Living with Scleroderma

Reflections on the Messy Complexity of Chronicity

Hearing

The Nose Knows

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One of the odd and frustrating complexities of my scleroderma is the production of calcium deposits. Typically these grow under my finger tips, at pressure points. And every so often, they rise to the surface—sometimes painfully, sometimes not—until they break through. Their consistency ranges from toothpaste to a pebble. The calcium can ooze out or poke like a pin beneath the skin.

No fun.

maya-1214706-639x424Especially when the calcium forms on the bridge of my nose. This has become a chronic issue for the past dozen years. About every two to three years, I’ll develop a lump of calcium large enough that I have to have it surgically removed in order to avoid the risk of a skin break and infection.

And so it was, a week ago Monday, that I went back to my ENT plastic surgeon to have a lump of calcium removed, once again, from my nose. I used to have a theory that the condition was exacerbated by my glasses (my eyes are far too dry from Sjogren’s Syndrome for contact lenses), and I have gone to great lengths and expense to get only the very lightest weight frames. Certainly these are more comfortable. But after this fourth excision, I’m beginning to think that the bridge of my nose is a little calcium deposit factory, and this is just an inevitable maintenance issue that I’ll face again.

I had felt the calcium lump growing for about a year—not huge, just large enough to poke up and stretch the skin. But our insurance policy was not great, and my specialist was in the second tier, with a big deductible. We couldn’t afford the procedure. Then, thank goodness, Al’s health coverage at work changed for the better (not in small part due to a lot of employee complaints and talk of unionizing). So the first week of January, I called for an appointment. Even though I knew I’d have to heal in cold weather, I couldn’t let it grow any larger without risking a skin break.

Al was able to take the day off and go with me to Boston. After about a half hour wait (during which time a woman sat near us in the busy waiting room and began to play her smartphone music without earphones—and no one in charge said a word), I was called in.

Despite the fact that I had specified what I needed done when I made the appointment (with a referral from my rheumatologist), however, no one seemed to know that I wanted my doc to take the thing out that morning. I made my intentions clear, and we got the ball rolling.

My specialist stepped in to see me, recognizing me right away, even though I haven’t seen him in three years. He checked my nose and started explaining the options, but I stopped him and said I wanted to take care of it now. Then he said, “All right, I’ll have one of my associates take care of you.” I looked at him, a bit stunned, straight in the eye, and said, “I really want you to do it.” So he agreed. I don’t know what was going on with communications there, but thank goodness he’s a good guy and a brilliant surgeon. I absolutely would not trust anyone else.

His resident took care of the local anesthesia. One shot, right where the lump lay. I was actually surprised, because the last time I had this done, I think it took at least two shots, and one was in the nostril, itself. Not a pleasant memory.

Only one problem. As soon as she gave me the shot, I began to shake. My heart started racing. Then I felt a pain in my lower gut, which quickly moved to my lower back. When I closed my eyes and tried to steady my breathing, I could see the light behind my eyelids pulsing with my very rapid heartbeat. When the resident came back in the room (she had stepped out for a few minutes), I asked what was in the shot.

Turns out it was Lidocaine plus epinephrine, a combination I have never had before. (The two are combined to make the Lidocaine “stay in place” and work more effectively.) Fortunately, the side effects passed as quickly as they came—but it definitely threw me. Some people are sensitive, my specialist commented. Yup.

Five minutes later, he had popped out the calcium, a pebble about five millimeters in diameter, and stitched me up. “You have a soft nose again,” he said. I was relieved. With a piece of surgical tape over the incision, I walked out into the waiting room and found Al. I was really glad he was there, because the aftereffects of that shot were still making me feel off kilter.

Anesthesia works through my system very slowly. It took about seven hours before it wore off completely, during which time I tried to sleep, couldn’t, even with a Vicodin, I’m sure because of the epinephrine lingering somehow. I did get to sleep, finally, that night, and was nearly back to normal the next day. By Wednesday, I felt like myself again.

