More on Entrepreneurship/Creators

Greg Lim
2 years ago
How I made $160,000 from non-fiction books
I've sold over 40,000 non-fiction books on Amazon and made over $160,000 in six years while writing on the side.
I have a full-time job and three young sons; I can't spend 40 hours a week writing. This article describes my journey.
I write mainly tech books:
Thanks to my readers, many wrote positive evaluations. Several are bestsellers.
A few have been adopted by universities as textbooks:
My books' passive income allows me more time with my family.
Knowing I could quit my job and write full time gave me more confidence. And I find purpose in my work (i am in christian ministry).
I'm always eager to write. When work is a dread or something bad happens, writing gives me energy. Writing isn't scary. In fact, I can’t stop myself from writing!
Writing has also established my tech authority. Universities use my books, as I've said. Traditional publishers have asked me to write books.
These mindsets helped me become a successful nonfiction author:
1. You don’t have to be an Authority
Yes, I have computer science experience. But I'm no expert on my topics. Before authoring "Beginning Node.js, Express & MongoDB," my most profitable book, I had no experience with those topics. Node was a new server-side technology for me. Would that stop me from writing a book? It can. I liked learning a new technology. So I read the top three Node books, took the top online courses, and put them into my own book (which makes me know more than 90 percent of people already).
I didn't have to worry about using too much jargon because I was learning as I wrote. An expert forgets a beginner's hardship.
"The fellow learner can aid more than the master since he knows less," says C.S. Lewis. The problem he must explain is recent. The expert has forgotten.”
2. Solve a micro-problem (Niching down)
I didn't set out to write a definitive handbook. I found a market with several challenges and wrote one book. Ex:
- Instead of web development, what about web development using Angular?
- Instead of Blockchain, what about Blockchain using Solidity and React?
- Instead of cooking recipes, how about a recipe for a specific kind of diet?
- Instead of Learning math, what about Learning Singapore Math?
3. Piggy Backing Trends
The above topics may still be a competitive market. E.g. Angular, React. To stand out, include the latest technologies or trends in your book. Learn iOS 15 instead of iOS programming. Instead of personal finance, what about personal finance with NFTs.
Even though you're a newbie author, your topic is well-known.
4. Publish short books
My books are known for being direct. Many people like this:
Your reader will appreciate you cutting out the fluff and getting to the good stuff. A reader can finish and review your book.
Second, short books are easier to write. Instead of creating a 500-page book for $50 (which few will buy), write a 100-page book that answers a subset of the problem and sell it for less. (You make less, but that's another subject). At least it got published instead of languishing. Less time spent creating a book means less time wasted if it fails. Write a small-bets book portfolio like Daniel Vassallo!
Third, it's $2.99-$9.99 on Amazon (gets 70 percent royalties for ebooks). Anything less receives 35% royalties. $9.99 books have 20,000–30,000 words. If you write more and charge more over $9.99, you get 35% royalties. Why not make it a $9.99 book?
(This is the ebook version.) Paperbacks cost more. Higher royalties allow for higher prices.
5. Validate book idea
Amazon will tell you if your book concept, title, and related phrases are popular. See? Check its best-sellers list.
150,000 is preferable. It sells 2–3 copies daily. Consider your rivals. Profitable niches have high demand and low competition.
Don't be afraid of competitive niches. First, it shows high demand. Secondly, what are the ways you can undercut the completion? Better book? Or cheaper option? There was lots of competition in my NodeJS book's area. None received 4.5 stars or more. I wrote a NodeJS book. Today, it's a best-selling Node book.
What’s Next
So long. Part II follows. Meanwhile, I will continue to write more books!
Follow my journey on Twitter.
This post is a summary. Read full article here

Muthinja
2 years ago
Why don't you relaunch my startup projects?
Open to ideas or acquisitions
Failure is an unavoidable aspect of life, yet many recoil at the word.

I've worked on unrelated startup projects. This is a list of products I developed (often as the tech lead or co-founder) and why they failed to launch.
Chess Bet (Betting)
As a chess player who plays 5 games a day and has an ELO rating of 2100, I tried to design a chess engine to rival stockfish and Houdini.
While constructing my chess engine, my cofounder asked me about building a p2p chess betting app. Chess Bet. There couldn't be a better time.
Two people in different locations could play a staked game. The winner got 90% of the bet and we got 10%. The business strategy was clear, but our mini-launch was unusual.
People started employing the same cheat engines I mentioned, causing user churn and defaming our product.
It was the first programming problem I couldn't solve after building a cheat detection system based on player move strengths and prior games. Chess.com, the most famous online chess software, still suffers from this.
We decided to pivot because we needed an expensive betting license.
We relaunched as Chess MVP after deciding to focus on chess learning. A platform for teachers to create chess puzzles and teach content. Several chess students used our product, but the target market was too tiny.
