Living with Scleroderma

Reflections on the Messy Complexity of Chronicity

managing chronic disease

Theory of Relativity

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Just over two weeks ago, we were in Ireland. How can that be? I feel as if a month has passed, already.

IMG_0438It’s so hard to hold onto that transformative sense of being elsewhere, once you’ve re-immersed in your everyday life. We have pictures and stories of our travels, and we’ve been sharing with friends and family, but with each day that passes, the details are a little less sharp. The minutiae of the moment clamor for attention.

Part of the reason the trip seems so distant is that I was in Chicago on business last week. This worked out better than expected, given that a mere seven days separated our European journey from my flying halfway across the U.S. on my own. After we had traveled all over Europe in two weeks, going to Chicago and even switching hotels once in three days was a snap. I was so relaxed about packing and flying that I surprised myself. Usually, I’m stressing about every detail. This time, I hardly did any preparation in advance. And I didn’t have any health complications along the way, thank goodness.

So even if our vacation seems like a long time ago, the travel experience has changed me. I know I can manage a lot of details on the fly. I know I can manage a health flare while far from home. I know I can do a lot of schlepping, get very tired, but recharge and keep going.

All of this is very encouraging. I would love to see more of the world before I really am too frail to travel.

In the days leading up to our Europe vacation, I felt as if I were jumping off a cliff. What if I couldn’t handle it? What if one of us got really sick on our journey? What if we lost our passports or they were stolen? On and on.

I’ve had so many episodes of strange, scleroderma-related health problems–infected ulcers, a resorbing tooth, spontaneous cellulitis–while on short trips not far from home, that I really didn’t know what to expect. The fear of illness in a foreign country has kept me from considering a bigger trip for years.

I prepared as best I could for all contingencies, including buying a good travel insurance policy that covered us for serious health complications. I carried an ample supply of antibiotics, which paid off when I did, indeed, suffer a bout of cellulitis in my right foot at the beginning of our travels. I planned our itinerary to build in opportunities to rest (not enough, but at least I tried).

In the end, I learned that I’m stronger than I thought. And I also discovered that a half-week business trip in one city is easy compared to a two-week vacation in seven. It’s all relative–a matter of experience, testing your limits and finding out what you’re really capable of, as opposed to what you’re afraid you cannot do.

Onward.

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.

Hands On

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How did it get to be July, already? With Independence Day behind us, summer is really here. It’s sunny and lovely and warm, and my hands are happy. I’m down to two bandages for my digital ulcers, one on each thumb. Always remarkable this time of year when I can feel with most of my fingertips.

photo-24This has been especially helpful because I’ve been sewing dresses. We’re getting ready for vacation, traveling through Europe to mark our 30th wedding anniversary (last December) and to do some research for a novel I’m writing.

It’s been unseasonably hot there (no complaints from me, although I’m encouraged that the forecast does not include temps upwards of 100 F, which was the case this past week). Dresses, as a friend observed, are easy. You don’t need to figure out what goes with what. Just slip one on, and you’re ready for the day.

One of the great joys of sewing is feeling luscious fabrics as your create your outfit. I’m working on a pattern for a wrap dress, and I found a buttery soft, beautiful rayon matte jersey print to sew.

I’ve learned from many mistakes that it’s best to test the pattern and any alterations first, before risking the good fabric, and I found some black and white cotton jersey in my fabric stash—perfect for experimenting.

So now the test garment is completed, and it looks and fits well enough to take along on the trip. I cut out all the good fabric and began constructing the second version on Sunday. It sews and serges like a dream, and I’m on schedule for finishing before we leave.

Best of all, my hands are fine. Despite whacking one finger on my serger and pricking another with a pin, they feel good as I write. I sew mostly by machine. The serger, which sews, trims and overcasts seams all in one step, is a tremendous help, saving time and extra hand motions. Even though it requires a lot of care when threading (and can be persnickety if I miss a step), it is a real boon. My other essential tool is a good pair of bent-nose tweezers, which helps with all the tiny manipulations I can no longer do with my fingertips.

I was marveling at the fact that my hands aren’t sore after all that work, and then I realized that fewer bandages really do make a difference. I’m so used to having at least four or five fingers wrapped to protect sore ulcers that going bare is full of surprises.

Travel will undoubtedly cause me to revert to more digital protection. I have all my supplies plus antibiotics ready, just in case. But in the meantime, I am savoring the freedom and enjoying the feel of wonderful fabric. It’s been a long time since I’ve been able to sew this much, successfully—a real summertime treat.

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.

Two Steps Forward, One Step Back

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I made good on my exercise commitment last week—I got to the fitness center twice, once for my barre class and once to ride the stationary bike for 25 minutes, plus I took half-hour walks on two other days.

