TRUTHSONG book tour starts today!

The fabulous Roxanne Rhoads is once again whisking me off on a blog tour!

Today's stops are  at The Book Tree , where you get to hear who'd be my dream cast for Truthsong (although they didn't have room for the pictures. I'll post them after the tour when exclusivity is no longer an issue!)

The Creatively Green Write at Home Mom has a list of my top ten favorite fantasy novels of all time. How many of yours match mine?

There's a raffle copter to win a free e-copy of TRUTHSONG on all of the stops in the next two weeks, so please enter!

A new Blog series: Blood and Guts – Medical Information for Writers

**NOTICE** In no way is this article a tool for diagnosis or meant to serve in lieu of a doctor’s advice.  Please consult the appropriate medical personnel if it applies to you or a loved one. It is informational only!

There are a lot of cliches writers fall back on which have basis in medical fact, but not necessarily accurate in the way it’s portrayed in popular film, television and literature.  In a series of blog posts, I’m going to try to help writers find balance between dramatic license and medical fact for a variety of topics.

In my non-writing life, I am a nurse.  I worked in a hospital medical-surgical unit for seven years, a wound care clinic, a post-partum and women’s surgical unit and briefly, school nursing. For the last three years, I’ve been a hospice nurse.

I personally rely on dark humor to help me cope – a lot of medical personnel do, in a ‘laugh or go crazy’ kind of way. My husband is a paramedic (he will also help me contribute to these posts for EMS descriptions), and we kind of …forget…that we can’t talk about the things we see when we’re out in public. The conversations we have at times would make most people flee in self-defense. Our kids are used to this sort of thing after a lifetime of dealing with our jobs. They just roll their eyes and tell us, “Mom, Dad—you’re scaring the normal people.”

In later posts, my husband (we’ll call him EMT Thor) and I will address some of these processes from a trauma standpoint. “It’s Just a Flesh Wound!” will be the next topic. We’ll discuss blood loss, blunt force trauma, and cavitation injury, among other things.

We’re happy to answer questions or take requests for subjects if there is something specific you want to know. 

In this post I’ll discuss natural death in general, either at the end of a long life, or due to an acute disease process. I’m going to do it as simply as possible, without a lot of gory detail. (That isn’t to say I won’t share gory detail if you think it’s critical to your writing. Just ask… and I won’t promise the rest of the articles will be quite as respectfully presented.)

 Post # 1 : Realistic observations about the dying process

One of the things I have learned in my hospice nursing is: death is an incredibly individual process for each patient. 

How we deal with death and dying is also a personal experience, and there are no ‘wrong’ reactions.  However… If the subject bothers you, please stop reading now. Again, this is a generalized description and does not necessarily happen for every individual.

Early symptoms of the dying process

After a chronic illness or disease process can no longer be controlled by medical intervention, we begin to look for trends that alert us vital organs are beginning to be compromised.

The heart and lungs are arguably the most important organs in the body. When they fail, every other organ falls in line. The heart delivers oxygen-rich blood to the brain and the rest of the body after its trip through the lungs, and if that perfusion is compromised, other organ function begins to decline.

Common trends on vital signs at the end of life: the blood pressure goes down. The pulse goes up, and the respirations go up. Extremely low blood pressures, usually below 80s/40s, are not unusual, and keep dropping as the body shuts down peripheral circulation to the extremities. Hands and feet may become cool to the touch and pulses in the wrists and feet may become weak and thready, or absent all together, especially in the feet.

Average pulse rates for an adult are between 60 and 100. At the end of life, the heart is working twice as hard to deliver oxygen to the brain and vital organs, and heart rates can soar. I’ve seen them as high as 160 beats per minute in the hours before death occurs, but usually, it is somewhere between 120 and 140.

Respirations get faster as the lungs try to provide oxygen for the blood the heart is trying to pump. Normal respirations are 12-20 for most adults at rest. At the end of life, respirations usually are in the 30’s, perhaps even the 40s, at rest. A person may use more of their accessory muscles to breathe: muscles in the throat, between the ribs, and in the abdomen. Less chest rise, more belly rise.

Sometimes, we see a pattern called Cheyne-Stokes respirations. This is a pattern of breathing that starts out shallow, works out to a crescendo of deep breaths, tapers back to shallow, followed by a pause in breathing called apnea. Then, the whole pattern starts all over again. I’ve usually seen this in patients with neurological compromise, like brain injuries or strokes, but it can happen to any patient. Apnea can last up to a full minute at times.

As the brain becomes starved of oxygen, or toxic chemical levels in the body rise due to kidney failure, something called terminal restlessness may occur. This can happen hours before or even up to two weeks before death: the patient becomes confused, delirious, can’t relax, and sometimes becomes combative.

A fever unrelated to infection is not uncommon during the early stages of dying, and can be quite high. The body's metabolism is changing and the thermostat is malfunctioning. 