The small incision is almost completely healed, a week later. The stitches are absorbing. I have been able to go without any bandage for 24 hours, even as the temperature has dropped into the teens and we’ve gone from springlike conditions to snow storms over the past seven days. It’s great to have that damn calcium pebble out of my nose.

I made notes so I’ll remember what happened and what to watch out for the next time I deal with this. And whenever I require a local anesthetic, you can be sure I’m going to find out what’s in it, ahead of time. Living with chronic disease means being vigilant, informed and a strong advocate for exactly what you need, when you need it. Nothing less will 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.

Image Credit: Tamer TATLICI

Mouse Wars

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When my daughters were very young, one of their favorite bedtime storybooks was the lovely classic, Goodnight Moon. We had to find the little mouse hiding in each illustration. It didn’t matter how many times we’d read the book. Finding that mouse was the best part.

full-moon-1506114-640x480A little gray mouse in a picture book is fun to find. A real gray mouse is not. Especially when there are a handful and they are running around your kitchen. And living room. And office.

With this week’s bitter cold and stormy weather, mice have decided our home is a nice place to hang out. They like it warm. We have that much in common. I believe they’ve actually been with us for a while, but had kept to our garage, where we made the huge mistake of leaving a big bag of birdseed unattended for more weeks than I want to admit, after it was clear that some critter had chewed a hole through the plastic.

A couple of times last week, I noticed a chubby black mouse racing away from the bag when I went to my car. High time to clean up the mess, so I bought a plastic bin with a tight lid, put on a pair of work gloves to protect my hands, swept away all the dropped seed and tossed it in the back yard for the birds, and sealed up the rest.

Of course, this meant that the chubby mouse was now deprived of its meals. Which drove it into the kitchen. Midweek, I was sitting in the living room and thought I saw something dart across the kitchen floor. I looked again. Nothing there. I dismissed it as a floater in my eye.

But I was right the first time. All of a sudden, in the midst of the weekend’s storm (only three inches here, nothing compared to all the snow farther south), mice started running through our house. I saw two black ones Saturday night as the snow began to accumulate.

What to do? I hated the idea of killing them. I looked up alternatives online. According to the American Humane Society, house mice don’t do well if you release them to the wild. Plus the idea of live-trapping mice and then transporting them to a snowy field somewhere, in bitter cold, seemed a pretty cruel fate (let alone quite time consuming). Mice can carry viruses, bacteria and fleas. I have an autoimmune disease. We decided to go with traps that did the job quickly.

Al caught one mouse in an old fashioned wood trap Sunday morning. No way I could reset it with my hands. He left it set with more cheese before he went out. I settled down to work on writing my novel at the kitchen table. When I looked again, the cheese was gone. No mouse.

Al had to work all day at the hospital. I tried to concentrate, but I kept hearing scrabbling noises, then nothing, from the kitchen. By mid afternoon, at least half a dozen—maybe some were the same mouse, maybe not—had skittered around the first floor of our home. They were making me crazy.

One darted out of my office just as I was talking to my younger daughter on the phone about the invasion. It ran behind Al’s armchair, under the bookcase, into the dining room and disappeared. Another scooted around the kitchen and into a closet. A little mouse poked out from under the fridge and ran away. But then it or another mouse proceeded to squeak and squeal from somewhere behind the fridge. I actually opened the door to make sure it wasn’t somehow trapped inside.

I’d had enough. I went to the hardware store and bought three quick-kill traps that I thought I could manipulate. I came home and set them up with cheese—not before snapping my finger at least once. Not good. Mouse’s revenge, I suppose.

I set them out and went for a walk. The idea of sitting and listening for the traps to snap was making me very uneasy. But no caught mice when I returned. Instead, as I sat in the living room, trying to distract myself with the Sunday New York Times crossword, a gray-and-white mouse suddenly darted from under the bookcase, skirted a nearby trap without so much as a how-dee-doo, and ran through the dining room before exiting somewhere under the counters. Twice, one of the traps in the kitchen went off without catching anything. And there was more squeaking behind the fridge.