We chose to quit rather than persevere or pivot.
BodaCare (Insure Tech)
‘BodaBoda’ in Swahili means Motorcycle. My Dad approached me in 2019 (when I was working for a health tech business) about establishing an Insurtech/fintech solution for motorbike riders to pay for insurance using SNPL.
We teamed up with an underwriter to market motorcycle insurance. Once they had enough premiums, they'd get an insurance sticker in the mail. We made it better by splitting the cover in two, making it more reasonable for motorcyclists struggling with lump-sum premiums.
Lack of capital and changing customer behavior forced us to close, with 100 motorcyclists paying 0.5 USD every day. Our unit econ didn't make sense, and CAC and retention capital only dug us deeper.
Circle (Social Networking)
Having learned from both product failures, I began to understand what worked and what didn't. While reading through Instagram, an idea struck me.
Suppose social media weren't virtual.
Imagine meeting someone on your way home. Like-minded person
People were excited about social occasions after covid restrictions were eased. Anything to escape. I just built a university student-popular experiences startup. Again, there couldn't be a better time.
I started the Android app. I launched it on Google Beta and oh my! 200 people joined in two days.
It works by signaling if people are in a given place and allowing users to IM in hopes of meeting up in near real-time. Playstore couldn't deploy the app despite its success in beta for unknown reasons. I appealed unsuccessfully.
My infrastructure quickly lost users because I lacked funding.
In conclusion
This essay contains many failures, some of which might have been avoided and others not, but they were crucial learning points in my startup path.
If you liked any idea, I have the source code on Github.
Happy reading until then!

Antonio Neto
2 years ago
Should you skip the minimum viable product?
Are MVPs outdated and have no place in modern product culture?
Frank Robinson coined "MVP" in 2001. In the same year as the Agile Manifesto, the first Scrum experiment began. MVPs are old.
The concept was created to solve the waterfall problem at the time.
The market was still sour from the .com bubble. The tech industry needed a new approach. Product and Agile gained popularity because they weren't waterfall.
More than 20 years later, waterfall is dead as dead can be, but we are still talking about MVPs. Does that make sense?
What is an MVP?
Minimum viable product. You probably know that, so I'll be brief:
[…] The MVP fits your company and customer. It's big enough to cause adoption, satisfaction, and sales, but not bloated and risky. It's the product with the highest ROI/risk. […] — Frank Robinson, SyncDev
MVP is a complete product. It's not a prototype. It's your product's first iteration, which you'll improve. It must drive sales and be user-friendly.
At the MVP stage, you should know your product's core value, audience, and price. We are way deep into early adoption territory.
What about all the things that come before?
Modern product discovery
Eric Ries popularized the term with The Lean Startup in 2011. (Ries would work with the concept since 2008, but wide adoption came after the book was released).
Ries' definition of MVP was similar to Robinson's: "Test the market" before releasing anything. Ries never mentioned money, unlike Jobs. His MVP's goal was learning.
“Remove any feature, process, or effort that doesn't directly contribute to learning” — Eric Ries, The Lean Startup
Product has since become more about "what" to build than building it. What started as a learning tool is now a discovery discipline: fake doors, prototyping, lean inception, value proposition canvas, continuous interview, opportunity tree... These are cheap, effective learning tools.
Over time, companies realized that "maximum ROI divided by risk" started with discovery, not the MVP. MVPs are still considered discovery tools. What is the problem with that?
Time to Market vs Product Market Fit
Waterfall's Time to Market is its biggest flaw. Since projects are sliced horizontally rather than vertically, when there is nothing else to be done, it’s not because the product is ready, it’s because no one cares to buy it anymore.
MVPs were originally conceived as a way to cut corners and speed Time to Market by delivering more customer requests after they paid.
Original product development was waterfall-like.
Time to Market defines an optimal, specific window in which value should be delivered. It's impossible to predict how long or how often this window will be open.
Product Market Fit makes this window a "state." You don’t achieve Product Market Fit, you have it… and you may lose it.
Take, for example, Snapchat. They had a great time to market, but lost product-market fit later. They regained product-market fit in 2018 and have grown since.
An MVP couldn't handle this. What should Snapchat do? Launch Snapchat 2 and see what the market was expecting differently from the last time? MVPs are a snapshot in time that may be wrong in two weeks.
MVPs are mini-projects. Instead of spending a lot of time and money on waterfall, you spend less but are still unsure of the results.
MVPs aren't always wrong. When releasing your first product version, consider an MVP.
Minimum viable product became less of a thing on its own and more interchangeable with Alpha Release or V.1 release over time.
Modern discovery technics are more assertive and predictable than the MVP, but clarity comes only when you reach the market.
MVPs aren't the starting point, but they're the best way to validate your product concept.
