Living with Scleroderma

Reflections on the Messy Complexity of Chronicity

As We Wait

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There’s a chill wind blowing as I write on Monday afternoon, and it feels more like January than the first week of November here in Massachusetts. We had six inches of snow last Friday, enough to pull down some tree branches that are still in leaf. But we made the most of it, and built a snowman. It’s still barely standing.

It was Al’s 70th birthday on Halloween, the kind of milestone you want to mark with a big bash. Instead, I made him a half-hour video montage with tributes from family and old-time friends, we had a Zoom family party, and an elegant take-out meal plus a delicious cake with chocolate mousse and raspberry preserve filling. The day felt truly festive, despite pandemic restrictions. Al, being Al, delivered candy treats to all the neighbors because there was no trick-or-treating in our fair city this year.

On Sunday, we at long last had our lower roofs repaired, a project that had been stalled for two months, first by weather, then by our Covid scare. No more leaks in my office every time it rains, or in the kitchen around the very old skylights. The new ones are solar-powered and close automatically when it rains, if we forget. I’m grateful this is finally done and we’re ready for winter.

The sky is a brilliant blue, and the sun is shining.

Whoever wins our national election, I must believe that we’ll find our way through. We have many searing problems to solve, a pandemic to overcome, far too much fear and misunderstanding. But there is also a wellspring of love and good will in this country. I’m praying for our better angels to prevail, for the ebb and flow of daily life to be all that’s remarkable, once again.

If you have not yet voted, please do so before the polls close. Be safe, stay sane, hug your loved ones, be kind to your neighbors. We won’t know the answer for a few days, or perhaps longer, until all the ballots are counted. That’s okay. Every vote matters.

Peace.

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: Jennifer Griffin

Flu Shot

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I got my flu shot last Thursday morning. Unlike previous years, when my health care provider would offer walk-in “flu clinics” that involved checking in, confirming that my doc was part of the practice, then quickly moving through the line to an exam room, getting the shot, and leaving, in Covid Time I had to make an appointment.

I was greeted by a car valet who squeezed sanitizer onto my palm, then the welcome staff who handed me a paper mask (can’t wear your own) with a pair of tongs. After checking in at six feet from the counter, I proceeded to the elevator, where another patient pushed the buttons for me (I would have used my elbow instead), then on to the adult medicine waiting room and took a seat.

To my dismay, I realized I’d left my phone at home—big mistake for waiting rooms—but, fortunately, the nurse came out within a few minutes to invite me to the exam room. The rest went as usual, and I barely felt the shot (unlike a few years ago, when the nurse hit a bone near my shoulder with the needle, big ouch). All done within about the same amount of time as a flu clinic.

Since I’m over 65, I got the super flu shot, and by that afternoon, I was starting to feel a bit out of it. My arm didn’t really hurt, but I was just tired and woozy. Watching the last presidential debate did not help. Sleep was most welcome, and by the next morning, I felt like myself again.

All this made me wonder: how bad is the flu this year? I don’t usually have that kind of a reaction. And, how awful would it be to get it in Covid Time, let alone get Covid? Fortunately, at least as far as the seasonal flu goes, I can just sit back and safely speculate—and urge you, if you haven’t done so already, to get your flu shot now.

We are blessed to have easy access to a flu vaccine. A hundred years ago, people didn’t have that option. The great influenza pandemic of 1918-1920 infected an estimated 500,000,000 people worldwide. Of those, about 50,000,000 died—including 675,000 individuals here in the U.S.

In the past eight months, at least 225,000 Americans have died from COVID-19. According to the best estimates, we won’t have access to a widely distributed vaccine until at least next summer. By that time, if we continue on our current path with mixed response to mask wearing and social distancing, the nonpartisan Institute for Health Metrics and Evaluation at the University of Washington projects that we will have lost nearly 383,500 of our fellow citizens by January 31, 2021. If everyone finally concedes to wear masks, the projection is still very grim, but lower, 321,500 deaths. And if we go the way of easing restrictions, the total jumps to a projected 480,000 dead—well on the way to the death toll of a century ago.

Just writing these numbers is mind-boggling. Covid cases are spiking across the U.S. as I write. In regions that are surging, hospitals are overwhelmed and running out of ICU beds. We are heading into a very dark winter. Even with best practices, because of inconsistent public health practices nationwide, we may well lose another 100,000 fellow citizens in just a few months.

Nonetheless, given that a safe and reliable Covid vaccine is still many months away, if everyone would just wear a mask, we could save about 50,000 American lives between now and February. Think about it. 50,000 lives.

