Living with Scleroderma

Reflections on the Messy Complexity of Chronicity

managing chronic disease

Gotcha

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So, we were supposed to go on a 10-day vacation over the past week, at long last flying across borders to savor another culture. But Covid had other plans.

Three nights before we planned to leave, Al started coughing. Not your normal clear-the-throat cough, but a deeper, barking cough that woke me up a few times. Just to be on the safe side, the next morning I gave him a rapid test. The T line turned purple even before the C line emerged. Not good.

After I got over being upset (I was quite upset) I realized that we should just try to reschedule the trip. Which, by the end of the day, I had successfully done. I had purchased Covid travel insurance, and I am sending off a claim for the additional cost of the switched airline tickets this week. I don’t know if it will be honored, given that I didn’t actually cancel the flights, but it’s worth a shot.

Meanwhile, Al and I both had PCR tests. His came back positive the next day, and mine, negative. But by Friday, the day we were supposed to leave, I was starting to feel crummy. Two negative rapid tests were not much consolation. Sure enough, Saturday morning my rapid test was definitively positive.

This all happened despite our both being fully vaccinated and double boosted. As has been widely reported, the current dominant strain of Omicron, BA.5, is highly contagious and can evade some of the vaccines. We have no idea how Al picked it up. And even as we did our best to mask around each other and for Al to isolate, it didn’t matter. I still got it.

Fortunately, Paxlovid, the anti-viral medication for Covid that is provided at no charge by the federal government, is a game changer. It made a huge difference for both of us. There are reports of side-effects and also significant contraindications for certain medications. I had to stop two of my meds in order to take the five-day course. The only side effect that I was aware of was the bitter aftertaste it leaves in your mouth. But that is a very small price to pay for stopping Covid from replicating itself in my body.

Before Paxlovid, I was experiencing aches, chills, overactive Raynaud’s, a lot of congestion plus very runny nose, and a really sore throat (like severe strep, hard to swallow because it hurt so much). The day before I tested positive, I also experienced a sudden bout of vertigo, and until the Paxlovid took hold, migrating pins and needles, not unlike shingles. Oh, and my heart rate sped up and my arrhythmia kicked in. No fun.

Within 36 hours of starting the Paxlovid, all of this began to ease up. It felt miraculous. There is no doubt in my mind that if I hadn’t taken all the precautions of vaccines and boosters ahead of this, I would have been in much worse shape. And the Paxlovid really helped to turn things around. Risks of long Covid are real, especially when my immune system is already compromised from both scleroderma and Sjögren’s Syndrome. Even if I experience a Covid rebound (which can happen after stopping Paxlovid), I’m confident that another five days on Paxlovid is worth it, and quite manageable. So far, so good.

Happily, we are both on the mend. Fatigue is still a factor, but not as bad as previously. I tested negative with a rapid test eight days after my positive test. PCR results may remain positive for a while because they pick up fragments of the virus, even when you’re no longer really contagious.

In any case, I intend to wear my mask in public long after I need to (five days past the five-day isolation period) according to post-Covid protocol. Just to be careful. I do not want to get re-infected, especially in the weeks leading up to our rescheduled trip.

I hope you are well and free of all this. I am grateful for all the medical advances that enabled me and Al to get better relatively quickly and never get severely ill. Covid is not to be messed with. Stay safe.

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: Gratisography

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.

How My Garden Grows

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I may get a purple thumb from Raynaud’s, but I no longer feel resigned to a purple thumb for plants. At least, as far as my year-old bonsai is concerned. My little Brazilian rain tree grew so lush over the past year that it needed quite a haircut this weekend, when I went back to the bonsai garden for a lesson in pruning.

This involved a bit of serendipity, or “going with the flow” or just trusting that things would work out. I had signed up for a class that I thought was about pruning, but actually was intended as a workshop for a specific bonsai technique called candling, which involves trimming away new growth on certain bonsai pine species. As it turned out, however, I was not the only one who misunderstood the workshop description, because two of the other students who came also had tropical trees, and the fourth person had the wrong species of pine.

No matter. Our teacher was very flexible and turned the session into a learning opportunity for each of us to do the pruning that our bonsai needed. Since I got there first, he was able to help me reshape my Brazilian rain tree to reveal more of the trunk and also to remove the wiring that we’d used to train it last summer. In fact, the tree had grown so much that the wiring was starting to bite into the trunk, so my timing was good.

And I was also able to accomplish my second goal—starting a new bonsai. I had hoped I could do this without signing up for a separate beginner’s class, and timing was, again, just right. For months I’ve been wanting to have an evergreen bonsai, a juniper, and I found the perfect little tree, with a beautiful recumbent swoop, and an aqua pot, just as I had imagined. With my teacher’s help (I can’t do some of the twisting and tightening of wires that’s required for anchoring the bonsai once its roots are revealed) I potted my new little beauty.

Now both bonsai are enjoying fresh air on the deck, near the hummingbird feeder that awaits a visitor and the bird feeder beyond the kitchen window that is filled with safflower seed—a favorite of cardinals, chickadees, house finches, house sparrows, and especially mourning doves, which are just beautiful to see up close. Squirrels, however, are not fans, which was my hope. No more jumping on the “squirrel-proof” feeder to spill sunflower seeds all over the ground.

Watching the birds and my bonsai is a true source of fascination and calm. Whatever craziness dominates the news soon dissipates as I sit down at the kitchen table and look out the window, or quietly sit on the deck and make myself part of the scenery, so the birds come to visit. We all need a personal oasis these days. I’m grateful to have found mine right  in our backyard.

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

Passing Storm

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It’s pouring rain as I write on Monday afternoon, much needed after a very warm weekend here in Central Massachusetts. I was planning to go out and run some errands, but fortunately I noticed the darkening sky and heard rumbles of thunder as I was getting ready. So here I am, back at my computer, waiting out the storm.

One never knows what is next.

All of us who live with life-altering disease know this feeling all too well. While we may be able to influence outcomes, given healthy choices, good access to quality care, and enough resources, our bodies eventually deteriorate. And we don’t control the timeline. The older I get, the more I appreciate that the present moment is the only reality. Paying attention is essential. So is the ability to pivot.

Now the sky is lifting and the rain, easing. Thunder grows fainter, confirmed by the radar on my phone app that the storm has passed. We have more information and tools at our disposal than at any previous time in history to help us make thoughtful decisions. But ultimately, making the most of our time on this spinning ball of earth and water and sky means simply to stay present.

I’ll be heading out soon. Be well, Dear Reader.

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: Dave Hoefler