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Andy Walker
2 years ago
Why personal ambition and poor leadership caused Google layoffs
Google announced 6% layoffs recently (or 12,000 people). This aligns it with most tech companies. A publicly contrite CEO explained that they had overhired during the COVID-19 pandemic boom and had to address it, but they were sorry and took full responsibility. I thought this was "bullshit" too. Meta, Amazon, Microsoft, and others must feel similarly. I spent 10 years at Google, and these things don't reflect well on the company's leaders.
All publicly listed companies have a fiduciary duty to act in the best interests of their shareholders. Dodge vs. Ford Motor Company established this (1919). Henry Ford wanted to reduce shareholder payments to offer cheaper cars and better wages. Ford stated.
My ambition is to employ still more men, to spread the benefits of this industrial system to the greatest possible number, to help them build up their lives and their homes. To do this we are putting the greatest share of our profits back in the business.
The Dodge brothers, who owned 10% of Ford, opposed this and sued Ford for the payments to start their own company. They won, preventing Ford from raising prices or salaries. If you have a vocal group of shareholders with the resources to sue you, you must prove you are acting in their best interests. Companies prioritize shareholders. Giving activist investors a stick to threaten you almost enshrines short-term profit over long-term thinking.
This underpins Google's current issues. Institutional investors who can sue Google see it as a wasteful company they can exploit. That doesn't mean you have to maximize profits (thanks to those who pointed out my ignorance of US corporate law in the comments and on HN), but it allows pressure. I feel for those navigating this. This is about unrestrained capitalism.
When Google went public, Larry Page and Sergey Brin knew the risks and worked hard to keep control. In their Founders' Letter to investors, they tried to set expectations for the company's operations.
Our long-term focus as a private company has paid off. Public companies do the same. We believe outside pressures lead companies to sacrifice long-term opportunities to meet quarterly market expectations.
The company has transformed since that letter. The company has nearly 200,000 full-time employees and a trillion-dollar market cap. Large investors have bought company stock because it has been a good long-term bet. Why are they restless now?
Other big tech companies emerged and fought for top talent. This has caused rising compensation packages. Google has also grown rapidly (roughly 22,000 people hired to the end of 2022). At $300,000 median compensation, those 22,000 people added $6.6 billion in salary overheads in 2022. Exorbitant. If the company still makes $16 billion every quarter, maybe not. Investors wonder if this value has returned.
Investors are right. Google uses people wastefully. However, by bluntly reducing headcount, they're not addressing the root causes and hurting themselves. No studies show that downsizing this way boosts productivity. There is plenty of evidence that they'll lose out because people will be risk-averse and distrust their leadership.
The company's approach also stinks. Finding out that you no longer have a job because you can’t log in anymore (sometimes in cases where someone is on call for protecting your production systems) is no way to fire anyone. Being with a narcissistic sociopath is like being abused. First, you receive praise and fancy perks for making the cut. You're fired by text and ghosted. You're told to appreciate the generous severance package. This firing will devastate managers and teams. This type of firing will take years to recover self-esteem. Senior management contributed to this. They chose the expedient answer, possibly by convincing themselves they were managing risk and taking the Macbeth approach of “If it were done when ’tis done, then ’twere well It were done quickly”.
Recap. Google's leadership did a stupid thing—mass firing—in a stupid way. How do we get rid of enough people to make investors happier? and "have 6% less people." Empathetic leaders should not emulate Elon Musk. There is no humane way to fire 12,000 people, but there are better ways. Why is Google so wasteful?
Ambition answers this. There aren't enough VP positions for a group of highly motivated, ambitious, and (increasingly) ruthless people. I’ve loitered around the edges of this world and a large part of my value was to insulate my teams from ever having to experience it. It’s like Game of Thrones played out through email and calendar and over video call.
Your company must look a certain way to be promoted to director or higher. You need the right people at the right levels under you. Long-term, growing your people will naturally happen if you're working on important things. This takes time, and you're never more than 6–18 months from a reorg that could start you over. Ambitious people also tend to be impatient. So, what do you do?
Hiring and vanity projects. To shape your company, you hire at the right levels. You value vanity metrics like active users over product utility. Your promo candidates get through by subverting the promotion process. In your quest for growth, you avoid performance managing people out. You avoid confronting toxic peers because you need their support for promotion. Your cargo cult gets you there.
Its ease makes Google wasteful. Since they don't face market forces, the employees don't see it as a business. Why would you do when the ads business is so profitable? Complacency causes senior leaders to prioritize their own interests. Empires collapse. Personal ambition often trumped doing the right thing for users, the business, or employees. Leadership's ambition over business is the root cause. Vanity metrics, mass hiring, and vague promises have promoted people to VP. Google goes above and beyond to protect senior leaders.
