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Living with Scleroderma

Reflections on the Messy Complexity of Chronicity

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Body

Touch Type

Evelyn Herwitz · December 2, 2025 · 2 Comments

As I was writing just now, I realized that I am typing with only my pinkies these days, with my thumbs handling the space bar. (Using an Apple keyboard makes this possible, because it requires only a very light touch.) Usually I also use my right ring finger, but it’s been out of commission for a few weeks due to another ulcer, which, of course, formed on a pressure point, as in where I touch the keys.

What’s so interesting about this is that I don’t actually notice, most of the time, how I’m typing. My hands have learned to adjust to various fingers being unavailable for so long that they “know” the distance between keys without my having to look (for the most part). Kinesthetic memory is a powerful sensory skill.

Many decades ago, when I could still play the violin, I could hear a piece of music and sense in my fingers how to play it—where each fingertip would land on the strings, which direction to ply the bow. I certainly can’t play Mendelssohn anymore, but sometimes I can still almost know, intuitively, how.

So, I guess I haven’t lost that skill. It’s just emerged in a different way. Pretty neat.

Our brains and bodies are quite amazing, even when they don’t work perfectly anymore.

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: Wayne Hollman

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Filed Under: Body, Mind, Touch Tagged With: finger ulcers, hands, managing chronic disease, mindfulness, resilience

Long Drive for a Short Appointment

Evelyn Herwitz · November 18, 2025 · 2 Comments

This is one of those periods when all of my many and various specialist appointments clump together. I can go for weeks without seeing any of my docs, and then, boom, lots of visits—most likely because they are on similar follow-up schedules, usually four months apart.

I definitely consider myself fortunate to have such an excellent team of specialists, both close to home and closer to or in Boston. But most of my team are at least a 45-minute to an hour-and-a-half drive from home, assuming traffic is light. Which basically kills half a day, between driving, parking, and waiting, plus the appointment itself.

Again, glad to have a great team in place. But what drives me crazy are the 15 minute appointments that require all that driving. As happened Monday, when I had my final follow-up with my excellent periodontist for my latest implant. Or this Thursday, when I need to drive into Boston for a 15-minute lung CT scan, a regular part of my protocol with my BMC pulmonologist who monitors my interstitial lung disease. Could I have this test done at a hospital near home? Yes, probably, but the communication of test results is not always great between providers. So this, in the long run, is more efficient.

Sometimes I’m able to schedule appointments in Boston all on the same day. I have such a plan in place for December when I was able to schedule check-ups with both of my pulmonologists (the other one tracks my Type Two pulmonary hypertension) plus a pulmonary function test. So, this will work so long as one of them doesn’t cancel out at the last minute. Not holding my breath.

Managing a complex disease like scleroderma takes a lot of time and scheduling. After 45 years of dealing with all of this, it’s just part of my routine. But I wish, sometimes, it wasn’t so time-consuming.

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: A n v e s h

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Filed Under: Body, Mind Tagged With: body-mind balance, managing chronic disease, resilience

Why Me?

Evelyn Herwitz · November 11, 2025 · 1 Comment

For all of the bad things that happened during the COVID pandemic, the one good thing that happened for me was reconnecting with old friends over Zoom. Five years ago, when we were hunkered down, I looked up friends from my teens and twenties and caught up online.

Some of us have continued those conversations, maybe once or twice a year. And this past Sunday, a bunch of old friends from my high school days shared our lives for a couple of hours. It was funny and poignant and an important touchstone for all of us, to recall where we came from and where we’ve ended up.

One of my friends, whom I haven’t seen in fifty years, shared that her sister had also had scleroderma. She died several years ago from a brain tumor, but lived with significant skin tightening for about 15 years. A number of years ago, I had also learned that the older sister of another classmate had died from very aggressive scleroderma. What are the odds that three women from the same small high school all got this rarest of diseases?

My friend on the call Sunday has wondered if the fact that our school was not far from a nuclear power plant might account for her sister’s illness and other rare autoimmune diseases that run in her family. I have wondered if the two years I spent in graduate school in Pittsburgh, living in a neighborhood on a hillside above the Jones & Laughlin Steel mill, which flushed its stacks every weekend, filling the air with the thick odor of rotten eggs, may have played a role in my disease trajectory.

Researchers still don’t know exactly what causes scleroderma, this formidable autoimmune disease that tricks the body into producing too much collagen that tightens and hardens skin and connective tissue. My rheumatologist at Boston Medical has told me the latest theories point to some kind of virus that triggers the disease process in people with certain genetic predispositions. It is not contagious, and very rare for direct family members to share the disease.

Stress also plays a role in disease onset. Research supports this, although other factors—genetic, hormonal, environmental, and immune system health—are all part of the mix. In my own case, I developed symptoms (puffy fingers, migrating arthralgia, gut issues, fatigue) in my late twenties after my first marriage ended in divorce. I was anxious and running on adrenaline while coming to terms with it all (not to mention the stress of the marriage itself, which was considerable). All that adrenaline flooded my body with cortisol—which at too high levels can damage the body’s immune system.