Something else that happens as circulation begins to shut down is mottling. The skin develops a diffuse, purplish discoloration as the blood pressure lacks the sufficient hydraulic pressure to return deoxygenated blood to the cardiovascular system. We usually see this start in areas of the body where capillaries are numerous, such as kneecaps, the fingers and palms of the hands, and the soles of feet. This can also happen across the bridge of the nose. It can progress to all parts of the body. It is a clear sign the circulatory system is failing.  Lividity can also happen before death—the blood pools in the lowest areas of the body, like the buttocks. There is a clear reddish level to the skin where the blood has settled—a bit like red liquid in a white plastic pitcher. It’s more common for this to happen after death, but it can happen a few days before.

“Death rattle” refers to sound made as fluid collects in the lungs. The circulatory system is one big hydraulic pump. When blood pressure drops, it lacks the pressure needed to draw interstitial fluids back into the bloodstream to be redistributed, and it goes naturally to the paths of least resistance. The lungs are built to let oxygen flow back and forth between tissues and the bloodstream, but fluids are not able to move back out once this process is compromised. It may collect in the respiratory system and cause a coarse, rattly, or even bubbling sound as the patient breathes. Expirations may become prolonged, and that sound becomes drawn out. Unfortunately, this may go on for days during the dying process. Medications can be given early to dry up these secretions and keep the patient more comfortable.

Agonal breathing, or “guppy breathing” refers to respirations that are entirely governed by reflex. The mouth and tongue may move, the throat may flex, but very little if any air is being drawn into the lungs. These are usually the last few breaths a person takes. Again, each person’s death is different. Some just…stop. There simply aren’t any more breaths after the last.

The bowels can evacuate in a large movement just prior to or after death. Urine production generally declines as the kidneys lose their oxygenation, and while a person becomes dehydrated during the dying process. 

Quickly after death, changes begin in the body. Color drains from the face as circulation ceases. The eyes do not always stay closed, even when we move the lids into place. The jaw drops as the muscles become flaccid. We will often roll a towel beneath the chin to keep the mouth closed. A few hours after death, rigor mortis begins to set in and the body becomes stiff. This passes somewhere around twelve to eighteen hours after death. 

Although there are common signs and symptoms of dying most people go through, it’s never a ‘classic textbook’ experience. People die in the same way they lived—in their own time, and their own unique manner. 

Book release day for TRUTHSONG!

The sequel is here!  https://goo.gl/mCz7KL

I'm ecstatic if still a bit sleepy from working this weekend, LOL! Telyn's new adventure is released into the wild TODAY! The cover art is from Caroline Andrus of Fire and Ice YA, my partners for this second book in the Songmaker series.

Below is the acknowledgements page from the book - if your name is in this, there's a signed paperback for you. I couldn't have done it without you!

Acknowledgements:

A writer only grows in their craft with the help of other writers as critique partners. I’d like to acknowledge J D Abbas for her excellent dissection of my work and help making this book submittable. Thank you, thank you! My early beta readers are incredible assets who keep me focused and enthusiastic with their feedback. Thank you so much to Sandra Warner, Mark Millham, Jessica Burche, Jeri Grove, Gary McNeff and Gina Juliano.

Thank you to my editor, Aubrey Wynne, who guided me through the early days of internet marketing and press releases, blogs and Twitter with my first book. She has helped me decrease my obsessive use of emdashes and ellipses! Her skill is legendary.

Last, I must again thank my family: Mark, Michaela and Gabriel, for recognizing how important writing is to me, sleeping in on mornings when I get up early to write so I can have an extra hour of solitude, and doing the never-ending laundry when Mom is in the throes of a new book. I love you all. 

I will be doing a book tour with the fantastic Roxanne Rhoads of Bewitching Book Tours in August, and there will be giveaways. I will be posting giveaways on Amazon and Goodreads through the month as well- both signed paperback and digital copies, so keep  your eyes open!  

If you haven't read the first book, it's on sale for 99 cents at Amazon, and 50% off at Smashwords through the end of July. 

Updates and Truthsong Cover Reveal!

This has been a busy year so far for me! I finished the first draft of DALI, my new adult sci fi, and got some wonderful advice and feedback from my excellent CP's and my developmental editor, the incomparable Jami Nord at Chimera Edits. I'm really stoked about it and have a self-imposed deadline to have it ready to query in September. 

In between edits for DALI, I've been doing final edits for TRUTHSONG, which has a release date of July 24th. I'm excited to have this one almost in the bag. I have notes for the final book in Telyn's adventures, LORD OF THE WOOD, and I have no idea yet when that will be finished. I'm kind of obsessed with Dali at the moment, and I always work better when I'm obsessed.

But without further ado, here is the beautiful cover for TRUTHSONG, once again rendered by Caroline Andrus, cover artist extraordinaire:

Lost in first draft land!

Whoa, it's been way too long since I updated the blog!

I've been obsessed by a new project-- I'm working on an adult space opera/sci-fi novel with a main character who blindsided me and just started talking. I'm up to 63K with my list of scenes to write getting shorter by the day. I can't wait to get this one out of my head so I can start to edit.

Truthsong will be out in July or August of this year from Fire and Ice YA, and I can't wait to work with my new editor, who is a writer and mentor I admire. You know who you are.

