Living with Scleroderma

Reflections on the Messy Complexity of Chronicity

Body

Strong Bodies

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Thighs like small boulders, wasp-waisted, she approaches the platform. The young Olympic athlete dips her hands in resin, claps, strokes her chalked palms back and forth over the steel barbell weighing 94 kilos—207 pounds—shifts from one foot to the next, then back again. The horn blasts. She clenches her jaw, squats, yanks the barbell up to her shoulders, strains to stand. But the weight is too heavy. She dumps it, thud, leaves the podium, head low.

She returns a second time, still cannot make the clean and jerk. Her coach drapes a jacket over her slumped shoulders. Other women in her weight class, with equally muscular bodies, have hoisted the barbells high. But I feel for her. I can barely imagine what it takes to grasp a weight that heavy and lift it even an inch off the ground, let alone heft it overhead.

The Olympics are contests of perfection. Swim and track meets are lost by hundredths of a second. Gymnasts fail by degrees of perpendicularity. Divers are dropped for splashing.

And yet. How extraordinary are those strong, perfect bodies. What amazing feats of stamina, coordination, speed and strength, even by those who never make the final eight. Whenever I watch the Olympics, especially the summer games, I’m always amazed—and a bit jealous. At no point in my life, healthy or not, was I athletic enough to entertain a glimmer of hope that I could be like that.

Or so I thought. Every year in high school gym class, dressed in our light blue bloomer jumpsuits, we would tumble and stumble through two weeks of gymnastics. It was always my favorite unit, though I was terrified of the beam (especially since we had to balance in sneakers, which, of course, made it impossible to feel or grip the narrow wooden span).

I loved the parallel bars, felt exhilarated when I could do a flip or a penny drop. I flew over the vault, throwing my legs cleanly across the padded horse and landing firmly. And I amazed my teachers and astonished myself when, one day, I shinnied all the way up one of the thick, scratchy ropes that dangled from the gym’s high ceiling and touched the top. Me, the shrimpy first chair violinist who was afraid of heights. I wrote it all off as a fluke.

Now physical challenges are so much harder. But I’m in better shape today, even with scleroderma, than I was 10 years ago. I take Pilates every Monday night and a dance class on most Thursdays, stretch each morning and walk Ginger in the afternoon. I want to look and feel my best as I age, and I don’t want to give in to my disease. The latter has proven to be a powerful motivation, more than vanity and my own drive for perfection.

I want to be strong. I know I need to be strong to fight scleroderma. Living with any chronic illness involves a willingness to accept limitations, but I keep pushing the envelope to find out which limitations are real and which are just obstacles of my own making.

Sometimes I wonder what my health would have been if I’d had that attitude back in high school and pushed harder to be athletic. If I hadn’t assumed I was a klutz. If I hadn’t bought into negative stereotypes of female jocks.

But it’s far too late for that, now. So I keep working out and take great pleasure and, yes, pride in discovering that my body still responds well to physical exercise. And I watch the summer Olympics, daydream what it would be like to be a competitor—and cheer for the losers who keep on trying.

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.

Blue Sea Glass

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How is it that vacations always end too soon? Just 24 hours ago, we were arriving at the ferry dock in Portland, Maine, back from a week on a lovely, remote island in Casco Bay. The sky was periwinkle, the breeze stiff. As we’d sailed to the mainland, our captain pointed out a half-dozen porpoise riding the tide, hunting fish. I never was quick enough to glimpse them, but I heard one cackling as it dived over the waves.

For eight days, Al and I slept in, took walks every afternoon and went to the beach late, when the sun wasn’t searing hot. We read and I wrote and sketched. We sat for hours watching the terns fly high over the water, then nosedive into the waves, snag minnows and pop back into the air, gulping their silvery catch as they flapped into the headwind to reconnoiter.

And we collected sea glass. Mounds of it. Mostly different shades of white with a tint of lemon or lime, a tinge of aqua, a hint of lilac; also beer bottle browns and greens.

I’ve been gathering sea glass since our now-grown daughters were little and we would scour the beach, holding hands, singing and skipping over surf. Finding even one piece would be cause for a little dance. Here, though, sea glass was bountiful. So the search was on for a sea gluncker’s treasure, cobalt blue.

From our first trip to the beach, the day we arrived, I was hunting for blue sea glass. A great meditation, especially since I was sick with a horrid cold when we left home, hacking and sneezing. And totally pissed off, because, of course, you’re not supposed to be sick on vacation, and I caught it from Al, who had come home sick the week before and missed several days of work, as a result. Plus, after my recent vitreous detachment in my right eye, my sight was full of floaters—so many that when I gazed out at sea, the sky looked like it was filled with space trash.

