This is the second of a 3-part post summarizing my experiences dealing with illness and starting a business in the past year. I recommend reading part 1 first, where I talked about taking control of my life and leaving my job. In this part, I’ll talk about the next steps I took after quitting, and how I fell into starting a business.

I will annoyingly stick with the Hobbit metaphors.

Out of the Frying Pan, Into the Fire

I had just left my job due to illness, and I had no solid plan. But I expected I would find other full-time work before my limited funds ran out. I definitely had confidence that I’d find other jobs I qualified for, since my web development skills are always in demand. But that didn’t make it any less scary to not have a real plan.

And reality hit me. I suddenly became really worried that unless I found an absolutely perfect employer who could be flexible enough to accommodate my needs, any position I found would lead to the same problems I’d encountered at my last couple of jobs. At the job I’d left I was putting in well over 40 hours a week, but it drained me to the point that I couldn’t function. And my schedule would be too unpredictable for most jobs.

Even more so, I was worried at the prospect of going through another medical accommodation process, which was a lengthy nightmare at my last job.


As I started to realize all this I got a little bit panicky. I started to accept that I just didn’t feel comfortable taking on another full-time job.

But while looking for a job and figuring out what to do, I picked up a couple of contract projects to make ends meet, and they went really well. Suddenly I was making decent money. And for the first time I realized I might actually have the skills and motivation to really work for myself, a prospect that had frightened me before, and still did to a degree.

It’s amazing what you can accomplish when you feel like you have no choice.

It’s like being pushed out of the nest and having to learn to fly on the way down.

I’d always had doubts about my ability to live on full-time consulting work – to find enough clients, to charge enough to get by, to not always know where the next check is coming from, and to not have regular benefits. I would worry that clients will always find someone better, faster, cheaper. But that mentality turned around for me thanks to two things – I’ve been extremely lucky to be part of a great mastermind group, and I’ve been following courses by Brennan Dunn and others, and through them I eventually realized that I was not just capable of doing the work I needed to do, but that I was able to sell myself and my skills for what I’m worth.

So I stuck with it. I started a consulting business, and so far I’ve been pretty successful. I’ve had a string of clients – many through referrals – to the point that we got by really well for the last part of the year. We had a nice Christmas, which I had no way of foreseeing when walking out of my job with no immediate prospects seven months before.

I have no plans to go back to full-time work for the foreseeable future.

But that doesn’t mean it’s all roses.

The Desolation of Brain Fog

It’s 3:00 in the afternoon and I’m staring at my keyboard, trying to remember what I was just doing. A minute ago I was cranking out code, but the fog has been creeping in…

Picture of my desk

Daily work is still an enormous struggle for me. It’s all indescribably better than the situation I was in the first half of the year, but instead of the demands of a daily full-time job, I’m trying to get client work done, spend time with family, and build my business (finding new leads, figuring out my finances and taxes, etc.), all of which gets disrupted by that second full-time job I still have – my illness.

There are many aspects of my dysautonomia that affect my ability to work. Some are physical, like my sleep difficulties and related fatigue during the day. I often feel light-headed when standing up, and occasional random tachycardia spikes interrupt my work (due to mundane reasons like changes in barometric pressure outside). My daily routine involves waking up very late and spending several hours waiting for medications to take effect, for food and caffeine to settle in, and to generally adjust to being vertical.

But the symptom that probably affects my ability to work the most is one that I rarely talk about publicly, and even downplay among family and friends, because I fear that it will directly impact perceptions of me and my ability to work. It’s called brain fog, and I think it’s the kind of thing that’s important to talk about.

A foggy lake
This is your brain on inadequate cerebral perfusion.

Brain fog is a general term for a type of cognitive impairment (PDF), usually thought to be brought on in cases of dysautonomia by an inadequate supply of oxygen to the brain thanks to reduced blood flow. As a result, I often find myself staring at my screen, trying to find a word or grasp a concept that should be immediately apparent. It causes me to have trouble holding my attention on a task. It affects my ability to hold the big picture of a system in my head like I used to. I feel like I’ve lost the ability to grok things.

As a professional whose primary work is in programming, it’s probably clear how this can impact my livelihood. It’s hard to request reasonable medical accommodation on the basis that sometimes programming is too hard. And it makes the prospect of technical interviews pretty daunting.

Brain fog and similar cognitive impairments have a huge effect not just on someone’s abilities and daily tasks, but also on their emotional state and self-perception. The most frustrating part of dealing with it for me is that I retain plenty of self awareness and metacognition to actually recognize my limitations (another patient, Michelle Roger, wrote a great piece about this from the perspective of someone who used to care for patients with cognitive deficits). It’s like hitting an invisible wall inside your mind, where the answers are just on the other side, out of reach.

And since I put a lot of effort into hiding or downplaying this, it gives me a special kind of imposter syndrome, in which I fear that I sometimes literally can’t do the kinds of work I need to be able to do, and that I’ll be found out at any time.