The decision-makers and beneficiaries are not the layoffees. Stock price increase beneficiaries. The people who will post on LinkedIn how it is about misjudging the market and how they’re so sorry and take full responsibility. While accumulating wealth, the dark room dwellers decide who stays and who goes. The billionaire investors. Google should start by addressing its bloated senior management, but — as they say — turkeys don't vote for Christmas. It should examine its wastefulness and make tough choices to fix it. A 6% cut is a blunt tool that admits you're not running your business properly. why aren’t the people running the business the ones shortly to be entering the job market?
This won't fix Google's wastefulness. The executives may never regain trust after their approach. Suppressed creativity. Business won't improve. Google will have lost its founding vision and us all. Large investors know they can force Google's CEO to yield. The rich will get richer and rationalize leaving 12,000 people behind. Cycles repeat.
It doesn’t have to be this way. In 2013, Nintendo's CEO said he wouldn't fire anyone for shareholders. Switch debuted in 2017. Nintendo's stock has increased by nearly five times, or 19% a year (including the drop most of the stock market experienced last year). Google wasted 12,000 talented people. To please rich people.
Matthew Royse
2 years ago
7 ways to improve public speaking
How to overcome public speaking fear and give a killer presentation
"Public speaking is people's biggest fear, according to studies. Death's second. The average person is better off in the casket than delivering the eulogy." — American comedian, actor, writer, and producer Jerry Seinfeld
People fear public speaking, according to research. Public speaking can be intimidating.
Most professions require public speaking, whether to 5, 50, 500, or 5,000 people. Your career will require many presentations. In a small meeting, company update, or industry conference.
You can improve your public speaking skills. You can reduce your anxiety, improve your performance, and feel more comfortable speaking in public.
“If I returned to college, I'd focus on writing and public speaking. Effective communication is everything.” — 38th president Gerald R. Ford
You can deliver a great presentation despite your fear of public speaking. There are ways to stay calm while speaking and become a more effective public speaker.
Seven tips to improve your public speaking today. Let's help you overcome your fear (no pun intended).
Know your audience.
"You're not being judged; the audience is." — Entrepreneur, author, and speaker Seth Godin
Understand your audience before speaking publicly. Before preparing a presentation, know your audience. Learn what they care about and find useful.
Your presentation may depend on where you're speaking. A classroom is different from a company meeting.
Determine your audience before developing your main messages. Learn everything about them. Knowing your audience helps you choose the right words, information (thought leadership vs. technical), and motivational message.
2. Be Observant
Observe others' speeches to improve your own. Watching free TED Talks on education, business, science, technology, and creativity can teach you a lot about public speaking.
What worked and what didn't?
What would you change?
Their strengths
How interesting or dull was the topic?
Note their techniques to learn more. Studying the best public speakers will amaze you.
Learn how their stage presence helped them communicate and captivated their audience. Please note their pauses, humor, and pacing.
3. Practice
"A speaker should prepare based on what he wants to learn, not say." — Author, speaker, and pastor Tod Stocker
Practice makes perfect when it comes to public speaking. By repeating your presentation, you can find your comfort zone.
When you've practiced your presentation many times, you'll feel natural and confident giving it. Preparation helps overcome fear and anxiety. Review notes and important messages.
When you know the material well, you can explain it better. Your presentation preparation starts before you go on stage.
Keep a notebook or journal of ideas, quotes, and examples. More content means better audience-targeting.
4. Self-record
Videotape your speeches. Check yourself. Body language, hands, pacing, and vocabulary should be reviewed.
Best public speakers evaluate their performance to improve.
Write down what you did best, what you could improve and what you should stop doing after watching a recording of yourself. Seeing yourself can be unsettling. This is how you improve.
5. Remove text from slides
"Humans can't read and comprehend screen text while listening to a speaker. Therefore, lots of text and long, complete sentences are bad, bad, bad.” —Communications expert Garr Reynolds
Presentation slides shouldn't have too much text. 100-slide presentations bore the audience. Your slides should preview what you'll say to the audience.
Use slides to emphasize your main point visually.
If you add text, use at least 40-point font. Your slides shouldn't require squinting to read. You want people to watch you, not your slides.
6. Body language
"Body language is powerful." We had body language before speech, and 80% of a conversation is read through the body, not the words." — Dancer, writer, and broadcaster Deborah Bull
Nonverbal communication dominates. Our bodies speak louder than words. Don't fidget, rock, lean, or pace.
Relax your body to communicate clearly and without distraction through nonverbal cues. Public speaking anxiety can cause tense body language.
Maintain posture and eye contact. Don’t put your hand in your pockets, cross your arms, or stare at your notes. Make purposeful hand gestures that match what you're saying.
7. Beginning/ending Strong
Beginning and end are memorable. Your presentation must start strong and end strongly. To engage your audience, don't sound robotic.
Begin with a story, stat, or quote. Conclude with a summary of key points. Focus on how you will start and end your speech.
