Living with Scleroderma

Reflections on the Messy Complexity of Chronicity

Touch

Thumbkin

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Memorial Day Weekend was low key for me this year. Not only because of the pandemic, although that certainly set the tone. The weather wasn’t the culprit; it was quite beautiful here for most of the weekend. There was simply nowhere that I felt like going to mark the beginning of what will be a most unusual summer season.

Some of my mood involved wanting to avoid crowds. I understand everyone’s restlessness and desire to get out and away, but I really don’t get all the celebrating without social distancing and masks. Pretending it’s over or choosing to ignore the risks to others from your own actions is to be willfully irresponsible. The virus doesn’t care how impatient we are. It will always have the last say. Tragically, the consequences of crowding over this weekend will be all too clear in a few weeks as the infection rates climb again.

The rest of my mood was due to spending the better part of the past few days recovering from a sudden and severe infection to my left thumb. I don’t know how I picked it up, though I suspect a visit to one of my providers in a hospital office a couple of weeks ago, when I was not allowed to wear protective gloves (hospital policy). In any case, several days after that appointment, my thumb started acting up, and by Monday, a course of topical antibiotics didn’t help, so on Tuesday I started my standby antibiotic to stem the tide.

It seemed as if this was calming down the discomfort for a couple of days, but by Thursday, I was experiencing more pain, and by Friday, I had spent a restless night trying to deal with what was becoming one of the worst bouts I’ve had with pain management in about three years. On a scale of 0 to 10, I was hovering around 8 or 9. The sensation was akin to the literal purpose of a ‘thumbkin’— thumbscrew torture—that, and unpredictable electric shocks from inflamed nerve endings. Not fun.

Fortunately, my infectious disease specialist prescribed a stronger antibiotic on Friday, and after the third dose on Saturday, the swelling began to recede and the pain was significantly less intense. I am exceptionally grateful to him, given that he’s the head of infectious diseases for one of our local hospitals and quite busy with COVID-19 cases. I’ve known him for at least 20 years, he trusts my account of symptoms, knows all the antibiotics I’m allergic to, and took an educated guess about this one, which seems to have done the trick without setting off a reaction (so far). We speak by a telehealth appointment this afternoon to review status.

The swelling and aftermath at the tip of my thumb caused the skin to rupture and allow pits of calcium and liquified calcium to escape, which also helped to relieve pressure and pain. I’ve known for decades that there’s a Milky Way of these pits in both thumbs due to calcinosis, and any inflammation or swelling stirs them up. I’ve been carefully debriding the wound, another skill I’ve developed over years of dealing with digital ulcers, and will be babying this thumb for weeks to come as it heals.

But here’s where the beginning of the summer season really is something to celebrate. It’s getting warmer, always good for healing. My energy bounced back pretty quickly after catching up on sleep over the long weekend. I’m feeling much more like myself again, and I’m grateful for the extra time to rest.

This infection is also a strong reminder that microscopic bacteria and viruses are ever present. Just because we can’t see them with the naked eye doesn’t mean they aren’t there. Skin is our first line of defense against disease. For those of us with scleroderma, caring for our skin and overall health is just a whole lot more complicated than hand washing. To get through this pandemic, however long it lasts, however inconvenient the restrictions may seem, there is nothing more important right now than taking the needed precautions that will protect ourselves and others, whether known or not.

End of rant. Be well.

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: Kon Karampelas

As the Rain Approaches

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The wind is blowing outside as I write on Monday afternoon. Yew boughs bounce and bend. A slight chill seeps through the floor of my converted-porch office. Beyond bay windows and walls, rushing air ebbs and flows with a whoosh and sigh, whoosh and sigh, like the sea, like a giant’s lungs.

The Earth breathes. I breathe. Every morning when I awake, I say a prayer of thanks that my lungs fill with ease. Each breath feels delicious, comforting, the most basic reassurance that I am alive and still healthy while mired in pandemic time. I meditate and follow my breath and observe how each inhalation and exhalation is so different and unique to that precise moment while at the same time so unremarkable as to be forgotten in the next.

Yews boughs bend and bounce. I watch for a cardinal or blue jay to brighten the branches that have turned gray-green in the pearly light of approaching rain. But they are wise to the weather, tucked into their nests or other hiding places to ride out the storm. Somewhere nearby, I can hear a bird singing, but don’t know enough to recognize the vocalist.

No bird answers. A car sweeps past. A siren wails in the distance. My ears ring with decades-old tinnitus that I usually ignore. It is a constant internal concert of rushing, high-pitched tintinnabulation on the right, countered by a deep, soft lowing on the left. It becomes more insistent in stillness, an irritant that I normally brush away with music or conversation or concentration.

On this pearl-gray afternoon, however, I don’t mind its reminder—that I am still here, sitting at my desk, pondering the next phrase, as the wind rushes outside, and the birds find refuge, and the rain approaches.

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: Mahkeo

Into the Woods

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Last weekend, I was starting to go stir-crazy. I hadn’t been outside more than twice during the week to walk around the neighborhood, thanks to chilly rain, and, given the coronavirus surge in our region, I did not run any errands. So when the sun finally emerged and the temperature hit 60, we drove to a nature preserve about a half-hour south of home.

On the way, we passed electronic highways signs urging out-of-state visitors to Massachusetts to self-quarantine for 14 days. Necessary warning, but it made my heart heavy. Traffic was moderate, and the small parking lot for the preserve, Cormier Woods, was almost full. With no one nearby, yet, we looped our face masks around our ears and tucked the fabric under our chins.

