Writers: Move Your Legs! Don’t Get Blood Clots From Prolonged Sitting.

If you sit for extended periods of time, such as during airplane travel or during long road trips, or if you have certain medical conditions, you may be at risk for “Deep Vein Thrombosis” (DVT), or blood clots that form deep in your veins. These clots are dangerous because they can dislodge from your veins and cause sudden death by passing into the lungs, disrupting blood flow, and creating dangerous changes in your heart and lung blood pressures.

A sizeable blood clot that lodges in the lungs can kill a person instantly. I know because I witnessed this on more than one occasion during my internship in Internal Medicine and my residency in Physical Medicine and Rehabilitation. Once big clots enter the lungs, there’s very little you can do to save the person.

Sadly, about half of the time, there’s no outward sign of DVTs. But when there are signs, patients usually complain of calf pain and swelling. They may also have pain on squeezing the leg or when they abruptly bend the ankle upward (this is known as Homan’s sign).

Several factors in addition to the sedentary lifestyle predispose to clots. One factor is family history. Another is the use of oral contraceptives or hormone replacement therapy. Still another is smoking. Additional factors include trauma (including venous catheter trauma), advanced age, cancer, elevated platelet counts, immobility or paralysis of the area (such as due to casting), plane travel, surgery, pregnancy, heart failure, obesity, or a personal history of blood clots.

One diagnostic test for DVTs is an ultrasound scan called a “Venous Doppler” study. Another test measures blood levels of “D-dimer,” which is a natural clot-dissolver found in elevated levels in case of DVT.

If you test positive for a blood clot, your doctor will most likely admit you to the hospital for and start you on clot busters or blood thinners. Sometimes, you might even have a “filter” inserted into the large vein in your abdomen (the vena cava) to trap clots that try to travel upstream to your lungs.

Now, let’s talk about the most important thing: blood clot prevention. First, try to minimize your chances of clotting. Quit smoking, get moving, and lose weight (if you need help with weight loss, check out my book, The Eden Diet. If you sit for prolonged periods of time, wear thigh-high compression hose, which are usually available at your local hospital supply store, and do “ankle-pumps,” where you bend your ankles up and down.

Depending on your risk factors, you may even want to talk with your physician about taking a medicine to prevent blood clots. As is true in many areas, when it comes to DVTs, an ounce of prevention is worth a pound of cure. Or, in this case, an ounce of prevention might even save your life!

Generating Buzz Through Book Reviews

beeOptimizing buzz from book reviews can be an key part of your book’s overall marketing campaign, so it’s important to make time for it, even if you’re like me and writing isn’t your primary day-job. 

Allow me to share a few tips that helped me get SIXTY-THREE book reviews and interviews for my new book, Radical Well-being, while suffering only a short-term, reversible case of utter exhaustion. Yay!!

(1) Establish your platform and develop relationships on the Internet long before you ask people to review your book.

When you pitch to book reviewers, it helps if you already have an established presence on the Internet and elsewhere. That’s why you need as many of these as possible (I included links so you can see what mine look like): an author website, Facebook fan/author & book pages, an Amazon.com author page, at least ten positive reviews on your book’s Amazon.com page, a Pinterest page, a Linked-In profile, a video book trailer on Youtube (see my latest book trailer, for example), a Twitter account, a blog (I actually created an interactive forum for discussion about my diet book–with a blog embedded in it), an Internet talk radio show, a newsletter or e-zine, magazine articles, and as many TV and radio appearances as possible. Don’t necessarily shoot for perfection on your Internet pages before you publish them. Just get your pages up and running. You can improve them gradually, over time, if need be.

(2) Pitch to every reviewer you can, and do it early.

I started collecting names and contact information for book reviewers, columnists, newsletter producers, and bloggers in my specific niche about six to nine months before the official launch date for Radical Well-being. As soon as the reviewers responded with interest, I asked if they would accept an electronic version of the book when it became available. If the answer was “No,” I put them on a separate list to receive a bound galley copy (a rough version of the book).

(3) Ask your publisher for an electronic version of your book to send to reviewers early. Also, get the cover art to include with the book file.