You should memorize your presentation's opening and closing. Memorize something naturally. Excellent presentations start and end strong because people won't remember the middle.
Bringing It All Together
Seven simple yet powerful ways to improve public speaking. Know your audience, study others, prepare and rehearse, record yourself, remove as much text as possible from slides, and start and end strong.
Follow these tips to improve your speaking and audience communication. Prepare, practice, and learn from great speakers to reduce your fear of public speaking.
"Speaking to one person or a thousand is public speaking." — Vocal coach Roger Love

Kyle Planck
2 years ago
The chronicles of monkeypox.
or, how I spread monkeypox and got it myself.
This story contains nsfw (not safe for wife) stuff and shouldn't be read if you're under 18 or think I'm a newborn angel. After the opening, it's broken into three sections: a chronological explanation of my disease course, my ideas, and what I plan to do next.
Your journey awaits.
As early as mid-may, I was waltzing around the lab talking about monkeypox, a rare tropical disease with an inaccurate name. Monkeys are not its primary animal reservoir. It caused an outbreak among men who have sex with men across Europe, with unprecedented levels of person-to-person transmission. European health authorities speculated that the virus spread at raves and parties and was easily transferred through intimate, mainly sexual, contact. I had already read the nejm article about the first confirmed monkeypox patient in the u.s. and shared the photos on social media so people knew what to look for. The cdc information page only included 4 photographs of monkeypox lesions that looked like they were captured on a motorola razr.
I warned my ex-boyfriend about monkeypox. Monkeypox? responded.
Mom, I'm afraid about monkeypox. What's monkeypox?
My therapist is scared about monkeypox. What's monkeypox?
Was I alone? A few science gays on Twitter didn't make me feel overreacting.
This information got my gay head turning. The incubation period for the sickness is weeks. Many of my social media contacts are traveling to Europe this summer. What is pride? Travel, parties, and sex. Many people may become infected before attending these activities. Monkeypox will affect the lgbtq+ community.
Being right always stinks. My young scientist brain was right, though. Someone who saw this coming is one of the early victims. I'll talk about my feelings publicly, and trust me, I have many concerning what's occurring.
Part 1 is the specifics.
Wednesday nights are never smart but always entertaining. I didn't wake up until noon on june 23 and saw gay twitter blazing. Without warning, the nyc department of health announced a pop-up monkeypox immunization station in chelsea. Some days would be 11am-7pm. Walk-ins were welcome, however appointments were preferred. I tried to arrange an appointment after rubbing my eyes, but they were all taken. I got out of bed, washed my face, brushed my teeth, and put on short shorts because I wanted to get a walk-in dose and show off my legs. I got a 20-oz. cold brew on the way to the train and texted a chelsea-based acquaintance for help.
Clinic closed at 2pm. No more doses. Hundreds queued up. The government initially gave them only 1,000 dosages. For a city with 500,000 LGBT people, c'mon. What more could I do? I was upset by how things were handled. The evidence speaks for itself.
I decided to seek an appointment when additional doses were available and continued my weekend. I was celebrating nyc pride with pals. Fun! sex! *
On tuesday after that, I felt a little burn. This wasn't surprising because I'd been sexually active throughout the weekend, so I got a sti panel the next day. I expected to get results in a few days, take antibiotics, and move on.
Emerging germs had other intentions. Wednesday night, I felt sore, and thursday morning, I had a blazing temperature and had sweat through my bedding. I had fever, chills, and body-wide aches and pains for three days. I reached 102 degrees. I believed I had covid over pride weekend, but I tested negative for three days straight.
STDs don't induce fevers or other systemic symptoms. If lymphogranuloma venereum advances, it can cause flu-like symptoms and swollen lymph nodes. I was suspicious and desperate for answers, so I researched monkeypox on the cdc website (for healthcare professionals). Much of what I saw on screen about monkeypox prodrome matched my symptoms. Multiple-day fever, headache, muscle aches, chills, tiredness, enlarged lymph nodes. Pox were lacking.
I told my doctor my concerns pre-medically. I'm occasionally annoying.
On saturday night, my fever broke and I felt better. Still burning, I was optimistic till sunday, when I woke up with five red splotches on my arms and fingertips.
As spots formed, burning became pain. I observed as spots developed on my body throughout the day. I had more than a dozen by the end of the day, and the early spots were pustular. I had monkeypox, as feared.
Fourth of July weekend limited my options. I'm well-connected in my school's infectious disease academic community, so I texted a coworker for advice. He agreed it was likely monkeypox and scheduled me for testing on tuesday.
nyc health could only perform 10 monkeypox tests every day. Before doctors could take swabs and send them in, each test had to be approved by the department. Some commercial labs can now perform monkeypox testing, but the backlog is huge. I still don't have a positive orthopoxvirus test five days after my test. *My 12-day-old case may not be included in the official monkeypox tally. This outbreak is far wider than we first thought, therefore I'm attempting to spread the information and help contain it.
