Living with Scleroderma

Reflections on the Messy Complexity of Chronicity

mindfulness

Aftermath

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One week past my second vaccination dose, one week to go until my COVID-19 immune response is full bore. Here’s how it went:

Getting the shot was a breeze. I found parking right away, not always guaranteed at Boston Medical, and there was no crowd at the clinic. A trainee was working with the nurse who administered my shot, and she engaged me in conversation, so I didn’t even realize I’d received the jab. My nurse recommended taking a photo of my CDC vaccination card and storing it in a safe place as documentation. I overheard another patient saying she planned to get hers laminated, which I thought was a good idea. Everyone was upbeat and wished me well. Very professional.

I drove home without a problem, ate some lunch and even did a little work at my computer. Then, the fatigue fog rolled in, not on “little cat feet” à la Carl Sandburg, more like a herd of elephants. I shut off my iMac, went upstairs, lay down in bed, and binge-watched Downton Abbey for much of the rest of the day. And I slept.

By Wednesday, my joints were flaring. No fever, and I was able to get a few hours of work done. But sitting at the computer became impossible by early afternoon. And my morning energy dissipated like mist. Fortunately, I had cleared my calendar in anticipation of a reaction. Back to bed and more Downton. It has been decades since I’ve spent that much time in bed watching TV because I wasn’t feeling well.

Throughout the day, family and friends kindly checked in to see how I was faring. By evening, about 30 hours after I’d received my dose, I felt the aches and fog lifting. I had done my best to keep hydrating, as the nurse had recommended, so I’m sure it helped some, but I also know my body well, and it always takes time for my system to clear. Just a waiting game.

I slept well again. On Thursday morning, I felt like myself, although I noticed that my left arm felt warm. When I checked in the mirror, I had a huge rash that stretched from where I got the shot to a few inches above my elbow. A little online research turned up a new term, “Covid arm.” This is a non-serious reaction to the shot, more common with Moderna, that can occur up to a week later, on average. Mine was only very mildly itchy and responded well to cortisone cream. I also took a Benadryl tablet that evening, which may or may not have had an effect.

Five days later, the rash is almost gone. I’m looking forward to next Tuesday, when I’m fully immunized. Months ago, when the Covid variants surfaced, I rescheduled my haircut to wait until I was fully vaccinated. Thanks to serendipity, I picked next Tuesday. Taming my four-month-long mop will be a great way to celebrate.

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: Chris Barbalis

Prepping

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Today I get my second Moderna dose. On Monday, I tried to remember to keep drinking fluids, which is supposed to ease side effects. We shall see.

I’ve also been prepping for the aftermath. Friends and family who’ve had the Moderna vaccine report a whole range of reactions, from some arm pain to brain fog to extreme fatigue to headaches to fever, lasting a day or so. I’ve cleared my calendar for Wednesday, hoping for the best but leaving space and time to deal with a stronger reaction. After my first dose, I was very tired for several hours after I drove home from Boston. We shall see.

Then there’s Passover prep. The first seder is Saturday night this year, and there’s still a lot to do between now and then. We’ve started our house cleaning, shopped for dry goods and dairy foods, and planned menus for the week of Passover. Al will finish the bulk of the cleaning this week and the rest of the shopping for perishables, but I still have client work pending and other to-dos to complete.

I’ve revised the Haggadah that I wrote last year, and we’re getting organized to have a Zoom mini seder with family on the first night. But there is still more cleaning and all the cooking to do. So I’m hoping that my second dose won’t throw a monkey wrench into the works. We shall see.

How is this week before Passover different from all other weeks before Passover? We shall see.

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: Aron Visuals

Brain Fog

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I forgot to write my blog for Tuesday morning. Completely slipped my mind on Monday, my usual blog-writing time, because I didn’t write it down in my Monday To-Do list. Usually, I organize myself in my bullet journal with a task list for the week, which I then break down for each day. But I’ve been busy with a lot of deadlines hitting at once, and I didn’t do the weekly task list, so I didn’t remember to write my blog.

Which is why, if you’re used to seeing this pop up in your in-box on Tuesday, it wasn’t there. Easy enough to “write it off” to aging, of course. But I had an interesting conversation with my Boston Medical rheumatologist on Tuesday that made me wonder. I was telling him how I feel that my memory just isn’t the same (this was before I realized I hadn’t written my blog, which gave me today’s theme . . . ).