Grumble, grumble, cough, cough, grumble, grumble. I walked the beach, focused on each stone and shell in my path. Will my vision ever clear? What if I get a retinal detachment? How can I get to the mainland fast enough?  I picked up a white stone shaped like a tiny ice cube and rolled it between my fingers. Why didn’t he wash his hands more carefully? Why was I so stupid to use his computer and not wash my hands after? I don’t want to be sick all week! We wait a whole year for this trip, and now what?

My breathing was so compromised that by Monday morning I woke up and decided that if I was still that sick by Wednesday, I was going home. I told Al, insisting that he stay and I’d pick him up on Sunday. He said he’d come with me, but I really didn’t want to spoil his week. We talked about future vacation plans and how I’ve realized, as my health gets more complex, I need better access to medical facilities, just for peace of mind. He agreed.

With that reassurance, I redoubled my efforts to make the most of the trip, breathed in healing sea air and kept searching for blue sea glass. By Wednesday I was doing much better, well enough to suggest a long walk to see an exhibit of paintings by local artists at the island’s historical museum. We headed out along one of the two main roads, which had just been repaved the day before. And stepped on warm macadam. Which glommed onto the bottom of my good walking sandals.

Grumble, grumble, cough, grumble, grumble. These are my favorite summer shoes! They support my crazy feet! What if I’ve ruined them? I kvetched as I walked along the roadside, trying not to step on any more tar and, instead, packed grass and dirt into the guck. Al said we could stop at the ice cream shack. We found some sharp rocks, and he was able to carve off most of the crud from the soles. When we got back to our rented house, he removed the rest with a putty knife and a nail. Then we went to the beach, Al’s pick.

This beach was next to the island marina. Al wanted to park our chairs with a good view of the moored boats. I wanted to walk a bit farther, but I agreed to his plan. After all, he’d rescued my sandals. As I set down my beach chair, I noticed a speck of cobalt in the sand, inches from the chair’s aluminum footing. It was a chip of blue sea glass, no bigger than the nail on my pinky.

That was the only piece we found on the trip. We walked miles of beaches, clambered over countless boulders, waded and swam in the ocean and trekked across sandbars at low tide. My cold waned and I caught up on my sleep. I discovered that the floaters are less visible when I look at multicolored and darker surroundings, and when I take off my glasses. My finger ulcers improved in the warm sun. I got a great tan. Time slowed.

Now, back home, having kept a morning business meeting, plowed through hundreds of emails and sat at the computer all afternoon, I wish it didn’t seem so long ago, already, that we were walking the beach. Later, I’ll layer this year’s sea gluncking finds to top off a jar on my bureau. And be sure to place the chip of blue where I can see it.

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.

You Know It’s Time for Vacation When . . .

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  • Your brain turns to sludge at the thought of starting a new project.
  • You would rather pet your dog than write another blog post.
  • You don’t care if your desk is a disaster area and how much more efficient you could be if you just cleared it off.
  • You begin drafting your “out of office” message a week before you’re out of the office.
  • You devote your creative problem-solving skills to convincing the family that it would be nice to go out to dinner for pizza instead of cooking something nutritious.
  • You find a dozen different fascinating questions to research online that have nothing to do with what’s left on your to-do list.
  • You stop adding items to your to-do list because you don’t want to do any of them.
  • Your body starts malfunctioning in all sorts of strange ways just days before you’re scheduled to leave town, causing you to need yet one more doctor’s appointment.
  • You can’t stand the idea of yet one more doctor’s appointment and try to talk yourself out of your symptoms.
  • You go to the doctor’s office after crying about your symptoms to your spouse and find out everything is stress-related and it’s time for vacation.

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.

Heat Wave

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In India, “cold weather” is merely a conventional phrase and has come into use through the necessity of having some way to distinguish between weather which will melt a brass door-knob and weather which will only make it mushy.
—Mark Twain, Following the Equator

It’s been extraordinarily hot in India in recent days, and here in Massachusetts, as well—not hot enough to melt brass door-knobs, but close. Temperatures in Delhi neared 109 degrees Fahrenheit over the weekend. We weren’t that far behind. I was in Cambridge on Thursday, and my Prius recorded 99 degrees outside around 7:00 p.m.

Normally, I enjoy hot weather. Summer is my time of year. My Raynaud’s quiets down, and my hands are comfortable most of the day. My ulcers heal. But last week’s record-breaking heat wave was too much, even for me. I hardly ever break into a sweat, but I was perspiring rivers.