*Update, 7/11: I have orthopoxvirus.
I spent all day in the bathtub because of the agony. Warm lavender epsom salts helped me feel better. I can't stand lavender anymore. I brought my laptop into the bathroom and viewed everything everywhere at once (2022). If my ex and I hadn't recently broken up, I wouldn't have monkeypox. All of these things made me cry, and I sat in the bathtub on the 4th of July sobbing. I thought, Is this it? I felt like Bridesmaids' Kristen Wiig (2011). I'm a flop. From here, things can only improve.
Later that night, I wore a mask and went to my roof to see the fireworks. Even though I don't like fireworks, there was something wonderful about them this year: the colors, how they illuminated the black surfaces around me, and their transient beauty. Joyful moments rarely linger long in our life. We must enjoy them now.
Several roofs away, my neighbors gathered. Happy 4th! I heard a woman yell. Why is this godforsaken country so happy? Instead of being rude, I replied. I didn't tell them I had monkeypox. I thought that would kill the mood.
By the time I went to the hospital the next day to get my lesions swabbed, wearing long sleeves, pants, and a mask, they looked like this:
I had 30 lesions on my arms, hands, stomach, back, legs, buttcheeks, face, scalp, and right eyebrow. I had some in my mouth, gums, and throat. Current medical thought is that lesions on mucous membranes cause discomfort in sensitive places. Internal lesions are a new feature of this outbreak of monkeypox. Despite being unattractive, the other sores weren't unpleasant or bothersome.
I had a bacterial sti with the pox. Who knows if that would've created symptoms (often it doesn't), but different infections can happen at once. My care team remembered that having a sti doesn't exclude out monkeypox. doxycycline rocks!
The coworker who introduced me to testing also offered me his home. We share a restroom, and monkeypox can be spread through surfaces. (Being a dna virus gives it environmental hardiness that rna viruses like sars-cov-2 lack.) I disinfected our bathroom after every usage, but I was apprehensive. My friend's place has a guest room and second bathroom, so no cross-contamination. It was the ideal monkeypox isolation environment, so I accepted his offer and am writing this piece there. I don't know what I would have done without his hospitality and attention.
The next day, I started tecovirimat, or tpoxx, for 14 days. Smallpox has been eradicated worldwide since the 1980s but remains a bioterrorism concern. Tecovirimat has a unique, orthopoxvirus-specific method of action, which reduces side effects to headache and nausea. It hasn't been used in many people, therefore the cdc is encouraging patients who take it for monkeypox to track their disease and symptoms.
Tpoxx's oral absorption requires a fatty meal. The hospital ordered me to take the medication after a 600-calorie, 25-gram-fat meal every 12 hours. The coordinator joked, "Don't diet for the next two weeks." I wanted to get peanut butter delivered, but jif is recalling their supply due to salmonella. Please give pathogens a break. I got almond butter.
Tpoxx study enrollment was documented. After signing consent documents, my lesions were photographed and measured during a complete physical exam. I got bloodwork to assess my health. My medication delivery was precise; every step must be accounted for. I got a two-week supply and started taking it that night. I rewarded myself with McDonald's. I'd been hungry for a week. I was also prescribed ketorolac (aka toradol), a stronger ibuprofen, for my discomfort.
I thought tpoxx was a wonder medicine by day two of treatment. Early lesions looked like this.
however, They vanished. The three largest lesions on my back flattened and practically disappeared into my skin. Some pustular lesions were diminishing. Tpoxx+toradol has helped me sleep, focus, and feel human again. I'm down to twice-daily baths and feeling hungrier than ever in this illness. On day five of tpoxx, some of the lesions look like this:
I have a ways to go. We must believe I'll be contagious until the last of my patches scabs over, falls off, and sprouts new skin. There's no way to tell. After a week and a half of tremendous pain and psychological stress, any news is good news. I'm grateful for my slow but steady development.
Part 2 of the rant.
Being close to yet not in the medical world is interesting. It lets me know a lot about it without being persuaded by my involvement. Doctors identify and treat patients using a tool called differential diagnosis.
A doctor interviews a patient to learn about them and their symptoms. More is better. Doctors may ask, "Have you traveled recently?" sex life? Have pets? preferred streaming service? (No, really. (Hbomax is right.) After the inquisition, the doctor will complete a body exam ranging from looking in your eyes, ears, and throat to a thorough physical.
After collecting data, the doctor makes a mental (or physical) inventory of all the conceivable illnesses that could cause or explain the patient's symptoms. Differential diagnosis list. After establishing the differential, the clinician can eliminate options. The doctor will usually conduct nucleic acid tests on swab samples or bloodwork to learn more. This helps eliminate conditions from the differential or boosts a condition's likelihood. In an ideal circumstance, the doctor can eliminate all but one reason of your symptoms, leaving your formal diagnosis. Once diagnosed, treatment can begin. yay! Love medicine.
