Living with Scleroderma

Reflections on the Messy Complexity of Chronicity

Upon Reflection

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It’s dreary and raining this Sunday afternoon. I’m writing now because Yom Kippur, the Day of Atonement and highest holiday in the Jewish calendar, starts this evening and goes through Monday, which is the day I normally write this blog. It’s a somber day that caps a period of self-reflection. We’re supposed to think about who we’ve wronged during the year and make amends. We’re supposed to ask hard questions: How can I do better, be better to my family, friends, my community, in my relationship with God?

I wish I felt better prepared. I haven’t been able to find time to think about all of this in advance. So tomorrow will be a crash review of the year and what I need to improve on.

I know a few things. I need to be more patient with those closest to me—and with myself. I cannot be or pretend to be Wonder Woman and do everything for everyone else who needs me. Sometimes it really is best to step back, even if my ego says I could/should step forward.

There’s more, much more, to contemplate. It seems like an onerous task, at first, but by sundown on Yom Kippur, I always actually feel clearer and lighter—not just from fasting, but from introspection.

And so, to all who observe this holiday, I hope you, too, had a meaningful day. Whatever your faith or beliefs, be well.

Evelyn Herwitz blogs weekly about living fully with chronic disease, the inside of baseballs, turtles and frogs, J.S. Bach, the meaning of life and whatever else she happens to be thinking about at livingwithscleroderma.com. Please view Privacy Policy here.

Image: Walter Walraven

No Clear Answers

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Back to another stretch of multiple doctor’s appointments. On Thursday I saw my rheumatologist at Boston Medical Center. I was back to BMC again for a visit to my GI specialist on Monday afternoon. Today it’s a drive to the South Shore to see my podiatrist. Then on Thursday, I go to the wound clinic at our local hospital to check in on my digital ulcers.

It’s a lot of appointments. It takes a lot of time to drive and wait and be seen. I have a great team. I just wish the visits were more spread out.

At Monday’s GI exam, we discussed all the diagnostic tests I’ve undergone in the past few months to figure out what’s going on with my gut. Turns out that I have normal motility in my small intestines, and the breath test for bacterial overgrowth thereof was negative, though it’s not the most reliable test.

Bottom line is that we don’t have any physiological evidence that there is excess bacteria in my gut due to slow movement of digested food through my intestine—which we had expected to find, a common problem in scleroderma, but apparently not my issue. So what is causing the chronic diarrhea?

We know that the gut microbiome is very important to overall health, my specialist explained, but there’s a lot we just don’t know. There are no definitive tests beyond what we’ve done to clarify what’s going on. So we’re down to trial and error. He offered me a free sample course of the very expensive antibiotic that I can’t afford, to see if it would help. But why do that if my gut is actually processing food with normal motility? So I asked him to recommend probiotics, and I’ll report back how that works.

And so it goes. I learn from my doctors, and they certainly learn from me. They are all well-versed in the research. But so much of what happens in scleroderma remains a mystery.

Evelyn Herwitz blogs weekly about living fully with chronic disease, the inside of baseballs, turtles and frogs, J.S. Bach, the meaning of life and whatever else she happens to be thinking about at livingwithscleroderma.com. Please view Privacy Policy here.

Image: Bioscience Image Library by Fayette Reynolds

At Summer’s End

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Labor Day has now passed, alas. The school year has already commenced in our fair city. Once again traffic is heavier on the Mass Pike when I drive into Boston for medical appointments and other events, always a sure sign that vacation season is over.

Time for sweaters and jackets and warm pants. I still leave the bedroom windows cracked at night, but not as wide open as in recent weeks. The heat has not switched on, yet, but it won’t be long before I’ll need it to get out of bed in the morning.

I won’t miss this summer’s sweltering heat and humidity. But I will, as always, miss the comfort of being able to walk outside without multiple layers of clothing. I won’t miss blasting air conditioning in public spaces that triggers my Raynaud’s and dries out my eyes. But I will, once again, miss the long hours of sunlight and the ease of wearing sandals.

New England has been my home for more than 40 years, now, and I still love living here, despite the prospect of another cold winter. I will adjust, as always, to the seasonal shift into fall. I always revel in October’s colors, the stark light of late November, and the pristine blanket of winter’s first snowfall.

In praise of temperate climates, here’s a link to a recording of Antonio Vivaldi’s The Four Seasons. Even as I’ll grumble as sunlight dwindles, there is still much to be grateful for.

Evelyn Herwitz blogs weekly about living fully with chronic disease, the inside of baseballs, turtles and frogs, J.S. Bach, the meaning of life and whatever else she happens to be thinking about at livingwithscleroderma.com. Please view Privacy Policy here.

Image: zero take

As the Leaves Begin to Turn

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It always surprises me this time of year to see leaves already dropping from the trees on our street. I mean, come on, it’s still technically summer here in New England! But the days are growing noticeably short, and less sunlight means less photosynthesis. So, yes, the leaves and other green plants are shifting into autumnal mode.

Al and I took a short hike on Sunday afternoon along a trail by a mill pond for a long-abandoned cider mill not far from our home. It was a bit too buggy for my taste, but the foliage was lovely and the air was moist and rich with the scent of forest duff. Here are a few photos. Enjoy (without the mosquitoes)!

Evelyn Herwitz blogs weekly about living fully with chronic disease, the inside of baseballs, turtles and frogs, J.S. Bach, the meaning of life and whatever else she happens to be thinking about at livingwithscleroderma.com. Please view Privacy Policy here.

Surf’s Up

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I love the ocean. I wish we lived close enough to walk the beach every day. I find the rhythm of the waves mesmerizing, and the moist sea air really helps my dry eyes, nose, and mouth due to Sjogrens.

Recently, I discovered a meditation technique called Ocean Breath, or Ujjayi Pranayama. It basically involves slightly constricting the back of your throat as you breathe in and out, mimicking the sound of waves rushing in to shore and receding. Here’s a link that describes the practice.

As always, there’s a caveat. If you have heart or lung issues, check with your doctor, first.

I’ve been using a guided meditation on the HeadSpace app, which I find extremely helpful, that varies a bit from the above instructions. It takes practice, but it’s quite soothing. You can do it any time of day or night. Great for easing into sleep, waking up in the middle of the night and finding your way back to sleep, or just whenever you need to take a stress-reduction break.

Breathe well.

Evelyn Herwitz blogs weekly about living fully with chronic disease, the inside of baseballs, turtles and frogs, J.S. Bach, the meaning of life and whatever else she happens to be thinking about at livingwithscleroderma.com. Please view Privacy Policy here.

Image: KOBU Agency