
I recently wrote a long note on my Substack and spent some time debating if it should remain there as a journal entry or if it belonged here on the website. My Substack is a place for raw, professional journal-style updates, while I consider this website my permanent library for all my considerable and varied thought pieces on all things books, reading, writing, and publishing-related. But I realized this has a place here precisely because it’s a lesson in self-awareness that I completely missed—and I suspect many of you might be missing it, too. And if it is something you’re aware of, then let this be a reminder since we all need those now and then.
When you run a business built on deep, high-value partnerships, ignoring your own boundaries is a common occupational hazard. I've decided to share the expanded version of my experience here to help you look beyond the obvious when the work starts feeling impossible.
You should also know when reading this that it’s not a bid for sympathy. It’s a wake up call and reminder to myself, and a hope that this will help others who are in a similar situation.
Here is the original note I posted:
This is for anyone who deals with chronic health issues. Let my dumbass, lack of self-awareness be a lesson to us all.
It’s long, grab a beverage…
About six weeks ago, I went into a mad rush of getting a host of work deadlines completed before I needed to take almost a week off because Hubby was going to have a total knee replacement surgery. For the first week, he was going to need a lot of care. I thought I was prepared for what that meant. I was NOT.
By the time his surgery rocked round, I was pretty fried. But the deadlines got done, and everything that needed doing and needed delivering was all tied up in a nice bow for my authors. I won't bore you with the details.
Then came the post-surgery full-time nurse (I joke that there was no cute uniform to go with it), and back to full-time work. Juggling the two was no joke because yes, more deadlines. This is publishing, we are a very deadline driven industry. And if I'm being honest, while not completely missing deadlines, I was a little late on delivering some things.
By the end of the second week after Hubby's surgery, I was kaput. And feeling very crispy around the edges. I'd been sprinting non-stop and attempting to hold up the sky. Note to self: I am neither Atlas nor Hercules. But I pressed on.
I started feeling kind of "off" about the middle of last week. This week has been kind of a wash. If you read my recap, I did get a fair bit done, but not with my usual zest and I felt like I was dragging myself through mud. I struggled to get out of bed, and I'd resorted to working from my bed desk to get work done because making it to my office was beyond me.
I got quiet and wasn't as engaged with my authors who are probably used to me checking in more frequently than I did. Then last night, while chatting with Hubby, I told him how I felt and how much I was dragging. And he asked me a very important question: When was the last time you had a B12 shot? Fortunately, I keep track of all my appointments in my calendar, and the last time (I checked) was October 2025.
I have chronic depleted B12. Have had since about two decades ago. A result of diabetes and a few other things. About a month ago, my doctor switched up my meds for my diabetes, liver treatment, etc., etc. One of the side effects of all that is my ability to absorb B12 is almost non-existent and I hadn't had a B12 shot in 7 months.
Also fortunately, I had a appointment with my doctor (he's fantastic and very preventive) for our annual flu and covid shots. I talked to him about the B12 and he asked if I wanted to get tested for my B12 levels first and wait for the results. I said no since I was already pretty sure what the problem was. When I took the time to stop and think about it, I had all the classic symptoms of chronic depleted B12 which masquerades as (for me):
Muscle Soreness & Tension: My neck, shoulders, and back pain weren't just from stress; they were peripheral neuropathy. The nerves were sending send constant, low-level pain signals because they were damaged/irritated.
TMJ Flare-ups: Low B12 increased my facial nerve sensitivity, making jaw tension feel much more acute and harder to treat with standard injections. I thought my recent jaw injections weren't working. (They were!)
Tingling or Numbness: I was starting to get this in the hands or feet (paresthesia), which felt like "pins and needles." I thought my usual "too much time at my office desk" symptoms were back.
Balance & Coordination: I was getting very clumsy and was bumping into furniture or feeling slightly "off-kilter" (proprioception issues). There has been some very stupid, clumsy, coordination mistakes.
The "Pseudo-Depression": I thought I was starting to slip into beign slightly depressed, because I felt flat, unmotivated, and lethargic. It looks like depression, but it’s actually a chemical inability to produce "reward" hormones.
Anxiety & Irritability: My "fuse" was becoming incredibly short. Things that are usually manageable (like my current workload which I normally wouldn't even blink at) suddenly felt insurmountable.
Brain Fog: I started to have difficulty concentrating, word-finding issues, and that "buzzing" feeling where you can't quite focus on the task at hand. Work seemed to be taking me longer to get done, and that bugged the heck out of me.
Memory Lapses: My short term memory was fried and I was forgetting small things. That was not fun. I would stop mid-sentence because I couldn't remember what I was going to say. If someone interrupted me in the middle of a thought, that effectively killed my ability to complete a sentence. I blamed it on menopause and laughed it off. Don't do that.
Chronic Fatigue: No amount of sleep was fixing this because the "fuel" (oxygen) wasn't reaching my cells effectively. B12 is essential for creating red blood cells to create oxygen, if you didn't know, so low B12 = low oxygen.
