Living with Scleroderma

Reflections on the Messy Complexity of Chronicity

Mind

It’s Up to Us

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There’s a lot going on in scleroderma research, particularly regarding efforts to understand the causes of fibrosis—what makes skin get too thick—as well as possible treatments. Just this October, a study published in Arthritis Research & Therapy found that “two approved treatments for pulmonary arterial hypertension— Tracleer (bosentan) and Opsumit (macitentan)—can block a molecular pathway that promotes fibrosis in systemic sclerosis (SSc), and may be a potential therapy for these patients as well, according to an early study.” You can find a summary of the study here, on the Scleroderma News website.

I’m particularly interested in this study, because I have taken Tracleer for years, and I noticed within a few months of starting this medication that skin on my face and backs of my hands had loosened a bit. I’ve discussed this with my rheumatologists, who agreed with my suspicion that the Tracleer may have been responsible. One note of caution: this is a very expensive drug. You need good health insurance to pay for it. But the study results are certainly encouraging. Not my imagination. Not by a long shot.

Path-breaking research into the causes of scleroderma, as well as the ongoing search for a cure, depends on all of us to contribute in any way we can—with financial donations as well as participation in research studies. As December 31 draws near, I hope you’ll join me in making a gift to the scleroderma organization of your choice. Here are some links:

We may not see a cure for this cruel disease in our lifetimes, but progress is being made. Each year brings more insight and increasing hope that we will get the answers, sooner than later. Thank you for your help.

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: Connor McSheffrey

First Snow

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img_2491It’s always a surprise, that first coating of white. This year, it arrived on Monday, just an inch, already melting by mid-afternoon. But the flakes fell softly in the morning, fat, puffy, like thousands of tiny parachutes drifting earthward. Clinging to evergreens, disguising flaws, the snow absorbed sounds as it fell, hushing the world, slowing all down.

Mid-morning, as snow continued to fall outside my window, I was on a video conference call with people in New York City (rain), the Catskills (snow) and the Netherlands (almost never snow). The two young daughters of the Dutch woman overheard us discussing the weather and asked to see. My client in the Catskills turned his computer around to give them a peek of his blanketed yard. Their eyes widened with amazement.

By early afternoon, I had to go to the post office to mail some packages. Should I wear boots? I tried to slip on my rain boots but had to pull them off again. A few weeks ago, I kicked myself in the inner left ankle, one of those slips of coordination that occasionally plague my stride. This has morphed into an ulcer, then a rash from bandage adhesive. I saw my podiatrist last week, who prescribed steroid ointment and compression socks, and explained how weakened veins in my ankles are exacerbating the healing process. Which is why I couldn’t wear the boots. I opted for walking shoes with good treads. I’m hoping the ankle will improve by the time the serious snow falls.

Two o’clock, when I returned home, the sun was shining, the snow compacting as it melted. My footprints revealed slate. I shed shoes for slippers, ate some soup, forbade myself from reading any more news and got back to work. I didn’t notice the sun setting and the darkness settling in.

Winter is coming, and cold, and ulcers, and more snow than I want to contend with. The days grow shorter and darker. Headlines weigh on my heart. But halfway around the world, two little girls giggled at the novelty of a world transformed by white. I did the same when I looked out my window Monday morning. Let there be Wonder.

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.

50 Shades of Brown

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On Thanksgiving weekend, Al and I took to the woods for an afternoon hike. Most of the trees were barren, their leaves forming a soft, subdued tapestry beneath our feet. Along the trail, there were still hints of green—a tuft of grass, a patch of lichen. But my favorite meditation on a late November walk is to study the subtle browns of autumn’s end: caramel, ginger, cinnamon, umber, burnt sienna, slate-brown cedar, the warm copper of an old penny. Such stunning variations on a theme. And the perfect antidote to tense times.

For you, Dear Reader, here is a sample of what I saw. Relax. Enjoy the view. And be sure to play the short video at the end.

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(If you can’t see the embedded video, click on this link.)

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.

Falling Leaves

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See how efficient it is,
how it keeps its shape—
our century’s hatred.
How easily it vaults the tallest obstacles.
How rapidly it pounces, tracks us down.

from “Hatred” by Nobel laureate Wisława Szymborska

Cruel words, cruel acts eddy and swirl in every corner of our country since Election Day. I await our president-elect’s forceful denunciation of the hate speech and hateful acts being committed in his name. Two weeks and counting.

I take comfort in the many acts of kindness and caring by everyday Americans to censor those who feel emboldened to say and do what they have apparently been thinking all along. This gives me strength.