Almost half of the sixty-three people who agreed to review my book were willing to accept an electronic copy. The copy was watermarked by the publisher to deter widespread bootlegging. Attach the book’s cover art, a short author bio, and a book synopsis to the book file when you email it to reviewers, and send sample interview questions if the blogger wants to run an interview about you, as well. Bloggers love it when you suggest questions they might want to ask you.

(4) Try to coordinate reviewers to publish on the day of your book’s actual launch date.

Start well in advance. Otherwise, you won’t allow your reviewers enough time to read your book and write their reviews before your launch date! I had to scramble in this regard, as my publisher unexpectedly moved up my book’s release date by two months! Yikes! To help my publicist get the galley copies out in time, I actually printed out cover letters and mailing labels and snail mailed them to her. That way, all she had to do was put the galleys in the envelopes, insert my signed cover letter, affix the mailing label, and send them off. It wasn’t necessary for me to do that, but it freed her up to get me more media hits than I could get on my own, so it was worth the effort on my part.

(5) Solicit radio interviews well in advance of your book’s launch date, if possible.

You don’t have to be a major author to get radio spots. Try for Internet radio! Some hosts with smaller audiences may be eager to have you on. The nice thing about radio is you can PRE-record shows, thus freeing yourself up for other buzz-building activities on your launch date. Plus, you don’t have to get all dressed up or travel far from home like you do with TV. As a side note…. when you pitch to radio producers, keep in mind they get hundreds of pitches a day. Odds are high they won’t make it past your email’s subject line if it’s boring, so write one that’s enticing! My subject line read, “Christian IvyLeague MedDoc/radio guest/author w/ unlimited FREE Kindle diet book downloads for ALL ur listeners, Jan8-12.” Yes, you read that right. I offered my first book, The Eden Diet, entirely FREE, in exchange for a chance to talk about my second book, Radical Well-being. (By the way, you can have my diet book for FREE, too, if you want it. It’s FREE on Kindle through January 12, 2013. Just follow the link above, which I shamelessly worked into this point. Do you see what I did there? Use every opportunity!)

(6) Make marketing opportunities for your book anywhere possible.

The launch date for my new book, Radical Well-beingA Biblical Guide to Overcoming Pain, Illness, and Addictions, was YESTERDAY!!!! Thus, I wrote this blog entry ahead of time and strategically set it aside for publication today. As you can see, preparing promotional material in advance is critical if you want to achieve optimal buzz around the time of your book’s launch.

(7) Send reminders to your reviewers and radio hosts.

Don’t expect everyone who promised you a review or an interview to necessarily remember your release date. In fact, just assume they already forgot. Send them a “thanks again for agreeing to publish my review on [insert launch date]. May I provide any further information to facilitate your writing the review?” Many reviewers responded with a “I’m so glad you reminded me…” or “Would you mind reminding me again in two weeks? I have a lot going on right now.”

(8) Thank your reviewers with back-links to their reviews. 

It’s only courteous! And it’s good for relationship-building. Keep in mind that you might write another book someday and might therefore solicit reviews again from these bloggers! As for me, I intend to publish “thank you’s” and back-links in the February 2013 edition of Dr. Rita’s Christian Health Newsletter, which goes out to over 3400 subscribers. I also posted thank you’s to my reviewers on Facebook and elsewhere.

As you can see, it isn’t easy to create buzz for your new books, but starting early, working hard, and establishing good cyber-relationships certainly helps. A little bit of OCD doesn’t hurt, either.

Do YOU have info to add, here? If so, I’m all ears! What additional advice do YOU have regarding how to solicit and coordinate book reviews and interviews to optimize book buzz? Any and all comments are appreciated!

Blessings from Dr. Rita!

How To Prevent Carpal Tunnel Syndrome in Writers

As a board-certified musculoskeletal specialist physician, one of the more common conditions that I diagnose in keyboarders is called carpal tunnel syndrome (CTS). It’s a painful hand condition that is caused by pinching of a nerve (the median nerve) as it courses through a bony tunnel in the wrist. Since “carpus” is Latin for “wrist,” you can understand why the condition is called carpal tunnel syndrome. (I threw that FASCINATING bit of etymological trivia in there because this is a writer’s blog, and, well…..I was just trying lighten up the medical jargon and appeal to your fascination with words. Did it work?)