Finally I gave up and called Al at work. He was getting ready to come home soon. By the time the Patriots lost to the Broncos, the little mouse was dead. One down. We went out to dinner because I didn’t want to cook in the kitchen. How many more to go? For all I know, we have an entire extended family in our walls and beneath the floorboards. If the traps don’t do the trick, it will be time to call the environmentally responsible critter control experts and pay the price.

Oh, and by the way, there was a bright, full moon this weekend. 

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.

Image Credit: Brandon Blinkenberg

Into the Freezer

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Okay, okay, it’s winter. I get it. Those unseasonably balmy December days are a distant memory. The temperature is dropping, the wind chill is rising, and it’s downright cold outside.

photoFive of my fingers are in bandages, one infected ulcer in my left middle finger has required antibiotics for more than a month, and it takes me forever to get going in the morning and to bed at night because of all the hand care.

But I refuse to give in to the weather. Forewarned is forearmed. Friends in Chicago have been telling me about the frigid temperatures there, and it was only a matter of time before the Arctic Freeze came our way. So this past weekend, I found a new pair of mittens with all the right qualifications: lightweight, thermal insulation, with cozy channels for my fingers like an interior glove, suede feel for driving, soft, easy to manipulate. A big score.

I also found a new winter hat (it helps that everything warm is now on sale). It’s one of those fake fur jobs, like a fuzzy bomber’s helmut, that covers my neck and ears and wraps under my chin. I did not buy this for looks. It is far from flattering, given my narrow face and long nose. But no matter. It’s definitely a good addition to my other winter gear, especially when paired with a snug wool hat underneath. It functions like a hood, better than the oversized one that came with my warmest winter coat.

So, the only item left on my list is a pair of insulated winter boots. I’ve somehow managed to go without for a long time, relying instead on a pair of cleated overshoe boots for really bad snow and ice. But they don’t work for driving or city walking. And my rain boots, made of rubber, make my feet sweat when I use them to drive, which only causes my toes to get chilled if I then walk outside.

It’s a lot of work, all the gearing up to go out. Reminds me of when I was a kid and my mom made me wear snow pants over my skirts for school, the kind that had clip suspenders to hold them up. I hated those snow pants. They made my skirts bunch up at the crotch. And those old red rubber boots, the kind with elastic bands as button loops. Clip-on mittens. The works.

Even still, I would play outside for hours in the snow, building snowmen, sliding down the back hill on our old Flexible Flyer, making snow angels. I’d play until my teeth chattered and my fingers went numb. For a healthy little girl, warming back up with a cup of hot chocolate was half the fun.

Now I have to force myself out the door just to walk in this weather. But once I’m all bundled up, I still love the fresh, crisp air, especially after a snowfall. I love the transformation of trees to Belgian lace. I love seeing all the critter tracks, knowing who was in our yard or up the street, otherwise unseen. I love the stark winter light and the way dusk turns snow blue.

So, here’s to you, Old Man Winter. Much as I dread your annual arrival, it wouldn’t be the same without you.

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.

If I Had a Billion Dollars

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Al and I were sitting at the dinner table Sunday night, finishing our meal of salad plus macaroni-cheese-and-tomato-sauce casserole. “The Power Ball is worth over a billion dollars,” he said ($1.4 billion, to be exact—but who’s counting).

rainbow-1393626-639x391“Really?” I said. “What would you do with a billion dollars? I mean, whatever was left after taxes?” (Even if it was less than half, that would still be a whole lot of money.)

We agreed that our first priority would be to pay off all debts—our mortgage, the equity line, the girls’ college and grad school loans. We’d make sure their futures were financially secure. And we agreed that our second priority would be to set up a charitable foundation.

“Who would you give the money to?” Al asked.

I began enumerating—certainly I’d donate to scleroderma research, also our favorite charities and our synagogue. I’d give a lot of money to climate change research, like how to desalinate sea water, alternative methods of farming during droughts, better ways to control coastal flooding. I’d fund interfaith dialogue and Middle East peace initiatives. Grants to fledgling artists and writers. For starters.