I feel wary. Will I be a target of derision, with my long pinched nose and tight mouth and awkward hands that slow me up at the checkout counter, while others wait? It is not a question that I have ever considered before. When I was grocery shopping on Friday afternoon, a man with tattooed arms hovered nearby while I rang up my items at the self-checkout lane. He kept moving closer, then stepping back, impatient. He said nothing. He did not make eye contact as I moved to the side to finish packing my bag. Before the election, I would have simply thought he was in a hurry. Now, I am not so sure. Or, perhaps, I am the one who is judging him unfairly.

Fears hover beneath the surface of normalcy. Thanksgiving is coming and I don’t feel celebratory. But I want to. I want to enjoy the holiday with my family. So I turn my focus to my many blessings: my loving husband and adult daughters, the warmth that greets me when I step inside our home from the approaching cold of winter, our quiet street, supportive friends and community, my clients who entrust me to promote their good works, the freedom to express my own truths through my writing, my art.

I am grateful for our great country, for all its fault lines and bitter conflicts. We can do better. 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.

Image Credit: Timothy Meinberg

Words Matter

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I am struggling to know what is real.

A red and blue map lays brutally clear the evidence that we are a nation deeply divided. Half of us hear words of hate as a harbinger of authoritarian rule and civil rights destroyed; the other half hear the same words as the not-to-be-taken-seriously polemics of a pragmatic deal maker who will solve all our nations ills.

I await in a state of suspended animation.

Our president-elect appears as stunned as we are that he won. Commenting on nationwide protest marches, he has tweeted that he “loves the fact that the small groups of protesters last night have passion for our great country,” the morning after he described the same as “professional protesters, incited by the media.”

He has said in a Wall Street Journal report on Friday that, after listening to President Obama when they met on Thursday, he will consider retaining provisions of the Affordable Care Act that protect people like me with pre-existing conditions and keep adult children up to age 26 on their parents’ insurance. He has described Secretary Clinton, whom he demonized relentlessly and threatened to jail if he were elected, as “very strong” and “very smart” in a Sunday 60 Minutes interview. He has also repeated his plan to export or incarcerate undocumented immigrants “who are criminal and have criminal records” and build a wall with Mexico that could include “some fencing.” 

He has said many disparaging, divisive words over the course of this brutal, cynical election that he has repeated over and over, others that he has denied or reversed in the blink of an eye. Asked by the Wall Street Journal if he regretted any of his words during the campaign, he said, “No. I won.” Asked by Leslie Stahl on 60 Minutes about his response to the rash of hate crimes and speech spreading across the country, he said “Stop it.” The same day that the interview aired, he named Stephen Bannon, former head of alt-right Breitbart News, as his chief White House strategist. A sample headline from Breitbart, while still under Bannon’s leadership last December: “Why Equality and Diversity Departments Should Only Hire Rich, Straight White Men.”

I don’t know whom to believe.

My world is filled with conversations among friends, in person and in cyberspace, arguing, debating, finger-pointing, grieving, offering empathy and support, urging resistance, counseling calm. Some are profoundly, genuinely scared for their lives. Others express deep gratitude for the support they’ve received from friends and strangers, alike. Still others say to stop whining.

Lists swirl through the media of potential cabinet secretaries and key appointees, including names of oil company executives and climate change deniers. GOP leaders boast of using parliamentary maneuvers to avoid any effort at bipartisanship in pushing through their agenda. The president-elect reassures the president of South Korea that the U.S. will still support her nation, despite his campaign claims questioning that critical strategic alliance.

People leading the protests in cities across the nation criticize President Obama and Secretary Clinton for capitulating in their efforts to promote a smooth transition of power—but buried in an account of the protests in this Sunday’s New York Times is the statement that many of the protest leaders “either did not vote or chose a third party candidate in the general election.”

An essay by Teju Cole in this week’s New York Times Magazine cites Eugène Ionesco’s 1958 play, Rhinoceros, as a chilling reminder of the insidious nature of evil and our willingness to rationalize the collapse of civil society until it is too late.

Kate McKinnon, in a cream-colored pantsuit, plays the piano and sings the late, great Leonard Cohen’s Hallelujah in SNL’s cold open segment that brings me to tears. She ends her finest Hillary impersonation with the words, “I’m not giving up. And neither should you.”

Words matter. My words, yours, what we say to each other, how we listen. What I write.

Of troubled times, author Toni Morrison offered these powerful words more than a decade ago:

“This is precisely the time when artists go to work. There is no time for despair, no place for self-pity, no need for silence, no room for fear. We speak, we write, we do language. That is how civilizations heal.

“I know the world is bruised and bleeding, and though it is important not to ignore its pain, it is also critical to refuse to succumb to its malevolence. Like failure, chaos contains information that can lead to knowledge—even wisdom. Like art.”

Image: “Paris Society” (1925/1931/1947) by Max Beckmann, on display at The Metropolitan Museum of Art’s current exhibit, Max Beckmann in New York. Beckmann was a German painter whose works were banned by the Nazis as “degenerate.”

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.