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Affordable Care Act and the Freelance Artist

Colleen Doran — Mon, 10 Dec 2018 20:42:29 +0000

This webinar is FREE provided by the Graphic Artist Guild, but you must register to participate. FREE Webinar Wednesday, December 12 at 2 p.m. EST (1 p.m. CST, noon MST, 11 a.m. PST) The enrollment period for health insurance via the public exchanges has been shortened by an additional two weeks, ending on December 15. But the Affordable Care Act (ACA) is still around, and with a change in House leadership, probably not going anywhere. So how does the changing political landscape affect your ability to access – and afford – health insurance? We’ll discuss how freelancers can enroll in health coverage and what the forecast is for health insurance costs in 2019. Also, as most of you already know, I do most of my blogging and updating of my work at my Patreon. However, I will continue to make public service posts like this open to all. Follow me on my Patreon to stay updated. Thanks.

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Effective Medical Treatment for Migraines

Colleen Doran — Mon, 03 Mar 2014 13:58:04 +0000

A migraine is not a headache. It is a neurological condition that affects the central nervous system. Those who do not suffer migraines dismiss them as the whines of malingerers. Those who get them want to put those people in a chair and hit them in the head with a spike so they can see how it feels. Migraine pain is said by many to be worse than natural childbirth. I have been a migraine patient for 25 years (chronic for eight) and gave birth to my first child a year and a half ago. Hands down, a migraine is more painful than labour and birth (including the episiotomy, lateral tearing and forcep delivery). I think it has to with where the pain is located. Migraines occur in our main control centre; our brains. When the pain is elsewhere, I find I can use my brain to distract more effectively (ie. watch tv, read, talk, music). This is not the case with a migraine because everything is controlled by our brains. We are completely debilitated when these hit us. I would echo the above sentiments….give me labour and delivery any day! Each round of migraine can last for days, and chronic migraine sufferers can experience this pain almost every single day. The pain is often accompanied by extreme nausea and vomiting, visual and auditory hallucinations, temporary partial or full loss of vision, tunnel vision, a bizarre series of preliminary symptoms known as migraine aura, and days of recovery from all of the above which leave the sufferer exhausted and feeling beaten – only for another migraine to pop up and start the whole series again. Lewis Carrol, author of Alice in Wonderland had migraines, and the hallucinatory imagery in the book is a pretty good description of the things migraine aura sufferers experience. There is a migraine aura phenomenon named after Charles Lutwidge Dodgson’s (Lewis Caroll’s) story of myriad transformations: Alice in Wonderland syndrome. The afflicted person perceives herself, or parts of herself, ballooning or diminishing in size. The neurological terms for the peculiar sensations of growing and shrinking are macroscopy and microscopy. Dodgson was a migraineur. I had my first migraines as a teenager. Several every month, accompanied by blindness and nausea, flashes of light and extreme discomfort similar to a stroke. There was no treatment for migraine when I was growing up except bed rest and a quiet, dark room. If the migraine was bad enough, a trip to the emergency room was required, and then you’d get some tests and a shot to knock you out. Everyone in my family has migraines, and I assumed this was my lot in life. As a freelance artist with a heavy schedule, I learned to make room for them. I knew I’d lose about four days work a month, and that was that. Just suck it up and deal. However, 10-15 years ago, I began to experience bizarre neurological symptoms that became debilitating. I wrote about them HERE in this post about Brain Fog. By 2006, I was pretty sure my publishing career was over, because not only did my memory and focus become so bad I could not remember simple things like my middle name, but my migraines went from acute to chronic, and frequency increased to 21 days a month. The nausea and vomiting was so violent, I busted blood vessels in my eyes and face. My income dropped from a very comfortable upper middle class rate to below poverty level. I was almost completely disabled. As a freelance artist, I had virtually nothing to fall back on but modest royalties, and because I did not want to ruin my future chances of work or to be seen as whining in public, I usually kept my problems to myself. After years of suffering, my doctor finally found out I had an endocrine issue that was the source of all of my symptoms, including the severity and frequency of the chronic migraines. Migraines are not necessarily curable, but they are treatable. A number of my pro friends have them, but almost none get professional treatment. Lifelong migraine sufferers like us often don’t seek help. After decades of stoically dealing with the pain, and being told there is nothing to be done (or being mocked by people who really don’t understand what the hell this is,) we get tired of asking. And, of course, for most of our lives, no medications were available. However, over the last decade, new treatments were developed. There are also over-the-counter supplements which have been proven to reduce symptoms and frequency of migraines. They work for me, and I strongly encourage anyone who has not consulted a physician to find one who is knowledgeable and sympathetic to your issues. (Not all doctors are.) The meds may cost, but you know what really costs? Not being able to function and enjoy life. I’ve lost years of livelihood and productivity because of this endocrine condition and the migraines