Taking Control

So in addition to all the physical problems I deal with already, I have to do a lot to compensate for this too. First and foremost, I take medication and salt pills to adjust my blood volume, as well as medication for attention deficit.

And I wear medical compression stockings. Yes, I wear stockings. Friends may be surprised by this until they realize they haven’t seen me wear shorts in years. Putting on my stockings in the morning to get out of bed makes me suddenly clear-headed and gives me a burst of energy – like a superhero putting on his power suit. It’s usually not enough to complete defeat the symptoms, but it’s amazing what a bit of proper blood flow can do for your physical and mental state.

Then I have a number of productivity techniques I stick to. I avoid phone calls as much as I can. I take a lot of notes. I have lists and lists and lists. Trello is a godsend. I keep a notebook with my current tasks and a star next to the most important item simply to convey “this is what you’re working on right now.” I automate whatever I can. And an interesting result is that I’m finding ways to focus on the end goal – delivering value and results, not the technology when coding.

But the important thing to stress is that since this problem comes and goes, and sometimes alleviates throughout the day, it doesn’t directly affect the quality of my work – it mostly affects when I can work, and sometimes what kind of work I can do. If I’m stuck in a fog during the day, I generally put off work or focus on menial tasks and come back to the heavy thinking when I’m able. Then I’ll typically reach a point in the late afternoon or evening where the veil is lifted, the clouds part, and my productivity sets in. I really get to work.

Then my family comes home.

So what it comes down to in a practical business sense is that the vast majority of my day – that damn metaphorical other full-time job – is unbillable time.

Finding Focus

The main problem I’ve started to find with freelancing is that my situation makes it difficult to work on an hourly basis. I do it, and I feel like I do the work well, but it’s completely draining to maintain the personal standards and high quality of work I insist on providing to my clients. And my schedule often is too unpredictable to commit to specific timeframes. I tend to compensate for this by not billing for all the time I work. I’m adamant about only charging clients for the work I’m providing.

So the biggest change I plan to make to address these challenges is to gear my entire business around them. I have a plan for this next year.

My goal is to transition to selling my skills and knowledge instead of my hours. Brennan touches on this in his course.  I want to develop “info products” like ebooks, courses, or even services – software or otherwise – that I can start to turn into processes, automate, and maybe hire out. I know that I can write, and I have years of experience I can share. I can still manage and coordinate tasks, so I can delegate to others. Amy Hoy touched on the benefits of bootstrapping a business this way in another really inspirational post about how her software-as-a-service (SaaS) business was able to run on its own while she dealt with her own dysautonomia.

So my first step is to start transitioning from hourly freelance work to either weekly billing or monthly retainers, and to productized consulting. I’m going to package up things that I’m good at, that are repeatable, and that will bring real value to clients, then I will market them. The process of selling myself and my skills in a repeatable way will help me learn better how to research, market, and deliver results to clients and customers.

Starting anything new is still difficult, especially given my circumstances. So I decided to jumpstart this approach last month after Amy Hoy took on a 24-hour product challenge (along with Nathan Barry), and wrote an ebook called Just Fucking Ship – which pretty well sums up the mentality I’ve been learning to adopt this past year. Just put stuff out there. Make some kind of change that moves you towards your goals, then learn from it and improve it. Stop making excuses and letting doubt and uncertainty keep you from moving forward.

So a number of friends and I were inspired to do our own 7-day product challenge. And considering my work and travel, I did the best thing I could – I scoped down my project to what was doable with only a couple of days’ work, and created my first productized consulting service to review and roadmap abandoned or inherited ASP.NET applications, a need I’ve seen at almost every client and employer I’ve worked for over the last several years. It’s a simple work-in-progress landing page, but it’s the start of a new direction for me, and a proof-of-concept and framework for future services that I’ll spend more time researching and marketing. It was an experiment in figuring out what I can offer, building a landing page, and creating a capture process for business leads.

[Update: I’ve since discontinued that service to focus on more custom solutions to clients for now, and removed the link here. But I hope to do similar things in the future. As mentioned, it was a great learning opportunity.]

I know I was stubborn to commit to building something I didn’t have time for, and to stick to it so hard (to the point of frustrating myself). But the one thing this past year has taught me is that you can’t wait to make changes, and you can’t wait for changes to come to you. And having external motivators and accountability can help push you forward.

I’ve only made the first steps in getting to where I need to be, by leaving my job, setting up a business, and now focusing on gearing that business around my capabilities. But I feel like I’m going in the right direction, and I can set some goals to get me there.

And I’m going to write about it as I go.

To Be Concluded

In the next and final part, I’m going to talk about the other big effort I’ve made this year to address all these problems – exercising. And why doing it represents something special to me.

If you want to be notified when the next post is up, or just want to follow along on my journey as I write about web development and starting a business, please sign up for my mailing list below. I promise not to spam, and you can leave at any time.

Update: part 3 of this series is now available.


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