Living with Scleroderma

Reflections on the Messy Complexity of Chronicity

Anticipation

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If all goes according to plan, next week I will be traveling to Germany to research my second novel. (Where is the first novel, you might ask? It’s in search of a literary agent, a long process. Details at my author’s website.) The second novel is set in Germany during 1928-1938, and I’m heading for Berlin, Dessau, and Munich. As we all know, when it comes to travel (and life in general) the adage “Man plans, God laughs” is often apt.

So, fingers crossed.

This is the first time I have ever ventured abroad on my own. I never traveled as a teen or young adult, with the exception of a two-week, whirlwind trip with my sister in 1973, a gift from our grandmother, who wanted us to see her German homeland and get a taste of Europe. We traveled by Eurailpass, back when it was really cheap to go First Class, from London to Berlin (we took the train-ferry across the English Channel to Belgium, then flew into Berlin since access was limited because the country and city were still divided), and on from Berlin to Copenhagen, Amsterdam, Zurich, and Paris. We stayed in youth hostels, dragged our suitcases everywhere, saw a lot, but decided to come home a few days early because we were totally exhausted.

In recent years, Al and I have traveled to Israel and made several wonderful trips to Europe, plus a lovely visit to Canada this past summer, and I’ve gained a lot of experience with travel planning. With this trip, I’m putting all of that to good use. I’ve cleared my plan with my entire medical team, who have been universally supportive and encouraging. And Al and our daughter are, as ever, supportive, too.

After all the restrictions of the pandemic and the past couple of years trying to figure out what exactly has been going on with my heart and lungs, I am both grateful to be feeling up for the adventure and trying my best to stay healthy prior to and during my travels. More than just a trip I’ve been dreaming of for several years and planning for months, this is a personal-best challenge to myself. I need to know, as I approach my 69th birthday next month, that I can just do it.

So, if all goes according to plan, I will be taking a break from writing here for a few weeks. I hope to have some great stories and photos to share when I’m back at the end of the month. In the meantime, Dear Reader, 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: Stefan Widua

On Managing Pain

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About six years ago, I developed deep, intransigent ulcers on five fingers that eventually caused irreversible damage to both hands. It was quite an odyssey, which involved two hand surgeries and 60 dives in a hyperbaric oxygen (HBO) chamber to heal. My 2017 account of the saga begins here.

I was in severe pain as my hands literally fell apart, which I was able to manage partly with medication. But I also used a meditation routine that I found on Headspace to help. The process involves focusing on sensations just beyond the locus of pain and gradually learning to isolate the specific spot that is causing such discomfort. It remains an important lesson in how pain generalizes, can be deceptive, and is exacerbated by fear and stress.

Surgery and the HBO therapy resolved both the acute and chronic pain issues, but perhaps the strangest outcome of all this was some phantom pain in my right middle finger. As part of the surgery, the top joint was amputated. But I still had sensations that hovered in the air where that fingertip used to be. It wasn’t pain, so much as a weird phantom itching. I would rub the blunted end of my middle finger, but it wouldn’t stop the itching entirely. It actually has taken all this time for that phantom discomfort to now be a very rare occurrence, as my brain has rewired to understand how my finger has permanently changed shape.

I share this because I recently listened to a fascinating podcast about pain management that explains my experience. In an interview with Ezra Klein, Dr. Rachel Zoffness, a pain psychologist at the University of California at San Francisco’s school of medicine, discusses the complex interactions between mind, body, and social cues that create the sensation of pain. She is very clear that pain is our body’s warning system of danger and physical damage, but that pain is also a function of our brain’s map of the body, and that the brain does not always truly know when danger is no longer present. This can be a significant factor, particularly, in managing chronic pain.

Pain management is a skill set for living with scleroderma, certainly, but also for life. So, here is the interview and a transcript. I hope you find it as illuminating as I did. 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:  Santiago Ramón y Cajal nerve cells ca. 1900

Oscillations

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It’s that time of year here in New England when the temperatures ripple like a sine wave. One day it’s in the 40s, then we slide into the 30s and even the 20s, then up to the 50s. As I write this afternoon on President’s Day, it’s a relatively balmy 54°F. Later this week we’re expecting snow showers, and the weekend promises to be frigid.

Al is more sanguine about this than I am. “It’s winter,” he says, with a shrug.