that accompany it. If it costs to get me a medication that enables me to triple my income, then boy howdy, hand that shit over. Almost every creator I know who has migraines told me the reason they feared asking a doctor is because they thought they would be subjected to expensive and painful tests. Not so. Medical history and symptoms should suffice. No one in my family who has treatment for migraines had to get a CAT scan or spinal tap. I suppose I was particularly easy to diagnose since I had a migraine in the doctor’s office a few year’s back and had to crawl to the toilet to puke. Then they gave me a shot in my ass and put me in my very own room to sleep it off. So, it was easy to tell I had a migraine, see. The medication you will probably get is Maxalt or its generic equivalent Rizotriptan. All hail this stuff. It’s tricky to gauge exactly how to take it and how it will work for you at first, because you have to take it at the onset of a migraine: within the first two hours. And then, if your migraine isn’t knocked out within about two hours, you take two more pills. Sounds easy, but it takes an awareness of what is going on with you, and it takes time to get used to what your body is telling you. You’ll question yourself: is this a real migraine coming on, or is this just me having a bad day? These pills are expensive! Maybe I should wait! Don’t wait. After some months of using it, and trying to figure out how to get it to work, driving my insurance company crazy because I’d use three month’s of the prescription in a week, the migraines have lessened in severity and frequency. Two years after first getting them, I now have about 4 migraines a month instead of a migraine every couple of days, and can usually deal with them by taking an Advil migraine pill instead of my prescription. This can vary: I’ve noticed a few times a year, I cycle back to frequent migraines for a few weeks, which can be quite severe, then they scale back again. God knows why. Overall, they just aren’t as bad as they used to be. I can even work with a migraine, whereas before, I was just completely knocked over when I got one. And since there is a generic equivalent of Maxalt available now, I no longer pay hundreds a month, I co- pay my insurance $40 for a prescription that can last 3 months. Your doctor may also decide to put you on a beta blocker or other preventative course of action: I chose not to, because I believe in avoiding taking any more medicine than I absolutely have to, and as my doctor predicted, over time and with careful use of the Maxalt, my migraines decreased. If they hadn’t, I’d gladly use that beta blocker. For many women, migraines disappear with menopause, and I just can’t wait for my plumbing to stop working to find out. For the 10-15 years before menopause, many women may experience migraines, often for the first time in their lives. Don’t suffer: get treatment. A neurologist also suggested I take L-Tryptophan, which is an over the counter supplement which increases your serotonin levels. People who get frequent migraines often have lower levels of serotonin. Serotonin is your happy juice: it’s what makes you feel good. I don’t know if being in constant pain drains your serotonin, or if not having enough serotonin causes migraines. Whatever. I take a supplement 3 times a day and find that it increases my mood, alertness, and the accompanying decrease in migraine activity is very welcome as well. There are many different migraine triggers for different people. One of the most annoying things about migraines is the stuff people throw at you that they are certain causes them: food, allergies, lights, stress, blah blah blah. Scientists believe migraines are similar to epileptic seizures and share a genetic trigger. And different people get migraines from different sources. So, it is not helpful to lecture someone who gets them on, say, doing more yoga, or eating less chocolate. Yoga never did a thing for my migraines and I can’t manage downward facing dog when I am puking. The only thing we really know about migraines is that they hurt like hell, and what works for one person may not work for the next. But what really REALLY won’t work is suffering through them when there is medical treatment that may help you. Please talk to your doctor. I would never have gotten treatment if my brother didn’t first: his doctor prescribed Maxalt and the miraculous results encouraged me to give it a try as well. I don’t leave my house without a Maxalt pill in my purse. To add to the weirdness of my neurological life, I also have a condition known as synaesthesia. Or, more precisely had this condition. When my brain fog symptoms worsened and became chronic, I noticed my synaesthesia began to fade. It was almost completely gone as of about two years ago. I read that this can happen when something changes in your brain, chemical or brain injury, and it reroutes its functions. I see little bits of floaty color once in awhile, but not with the intensity I used to. I don’t really miss the synaesthesia experience. I grew up thinking everybody had it, was surprised to learn they didn’t, and couldn’t understand why people didn’t have the same reactions to colors I did. I now tend to wear more colors than I used to because my emotional reaction to color is gone. I assumed that everyone saw emotions as color, and that is why they equated anger with red and sadness with blue. I was really surprised when they didn’t. In fact, I think the reason I worked in black and white most of my life is to avoid the issue of emotion and color. I know some people embrace it in their work, but I never did. Now that it has faded, I use more color in my work and in my life. Funny, hunh? Anyway, for me, anger was black, red and white splotches. It kind of looked like Frank Miller’s art, actually. Anyway… There are a number of books on Amazon that I recommend, especially The Migraine Brain by Carolyn Bernstein MD.