The symptoms of CTS include numbness, tingling, pain, and swelling, usually in the index, long, or ring fingers, but sometimes the symptoms extend into the thumb and up into the forearms and even the shoulder. Patients tend to say their hands go numb while fixing their hair, putting on make-up, or driving. They also say that the symptoms wake them from sleep at night and cause them to shake out their hands, and that the associated numbness causes them to drop small objects, like pens, spoons, and coffee cups.

Though these symptoms may be intermittent at first, eventually, if the condition is left untreated, the symptoms may become constant and/or severe.

Though CTS can occur in healthy individuals, it is even more likely to occur in those who are diabetic, hypothyroid, or heavy consumers of alcohol–especially if they keyboard excessively.

The main diagnostic test for CTS is called an electrodiagnostic study and is sometimes abbreviated as an “EMG.” I’ve personally performed many thousands of these tests and I can assure you it isn’t a fun test. In the first part of the EMG, I have to zap your nerves with electricity to see how well they conduct, and in the second part, I have to insert a fine wire through your skin and into your muscles to determine if the muscles are electrically unstable due to an underlying nerve problem.

Early treatment for CTS generally consists of wrist splinting at night along with non-steroidal anti-inflammatory medicines. Carpal tunnel steroid injections may be utilized for diagnostic purposes in some cases (like if the EMG is equivocal) but those injections don’t seem to fix things for long. In most cases, surgery is an excellent alternative–especially if it’s done by an experienced orthopedic sub-specialist hand surgeon or neurosurgeon.

Like with many other conditions, an ounce of prevention is worth a pound of cure. Optimize your chair and desk height so that your wrists remain in “neutral” position (i.e. straight) as you keyboard, maintain tight control of your blood sugar if you’re diabetic, minimize alcohol consumption, work with your physician to optimize your thyroid hormone levels, avoid bending your wrists at night by wearing wrist splints, and take frequent rest breaks from keyboarding—like I’m going to do right now!

SEO Is Not Enough To Grow Your Blog Subscriber List!

Only five years ago, you might have heard, “Radio doesn’t sell books. TV sells books.” Now, you’re more likely to hear, “TV is okay, but social media sells books.” If you get bloggers talking, tweeting, sharing, and posting about your books, you’re likely to experience enhanced success at marketing your book.

But, alas, marketing your blog is different from marketing your regular website. Specifically, plain old search engine optimization (a.k.a., SEO) isn’t enough to make you a widely read blogger.

The blogging system has added variables beyond SEO, like the warm, fuzzy, social element (hence the “social” in “social media.”) Search engines are “cold” and comb through blogs, looking for key words, tags, page relevance, back-links from other reputable sites, etc., but real people are “warm” and click on “forward” and “share” buttons if they feel that your message resonates with them on a personal, emotional level. Catch my drift? You have to be an expert at both the cold and warm elements in order to succeed at blogging.

By the way, in case you’re wondering what a “back-link” is, I’m going to be self-serving and include one here. It’s a link back to my own website, www.TheEdenDiet.com. Voila! I just raised my own website’s search engine ranking by linking it to the highly respected Wordserve Watercooler blog.

In the same way, let me return a favor to a fellow Wordserve author. A while back, Jordyn Redwood interviewed me on her blog, Redwood’s Medical Edge, and she included a back-link to my Eden Diet website. Now, I just returned the favor with a back-link from the Watercooler. Her blog’s search engine rankings just went up a bit. Do you see how it works? The “social” in  “social media” augments your search engine optimization.

Unfortunately, even if your blog content resonates with people on a warm, human level, only a small percentage of your subscribers will click “share” and “forward.” Probably, most will be passive and neither comment on nor share your posts. Thus, to expand your subscriber list, you must find ways to engage and mobilize that small minority of blog followers who could actually help you spread your message.

