long as she was in the hospital they decided to use the stronger stuff.)

She stayed in the hospital from Thursday to Sunday. Each day she felt better than the day before, but every night she had trouble in the early AM. Tests for C. Diff, norovirus, Shiga toxin, bacteria, and the most common virus for stomach bugs all came back negative. Finally the enterologist suggested that the symptoms were consistent with “autonomic diabetic neuropathy” — basically, high blood sugar weakens your sympathetic nervous system so that your GI tract doesn’t work right, especially when you’ve been sleeping for hours.

Getting her blood sugar down (from 408 Wednesday to 149 Sunday; normal is 140 or less) and giving her Imodium brought the trouble mostly under control, and she went home Sunday. But her sugar has been so high that metformin isn’t going to cut it, so we will have to inject long-acting insulin every morning, and test her blood sugar and inject the appropriate amount of regular insulin before every meal. Also we need to change our eating habits — reduce carbohydrates, increase fiber, eat more smaller meals, you probably already know this drill. We were already doing pretty well on this score but will need to do even better.

Kate is absolutely not up for travel this week. We considered whether I could go to the Worldcon without her, but with this new and complex drug regimen to manage, plus follow-up visits with the doctor, it doesn’t look as though I can go for even one day. Kate can’t manage this by herself right now, it isn’t something I could ask a friend to do, and I don’t want to leave her with strangers (we would have to find, interview, and hire someone in just a day or two). It might be different if we were more experienced with the routine of blood, drugs, and pointy things, but not in the first week.

So… no Worldcon for us.

To say that I am disappointed would be a severe understatement. Shattered, more like. Also angry, sad, and resentful. Not at Kate, but at the terrible situation we both find ourselves in.

Kate’s progress: July

As faithful listeners will no doubt recall, Kate’s treatment consisted of surgery, six weeks of daily radiation and chemo, a month off, and six months (or more) of monthly chemo. Well, she just finished up her sixth round of monthly chemo and at the moment it looks like that will, indeed, be it. Which is a good thing, as the nausea and fatigue, while never completely debilitating, have been getting a little worse each round and this one was pretty bad. So, even though we’re not out of the woods by any means, we can celebrate the end of treatment for the cancer per se. I hope that as we get further away from chemo Kate will see her energy levels increase and spend less time napping.

This month, though, we learned that steroid-induced hyperglycemia (aka steroid diabetes) is a thing. Diabetes, it turns out, is a condition with multiple causes. Type 1 and type 2 (formerly known as juvenile and adult-onset diabetes) are basically two different diseases, and gestational diabetes is the third well-known cause of the same condition. But there are many other causes, and apparently taking “pharmacologic doses” of dexamethasone for a long time is one of them. This explains Kate’s headaches, dry mouth, and some other symptoms that have cropped up recently.

As with gestational diabetes, usually steroid diabetes goes away along when you stop taking the steroids… but that isn’t likely to happen any time soon, so the oncologist suggested using diet and exercise to try to bring her blood sugar down. We met with a dietician, who recommended whole grains, plenty of colorful vegetables, and a good balance of carbohydrates, protein, and fat in every meal and snack… which is basically what we were already trying to do. As for exercise, that’s difficult because of chemo fatigue and steroid-induced muscular atrophy. We will just have to try to be more consistent in eating right and exercising, and see how it goes.

I mentioned last month that we were working with a physical therapist, occupational therapist, and speech therapist. They were all helpful, but all those appointments were tiring, so we decided to discontinue the speech and occupational therapy and continue with the physical therapist every two weeks. (Did I explain the difference between physical and occupational therapy? The line is fuzzy, but basically occupational therapy covers anything you do with your hands and physical therapy is everything else you do with your body. Both occupational and speech therapy can include cognitive stuff.)

However, life continues. We have signed with a contractor to properly bolt the house to its foundation for earthquake resistance; we visited Seattle to hang out with friends and attend a Clarion West party; I’ve been soliciting blurbs for ARABELLA OF MARS (some awesome ones have come in already) and plugging away on writing the sequel; and I recorded an Act of Whimsy video for a charity fundraiser which required having a fabulous English Regency men’s outfit made. I’ll be wearing that outfit for my readings when the book comes out next year.

The bottom line is… we keep on keeping on. Kate is weak, wobbly, fatigued, and has some memory and cognitive issues, and I’m kind of fatigued myself, but we are doing our best to take care of ourselves and each other. Anything you can do to help would be appreciated.

Thanks to Janna, Mark, Cynthia, Kate & Glenn, Hal & Ulrika, John, Shannon, Tempest, Elsa, Elizabeth, Cole, Melissa, Michelle, Len, John, George & Brian, Page, Tina, and everyone else who came for a visit, helped with a task, or joined us for a meal. It may not seem like much, but it really helps.