My symptoms two weeks ago did not suggest monkeypox. Fever, pains, weariness, and swollen lymph nodes are caused by several things. My scandalous symptoms weren't linked to common ones. My instance shows the importance of diversity and representation in healthcare. My doctor isn't gay, but he provides culturally sensitive care. I'd heard about monkeypox as a gay man in New York. I was hyper-aware of it and had heard of friends of friends who had contracted it the week before, even though the official case count in the US was 40. My physicians weren't concerned, but I was. How would it appear on his mental differential if it wasn't on his radar? Mental differential rhymes! I'll trademark it to prevent theft. differential!
I was in a rare position to recognize my condition and advocate for myself. I study infections. I'd spent months researching monkeypox. I work at a university where I rub shoulders with some of the country's greatest doctors. I'm a gay dude who follows nyc queer social networks online. All of these variables positioned me to think, "Maybe this is monkeypox," and to explain why.
This outbreak is another example of privilege at work. The brokenness of our healthcare system is once again exposed by the inequities produced by the vaccination rollout and the existence of people like myself who can pull strings owing to their line of work. I can't cure this situation on my own, but I can be a strong voice demanding the government do a better job addressing the outbreak and giving resources and advice to everyone I can.
lgbtqia+ community members' support has always impressed me in new york. The queer community has watched out for me and supported me in ways I never dreamed were possible.
Queer individuals are there for each other when societal structures fail. People went to the internet on the first day of the vaccine rollout to share appointment information and the vaccine clinic's message. Twitter timelines were more effective than marketing campaigns. Contrary to widespread anti-vaccine sentiment, the LGBT community was eager to protect themselves. Smallpox vaccination? sure. gimme. whether I'm safe. I credit the community's sex positivity. Many people are used to talking about STDs, so there's a reduced barrier to saying, "I think I have something, you should be on the watch too," and taking steps to protect our health.
Once I got monkeypox, I posted on Twitter and Instagram. Besides fueling my main character syndrome, I felt like I wasn't alone. My dc-based friend had monkeypox within hours. He told me about his experience and gave me ideas for managing the discomfort. I can't imagine life without him.
My buddy and colleague organized my medical care and let me remain in his home. His and his husband's friendliness and attention made a world of difference in my recovery. All of my friends and family who helped me, whether by venmo, doordash, or moral support, made me feel cared about. I don't deserve the amazing people in my life.
Finally, I think of everyone who commented on my social media posts regarding my trip. Friends from all sectors of my life and all sexualities have written me well wishes and complimented me for my vulnerability, but I feel the most gravitas from fellow lgbtq+ persons. They're learning to spot. They're learning where to go ill. They're learning self-advocacy. I'm another link in our network of caretaking. I've been cared for, therefore I want to do the same. Community and knowledge are powerful.
You're probably wondering where the diatribe is. You may believe he's gushing about his loved ones, and you'd be right. I say that just because the queer community can take care of itself doesn't mean we should.
Even when caused by the same pathogen, comparing health crises is risky. Aids is unlike covid-19 or monkeypox, yet all were caused by poorly understood viruses. The lgbtq+ community has a history of self-medicating. Queer people (and their supporters) have led the charge to protect themselves throughout history when the government refused. Surreal to experience this in real time.
First, vaccination access is a government failure. The strategic national stockpile contains tens of thousands of doses of jynneos, the newest fda-approved smallpox vaccine, and millions of doses of acam2000, an older vaccine for immunocompetent populations. Despite being a monkeypox hotspot and international crossroads, new york has only received 7,000 doses of the jynneos vaccine. Vaccine appointments are booked within minutes. It's showing Hunger Games, which bothers me.
Second, I think the government failed to recognize the severity of the european monkeypox outbreak. We saw abroad reports in may, but the first vaccines weren't available until june. Why was I a 26-year-old pharmacology grad student, able to see a monkeypox problem in europe but not the u.s. public health agency? Or was there too much bureaucracy and politicking, delaying action?
Lack of testing infrastructure for a known virus with vaccinations and therapies is appalling. More testing would have helped understand the problem's breadth. Many homosexual guys, including myself, didn't behave like monkeypox was a significant threat because there were only a dozen instances across the country. Our underestimating of the issue, spurred by a story of few infections, was huge.