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Brain Fog

Colleen Doran — Fri, 07 Feb 2014 22:47:30 +0000

You used to be able to do long division in your head. Now you can’t do simple math on paper. You always knew what time it was, never needed a watch, and had the entire television schedule memorized. No one bought a TV Guide because they had you. Now you can’t keep up with your favorite shows because you can’t remember the storylines. Or when they were on. You never had to study because one pass over a book and you had it down. Now you can barely remember what you’ve read a half hour after you put the book away. You write for a living, but you stumble over spelling words like “who”. Brain Fog or Cloudy Consciousness is a cognitive disorder caused by…something. …inattention, thought process abnormalities, comprehension abnormalities, and language abnormalities…reduces quality of life by impairing work activities, social interactions, and driving, but it does not effect basic daily life activities such as dressing, personal hygiene, eating, shopping, answering the phone, or taking public transportation…may even exhibit normal cognitive performances, but overall productivity may suffer from inattentiveness and fatigue secondary to attention abnormalities…(Doctors) have a tendency to “psychologize” it and misdiagnose it as depression or apathy. So, I’ve been struggling with this for over a decade, and did not get a diagnosis or adequate treatment until 2012 (UPDATE: diagnosed in part, but underlying cause not addressed until 2016 – auto-immune disease. Bummer.) It got bad enough that for years there, I was pretty much disabled, producing only a few pages of work a month. I was so out of it that I had trouble remembering things like my middle name. Every day was one long comedy of errors – variations of not being able to find my keys. By 2006, I thought I was pretty much done and would not be able to work in publishing anymore. A close relative also had the same symptoms, and, as I did, later developed severe migraines. (For those of you who have never had a migraine, chronic migraines are debilitating. Mine include migraine aura, temporary blindness, and vomiting. Hit with migraines up to 21 days every month, as a writer and artist, I was simply unable to perform.) He was diagnosed with ADHD and given drugs that made his problems even worse. Only after years of bad reactions to the medication did a doctor finally figure out the real problem behind his brain fog was chronic Lyme Disease. My issue was an even more obvious and common problem – an endocrine imbalance (EDIT: alas, caused by that auto-immune disease that went undiagnosed for years. Can you say bummer, twice? I knew you could.) Once that was addressed, most of my brain fog symptoms disappeared (They can go into remission as the disease does, and come back whether you’re getting treatment or not. I got gobsmacked Fall 2016, but feel better several months later. Hope springs eternal.) After years of unproductivity, I’ve published a number of books over just the last couple of years. Brain fog isn’t just forgetfulness: it’s living in a bizarre twilight world where you are half in and half out of consciousness. Everything seems grey, and you don’t feel the passage of time. ( I could not remember the month, day or year it was.) You float through life, but it’s not a good feeling. You have an almost complete lack of awareness. You’re there, but you do not process what you’re experiencing. What memories you do manage to internalize seem as if they happened to someone else. If you’re a high energy person like me, you feel as if you’ve had a personality transplant – not a good one. You are listless, apathetic, and you don’t have the energy to fight to get better. What’s worse is it may seem like depression or ennui to others, when what you really have is a medical problem no one has caught yet. So you’ve got people telling you to snap out of it as if you have magical powers over your thyroid or your progesterone levels, as if you can talk yourself out of Lyme Disease, Celiac’s Disease, or Lupus. After a few years of dealing with all this, you do get depressed about it in the end. Back in the 1980’s I had chronic fatigue syndrome (they call it myalgic encephalomyelitis now, I’m told,) and when I began having brain fog problems, I was terrified that the viral infection had returned. I’d been symptom free for over 10 years. However, unlike chronic fatigue, my brain fog had no accompanying flu-like symptoms or fever (EDIT: not at first. Later came joint and muscle