Living with Scleroderma

Reflections on the Messy Complexity of Chronicity

Taste

Airborne Again

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After 27 months of mostly staying put, I finally got on an airplane once again. And, just as I did in March 2020, right before Covid shut down the world, I flew to Philadelphia to see our younger daughter. We had been planning this visit for months, hoping that neither of us would contract the virus last minute and have to scuttle the trip. Thank goodness, we both tested negative on Thursday night, the evening before my Friday morning flight.

And so, I found myself back in the stressful world of air travel, with its crowds and TSA checks and worries about whether my flight would actually be on time or late or, at worst, cancelled due to lack of available aircraft or staff. Thank goodness, the weather held, the flight was on time, and I survived feeling squished in a cramped, worn-out seat. And yes, I wore a mask from the moment the shared van picked me up at home until I stepped out into the warm June morning and found my daughter, waiting for me in her car.

And we had a great visit. Photos below include some of the highlights: a walk through the Magic Garden of mosaics in South Philly, my first in-person view of the Liberty Bell, an abortion rights rally outside the National Constitution Center—one day after the Roe decision came down from SCOTUS—with Pennsylvania Attorney General Josh Shapiro (Democratic candidate in the crucial gubernatorial race this fall) and 1,500 citizens, a stroll down historic Elfreth’s Alley, and a brief but wonderful tour of Independence Hall and “the room where it happened”—debates over the Declaration of Independence, the Articles of Confederation, and what was to become the U.S. Constitution. Oh, and a lot of great meals.

Flying back on Sunday morning was a bit less smooth: my flight was delayed about 25 minutes because the co-pilot had to arrive from a separate flight, due to last minute staffing issues. Given all the SNAFUs that could have evolved from that one logistical issue, including a delayed arrival of the co-pilot leading to time-out issues for the rest of the crew (yes, this once happened to me), it was a relatively minor inconvenience. Overall, the trip was a home run.

How appropriate to visit Philadelphia at this critical inflection point in our nation’s history, how meaningful to be able to share it all with my younger daughter—and how great to feel like I can travel afar, relatively safely, once again.

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.

Play Ball

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Today in the Northern Hemisphere, the sun appears at its highest point in the sky and daylight peaks. I always find it ironic that summer opens with a climax of daylight, which begins to ebb the very next day. But perhaps it is the best of balancing acts: as the days grow hotter through summer months, our exposure to the burning sun gradually eases.

Summer always feels full of promise. This weekend, we welcomed its nascent approach with that most summery of summertime activities, a baseball game. Our Fair City is home to the Red Sox minor league team, and we lucked out with a Father’s Day home game in our beautiful year-old stadium, on a comfortable afternoon of intermittent sunshine. Our eldest daughter joined us for a relaxing time with a great view above home plate. And we even won, 5-4!

Some people find baseball too slow. For me, especially in our hurry-up-do-it-now-before-you-miss-out society, the pace is perfect. There’s plenty of time to chat and just sit back, watch the game and all the playful side contests between innings (catch the ball and win a pie!), enjoy a ballpark snack, stretch and sing Take Me Out to the Ballgame at the seventh inning and Sweet Caroline (the Red Sox Nation anthem). I was having so much fun just hanging out with my family that I missed a few key plays, but no matter. The ninth inning packed in some real excitement, and we all had a great time.

For those few hours, I felt transported—away from all the stresses and worries of our present moment. It felt like a real mini summer vacation. I came home refreshed.

Recently I was listening to a discussion about language, how American English is full of violent metaphors to express resilience and success. A good performance is described as “killing it” or “blowing them away.” To be precise is to “nail” a presentation. We’re advised to “power through” pain or adversity, just “hang in there.” To ask someone their opinion, we say “shoot.” And that’s just a small sampling.

While baseball certainly has its own slugger language, the sport has also brought us some kinder, gentler expressions: “play ball” when it’s time to begin; “step up to the plate” to meet a challenge; bring your all when it’s “the bottom of the ninth.”

How would our world change if we framed our thoughts in baseball idioms? How would life be different if we took time to savor what’s right in front of us, enjoy the slow moments and pauses, sing and laugh more? It’s summer here in the Northern Hemisphere. No better time to find out than right now.