One way to recruit supportive blog followers is to cross-promote with other reputable bloggers who have large subscriber lists. Imagine the ripple effect of increased numbers of subscribers when other big-time bloggers link back to your blog (not to mention that the back-links will raise your blog’s standings with the search engines).

Because it isn’t easy to get big-time bloggers to notice let alone promote and share your content, let me tell you some strategies that have worked for me: (1) Ask to feature/interview other bloggers for your own blog. Try to pick those with large followings. Many will offer to feature/interview you on their blog, in return.  (2) Offer free books to those who interview you and suggest that they give them away to their own followers. When you first help others, some return the favor!

In summary, your ideal blog marketing strategy should be (1) get noticed (through regular SEO, using key words and tags, getting back-links, etc.); (2) hold your readers’ attention with a warm message that fills their needs; (3) encourage readers to actually participate and share your message; and (4) get noticed by and develop relationships with well-known bloggers who have big followings. Help your fellow bloggers spread their message by featuring them on your site, and maybe someday they will offer to help you spread your message.

Media Training 101: How to Create an Outstanding Promotional Video for Your Book

A growing trend in the book industry is for publishers to ask authors to create their own promotional videos. The publishers then upload these videos to websites such as YouTube, as well as show them to book buyers at conferences and to media producers in hopes of securing TV time for their authors.

In case you are asked to create such a video, don’t worry. I can help. Below are ten steps that I learned through formal media training and from my own TV appearances. These tips can save you thousands of dollars in formal media training costs, not to mention greatly increase your chance of landing promotional TV spots.

First, read the enumerated suggestions below, then follow the link to my last book trailer, and see if you can spot what I did right, and, perhaps, what I did wrong.

Trailer For Dr. Rita’s Book: Radical Well-being, A Biblical Guide to Overcoming Pain, Illness, and Addictions (January, 2013, Charisma House).

1. Create Good Content: Your content should be persuasive, entertaining, and/or helpful. For non-fiction, establish your professional credibility by stating your qualifications when you first introduce yourself. Discuss your book’s focus, and establish how your book can solve the viewer’s problem. However, if you write fiction, it’s probably more important for you to entertain the viewers. “Hook” them with your captivating story line, and tell them just enough to make them want to hear more. Consider re-stating your name and the name of your book for emphasis at the close of your trailer.

2. Take Care in Your Delivery: Make an effort to speak slowly and deliberately, and don’t forget to enunciate. To do so, have a succinct, goal-oriented script with only one or two main points. Also, stay within the time frame requested by your publisher.

3. Choose Your Attire Carefully: Pick a solid color that doesn’t distract. Avoid red, black, white, and bold prints. Avoid large jewelry. When in doubt, go with simple and understated clothing and accessories. Men: unless you have six-pack abs, button your jacket, or you’ll look sloppy.

4. Watch Your Posture and Body Language: Sit up tall and straight, preferably at the edge of your seat, and lean slightly into the camera. Avoid direct head-on shots. It’s better to sit with your body angled slightly as you face the camera. Avoid exaggerated movements, as they can distract from your message.

5. Make It Personal: If you wish to make an emotional connection with your viewers, write a monologue about your book, and deliver it directly to the camera. Doing so gives each individual viewer the impression that you are having a private conversation with only him or her.

6. Be Happy, Relax, and Have Fun: Your positive energy will make you more attractive, and it will entice viewers to want to hear more of what you say. Also, try to relax. When you feel relaxed, you look relaxed, and your gestures appear more natural.

7. Smile More Than Usual: Video is a very cold communication medium. Facial expressions that look “neutral” in person cause you to appear cold and distant on camera. Smile the entire time you’re talking.

8. Wear Make-up: You can forgo the lipstick and eye shadow if you’re male, but don’t forget the oil-absorbing powder. Apply a generous amount to your forehead, chin, and especially the tip of your nose. The camera lights make you look greasy and pale, otherwise.

9. Hire a Professional Camera Operator: Subtle factors like choice of background, lighting, and camera angle strongly impact the image and feel of your video. Nonetheless, you could shoot a homemade video, first, for practice, and then get feedback from your agent or other professionals regarding your content, delivery, attire, and background before you hire the professional camera person at $100 per hour.