Public health officials' response to infectious diseases frustrates me. A wait-and-see approach to infectious diseases is unsatisfactory. Before a sick person is recognized, they've exposed and maybe contaminated numerous others. Vaccinating susceptible populations before a disease becomes entrenched prevents disease. CDC might operate this way. When it was easier, they didn't control or prevent monkeypox. We'll learn when. Sometimes I fear never. Emerging viral infections are a menace in the era of climate change and globalization, and I fear our government will repeat the same mistakes. I don't work at the cdc, thus I have no idea what they do. As a scientist, a homosexual guy, and a citizen of this country, I feel confident declaring that the cdc has not done enough about monkeypox. Will they do enough about monkeypox? The strategic national stockpile can respond to a bioterrorism disaster in 12 hours. I'm skeptical following this outbreak.
It's simple to criticize the cdc, but they're not to blame. Underfunding public health services, especially the cdc, is another way our government fails to safeguard its citizens. I may gripe about the vaccination rollout all I want, but local health departments are doing their best with limited resources. They may not have enough workers to keep up with demand and run a contact-tracing program. Since my orthopoxvirus test is still negative, the doh hasn't asked about my close contacts. By then, my illness will be two weeks old, too long to do anything productive. Not their fault. They're functioning in a broken system that's underfunded for the work it does.
*Update, 7/11: I have orthopoxvirus.
Monkeypox is slow, so i've had time to contemplate. Now that I'm better, I'm angry. furious and sad I want to help. I wish to spare others my pain. This was preventable and solvable, I hope. HOW?
Third, the duty.
Family, especially selected family, helps each other. So many people have helped me throughout this difficult time. How can I give back? I have ideas.
1. Education. I've already started doing this by writing incredibly detailed posts on Instagram about my physical sickness and my thoughts on the entire scandal. via tweets. by producing this essay. I'll keep doing it even if people start to resent me! It's crucial! On my Instagram profile (@kyleplanckton), you may discover a story highlight with links to all of my bizarre yet educational posts.
2. Resources. I've forwarded the contact information for my institution's infectious diseases clinic to several folks who will hopefully be able to get tpoxx under the expanded use policy. Through my social networks, I've learned of similar institutions. I've also shared crowdsourced resources about symptom relief and vaccine appointment availability on social media. DM me or see my Instagram highlight for more.
3. Community action. During my illness, my friends' willingness to aid me has meant the most. It was nice to know I had folks on my side. One of my pals (thanks, kenny) snagged me a mcgriddle this morning when seamless canceled my order. This scenario has me thinking about methods to help people with monkeypox isolation. A two-week isolation period is financially damaging for many hourly workers. Certain governments required paid sick leave for covid-19 to allow employees to recover and prevent spread. No comparable program exists for monkeypox, and none seems to be planned shortly.
I want to aid monkeypox patients in severe financial conditions. I'm willing to pick up and bring groceries or fund meals/expenses for sick neighbors. I've seen several GoFundMe accounts, but I wish there was a centralized mechanism to link those in need with those who can help. Please contact me if you have expertise with mutual aid organizations. I hope we can start this shortly.
4. lobbying. Personal narratives are powerful. My narrative is only one, but I think it's compelling. Over the next day or so, i'll write to local, state, and federal officials about monkeypox. I wanted a vaccine but couldn't acquire one, and I feel tpoxx helped my disease. As a pharmacologist-in-training, I believe collecting data on a novel medicine is important, and there are ethical problems when making a drug with limited patient data broadly available. Many folks I know can't receive tpoxx due of red tape and a lack of contacts. People shouldn't have to go to an ivy league hospital to obtain the greatest care. Based on my experience and other people's tales, I believe tpoxx can drastically lessen monkeypox patients' pain and potentially curb transmission chains if administered early enough. This outbreak is manageable. It's not too late if we use all the instruments we have (diagnostic, vaccine, treatment).
*UPDATE 7/15: I submitted the following letter to Chuck Schumer and Kirsten Gillibrand. I've addressed identical letters to local, state, and federal officials, including the CDC and HHS.
I hope to join RESPND-MI, an LGBTQ+ community-led assessment of monkeypox symptoms and networks in NYC. Visit their website to learn more and give to this community-based charity.
How I got monkeypox is a mystery. I received it through a pride physical interaction, but i'm not sure which one. This outbreak will expand unless leaders act quickly. Until then, I'll keep educating and connecting people to care in my neighborhood.
Despite my misgivings, I see some optimism. Health department social media efforts are underway. During the outbreak, the CDC provided nonjudgmental suggestions for safer social and sexual activity. There's additional information regarding the disease course online, including how to request tpoxx for sufferers. These materials can help people advocate for themselves if they're sick. Importantly, homosexual guys are listening when they discuss about monkeypox online and irl. Learners They're serious.
The government has a terrible track record with lgtbq+ health issues, and they're not off to a good start this time. I hope this time will be better. If I can aid even one individual, I'll do so.
Thanks for reading, supporting me, and spreading awareness about the 2022 monkeypox outbreak. My dms are accessible if you want info, resources, queries, or to chat.
y'all well
kyle