Living with Scleroderma

Reflections on the Messy Complexity of Chronicity

Hearing

Best Vacation Ever

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As a child, I used to watch a public TV program about Japanese brush painting, and I learned how to paint the images that the artist demonstrated. It has been a dream for decades to travel to Japan. And so, for two weeks in June, Al and I made that dream come true. Back home since Thursday night, after a phenomenal trip—strenuous, but worth every minute.

We flew from Boston to Montreal, stayed overnight, then made the 12-hour flight to Tokyo, where we stayed for a couple of nights in a ryokan, a traditional Japanese inn with tatami mats as flooring and a futon bed on the floor. Then it was on to Kyoto by the Shinkansen bullet train. Our accommodation there was a rented home in a family neighborhood, lovingly preserved and decorated. The bedrooms were up a narrow staircase hidden behind a sliding bookcase.

We spent five days in Kyoto, which included a day trip to Nara, the ancient capital of Japan where deer are sacred and roam free. Then we took a Shinkansen to Hiroshima, where we stayed in another traditionally decorated apartment in a residential neighborhood. Our time there included a powerful visit to the Hiroshima Peace Memorial Museum, which commemorates the victims of the atomic bomb attack on August 6, 1945. We also took a day trip to the nearby island of Miyajima, home to UNESCO World Heritage temples and shrines. Then we moved on by train and ferry to spend three days on the island of Naoshima, known for its art museums and galleries. On our way back to Tokyo, we caught a glimpse of Mount Fuji.

Yes, it was another of my super-charged itineraries. We saw exquisite gardens, ancient temples and shrines, museums, shops, street life, and navigated the food scene. Google Translate was a huge help, both for speaking with people and translating signs and other text.

I will be thinking about this trip for years to come. It was inspiring, transformative, and, yes, challenged my physical endurance. But I am so, so glad we went, as is Al. Here are some pictures. Enjoy.

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.

Until Next Year

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Last Wednesday night marked the beginning of Passover, when we always host the first seder for our extended family. Al’s first cousins always host the second seder. This is a family tradition that dates back to Al’s mother and her youngest sister, who alternated hosting the two festive meals every year, when we join Jews around the world in retelling the Exodus story.

Even though we share the meals between the two families, it’s still a lot of work. My hands were in rough shape as the holiday approached, with six fingers in bandages, due to persistent ulcers and calcium bits that had chosen just this time of year to travel up to the surface and hang around without popping out. This feels like having grains of sand stuck under your skin. No fun.

Fortunately, our younger daughter had already planned to come up from Philadelphia to help out with the cooking for three days. Yes, it takes that long, because I can’t help myself. I always plan a very special meal with lots of courses. Even when I’ve mastered all the recipes and know how to pace myself with the meal prep, it’s just a lot of work.

So, we cooked and shopped and cooked together for several days. She did the lion’s share of the chopping and mixing and frying and baking, while I directed and handled a variety of smaller details that were essential for the final meal. Here’s what we made: Egyptian charoset, which is a mixture of dates, raisins, ground nuts and sugar; hard boiled eggs; pickled salmon (a family favorite, as an appetizer); Egyptian potato soup; spinach patties; roasted carrots, beets, and turnips; a salad of oranges, avocados, red onions, arugula, and a cinnamon vinaigrette dressing; apricot sponge cake, chocolate chip meringue cookies, strawberries, grapes, and chocolate for dessert. And, of course, there was plenty of matzah, including gluten free.

It was a hit. Worth all the effort. We had fun cooking together, though I was quite tired afterwards.

Learning how to ask for and accept help is a crucial part of living with scleroderma. I’m very grateful to our daughter for being so willing to step up and keep the family tradition going. Until next year . . .

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.

Olympic Interlude

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Nearly every night for the past 11 days, I have been reveling in the Milan Cortina Winter Olympics. Watching these amazing athletes’ extraordinary feats has been the best antidote to horrible headlines and stress. It has also helped me get through my bout with the flu and the lagging fatigue and residual, annoying cough.

I am a sucker for the whole spectacle. I feel elated when “old” athletes, who are at least half my age, triumph, as did Italy’s Federica Brignone, whose courageous comeback in the women’s giant slalom earned her gold. Honestly, her win brought tears to my eyes (to the extent I can make tears).

And my heart goes out to those who fall, like champion skier Lindsey Vonn and ice skating wonder Ilia Malinin. Vonn’s skiing career may be over (I really hope she doesn’t risk breaking her leg or shredding her ACL again), but Malinin will be one to watch in 2030. I wish him well and hope he learns from his Olympic experience to keep growing and striving for his personal best.

I will never be able to soar through the air like freestyle skier Eileen Gu, but I love watching her fly with such joy. I am inspired by the extraordinary grace and strength of ice dancers Madison Chock and Evan Bates. But what moves me the most is the sportsmanship of so many athletes from around the world, who compete so intensely and then congratulate each other so graciously.

Our world could use a lot more of that spirit. May it be so.

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: Passo Falzarego, Cortina d’Ampezzo, Italy, by Marco Czollmann

Why Me?

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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

Tornado Warning

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On Saturday afternoon around 4:15, I was lying on our living room couch and reading (not light reading, literally and figuratively, an 850+ page history of the Thirty Years War, but that’s another story), when my cell phone alarm went off. Really loud: a National Weather Service warning of potential for a tornado in our vicinity for the next half-hour. TAKE SHELTER! it advised, with more details in all caps.

Now, it was already dark and pouring outside, and we’d experienced a bright flash and loud crack of thunder a few minutes earlier. A severe storms was definitely passing through. But tornado watches are rare in New England, let alone a tornado warning. (Years ago when I lived in Illinois, I never got used to all the watches and warnings, and tornadoes were my dream metaphors for anxiety, but all that ended when I moved back east.) Being the more cautious of the two of us, I checked with Al, who was immersed in another activity, to be sure he’d heard the alert. He shrugged and went back to what he was doing.

I went downstairs with my heavy book to read. Since our daughters moved away, our basement family room is really now a junk room for storage, but there’s still a couch and decent lighting. It’s musty and needs a good clean-up, one of my perpetual to-do’s that I mean to get to this winter (there, I’ve put it in writing). Part of Al’s old vibraphone was lying on the couch, so I rolled up the wooden tone bars, moved them to the side, then picked up the strip of metal resonator tubes, to do the same, lost my balance and fell. Fortunately, I fell on a rug (mostly), but I banged my knee on part of the vibraphone. Which was not fun.

There’s a small, high window in the room, and it was quite dark outside. I could hear the rain, but no thunder or lightening cracks. So I read and checked the time and read and finally went upstairs at 4:45. Al was still immersed. I got an ice pack out of the freezer for my knee and went back to my history book on the couch. I felt kind of silly, but so be it.

Until I learned, not long after, that a tornado had actually briefly touched down in a suburb not far from us at exactly 4:15. Known as a “spin-up” or “land spout” by meteorologists, it was relatively small and lasted only a few minutes. But the damage was significant. In that brief visit, it uprooted and destroyed numerous large trees, including some oaks, which are among the sturdiest trees in this part of the country.

Which just goes to show that you never know what’s just around the corner, and that it’s worth being cautious when the NWS sends you an all caps warning about approaching storms. Especially in this time of severe weather, I’d rather sit in our musty family room for a half-hour than risk a tree falling on our house. If I get my act together, the next time this happens, our old family room will be a much more pleasant space to wait it out.

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: Greg Johnson