10. Once You Land a TV Spot: It’s more likely that you will be interviewed by a show host if you are asked to be on TV. In that case, keep your eyes fixed on the interviewer the whole time. Do NOT look directly at the camera as you might in a monologue. TV viewers want to feel like they’re eavesdropping on the private conversation between you and your interviewer. Make sure you’re the first one in position (sitting up tall, smiling, looking at the interviewer) when the cameraman starts counting down, and make sure you’re the last one still in position when the video shoot is over. Doing these subtle things helps build your reputation as a good TV show guest, and it might also earn you a return invitation to talk about your next book.

Do you have any suggestions for TV appearances? Any questions about something I did not address above?

From Self-Published to Contracted Author (In Ten Thousand Easy Steps)

Five years ago, when I attended a Harvard University writers’ workshop for medical doctors, I was one of the few in attendance who actually had an edited, polished, pitch-ready manuscript in hand. But, still, I left that meeting with no agent and no publishing contract. The reason is I didn’t have a media platform.

Right or wrong, after that meeting, I decided to self-publish. I figured it would be easier to build my platform once I had a tangible book in-hand, and the fastest way to turn my manuscript into a tangible book would be via self-publishing. I thought, “I can always sell my book to the publisher later, if it succeeds,” and “How hard could it be to self-publish and succeed?” Little did I know how much work the whole venture would entail.

Over the following year, I hired freelance editors and artists to tweak my book into publishing house quality. I even started my own publishing LLC, so I could print my books via Lightning Source, Inc. and get them into the warehouses of the major distributors like Ingram and Baker&Taylor.

Next, came the marketing. Ugh! Being that I had no contacts in the media, I still don’t understand how I landed those first few radio and TV interviews. Okay…I confess. Maybe it had to do with me calling the stations and saying, “Hello. This is Dr. Rita Hancock. I need to leave a message for [the producer’s name], so please connect me to her voice mail.” It’s not my fault if the receptionist put me through because she thought I was calling to leave pregnancy test results. It’s not like I implied that exactly.

During this platform-building year, I also built my book’s website and online interactive support forum and began sending out monthly newsletters, answering questions on “Ask the Expert” websites, and utilizing pay per click advertising to drive traffic to my website.

Eventually, thanks to the platform-building, I landed both an excellent agent and a contract with a bona fide publisher. However, what came next utterly shocked and disappointed me. I didn’t yet know the adage “The top 20% of the authors get 80% of the marketing dollars.” Being a newbie author, I was left almost completely on my own to market. In a sense, it was “do or die” for my writing career. So, over the subsequent few years, refusing to “die,” I redoubled my efforts and took media training classes, learned how to write press releases, secured book endorsements, cross-promoted with other Christian authors, and built up my presence in social media like Facebook and Twitter.

I hoped that through these continued efforts, I would eventually be in the top 20% on some publisher’s author list—if not on my first book, maybe on my second, and, if not with my first publisher, maybe with a different publisher. And that’s exactly what happened. One day, during a conference call over my second book, I heard the publisher say what sounded like music to my ears. “Dr. Hancock, we’re prepared to put a lot of money and a lot of energy into promoting your next book.” Amazing! All that hard work finally paid off, and it took only ten thousand easy steps to get there.

What steps are you willing to take to promote your book?

Amazon.com’s ‘Vine Program’ Can Either Help Or Hurt You

Not all marketing tools are created equal. Some will move books; some will bite you where the sun doesn’t shine. Today, allow me to tell how the use of one book marketing tool could have sunk my book.

“The Amazon.com Vine Program” is a service offered by Amazon.com to book publishers. Basically, publishers contract with Amazon.com to send out a certain number of books to reviewers in exchange for their unbiased ratings. Theoretically, it’s a way to jump-start ratings on an author’s page immediately after a book is released.

But there can be problems with this system. In at least one case that I know of (MINE!), the publisher failed to communicate with the Vine Program that the book in question had a Christian viewpoint. And since nothing noticeably Christian appeared in the title, subtitle, cover art, or even in the book’s description, it was a cauldron of trouble. The book ended up being inadvertently sent to people unsympathetic to faith issues who rated the book poorly and then slammed the publisher for being deceptive about its religious agenda.