So, whatever else I was exposed to and whatever my particular genetic mix, that probably set the stage for my getting scleroderma.

If there’s one thing I’ve learned from all of this, it’s to take stress seriously and to do my best not to let it overwhelm me (not always successfully in our tumultuous times). Meditation helps. So does exercise (Pilates, walks, stretching). So does surrounding myself with nature and art and music. Loving family and friends are essential supports.

Recently I was listening to a meditation app that mentioned a Korean custom to eat only until you’re 80 percent full. The idea is to not overdo, to leave room to appreciate what you’ve enjoyed. It provides a good metaphor for living, as well—to engage fully, but not to the point that you deplete your energy (or run your health into the ground). Keep that 20 percent reserve for resting, recuperating, and recharging.

I’ve been thinking about this a lot, lately. I hope it’s a useful concept for you, as well, Dear Reader, especially right now. Take care.

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: engin akyurt

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Filed Under: Body, Hearing, Mind, Sight Tagged With: body-mind balance, COVID-19, managing chronic disease, mindfulness, resilience

Open Air Cathedral

Evelyn Herwitz · November 4, 2025 · Leave a Comment

Beautiful, crisp fall weather this weekend beckoned for a walk. Our trees here in Central Massachusetts have carpeted lawns and streets with leaves, but there is still much beautiful foliage to enjoy. So I set out on Saturday afternoon to stroll through a historic cemetery in our fair city.

Why a cemetery, you ask? Because this one, Rural Cemetery, was first created in the 1830’s during the eponymous 19th century movement to create “open air cathedrals” for burying the dead, as opposed to cramped burial sites that dominated urban centers. Aside from the aesthetics, these park-like cemeteries limited the risk of ground-water contamination from decaying bodies. And so, our Rural Cemetery is an arboretum with some very old and magnificent trees.

The cemetery is also the resting place from some famous local citizens, whose names define many streets and landmarks here. Being a local history nerd, I find it fascinating to discover them, as well as to observe the art of gravestones from earlier times and how it reflects social attitudes and values about that most mysterious aspect of life—what comes next.

I hope you enjoy this stroll with me. . . .

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.

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Filed Under: Body, Mind, Sight Tagged With: exercise, mindfulness, resilience

Gutsy

Evelyn Herwitz · October 28, 2025 · 2 Comments

My gut has not been happy, of late. I simply don’t process food easily, and I often have to go to the bathroom a lot during the day. Last week, this had gotten to the point that, despite multiple trips to the john that morning and yards of toilet paper,  I left the house only to have to run back inside for one more bout of diarrhea before I could get on the road to Boston for an appointment with my rheumatologist, Dr T.

This is a common issue with scleroderma. As Dr T explained (once again, because this is not a new conversation), over time the vascular supply to my small intestine has decreased, which slows the peristalsis (muscle contractions) that move digested food through my system. As a result, good bacteria that normally resides in the gut overgrows, and that’s what causes all the runs to the bathroom.

Ironically, the solution is antibiotics. Normally, antibiotics can cause diarrhea because they destroy the good gut bacteria along with whatever bad bacteria they’re aimed at. But with bacterial overgrowth, certain antibiotics can bring the issue under control.

I’ve actually noticed this whenever I end up taking antibiotics to manage an ulcer infection, or, most recently, when I had a dental implant and took Cipro to mitigate against infection. Sure enough, my gut issues improved.

Turns out Cipro is one of the antibiotics that helps with gut bacterial overgrowth. So Dr T wrote me a prescription for 10 days. Literally within hours of taking the first pill, my gut began to calm down. What a relief.

I also asked Dr T for a referral to a GI specialist. I haven’t had one in years. I think the last one retired or moved and I wasn’t as concerned as I am now to have that end covered. Fortunately, BMC has gained a new GI doc who knows scleroderma, too, which is what I was hoping for. Now it’s just a question of how long I’ll need to wait to get an appointment. This problem isn’t going away, but at least I have a stop-gap treatment in the meantime.

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: Janelle Hiroshige

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About the Writer

When not writing about living fully with chronic health challenges, Evelyn Herwitz helps her marketing clients tell great stories about their good works. She would love to win a MacArthur grant and write fiction all day. Read More…

Blog Archive

Recent Posts

  • Touch Type
  • Open Wider, Please
  • Long Drive for a Short Appointment
  • Why Me?
  • Open Air Cathedral

I am not a doctor . . .

. . . and don’t play one on TV. While I strive for accuracy based on my 40-plus years of living with scleroderma, none of what I write should be taken as medical advice for your specific condition.

Scleroderma manifests uniquely in each individual. Please seek expert medical care. You’ll find websites with links to medical professionals in Resources.

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