Then I developed an ulcer in the nail bed of my left big toe. It’s infected. I have no idea how this happened. I am meticulous with skin care. It might have been as simple as picking up bacteria while walking around in sandals. Or just bad karma.

So, I’m back on antibiotics, limping a bit, carefully testing pressure on my left foot. I was able to walk around the block on Monday and get through most of the exercises in my barre class last night.

This is the minutiae of living with scleroderma. Just when you think you have everything in balance, something kicks it out of whack and you have to recalibrate.

But there are much more important issues in the world than an infection in my big toe.

On Sunday, at Al’s initiative, I joined my husband, our rabbi and cantor, and about a dozen other members of our synagogue at morning services at the local A.M.E. congregation. We came to show solidarity over the tragic shootings at the historic Emanuel A.M.E. Church in Charleston, S.C., last week.

Al had called ahead, the previous Friday, to ask if it would be okay with the pastor if we came. We were welcomed with thanks and gracious hospitality. Other members of the community came as well, in a spontaneous show of support. It was heartening to be part of a mixed sea of faces, all gathered to assert that what happened in Charleston was terribly wrong, that we care, that we must pull together as a society to end the violence and bridge the widening racial divide in this country.

Will any lasting good come of all those people, from different backgrounds, gathered together in prayer on a Sunday morning? I cannot say. But I know we helped to comfort our neighbors and sent good will out into the universe, and that must count for something.

After the service, we went out with friends for a Father’s Day brunch, then to the art museum, then home. Al mowed the lawn. I lay down and rested my sore foot.

My toe will heal, albeit slower than I want it to, with a combination of medication and careful tending. I will get back to my exercise plan. There will undoubtedly be other physical setbacks, but I’ll deal with those, too.

Would that our nation’s ills could heal as readily.

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.

Photo Credit: Stròlic Furlàn – Davide Gabino

Hail, Caesar!

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I tried an experiment last week. I had to go to New York City on business overnight. There is no easy, direct public transit from Central Massachusetts. So, because I was in Boston during the day on Wednesday, I took Amtrak to Manhattan, and planned to take a bus back home the following evening. The bus was scheduled to make three stops in Connecticut along the way, including a transfer in Hartford.

247603105_e1a7241212_zI’m not crazy about long bus trips, but the plan saved me from having to drive home late at night, either from Boston in the east or from Springfield in the west, if I had gone Amtrak all the way. 

I thought I was being very organized. I had all my tickets printed out, in addition to the email versions on my phone. For some reason, the bus tickets (one for each leg of the trip home) printed out back to back, which rarely happens on my printer. So I assumed it was intentional to save paper.

Wrong. After a full day’s meeting on Thursday, I made my way to the Port Authority Bus Terminal in Midtown and found my gate. Then I noticed, to my dismay, that everyone else in line had two tickets—one to Hartford, and one to their connection.

When it was my turn to present my ticket and photo ID to our driver, I explained my dilemma and asked if I could just show him the ticket and keep it for my transfer. No, he informed me, he had to take it. They don’t accept electronic versions. Only paper. I needed to reprint my ticket when I got to Hartford.

Now, we had 15 minutes in the schedule to transfer busses. I knew the Hartford bus station was small. But I was nervous. And frustrated. If only I’d thought to make a second copy, just in case. After everyone was on the bus and our driver was finishing his paperwork, I asked him again if there was any chance I could show the PDF on my phone to the other driver. No, he reiterated, but he was sure I’d have enough time to take care of it in Hartford.

Nothing I could do but wait the three hours until we got there. We pulled out of the below-ground gate and up into traffic. Lots of it. Our driver welcomed us on the bus and introduced himself as Caesar. If it was too hot or too cold, he said, let him know. No loud phone conversations or music. No photos. I watched a flock of pigeons battling over something on a sidewalk and told myself there was no use getting upset. I just needed to sit back and see what happened.

By the time we got to New Haven, our first stop, we were already 20 minutes late. I was trying my best not to freak out. I called Al and gave him a head’s up—if I couldn’t make my connection, I needed him to drive over an hour to pick me up. Fortunately, he was his good-natured self about this delightful prospect, which at least eased the pressure.

For reasons unknown, on the way to our next stop, New Britain, we got off the highway and onto a series of side roads and byways lined with strip malls, then back on the highway. That put us behind by 25 minutes. I had no idea where we were, so I followed our route on my phone app, just to reassure myself we weren’t lost.

Finally, we pulled into Hartford, a full half-hour behind. I had traded seats with my seat-mate to be on the aisle and able to get off sooner. Caesar told us the gate number for our connection. By a miracle—or, rather, the inefficiency of bus travel—that bus was late, too, and had not yet arrived. So I grabbed my bag and ran to the ticket counter.