Nectar and Ambrosia has seen some interest and I rewrote the first few chapters in keeping with suggestions from an editor of a small press. We will see if anything comes from that, but the nagging voice I had started the novel in the wrong place has been silenced by that rewrite. Even if they pass, I think it was a good change.

The day the music died

I know I'm not a kid anymore, but last week's loss of David Bowie hit me harder than I thought it ever would. I have already lost some of the musicians I grew up with, like Freddie Mercury and Michael Jackson, but David Bowie spoke to me on so many levels it was a more personal loss.

I first fell in love with Bowie at a very young age when I saw the album cover of my aunt's copy of Ziggy Stardust and the Spiders from Mars. I'd never seen anyone who looked like that. He was beautiful and strange and something about his voice captivated me right away. I am pretty sure I saw the original airing of Bing Crosby's Christmas Special and falling in love with Bing and Bowie's duet of The Little Drummer Boy (yes, I am dating myself). And there was a weird time when my Mom's Barbara Streisand album had a cover of her singing Is There Life on Mars. It just goes to show the power of the songwriter that even her foray into Bowie's territory was kind of cool in a very, very odd way.

I wasn't really into that kind of music yet when I fell in love with the alien on the album cover, so years passed before I rediscovered David Bowie and A Space Oddity in my teens. "The Man Who Fell to Earth" was a bizarre sci-fi movie he starred in and I had the paperback novel with the stills from the film in the middle. Thanks to MTV,  Ashes to Ashes was a visual trip into my old friend's newer music. Suddenly, everybody knew who he was. Fashion, China Girl, Let's Dance, Modern Love, Blue Jean- his renaissance was a thing of beauty that only continued to grow. "Merry Christmas, Mr. Lawrence" was a beautiful film in which he played a British prisoner of war. "The Hunger" saw him portray an aging vampire. There were other films, but these were my favorites. And then came "Labyrinth".

I sneaked out of work early to see "Labyrinth" at the theater for a second and third time without anybody knowing. Ye gods, the man was beautiful as the Goblin King.

If you haven't seen Bowie's final masterpiece, the video for Lazarus, seek it out. It made me cry. The dying man in the bed, the artist/writer scribbling desperately to outrace mortality and continue to create...he was truly saying goodbye, although none of us knew this until after the fact, when it hit home with all too painful truth.

He was an artist who wed music to science fiction, a consummate performer who reinvented himself over and over. I'm thankful for the body of work he leaves behind.

I'm Eleven Again! (NO SPOILERS)

This is me right now.

Star Wars was a turning point in my life. 

I was eleven that summer, and the world of science fiction had already begun to tempt me to fully join the Nerd Side. I'd read Heinlein's Tunnel in The Sky, loved Lost in Space. My main genre was still fantasy.

Then, I met Luke Skywalker, Princess Leia, and Han Solo. It was love at first sight. I can still study the Brothers Hildebrandt poster for hours, the warm, sunset colors illuminating the abs Mark Hamill wished he had. I had a yellow t-shirt with the same iron-on transfer. I wore it until I outgrew it.

I decided I was Luke Skywalker's sister, Diana Skywalker, Jedi Knight in training. (Remember, we didn't know Leia was related yet.) My long suffering friends in the neighborhood, already used to my dead-serious games of make believe based on stuff they had never read, were dragged into my new obsession. My friend Stephanie was Biggs Darklighter's sister, of course, and we trained together in the field at the end of the street, whacking at each other with unstrung plastic archery equipment for light sabers. She was very good natured about the whole thing, but I knew she really wasn't into it.

I saw Star Wars eleven times that summer. All but maybe three or four times, I was alone.

It was then I discovered that sci-fi and fantasy fandom is sometimes a lonely thing. People don't understand you or your obsessions. When I did find somebody who knew what I was talking about, there was this great rush of joy and we could play with my Star Wars action figures and look at my bundles of trading cards. But nobody was really as 'into it' as I was. 

That continued through most of my life. I'd occasionally find friends who were as obsessed as I was about my various fandoms, joined a D&D group, and did other social things with like minded people. But I was always happiest alone, writing my stories that we didn't call fanfic yet, dreaming about traveling other worlds, and re-reading my favorite books. Before the advent of the internet which made it possible for us to find Our People easily, many of us were clandestine, solitary individuals waiting for a sign that it was safe to reveal our secret obsessions.

I found friends who were like me. At last, My People! I married one of them twenty one years ago and we have been happily geeking out for that entire period.

And then, we had children. Muahahahahaha. And we warped them in our image. My daughter and I have conversations in fandomspeak that even my husband doesn't understand. 

Seeing Star Wars: The Force Awakens with my family today was a joyful event. The moment that crawl and the brass fanfare came on my face started to hurt from smiling. Best of all was being able to share the 'in jokes' that JJ Abrams and crew inserted into the film. And my son, during an intensely emotional scene, putting his arm around me and saying, "It's OK, Mom." He understands my attachment to these characters, and that I have known them almost literally my entire life. 

It was everything I hoped it would be. Well done, JJ. Thank you.

And I'm eleven again, even though I will turn fifty on Monday. But this time I get to share my obsession with my family and My People, all over the world.