“What else?” he asked.

“Well, I’d fix up the house, do all the projects we’ve put off. Maybe I’d want to sell it and downsize.”

“Downsize? With all that money?”

“Sure. Then we could buy vacation places around the world. Except they’d be a lot of upkeep.” (So much for downsizing.)

“It wouldn’t matter,” said Al, caught up in the game. “We’d have enough to pay for a home on Block Island.”

“Okay, then we could also have an apartment in Tel Aviv and a place on the French Riviera. And I’d want to travel. First class. Go to Antarctica.” (I could certainly afford to buy whatever gear I needed to stay warm, there or here, for that matter.)

Al smiled. He began to clear the dishes.

I imagined buying custom-made shoes for my hard-to-please feet and any clothes I wanted.

“You could get a personal trainer,” he said, picking up my empty dinner plate.

“Yeah,” I said, “and I’d want to put aside enough money so we’d be able to afford in-home care, 24/7, for when we get older, so we’d never have to live in a nursing home.” (Might as well be a little practical about the future with all that imaginary money. Certainly no more worries about medical expenses!)

What about work? We agreed we’d have our hands full managing our foundation, even if we hired staff to run it for us. We’d also be busy traveling. The rest of the time, I’d want to write my novel.

“Better buy some tickets,” I told him. (I can dream, can’t I?)

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.

Image Credit: Yarik Mishin

The Monday After

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Ah, yes. Getting back to work after a long holiday weekend. It’s always a slog. Even when I’ve planned well and given myself a lighter schedule to ease back in, as I did yesterday, I still find it hard to get fully motivated.

nap-1572984-639x424When I used to work in an office, it was all too easy to spend at least half The Monday After chatting with colleagues and sorting through a gazillion emails. Trying to get any serious work done was nearly impossible. I always felt like I was waking from a long nap and just wanted to roll over and go back to sleep.

Working for myself, I don’t have coworkers to chat with or the distractions of an office setting. And I’d rather be writing than doing chores or other stuff around the house. But it was still a challenge to sit at my computer and get down to business.

That was the only good thing about the Arctic freeze that struck Monday morning (we’ve been totally spoiled with above normal temperatures here in Central Massachusetts for most of December)—it was way too cold to go outside. I stuck my arm out the front door to collect the mail and immediately decided that I would subject no more of my body to the elements for the rest of the day.

So I had to stick to my desk and get through my projects. Which I did. But it took several hours for my brain to fully focus on the work at hand.

At least I had a good reason to still be in holiday mode. New Year’s was great. We started celebrating early, last Wednesday night, because Al won four tickets to a Celtics-Lakers game in Boston (he made a contribution to United Way at the hospital and won the big raffle drawing). Not only did he win four seats—they were club seats, with great views and a bonus of free parking thrown in. The Celts lost (boo), but we had a wonderful evening with our daughters, cheering and chatting and taking silly selfies.

On New Year’s Eve, Al and I joined foodie friends for an annual festive meal and spent half the night singing our favorite oldies from the ’60s and ’70s. (How can those songs really be OLD?) The rest of the holiday weekend, I relaxed, read, saw friends at synagogue, took long walks, and worked on a photo book of pictures from our Europe trip (only five months after the fact). What could be bad?

I also managed to stay away from the news, which was probably the smartest thing I did for four days.

And now it’s back to reality. I am ever grateful to be working for myself successfully. This makes it possible to sleep a little later on the Monday after a long weekend, avoid any contact with my car and the out-of-doors if it’s just too cold to venture forth, and set my own pace with projects.

I’ve been my own boss for six years this month, and as hard as the transition has been from the workplace to self-employment, with some very sleepless nights about cash flow along the way, I’m so glad to be here, now. I am certain this arrangement has helped to keep me healthier. It’s certainly helped to keep me sane.

So, hello 2016! What’s next?

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.

Image Credit: Marcelo Gerpe