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Living with Scleroderma

Reflections on the Messy Complexity of Chronicity

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lung scarring

Inhale Exhale

Evelyn Herwitz · September 21, 2021 · Leave a Comment

It’s been three years since I’ve had a complete series of pulmonary function tests. Last year, my new rheumatologist here at home ordered a PFT, but when I had the test done, I quickly realized that this was not the full series I was used to.

So on Monday, in order to have comparable data, I redid the test with the full set: spirometry, which measures how much air you can breath in and quickly exhale; diffusion, which determines how well the oxygen in the air you inhale moves from your lungs into your blood; and body plethysmography, which tests how much air is in your lungs after you inhale deeply, and how much is left after you exhale as much as you can.

These tests are never easy. They have gotten more challenging over four decades, which is to be expected. But my results are not normal. Though I don’t, fortunately, have interstitial lung disease that can result from scleroderma, I do have enough scarring to reduce my lung capacity. Which is why it’s so important to keep track of any changes.

Covid has complicated PFTs. First of all, you need a negative PCR test to even do the exam (can’t risk exhaling Covid droplets and spreading the virus). In addition, appointments are harder to get because of protocols that require test rooms to be vacated for 30 minutes between patients.

When I arrived at the hospital, I was first taken to a room without the plexiglass box (kind of like a phone booth that you sit in) that is required for the plethysmography. I told the respiratory therapist about the lack of a complete series last time, that I needed to be in the box. Fortunately, they were able to switch rooms to the right one after waiting a few more minutes for it to be deemed safe. (This was also helped by the fact that the scheduled patient didn’t show up.)

A second respiratory therapist handled my full set of PFTs. Before we began, she had to don a full blue plastic gown, gloves, two masks, and goggles. Definitely a riskier occupation these days. Then we started. I had to repeat the spirometry quite a few times, because I couldn’t do it without coughing. After several aborted attempts, she had me inhale a dose of Albuterol, which ultimately helped me to complete the test, but gave me the jitters.

The other two tests also required several tries until I could produce consistent results. All told, it took about 45 minutes. And, not surprisingly, my lung capacity over the past three years has declined a few points, down to 82 percent. Some of this is due to aging, but I can also tell, from how much trouble I have completing the tests, that it’s just getting harder with time.

At least it’s done. And I worked most of the Albuterol jitters out of my system by afternoon, though the breathing benefits persisted. Which was a nice side benefit. So it’s done for at least another year, maybe two. My lungs are far from perfect, but also far from limiting me, as long as I stay active and exercise. Still a lot to be grateful for.

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: Kind and Curious

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Filed Under: Body, Mind, Smell, Touch Tagged With: lung scarring, managing chronic disease, PFT, resilience

Carpe Diem

Evelyn Herwitz · November 5, 2013 · Leave a Comment

A glorious weekend, indeed, this past. Leaves crinkle and swirl in honeyed showers as temperatures hover now in the upper thirties. But Saturday afternoon, hours before we turned back the clocks to usher in bare-branched November, the trees were still lush with mulled hues of cinnamon, ginger and burgundy, and the air was warm.

Al and I looked at each other. It was simply too beautiful to stay indoors. So we put on our hiking shoes and climbed into the car with Ginger, our aging Golden, whose reddish fur matched the day’s pumpkin glow. It was a bit of a scramble. Her haunches are arthritic, and she needed a boost to the back seat.

But once we arrived at our favorite hiking spot, about 20 minutes from home, Ginger was in her element. She’s 15, now, a centenarian in human years, but she can still trot along with us, up and down the gently sloping trails.

We took our time, pausing as I snapped pictures of milkweed pods—my childhood favorite for late autumn—and a slender sapling glowing gold in the midst of deep green pines. Ginger loped ahead to catch up with Al, then turned and waited to be sure I was still coming.

As we climbed a steep hill, she kept apace with Al. I brought up the rear. I’m slow at this, my breath shortened by lung scarring from my scleroderma. It always takes a while before my breathing can catch up with the exertion of walking up an incline. But as long as I pace myself, eventually my metabolism matches my intentions.

And there was so much to savor: cream-colored mushrooms large as saucers, a hillside aflame in scarlet shrubs, tree chunks carpeted in lime-green lichen. Deeper into the woods, all we could hear were Ginger’s panting and our feet scuffling through crisp leaves, interrupted by the occasional thrum of a private plane flying somewhere overhead. The air was fresh, sweet, enriched by decaying foliage.

We stopped by a bridge high over a brook, the water low from lack of rain, but still burbling. Ginger wandered back and forth, then patiently waited as we pulled tufts of loose fur from her hips. “You okay?” I kept asking her, once we moved on, as she trotted back to check on me.

Rounding through the wildflower meadow near the trail head, Al stopped to crack open a dried milkweed pod and strew its glinting silk to the light breeze, ensuring a good crop for another visit. Late afternoon sun illumined leaves like stained glass.

My knees gave out just as we walked down the road to the car. Perfect timing. Ginger clambered into the back seat with some help and lay down, panting, with a Golden’s grin.

“I’m so glad we decided to go,” I said to Al. He smiled and nodded, then drove us home.

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.

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Filed Under: Body, Hearing, Mind, Sight, Smell Tagged With: body-mind balance, lung scarring, managing chronic disease

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About the Writer

When not writing about living fully with chronic health challenges, Evelyn Herwitz helps her marketing clients tell great stories about their good works. She would love to win a MacArthur grant and write fiction all day. Read More…

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I am not a doctor . . .

. . . and don’t play one on TV. While I strive for accuracy based on my 40-plus years of living with scleroderma, none of what I write should be taken as medical advice for your specific condition.

Scleroderma manifests uniquely in each individual. Please seek expert medical care. You’ll find websites with links to medical professionals in Resources.

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