Hypertension (High Blood Pressure): I could actually feel this happening to me. High homocysteine levels (caused by low B12) stress the arterial walls and force the heart to pump harder. I thought it was stress and made myself roll with it.
Headaches/Migraines: I had vascular stress and nerve irritation in the neck which caused chronic tension headaches. Again, I thought it was my jaw injections malfunctioning.
And finally, low B12 can cause malabsorption due to the lining of the stomach getting inflamed (atrophic gastritis), and making me even less able to absorb the B12 from food, making the depletion worse.
That coupled with a loss of appetite and nausea, I would have the munchies late at night, but in reality it was my brain screaming for energy while my stomach was physically struggling with the ability to process actual food. I thought it was just my usual diabetes and liver condition triggering my digestive issues. It was not.
I thought it was just stress or “menopause brain,” but the reality was a biological system failure.
The Joke That Wasn't
It started with what was supposed to be a joke. I was chatting with Rachel from BadRedhead Media, and she quipped that a bunch of drafts should be called a "panic." I laughed, looked at my editing queue—a novella, a couple of novels, some short stories, plus website branding and cover designs—and agreed that "panic" felt appropriate.
But a few days later, the joke stopped being funny. My brain essentially short-circuited. I was looking at a manageable list of tasks and feeling entirely overwhelmed.
To put this in perspective, in my past corporate life, I was the program office director and operations manager for a project that built a new bank from the ground up in a country in South East Asia. That was my most recent major project where I managed a 70-person team on the ground, ran the HR and Finance systems implementation, and still maintained publishing partner duties for two active clients on the side. That project had a strict 12-month deadline with severe financial penalties for failure.
I didn't break my stride then. So why was I suddenly short-circuiting over an editing queue that was, objectively, a fraction of that workload?
The Mirror and the Medical Reality
We often try to look inward to solve our problems, but sometimes you need a high-trust mirror to show you what you're missing. For me, that sounding board is Hubby. When I finally confessed how much I was dragging, he didn't tell me to push through it. He asked one simple, practical question: "When was the last time you had a B12 shot?"
That question cut through all my excuses about menopause insomnia or temporary burnout. The difference between my capacity during the project I mentioned above and my capacity now wasn't the workload. It was the biological fuel required to run the system.
This isn't just a personal quirk, either. Kevin Hwang, a physician and author, commented on my original note:
"I’m sorry you were going through that. B12 deficiency is no joke. At the medical school where I work, we’re setting up a system to better identify patients who have been prescribed medications known to decrease B12 absorption."
Having a medical professional validate this was a huge reality check. This wasn't a lack of mental toughness or a failure of willpower. It was a recognized, biological system failure.
Chemical "Brain Death" vs. Creativity
When your business relies on being a strategic partner and a creative co-conspirator, your brain is your primary asset. Publishing is a deadline-driven industry, and high-touch service delivery requires precision. With my B12 tanked, tasks that should have been straightforward turned into a mud-crawl. Everything took longer, creating a massive drag against my due dates and deadlines.
That depletion also stifled my creativity and strategic vision. I had been working on trying to execute an author's idea for a book cover. We got there in the end, but the process was agonizing. I know the mechanics and the strategy of cover design inside out, but I couldn't reach those instincts through the mental fog—my creativity felt completely locked away and I was hitting a wall over and over for much longer than I liked.
This fed straight into what I call the procrastination paradox. Usually, I'm a huge proponent of "productive procrastination"—knocking out small, quick wins to get into the right frame of mind for deep work. But this was different. The "juice" to start the engine was physically missing. It took an immense amount of energy just to get into the groove because my brain lacked the chemical ability to produce the "reward" hormones that normally drive the process. I languished in the procrastination phase way longer than it was healthy.
The New Non-Negotiable
Competence is not the same as capacity. You can be the most skilled expert in your field, but if your internal infrastructure is depleted, your expertise gets trapped behind a biological wall.
In about four weeks' time, I'm back to being full-time nurse Deanna because Hubby is going back for his second knee surgery. I have a massive amount of work to complete leading up to that. To make sure I don't collapse in a heap again, we are being very intentional about our next steps. A week before his surgery, we're taking a short break at a lovely beach house we've stayed at in the past. Getting out of our routine—especially since we work from home—will be a crucial, refreshing reset.
Then, two days before Hubby's surgery, I have my next monthly B12 shot scheduled, with the third already on the books. It is now in my calendar on repeat. I am very fortunate to have an incredible doctor who is a huge proponent of being preventive.
If you are out there "Atlas-ing" your way through your business, holding up the sky for your clients, your family, or your team—please remember that you cannot serve as a strategic guide if your own system is running on empty. If you're feeling off, unmotivated, or overwhelmed by a workload you know you can handle, look beyond the obvious. Go back to basics and check everything.
Because an empty tank doesn't care how much you know.
Let’s Chat!
If this has sparked a thought about your own "system failure" moment—or if you just want to talk shop—come find me on Substack. That’s where I’m spending most of my time these days, chatting about story and strategy. You can also catch my latest updates via my newsletter, or reach out the old-fashioned way via email, or Facebook. I’d love to hear from you.
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