We New Englanders are fond of saying if you don’t like the weather here, just wait a few minutes. Not so last week, when the heat wave locked in for nearly three solid days. I was grateful to be in air conditioning, which I usually can’t stand.

I used to work in an office that was so cold in the summer, those of us with slighter builds would walk around in heavy sweaters and, sometimes, coats. What amazed me (to put it mildly) was that we had to put up with it. Some of my co-workers had heftier physiques and thrived in the cold. Some were men, who just seem to burn hotter than women (and who always, especially the heftier variety, seemed to be in charge of the computer program that ran the heating and cooling system). Some had normal internal thermostats, unlike myself. Whatever the reason, the majority didn’t want it any warmer. Some complained it wasn’t cold enough. This, despite the need to conserve energy and finances. The shivering ones among us were told to put on sweaters and deal. Infuriating. One of the many reasons I’m glad to be working for myself, now.

When you have severe Raynaud’s and finger ulcers, air conditioning isn’t just a nuisance. It hurts. More than winter’s chill, because you can’t escape the cold in the space where you need to do your work, keep your appointments or shop for food. Your blood vessels contract and your ulcers smart like crazy.

I always carry layers with me in the summer—a sweater and my Wristies, which are great fleece hand-warmers. This usually does the trick. But it’s a constant balancing act, because my hands can turn blue even if it’s in the ’80s and a breeze starts blowing. Summertime is all about managing relative temperature changes, more than absolute temperature. Except above 90 degrees.

At home, we have no air conditioning, just ceiling fans and window screens. Al is fine with it, concerned for my health and glad to save money on our electric bill. Our daughters both grew up with no AC and understand my issues with staying warm. For most of the summer, this works well—except on days like the end of last week.

It was so hot (how hot was it?) that I went to the grocery store without a sweater to protect me from the freezer section. I never do this. I hate grocery shopping because the stores are so cold, they make me feel sick from numbness. It was so hot that I had to put my Aquafor ointment in the refrigerator so it wouldn’t turn to soup when I squeezed it onto my finger ulcers. It was so hot that I blasted the AC in my car at 68 degrees and directed the vents onto my face and neck to clear my logy brain.

Today, we’re back to normal, whatever that means with global warming on the rise—another rainy June day, thunderstorms, temperatures in the ‘70s. Later in the week, it’s supposed to creep up to 90 again. It’s going to be an interesting summer.

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.

Until Next Time

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I’ve had a lot of doctor’s appointments, lately. This seems to happen every couple of months. They come in clusters of scheduled follow-up appointments, with an occasional diagnostic test or blood work or acute care visit thrown into the mix.

In a period of about two weeks, I’ve met with or will soon meet with my cardiologist, uro-gynecologist, rheumatologist and podiatrist—all regular, periodic check-ups. In addition, I met last week with an infectious disease specialist to get a better handle on how to deal with my all-too-frequent digital ulcer infections. This was on top of a couple of phone consults to discuss a nasty infection in my left thumb that has, fortunately, healed after two weeks of oral antibiotics.

It’s gotten to the point that I bought a notebook to keep track of all the information I learn with each visit. I used to be able to keep it all in my head, but no more. It’s simply too much detail, and my brain just doesn’t work that way post-menopause. Plus, sometimes my docs read test results differently, and their assessments need to be squared with each other. And I ask a lot of questions.

In addition to the notebook, I always bring something to read. And I never arrive the prescribed 15 minutes early, because I’ve learned that chances of any doctor running on time is next to zero, and I don’t want to add time to the wait. So I aim for arriving right on the dot. Then I usually wait at least a half-hour to be seen. I’ve taken to bringing my Kindle, so I can flip around from one book to another, depending on my mood. Sometimes I bring work, as well. Having something interesting and worthwhile to do helps minimize the frustration of losing control of my time.

My only other rules for doctor’s appointments are to dress in layers to deal with overly air-conditioned exam rooms, and to dress well. There’s something about walking into the doctor’s office and looking my best that helps me cope with being there in the first place. So much of our conversations are about what part of my body may not be working right, that if I make myself look good, I feel better about myself and not owned by my scleroderma.

At least, until I leave the appointment and start to absorb the latest assessment. I have wonderful, supportive physicians who are great about taking the time to answer all of my many detailed questions. But the news is usually mixed, and the list of potential complications keeps growing. I often find that it takes the rest of the day to put everything in perspective and keep anxiety about the future in check.

By morning I regain my equilibrium, refocus on my writing and family and project work, and let my scleroderma concerns drift into the background of my days. Until my next acute episode or my next doctor’s appointment.

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.