Living with Scleroderma

Reflections on the Messy Complexity of Chronicity

Hearing

Falling Back

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On Sunday we made the big shift, setting clocks back an hour to Eastern Standard Time and befuddling our brains in the process. Wait, the sun is nearing the horizon and it’s only four o’clock? Every year we go through this rigamarole, and every year I feel the darkness settle.

Sunlight in November is precious. I used to hate this month when we turn back the clocks, bringing nighttime all the more near. But in recent years I’ve come to appreciate it, despite too-early sunsets and crumbly brown leaves. The light is stark. It casts bare branches silver by day and coats them gold by late afternoon.

Nowhere is November light more beautiful than on Cape Cod, where Al and I spent the past weekend. We walked beaches at sunset, nature preserves at Noon, rediscovered a beloved bookstore frozen in time since the sixties, ate many good meals, and just enjoyed a much needed break. Here are some of my favorite photos from our trip. 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.

Public Service Announcement

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I’ve been dipping my toes into local politics lately. A friend teased me the other day that I’ll end up running for mayor.

No way.

But it’s been quite the education. Since July, I’ve been coordinating a group of concerned citizens who care a lot about our city’s trees to push our City Council to create an Urban Forestry Tree Commission. And we’ve succeeded. The Council unanimously approved the concept in August, the City Manager’s team wrote an ordinance, and it was unanimously approved by the Council a couple of weeks ago. The Commission, which we hope will start up in January, will advise city officials about best practices for preserving and growing our tree canopy and advocate for tree stewardship. Essential as the climate crisis intensifies.

It’s been exciting to see progress come from citizen action. I feel like I’m part of something really positive instead of just wringing my hands about global warming. And I’ve gotten to know our district’s City Councilor, who brought our cause to the Council. Now he’s in a very tight race for re-election, and the politics have gotten pretty nasty, with a lot of disinformation coming from his opponent’s campaign.

So, that’s how I ended up Monday afternoon participating in a “standout” for our man, which is a local tradition where supporters hold candidate’s signs at busy traffic intersections and wave at passersby. I’d never seen this before I moved to our fair city four decades ago. I used to think it odd. But I get it. It’s all about name recognition and show of support. I waved and held a sign and chatted with our candidate and some of the other supporters until my hands got too cold.

It’s easy to ignore local elections. But all elections have consequences. And local government is where you have a chance to have the most impact, especially when turnout is low in off years.

Today is Election Day. If there are elections in your community, please take the time to vote.

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: Elements5 Digital

Autumnal Perfection

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Sunday was one of those perfect, crisp fall days here in Massachusetts, just right for a good walk. So I took advantage of the weather to follow the trail around a drumlin nearby, one of the hidden gems of our city’s parks. Within a few minutes, you can immerse yourself in woodland. Even as car horns and swooshing traffic penetrate, the sounds of the city become more muffled the farther you climb the hill. My personal challenge is to make it all the way up the circular trail without stopping—good aerobic exercise. Trees along the way to the park, up the hill and down, provided inspiration. I hope you enjoy the view!

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.

Booster

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Last Thursday afternoon, on my rheumatologist’s recommendation, I got my third Moderna vaccination. CDC guidance has been confusing of late regarding boosters, but for people who are immunocompromised, the advice has been fairly consistent to get a third shot. Just who qualifies as immunocompromised, however, is also subject to interpretation.

People who are receiving active cancer treatments, have received organ transplants, stem cell transplants, have advanced or untreated HIV infections, or are receiving high-dose corticosteroids or other drugs that suppress the immune system are advised to get the third shot. In general, the CDC recommends that anyone “moderately or severely immunocompromised” get the booster now, because of Delta’s high contagiousness and questions about whether immunocompomised people have been able to mount a strong enough response to the first two doses.

Still, scleroderma was never on the initial list of conditions for the first round of vaccines back in the winter. So I wasn’t sure what would happen when I went to my local pharmacy to get my booster.

The first obstacle I ran into, however, wasn’t about whether I qualified. It was about what shots were offered. My local Walgreens, where I get all my prescriptions, only gives out Pfizer, as it turns out. So I went home and went online to see where Moderna shots were offered. The pharmacy at my favorite supermarket was listed as giving all three—Pfizer, Moderna, and Johnson & Johnson. But when I got there, that day they were just giving J&J shots. So I called another Walgreens that my local store had mentioned, and, indeed, they had Moderna and were giving boosters.