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.

Venturing Out

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It’s been years since Al and I went to a wedding in the Before Times. This spring-summer-fall, we have four. The first was this past Sunday evening, the celebration of a young couple’s wedding that actually took place two years ago. After several postponements due to Covid, they had a reaffirmation of vows and a big bash at a country club, about an hour’s drive from our home.

The weather was hot, in the 90s, as thunderheads slowly filled the horizon. Despite one threatening rumble, however, the storm passed us by, the couple had a lovely outdoor ceremony and a romantic photo shoot, and we all moved on to the party indoors in a cavernous event space.

Now, Al and I had our K95 masks for the indoor bash, but the vast majority of guests went without. A few other older adults wore masks, so we didn’t feel completely alone, and even a couple of younger guests did, too. No one made any snide comments, thank goodness. Still, it was a bit awkward to be among the very few covering our noses and mouths, even as I was aware that the crowd included medical professionals and others who believed in vaccines.

At the same time, there was no way I was going to chance it maskless. We’re still in a pandemic, even if almost everyone wants to forget about it. I cannot take any undue risks, given my scleroderma, and neither can Al. Fortunately, we were seated at the back row of tables, and the only other couple at our table wore masks, as well. The rest of the place settings remained empty because, we later learned, those people had cancelled last minute due to medical risks and worries about the Omicron surge. The other couple never removed their masks, avoided the meal, and stayed only part-way through the party.

So we ended up with the best possible setting, by ourselves at a large round table, well distanced from others, while we ate. We danced a little, wearing masks, staying at the edge of the dance floor. And we left after dessert. We both enjoyed ourselves and were very glad that we could celebrate with the happy couple, family, and friends.

I’m hoping that we made the right decisions and have avoided exposure to the virus. So far, a day later, I feel fine, and so does Al. I don’t know when we’ll ever get back to “normal,” whatever that means now. I’m not ready to eat indoors at a restaurant, where we have no idea if others are even vaccinated and the space is more confined (with one exception back in April that worked out okay). I’m starting to plan some travel this summer that requires flights. I’m investigating travel insurance that covers sickness from Covid.

While the introvert in me has managed quite well, thank you, with limiting in-person socializing since March 2020, I now need to get out and about again—beyond just trips to the doctor, small family gatherings, short errands, or our synagogue, where I help to set our Covid policies and we have strict vaccination and masking rules in place that have proven prudent. We’ve enjoyed some lovely, albeit limited, long weekend getaways, and my two writing retreats over the past two years have been godsends. But my world now just feels too small.

So, it’s time to venture forth. It’s time to not be cowed by what-ifs, while taking appropriate safety measures, regardless of what others are doing. Much as I hate wearing my mask, I will continue to do so when in crowds or other Covid-risky situations, both inside and out, as I go.

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: Marc A. Sporys

Eleventh Plague

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Last week was a roller coaster ride. It’s always a hectic time, preparing for Passover, what with all the cleaning and switching over our kitchen to our special Passover dishes and cooking, cooking, cooking. But this year, for the first time in three, we had planned to host the first seder on Friday night in person. Like so many families readying for the big holiday weekend, be it Passover, Easter, or the evening meals of Ramadan that coincide this year, we were really looking forward to, at last, celebrating together across a real table, rather than on Zoom.

Al had worked late in the kitchen on Tuesday, getting things ready so I could begin cooking the next morning. But when I came downstairs on Wednesday, he seemed weary and not himself. “Are you okay?” I asked. “I’m just tired,” he said. About an hour later, he was retching in the bathroom. My heart sank. I had recently learned that the Omicron BA.2 variant of Covid often presents with GI symptoms.

I sent him to bed, donned mask and gloves, and gave him a rapid test, which turned up negative. But I also knew that the rapid tests aren’t necessarily accurate in the first few days of symptoms with this variant. So I called our clinic and was able to get us in for PCR tests early that afternoon. They said we’d have results by the next day. I emailed our family that we were in a holding pattern for Friday night.