So I layer up my sweaters and shed them as warranted. My fingers are cracking, like a sidewalk that shrinks and expands with winter’s thaw. I’m using up more bandages, as I always do this time of year.

The transition to spring is always the toughest on my digital ulcers, harder than in the coldest months, when the cold is more constant. At least, it used to be. With climate change comes more temperature ups and downs. A geographer friend once told me that our weather here in Massachusetts will become more like Virginia’s, and Maine’s will become more like ours used to be. His prediction seems prescient. So far, we’ve only had one short stretch of Arctic temps this season and hardly any snow.

I am profoundly concerned about the implications of a warming planet and am devoting volunteer hours to my city, helping to mitigate the effects of climate change locally. But, I must admit, my hands don’t mind. It’s selfish of me, but these milder winters are just easier to manage, without our having to move south. The transition to spring and summer will always be a challenge, because it’s the relative temperature change that plagues my ulcers. But shorter spurts of bitter cold? Less snow and ice? I’ll take it.

Life is a series of adjustments. Some we can predict. Others, we can’t. The older I get, the more I realize that staying nimble in the face of all that we can’t control is crucial to resilience.

And so, with just one more week of February ahead, as daylight grows notably longer and the switch to Daylight Savings Time looms on the horizon, I will continue to layer up and shed and layer up again, tend my fingers, and make sure I have a full inventory of bandages and other dressings. I can’t change the weather, but I can surf the sine waves.

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: Pittigrilli

Candy Heart Wish

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It’s Valentine’s Day, and we could all use a bit more love in this world. While I can’t send you a box of chocolates or a rose bouquet, Dear Reader, if I had my own little candy conversation hearts to share, here is the one message I’d print on them:

BE WELL

Easier said than done, certainly. But it’s a phrase that I’ve been thinking about a lot, especially since the pandemic. I use it to sign most of my email correspondence these days, business and personal.

Being well is more than just a physical state. We don’t necessarily have control over what our bodies do, especially with a disease as complicated as scleroderma and all its associated ailments. Assuming access to good medical care, however (and that’s a big assumption, given health care consolidation and the health insurance mess in the U.S.), it is possible to get treatments and medical support to ease the disease process. It requires recognizing and understanding your personal situation, learning what help is available and whom to trust, being a strong self-advocate, and following through on treatments and protocols.

There is a lot to learn about scleroderma, and a lot to process. My resources page links to leaders in scleroderma research and education, to help you. But the self-advocacy piece is, for me, the most important aspect of dealing with this disease for the past 40 years. I’ve learned to push my doctors for information and explanations, and to share my fears, as well. I’ve also learned to challenge treatment recommendations that don’t make sense, and how to find research that I’ve shared with my medical team to move in a more logical direction. And I make sure that I get all my questions answered in every appointment, regardless of how long it takes. I’m grateful that my medical team respects me for it, as much as I respect them.

In this sense, to BE WELL means that you are not your diagnosis. You are a complex individual with a complicated disease that requires you to stand up for yourself and what you need to remain as healthy, active, and involved in life as you are able. Wellness is as much a state of mind as a physical state. If there is one message that I hope this blog conveys to anyone with scleroderma, newly diagnosed or a veteran like me, it’s about living, not the diagnostic label.

So, happy Valentine’s Day to all. 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: Laura Briedis

Soup’s On!

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This past weekend here in New England was bitter cold. As in negative teens, even before the windchill factor. Not my kind of weather, not by a long shot. Fortunately, it passed quickly. But winter, regardless of an unwelcome Arctic vortex, is time for soup in our home. So, Dear Reader, here are two wonderful soup recipes I recently discovered from New York Times Cooking, as well as a delicious bean stew:

Golden Leek and Potato Soup by Melissa Clark
The best recipe with leeks and potatoes that I have ever found. I left out the heavy cream, because I don’t do lactose, but it’s fine and rich without.

Roasted Carrot, Parsnip and Potato Soup by Martha Rose Shulman
Recipe calls for a blender, but I just pureed it in my old Cuisinart, and it worked fine. Easy to make.

Rosemary White Beans with Frizzled Onions and Tomato by Melissa Clark
I never knew that onions sauteed until they caramelize are “frizzled,” but whatever you call them, they are yummy! This is also an easy recipe and just so, so good, especially on a cold winter day.

Bon appetite, and if you have links to favorite soup recipes (especially vegetarian) to share, please do!

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:  Dexter McQueen