The ticket agent was, of course, helping someone else. And. Taking. A. Long. Time. I asked if I could just reprint my ticket, and she told me to wait my turn. Then she announced that her computer was not allowing her to print the other customer’s ticket. Meanwhile, the connecting bus had arrived.

I was at a loss for what to do. Fortunately, Caesar had come to the ticket counter. I’m not sure if he would have checked in anyway, or if he was following up on me. But given that we’d arrived late and he was due in Springfield, he could have just left. Instead, he walked with me back to our bus, pulled out his envelope of tickets, found mine, walked me back to the ticket counter and asked the agent to make me a copy. Of course, the copier was off and needed to charge. Did I mention this is not a 21st century operation? But within a couple more long minutes, it fired up and I had my copy. I thanked Caesar profusely and ran to the connecting gate.

I was the last person on the bus. We sat for another 10 minutes, for reasons unknown, and then departed. I called Al to let him know I’d made it.

“I guaranteed you would,” he said.

“How?”

“I just looked up the directions to Hartford.”

We laughed. Thank goodness. In the end, I made it to our own Union Station just 15 minutes later than I should have and was very glad, indeed, to see Al waiting for me with an open car door.

My knees were shot from the bus ride, with its cramped seating and worn out shock absorbers. And my nerves were a bit frayed. I was really tired. But if it weren’t for our driver, who took the extra few minutes to make sure I was able to make my connection—despite the fact that I was the only one on his bus who did not know the rules of the archaic ticketing system—it would have been a much longer ordeal. Maybe he took pity on me. Or maybe he thought it was ridiculous, too.

Hail, Caesar.

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.

Photo Credit: Daniel Lobo

Salute

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Memorial Day is just past, the unofficial beginning of summer. I know this because my email in-box has been swamped with sales promotions since last Thursday, the scent of barbecues wafted through our neighborhood for the past three days, and numerous friends posted testimonials to veterans on Facebook.

Beyond that, however, one could easily have spent the entire past weekend with no sense of the holiday that marks sacrifices made by our nation’s soldiers.

On Sunday and Monday, Al and I walked to friends‘ homes to share meals. We strolled along leafy green streets, watched kids shooting hoops in driveways, greeted neighbors working in their gardens. I thought how lucky we are to live in a place that’s so peaceful and safe—untouched by the ravages of war on home soil.

We have our nation’s strong defenses to thank for that, and I’m grateful to all those who serve to protect us from harm. There are many, many problems to solve in this country, and our security in a dangerous world is not a given.

It’s easy to forget this as we get immersed in life’s daily upsets and annoyances. On Friday afternoon, I went to CVS to pick up a prescription that I’d called in the week before. It had been misplaced. After twenty minutes of fruitless searching, the pharmacist refilled the order. But she told me that she could only give me 30 days’ worth of pills, rather than the 90 days I was accustomed to, due to an unannounced change in our insurance. This had significant financial implications—the copay is $100 for one month’s supply, but had been $200 for three months. So, now, I am stuck with a whopping 50 percent increase for medication I need. This made me quite frustrated, to say the least.

By Monday evening, however, I had regained perspective. Yes, this is unfair and extremely expensive. But I consider myself very fortunate to be able to get the medications and health care I need to stay strong—despite the many imperfections in our health care system. Elsewhere in the world, where those systems break down due to war or civil insurrection, managing a chronic disease can become impossible.

When I was growing up in the early ’60s, we marked Memorial Day with a parade in our town. I was a Girl Scout, and we marched with our troop in green uniforms and badge sashes and white gloves, along with our elementary school principal and school district leadership and the local post of the Veterans of Foreign Wars. There were bands and flags and red-white-and-blue bunting on buildings. It was both solemn and exciting to participate. I had a sense of being a part of something greater than myself.

In recalling this, I am not trying to glorify or sentimentalize war or to promote ersatz patriotism, which only serves to muddy serious and necessary debate about our country’s future. I simply think something important has been lost when Memorial Day is no longer a communal occasion for honoring veterans—when our attention span has shrunken to “liking” a salute to veterans on Facebook, and the weekend’s main events are barbecues and car sales.

In synagogue this weekend, we said a special memorial prayer for all of the soldiers who have served our country. Our rabbi called up any veterans for recognition at the end of services. Three men stood up—all in their eighties.

I’m glad they’re still with us. And I’m grateful to so many others who have been injured or who laid down their lives to protect the rest of us, so we can enjoy a good meal with friends on a warm May evening without a second thought.

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.

Photo Credit: Christopher Koppes