Al spiked a fever that afternoon and evening, but fortunately, he was fever-free by Thursday morning, not yet hungry, but able to eat a bland diet. I spent the rest of the day food shopping, cleaning, and cooking more food that evening. His condition continued to improve, but no PCR results. I emailed family that things were looking better, and we would confirm plans in the morning. I went to bed dog-tired.

Friday morning, still no PCR results, but Al was back to normal. We decided to green-light the seder, understanding that anyone who felt uneasy about coming should do what was best for them. All had to take rapid tests and have a negative result to attend. Our cousin’s husband, a physician, decided to stay home because he had been fighting a cold, which he told me with “97% certainty” was not Covid, but he went ahead and got a PCR test anyway, at his wife’s insistence. Finally, late morning, our PCR tests came back negative, a huge relief. Our daughters arrived late afternoon, and our other relatives that evening. I finished all my cooking just before everyone came. We had a wonderful seder together, and all felt so good to finally be able to share the meal and all the rituals in person.

Saturday morning, our physician cousin, whose family was hosting the second night, sent us all an email. He had tested positive. Now what? To my surprise, I did not freak out. There was nothing to be done. And I wasn’t going to spend the weekend fretting about the possibility of developing Covid symptoms. We ended up with just the four of us for the second seder. Our eldest returned to Boston that evening, and our younger daughter left for Philly the next morning. None of us have developed any symptoms, nor have our cousins who were exposed at home, who came here. Given that, if you’re infected, you can shed the virus 24-48 hours before becoming symptomatic (and most people do have symptoms), but all appeared to have spent the weekend symptom-free, we are most likely in the clear of a second-hand Covid infection.

A good thing, because Monday was my 68th birthday, and I really didn’t want the gift of Covid! I spent the day writing, which was wonderful.

So goes life in Covid times, which are not really over. Not yet. I hope you and yours enjoyed a lovely weekend, whatever holidays you may or may not celebrate. Stay safe out there.

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.

Say Cheese

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We could all use a reason to smile right now, and I have a good one. I finally have a full set of teeth.

Back at the end of last July, I once again had to have a tooth extracted due to root resorption from scleroderma. It’s been a long nine months without my lower front tooth, #24, waiting first for the bone graft to heal, then for the implant to heal, then for the crown to be made, and finally, on Monday, to complete the whole process and get my new tooth.

Except I actually lost another tooth along the way. When I saw my dentist last month to take the impressions for the crown for #24, I told him that my periodontist had said #23, right next to it, was already 50 percent resorbed and quite fragile. Would I be able to have a second implant next to the first? I asked.

He paused, then shook his head. Not enough room, not enough bone in my jaw to make it work.

My heart sank. Now what?

Fortunately, he had a good solution. Have #23 extracted soon, then he would order a “cantilevered” crown—essentially, a false tooth for #23 attached to the crown for #24. I’d need a temporary version for the three months it would take for my gums to fully heal from the extraction and bone graft, then a permanent crown by summer.

Not that I wanted the discomfort and expense of another extraction and bone graft so soon, but better now than later. So I went ahead and had #23 removed by my periodontist a couple of weeks ago. It went as well as could be hoped, my gums healed in a week, and I got my temporary crown on Monday afternoon.

I have to say, it’s very, very nice to be able to smile without a big gap in my lower front teeth. My tongue misses having that gap to play with (back to second-grade-missing-teeth time), and the crown takes some getting used to. But given that mask mandates are gradually easing here in Massachusetts, it is great to have a full set of teeth, once again. And I am very grateful that we have the means to afford it.

Not so for many. It really is high time for dental insurance policies to cover more than just cleanings and fillings. Healthy teeth and gums are not cosmetic luxuries. They’re essential for eating well and communicating, and play a huge role in how we’re perceived by others and feel about ourselves. Scleroderma can cause significant dental damage. Some recent research is delving into this issue, which points to a correlation between digital ulcers and so-called Multiple External Root Resorption (MERR), but it needs more attention and a search for mitigating options for those of us who must deal with this rare but particularly disfiguring and debilitating aspect of the disease.

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.

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