Three’s a charm. Not only did they have the right vaccine for me, but also, their consent form had a category of “other” autoimmune diseases, so I could honestly check that box. I had told them that my rheumatologist recommended the booster, which helped, too.

As for the experience of getting my third shot, I did not have as strong a reaction as I did the second time: no Covid rash on my arm, less fatigue. I was able to get stuff done that evening and next day. However, my joints flared, once again, and my Reynaud’s went into high gear. My rheumatologist had told me to try to avoid analgesics, like ibuprofen, because there are some indications that they can suppress the immune response in the first few days. I waited as long as I could, but I really needed the meds for my joints or I wasn’t going to get any sleep.

By Saturday morning, I felt like myself again. It’s now been almost two weeks, and I’m feeling more confident that I’ve done what I could to protect myself and those around me. I still wear a mask everywhere when I am indoors or in an outdoor crowd. I suspect we’ll all need to be doing that for some time to come.

I hope you, too, Dear Reader, consult your specialists and determine when and if it makes sense for you to get a booster—or your initial dose(s), if you have not already. Together, we can beat this terrible pandemic. Together, we must.

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: Ivan Diaz

Course Correction

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Our long August weekend in Burlington, Vermont, already seems like months ago. But I’ve been thinking about one of our adventures, a two-hour sailboat cruise on Lake Champlain, ever since.

It was Friday afternoon, hot, humid, perfect weather to get out on the water. A family of four sat at the bow, beneath the jib, and Al and I sat aft, behind the mainsail. When I mentioned to our captain how much I love sailboats, he said, “Would you like to sail it?”

Now, it’s been about 40 years since I’ve taken sailing lessons, but I figured he would be right there, so I agreed. And that is how I found myself taking the helm, gripping the stainless steel wheel, and wondering what exactly I had gotten myself into. “Relax,” said the captain. Sure, I thought, easy for you to say, but I really don’t want to capsize our sailboat with that nice young family up front.

He told me to turn the wheel back and forth to see what happened. As I moved the rudder, the boat shifted direction slightly to left or right, with a momentary delay. It was as if wind and current had to negotiate a bit before our direction was determined. For the next twenty minutes or so, I did my best to sail us safely out of the harbor between the breakwaters and into the huge lake, focused on a cleft between two mountains on the horizon, as our captain instructed.

It was not easy. Wind and current competed constantly, and I had to make many small adjustments of the rudder to keep us on course. To me, it looked like we were zigging and zagging through the water, but the family at the bow seemed to be enjoying themselves, and the captain was not in the least concerned. Al just enjoyed being along for the ride.

When I handed back the helm, the captain attached the wheel to some cables connected to an internal computer, set the course, and the boat effectively sailed itself. But the computer constantly adjusted the wheel back and forth, just as I had, to balance out the tug of current and push of wind. So that made me feel better.

Staying on course is never a straight line.

Every moment of every day, we make choices. We’re buffeted by many options, distractions, demands on our time and attention. It’s easy to go on autopilot in our daily routines, following the familiar course of waking, grooming, meals, work, school, chores, homework, childcare, exercise perhaps, maybe pursuing a hobby or reading a book, Zooming, or just collapsing in front of the TV or computer before bedtime.

As I was sailing on Lake Champlain, gripping the helm, I could feel the tug and pull of water below and wind above. I was acutely aware of how my hands on the wheel controlled the rudder and direction of the boat, how turning it a little too far to left or right would steer us off course. I had to pay attention.

It was not relaxing. And I couldn’t maintain that level of focus for more than twenty minutes on a day when I wanted to just be on vacation. I don’t think it’s realistic for anyone to be fully alert for every waking minute—or even healthy, for that matter. Witness the burnout of our front line workers battling Covid, 24/7, throughout the pandemic, who so desperately need rest and recuperation.

But I do think there is a lot to be said for being more mindful of our actions, how small actions can add up to big ones with significant consequences, for better or worse. For me, and for Jews around the world, today is Rosh Hashanah, the Jewish New Year, a time for introspection about the year past and reflection about how to do better going forward.

It’s been a tough year, navigating through the pandemic, which seems endless. I’m setting my sights on trying to be more conscious of the pushes and pulls that can throw me off, the ways words and worries steer and jostle my actions and those whose lives I touch, and how, with a little more care, a little more attention, I can chart a better course—not only for myself, but for others, known and not yet known.

Sail on, Dear Reader, sail strong.

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.