You could argue that this was really the publisher’s mistake and not the Vine Program’s. But it still highlights the fact that the Vine Program can be utilized ineffectively and, hence, end up hurting your efforts more than helping.

How can you avoid this situation? Ask your PR and/or marketing folks if they intend to utilize the Vine Program. If so, work with your agent to make sure your publisher adequately broadcasts your book’s content through its title, subtitle, description, and cover art. Otherwise, your book won’t get to its intended readers, and your reviews may be less than stellar.

Even if this Vine problem doesn’t happen to you, expect some unfair ratings to come your way in the Amazon.com rating system. People are imperfect; therefore, readers (and publishers and authors) are imperfect. Some readers aren’t capable of understanding what you say, and others read too hastily or misunderstand your message for other reasons.

The good news is, eventually, justice tends to prevail. Unfair and/or misleading reviews tend to fall off the map. Once enough people rate the unfair reviews as “unhelpful,” the Amazon.com rating system automatically deletes them.

In addition, reviewers have the option to “comment” on each other’s reviews and clear up any confusion. (Only, sometimes, their comments make things worse rather than better. You should see the caustic verbiage that flew back and forth between two reviewers of my book, The Eden Diet. I have an overall five-star rating, but I got a two-star review that apparently ticked off one of my supporters. The comments that followed were so mean that they were actually funny–in a “Pulp Fiction” kind of shocking-human-nature way. It was like a psychology experiment went wrong, right on my Amazon.com review page. Thanks a lot, people!)

The point is, online review systems are fraught with inherent inaccuracy and bias, and they sometimes hurt more than help. But if you want to be a writer, you have to get used to this and other imperfections in the system as a whole. That’s why book writing (and the reading of book reviews on said writing) is not for the faint of heart!

Care to share some of your review experiences?

Authorship Is A Lesson In Humility

The pain was almost unbearable as I read my book doctor’s lengthy and critical evaluation of my first manuscript. I felt like my heart was being ripped out of my chest. Without significant additional help, not to mention hundreds of hours of work and a lot of money for surgery, my manuscript wasn’t going to live. It was my first lesson in humility as a would-be author.

Thankfully, my book doctor was funny and tactful as he delivered his prognosis. He told me he could teach me how to resuscitate my baby if I was willing to pay the $80 per hour co-pay.

As if my deficiencies as a writer weren’t a big enough blow to my ego, I was also told I had to wait three months before he could carve out time for my writing lessons. Come on, man! Three months? Really?

The harsh truth was no matter how much authority and respect I garnered in my day job as a physician, in the world of book-writing and publishing, I was a vulnerable, inexperienced nobody. I couldn’t even get a writing coach’s quick attention when I was paying.

Fast forward a year, and thanks to my book doctor’s worth-the-wait teaching, plus my own endurance through repeated rejections and humiliation, I produced a much-improved manuscript and ultimately went on to secure Greg Johnson as my agent and a publishing contract with Zondervan for The Eden Diet.

Woo-hoo! I got an amazing agent and a book contract! I thought that meant, “No more begging for people’s time and attention regarding my book.” Wrong! I hadn’t yet even begun to market. I didn’t know yet how humiliating book signings can be, “Please, Mrs. Bookstore Patron, may I interrupt your shopping agenda and tell you about my book?” Many stopped and listened, politely, but some walked right by, as if they didn’t hear me talking.

Compare that to my life at the office. In my doctor-world, I have actual authority and garner near-immediate respect from people who don’t even know me.

Fast forward again and now I have a contract with Strang/Charisma House for a book that can help even more people. Will I risk rejection again as I hold book signings and market for this second book? Absolutely. I counted the cost, and it’s worth the price. My message can bring countless readers into physical, mental and spiritual wholeness. Isn’t their profound healing worth a little momentary discomfort on my part?

Besides, any tiny shred of humiliation I endure along the way to help other people is infinitesimally small compared to the humiliation my Lord suffered when He was hung on the cross. Actually, now that I think about His humiliation for the greater good, I don’t even have the right to talk about humility.