Our national election is truly a life-or-death decision this year. Please wear a mask. Vote safely. Vote.

And when that effective, scientifically-proven Covid vaccine is finally available, get in line. The safety of all depends on each of us.

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: “Boston Red Cross volunteers assembled gauze influenza masks for use at hard-hit, Camp Devens in Massachusetts,” 1918, Centers for Disease Control.

Two Weeks and Counting

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We voted on Sunday. No fanfare, no lines, just drove to a ballot drop-box outside a city fire station near the site of what was once Al’s dad’s pharmacy. A bottle of hand sanitizer sat atop one of the two drop-boxes there. Only the polished red fire engine, parked inside the glass-windowed garage, watched over us as we deposited our Massachusetts ballots. It felt good.

I never debated whether to vote in person this year. Given scleroderma, I have no desire to expose myself to more Covid risk while standing in a long line or from handling shared marking pens (we still do paper ballots here). We’re very fortunate in our fair city to have easy access to ballot boxes at all fire stations, City Hall, and outside polling places that are now open for early voting. Others are not so lucky, and options, more limited—a serious issue that I hope will be properly addressed long before the next presidential election.

Still, I admit that I missed the thrill I get whenever I have voted in an election, especially for the president. There is just something so powerful about fulfilling that sacred act of citizenship. I always like to watch the number of ballots cast increase by one as my paper ballot is sucked into the ballot machine. I like getting my “I Voted” sticker. I like feeling  part of a civic action that is so essential to our democracy.

But this year, in so many ways, is different. So I will take joy, instead, from the serendipitous rainbows that scattered across my ballot before posting this weekend, when sunlight briefly refracted through my crystal pen holder. I captured the image with my phone camera just as it looked like my pen was shooting optimism. I’ll take that as a good omen.

Here’s a great resource for voting information throughout the U.S. If you haven’t yet voted, please make a plan to vote this year and follow through. With only two weeks to go, we all need to step up. The future of our democracy is on the ballot.

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.

Dress Rehearsal

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Last week, we had a Covid scare. Al woke up early Tuesday morning, sick to his stomach, with a fever. This is highly unusual for him. At any other time, I would have just assumed he’d caught a GI bug, but given that COVID-19 can occasionally present with these symptoms, we immediately went on high alert.

I spoke to our clinic twice that morning and was basically advised to have him isolate, hydrate, and take Tylenol to control his fever, which had gone up to 101.1. We have a pulse oximeter that I’d purchased months ago, just in case one of us had Covid symptoms, and I had him check his oxygenation level, which was fine at 98 percent.

I spent the next few hours trying not to freak out. I tried to concentrate on how he was doing as well as my work. A planned Zoom call with one of my clients, who is also a longtime friend, helped me regain some perspective. I dug into my writing, which is a meditation for me. By afternoon, Al was doing better, able to make arrangements for coverage for his social work responsibilities, and his temperature had settled around 99. He was able to drink fluids. And he slept.

But I would be lying if I didn’t admit I was really scared. Both of us are over 65, with health issues that put us at risk for serious Covid complications. I tried to schedule Covid tests for that day, but couldn’t get anything until Wednesday morning. So, like millions of other Americans finding themselves in this terrifying dilemma, we had to just sit tight and wait to see what happened.

By bedtime, Al was looking and feeling a bit better, able to eat a few rice cakes. (I’m a strong believer in the BRAT diet for stomach distress—bananas, rice, applesauce, tea/toast—with rice always the first step.) Just as he was settling down in a separate bedroom, and I was ready to go to bed, I suddenly remembered that the nurse had told me to monitor his oxygenation level. If it dropped below 95, I was supposed to let them know.

So I gave Al the meter for him to measure his levels. I was being very careful not to come into his room, per all the CDC guidelines. Three times he measured his levels with the finger-clip meter on three different fingers, and each time, it came back 88. How could his levels have dropped ten points with no sign of respiratory distress? But I knew this is one of the hallmarks of Covid: your lungs can be overworking before you actually sense it, which is why these readings at home are so important.

After a long discussion with the clinic, I was advised to bring him to the ER. We arrived at Midnight, but, of course, I could not go with him. He texted me as soon as I walked in the house that he was already in a room, and that his pulse/ox was 96 percent. So, obviously our meter was off. I was very relieved, though still confused.

Three hours later, after he’d had a clear lung Xray and other negative lab work, plus a Covid test (results in 48 hours), plus IVs and potassium to replace his lost fluids from the morning, I picked him up and brought him home. His ER doctor did not suspect Covid, which was also a relief. We both went to bed.