As soon as we headed down the first trail, I began to relax. Just getting out in fresh air, in a sylvan setting, was a relief. Nature, which has brought us the deadly coronavirus (with all too much help from humans), also now brings life’s rebirth here in the Northern Hemisphere. Each emerald sprout, each hopeful pine sapling pushing through fallen leaves, reaching for light, promised that life still flourishes.

When other hikers passed us by, we all performed the new greeting ritual—pull up the mask over your nose and mouth, step to the side about six feet, and wish each other well. Everyone seemed in good spirits, and it was nice to see others in the flesh, rather than via computer pixels.

Here is a sampling of that lovely afternoon. I hope, Dear Reader, that you, too, are able to find some safe relief in whatever way Nature provides for 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. Please view Privacy Policy here.

66

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Celebrating my birthday this past weekend, in the midst of a pandemic, was different, to say the least. Not only were we stuck at home, but also it snowed. In April. I cannot recall this ever happening. Cold, yes. Snow, no.

So, I said to Al, “Let’s build a snowman!” He was surprised, because I never suggest anything that could make my hands cold, but he was also an enthusiastic participant.

When I was a kid, I loved making snowmen. I would stay outside in our front yard, rolling each ball of snow, arranging and decorating, until I was frozen myself. Back then, I didn’t care. I have a dim memory of doing this late one afternoon, the snow tinted blue as darkness fell, mittened fingers totally numb, but still feeling joyful in the act of creating.

Of course, the snow has to be just the right consistency for construction purposes, and we were in luck. Big, fat, pasty flakes had fallen all morning, a few inches worth, the kind of wet snow that gloms together into heavy blobs when you scoop up a handful. We headed out the front door and got to work.

With a shovel, Al created a mound for the base. We slapped on more snow globs to round it out a bit, and then I rolled two very heavy balls for the middle and head (needed Al’s help to stack them). We added stones for eyes and buttons. I found a couple of twigs from a fallen tree branch (very windy last week) for arms. Al added what was left of our horseradish from Passover for a nose, and contributed an old baseball cap. Together, we secured the finishing touch—a green bandana for a face mask. And so, in about twenty minutes, “Covie” was complete.

As we worked, a few neighbors walked by with their dog and voiced their approval. I took Covie’s portrait on my phone and headed inside. My mittens were soaked, just like that day long ago, and my fingers icy, but it was worth it.

Other birthday activities included reading a novel, listening to an inspiring podcast, enjoying birthday greetings from friends and family, catching up with my sister on the phone. In the afternoon, we had a Zoom party with my daughters, complete with a cake baked by Al, and an online card game that kept us laughing for a couple of hours. In the evening, we marked the occasion by making contributions to a variety of non-profits that are helping during the pandemic. This felt good. We capped off the day watching a movie online.

Throughout, I was in an upbeat mood. (This was helped by not reading any news.) For a cooped-up birthday during the scariest experience of my 66 years, it was lovely, memorable, and a good lesson in how much each moment is shaped by how we decide to approach it.

Now, if only the pandemic could end as quickly as Covie melted . . .

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.

Mask-maker, Mask-maker, Make Me a Mask

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More than half-way through Passover now, I’m finding the holiday’s food and kitchen restrictions (no leavening, separate dishes and utensils) a fitting metaphor for our new reality. That, and the spread of matzah crumbs throughout our home. I’m also finding the rituals and rules about what and how to cook strangely comforting. Having our mini Seder last Wednesday night via Zoom with two dozen family and friends from across the country was wonderfully uplifting. Sticking with our Passover observance feels like an act of defiance in the face of this pandemic, that it can’t uproot everything we hold dear.

But there is still a lot to contend with, of course. Here in Massachusetts, we are being told to wear fabric face masks when going anywhere that makes physical distancing difficult, like grocery shopping. So, on Sunday, I pulled out my trusty 35-year-old Viking sewing machine and experimented with making masks out of old pillow cases.

I still love sewing, but it has become much more challenging since I had my hand surgery several years ago. Tweezers are an essential tool for threading the needle. I have to constantly be mindful not to reach quickly as I adjust the sewing foot, thread the bobbin or change stitch settings, or I’ll mash what’s left of my fingertips on metal. Then there’s the nuisance of cut threads sticking to my bandages.

Nevertheless, I persisted, using a pattern I’d found online, one magenta-and-pink and one cobalt-blue pillow case, and a few pieces of quarter-inch elastic from my five-decades-old sewing stash. I cut out enough fabric for several masks, but only finished two—in part, because I skillfully managed to sew the second one together wrong side out and had to pull all the stitches, a real challenge for my hands. I made an opening in the back for an insert. From what I’ve read online, coffee filters are considered one of the best options.

Along the way, I discovered a couple of mistakes in the directions. The biggest issue is how long to make the elastic loops to go over ears. The pattern said seven inches, which seems to be standard advice, but that’s way too big for my narrow face. So, a word to the wise: If you decide to sew your own mask, plan on the first one being a prototype that needs adjusting.

Here is a good article from The New York Times that includes everything you need to knows about wearing and making your own mask.

I hope, Dear Reader, that whatever your circumstance, whatever holiday you may have been celebrating or will be, soon, that you are staying safe and well. And if you can’t sew, here’s how to make a mask from a teeshirt that requires no stitching.

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.