pain, but I no longer run a mild fever, which I always did when I was first hit with encephalomyelitis. I ran a fever almost constantly for years. Researchers believe that encephalomyelitis, which is an auto-immune disorder, may go hand in hand with the Hashimoto’s disease, with about 20% of patients having both diseases. Hashimoto’s also runs in my family. ) I wondered if a series of personal problems hadn’t plunged me into a depressive state. Everyone feels sad when people die or when someone embezzles your money. Most of us move on. I moved on, but didn’t feel better. Whatever, I felt lousy and couldn’t get stuff done. I was able to get some relief from my symptoms with over the counter energy supplements and herbal remedies supposed to increase pep and attentiveness, like Black Cohosh and green tea. Back in 2010, I blogged about “losing my mojo” and gradually getting back in the game. Even so, I was only working at about half the rate I used to. Now I feel pretty darned good and am working at about 80% of my prior work capacity. I expect that will improve in the coming months. But I wish my doctor had found out what was really going on, oh, about ten years sooner. Because I lost a heck of a lot of quality of life in there. There are many medical problems that can cause brain fog. It’s hard to deal with because you feel so listless and out of it that you have trouble finding the motivation and energy to find out what’s wrong. You may have something that affects a lot of people such as low testosterone or peri-menopause, or a thyroid problem. Or you may have a disease no one thought to look for. If you are unproductive, people tend to dismiss that as a character flaw. At first, I wasn’t very kind to myself when this was going on. I kept thinking if I exercised regularly, or ate the right foods, or stayed motivated, I’d snap out of it. I thought I’d gotten lazy. I’m sure lots of people thought so. People would joke about my absentmindedness, and when I was at shows, I’d be embarrassed by my inability to add up a total on a purchase, or remember things I’d worked on. Clients didn’t appreciate my spacey attitude. Friends who used to chatter on the phone with me wondered why that stopped. People I met at conventions were offended that I couldn’t remember them. I’d screw up orders and commissions. I’d forget entire assignments. Now that I know I have an medical problem, it’s easier to take. But I have a lot of catching up to do. My income plummeted for a long time, my medical bills skyrocketed, and I’ve lost years of prime productivity. When I first mentioned my spaciness, dizzy spells, headaches and other problems more than a decade ago on my old (now down) blog, several of you figured it out immediately, long before my doctor did! But a couple of you blogged that I must be a drug addict or drunk. That was sweet. I forgot a lot of things during all this, but I remember you. Several readers who also struggle with brain fog ask me to blog about how I deal with the problem. Sometimes, not so well. Sometimes like a champ. These days I’m much better, because hey, we know what’s causing this and the fix is pretty easy. But it’s a question of maintenance and I still have brain hiccups. For whatever reason you’ve got your brain fog, your working memory is completely screwed. You have to reduce stress and replace working memory with organization. Get organized, stay organized, and keep notes and records on everything. You will not be able to remember things other people take for granted. Think like an engineer, and back up, back up, back up. Redundancy is your friend. This is why I beg people to follow up with me, and to never make requests of me at conventions or other events. I simply won’t remember them, and then I have to deal with these people being pissed off later. Keep a blog or private journal, save every email, take notes on everything, and keep them in an organized format to which you can easily refer. Don’t try to reinvent the wheel with list-making: keep to a simple, easy to follow routine. Let the people who need to know realize that they must follow-up with you. You don’t have to give clients your sob story: few people appreciate it when they feel guilted into treating you differently. Everybody has problems and some are much worse than yours. Just send a friendly note once in awhile to let your associates know to follow up with you. OK, I’ll blog more about this later. I promise to remember. Acephalous made Work Bird. Work Bird made Acephalous write a dissertation.

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