A few hours later, I got up and went to a nearby clinic for my own Covid test, just to be on the safe side. It was much easier than expected, a well-organized drive-through tent, and only the base of my nostrils were swabbed, no dreaded brain scrape. Throughout the rest of the day, Al continued to improve, and by evening, his temp was normal.

On Thursday afternoon, we both got our test results back: Negative. Hallelujah!

And what of the mysterious 88 pulse-ox reading? I realized, on Wednesday, that 88 is the default reading on the meter when it’s on but can’t register a measurement. Sure enough, the rubber pad inside the finger clamp had come off, so the meter had broken. If I’d taken the reading myself for Al, I would have known. But at that late hour on the first day, I was way too exhausted to think clearly and figure that out.

In any case, I’m glad he was seen that night, inconvenient as it was, because we found out his lungs were fine. Here’s hoping the copay isn’t outrageous.

Of the many lessons learned, here are my takeaways:

  • There are plenty of viruses out there that are not Covid. We have to be extra vigilant, but each sneeze, cough, or upset stomach may just be routine, rather than exotic and deadly. The biggest red flag last week was Al’s fever. As hours passed, the fact that his temp went down and his appetite returned was a good indication that all he had was a run-of-the-mill virus.
  • I need to get a better pulse oximeter and, if needed, read the results myself if Al is sick.
  • It will take extreme precautions, if one of us gets Covid, God forbid, for the other to be the caretaker and not get sick. I never got Al’s stomach bug, thank goodness, so I must have been doing something right. But there are so many touch points to avoid, so many tiny details to be aware of—how do I wash his dishes v mine? how often should I change gloves? can I safely clean up after him when he’s sick and not contaminate myself without wearing PPE?—that in a house our size, not small, but not huge, either, it will be a real challenge. (All the more so for those who live with multiple family members in small apartments. The whole situation infuriates me, but that’s another post for another time.)
  • It is all the more important for both of us to be extra careful with masks and hand hygiene when out in public. I don’t want to have to go through this for real.
  • I’m very grateful to have Medicare and Medex coverage, and to live in Massachusetts, where we have aggressive contact tracing and plenty of free Covid testing sites. We were told we’d get results in a few days, but actually, we both heard in under 36 hours.

Bottom line: we dodged the bullet. Here’s hoping this was only a dress rehearsal for a play that will never open. Stay well, all.

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: Gwen O

May We Be Healed

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May I be healed.
May you be healed.
May we be healed.

Years ago, I learned this meditation. It’s more resonant now than ever. As I write, according to the Johns Hopkins COVID-19 dashboard, there are 35,272,679 souls around the globe who are infected with COVID-19. Of those individuals, each grappling with the fear and suffering of this insidious virus, are 7,426,686 people here in the U.S., including the president. Worldwide, 1,038,307 people have died from Covid and its complications; 209,857 were Americans. All, with their own hopes, families, dreams.

By the time you read this, the pandemic will have claimed more victims.

May I be free of suffering.
May you be free of suffering.
May we be free of suffering.

We will never know how many lives would have been saved it everyone had complied with social distancing and wearing masks in the early days of the pandemic. I have seen estimates as high as 100,000 lives. Projections by the University of Washington’s Institute for Health Metrics and Evaluation (IHME) indicate that more than 363,000 Americans will have died from Covid by January 1, 2021, if we continue on our current trajectory. With universal masking, the model projects 277,000 total deaths. That’s still far too many. But 83,000 lives could be saved.

Think about it. By simply wearing masks, we could prevent the equivalent of 9/11 happening every day from now until the November 3rd election.

May I be full of self-compassion.
May you be full of self-compassion.
May we be full of self-compassion.

I wish this disease on no one. If any good comes of the president’s Covid infection—and the infection of so many in his orbit—I hope it will be a profound lesson in the importance of wearing masks in public. I fervently wish everyone would think beyond themselves and commit to the greater good of the community at large. Our partisan divide is now deadly, with masks or masklessness reduced to symbols of party affiliation. Enough, already. This past weekend’s news is the clearest evidence, yet (as if we needed any more) that large gatherings without masks, particularly indoors, will increase the risk of contracting Covid.

We need to take care of ourselves and each other. It’s scary enough, at the first sign of the slightest congestion, or cough, or sneeze, to wonder and worry that this may not be a simple cold, but Covid. All the more so for those of us with chronic auto-immune diseases and other serious medical conditions. Public masking is imperative.

So is voting. Our health as a people and a nation and a planet are all on the ballot this November. Make your voice heard.

May I be healed.
May you be healed.
May we be healed.

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: Jay Castor