Word-finding when I’m stressed has been hard ever since I hit menopause years ago, so I’m used to that. And we all know what it’s like to go into a room to get something and forget what it was. But now I’m finding that I can think of something I want to do and go to write it down (to remember), but the actual act of writing it makes the idea vanish for seconds or even minutes, sometimes. This is not only frustrating, but for someone who writes for a living and for my art, it’s upsetting. Fortunately, when I am thinking at the keyboard, the words continue to flow easily onto the screen.

Long-term memories are also getting harder to retrieve. Some of this is age, of course. But my maternal grandmother used to tell me stories from her twenties that were vivid with details. I had the same capacity for years, but now it just seems harder to recall long-ago details.

My rheumatologist tells me that brain fog is common with autoimmune disease. In the forty years I’ve had scleroderma, I never knew this. (Or if I did, I forgot!) Some of this has to do, in my case, with how my circulatory system is just not as efficient as it used to be due to the disease, so my brain isn’t as well-profused by blood. I also have Sjögren’s Syndrome as a secondary diagnosis, which causes dryness in my eyes, nose, and mouth, and apparently can also cause brain fog.

I haven’t changed medications in quite a while, other than eliminating a few that weren’t really helping me and cost way too much under Medicare. So this isn’t a reaction to drugs.

What to do? It comes back to the basics: get enough sleep, eat a balanced diet with foods high in omega-3 fatty acids and antioxidents, and exercise. I’m pretty good at the first two, and really need to improve at the latter. Over this past week, I barely got outside because of the cold. So on Tuesday afternoon, after my telemed call with my rheumatologist, I took a brisk walk.

A few hours later, when I finally wrote up my week’s To-Do’s, I remembered that I hadn’t written my blog. So, here I am, a day late. But at least I got here.

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: Phillip Belena

Mud Puddles

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I read somewhere that March 2020 came in like a lion and stayed. So here we are, a very long and difficult year later, and the wind is gusting outside. I take a walk on a late Monday afternoon, before the sun sets, and the chill catches me by surprise. But I keep on walking. My flannel winter mask helps to warm the air I breathe.

When there’s no one else nearby, I lower my mask to inhale more freely. As soon as I see or hear someone approaching, I raise it again. I’ve gotten quite adept at moving to the opposite side of the street as another walker appears along my path. It’s all part of our learned choreography in Covid Time.

Most people I pass wear masks, too. And most everyone waves or says hello—more so than in the Before Time, when we took passersby for granted. Now, it feels all the more important to acknowledge each other when we can see only eyes.

Where snow is finally receding, mud puddles glisten in the late afternoon light. The ground looks like chocolate pudding. I inhale the earthy scent and notice a few matted blades of green where lawns have emerged from beneath their white blankets. Mourning doves coo as shadows grow long.

It’s after five o’clock when I return home, grateful for a warm kitchen, but glad that I stretched my legs and worked out the strain in my lower back from sitting too long at my computer. The sun still illuminates scudding clouds with a golden glow. I marvel that I can walk this late in daylight.

Spring is less than three weeks away, March 20. Three days later, I get my second Moderna vaccine. Then comes Passover. I mark time with ancient rituals, miraculous milestones, and the spinning of the Earth.

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: Jock Ocularic

Dormancy

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There was a table set out under a tree in front of the house, and the March Hare and the Hatter were having tea at it; a Dormouse was sitting between them, fast asleep, and the other two were using it as a cushion, resting their elbows on it, and talking over its head.

—Lewis Carroll, Alice’s Adventures in Wonderland

It is mostly white outside. Although recent snows have melted or sloughed from the yews outside my window, the ground is still hidden beneath a thick coat. The crust is soggy with Monday’s mist. Soon it will sparkle and crunch. We expect a half-inch of ice Tuesday along with another few inches of snow.

February, according to the poem we used to recite as kids, is supposed to bring the rain and “thaw the frozen lake again.” Not so anymore. While it seems counterintuitive, climate disruption caused by global warming has triggered a polar vortex that is sweeping the U.S. with record-breaking cold, ice, and snow. Nothing to do but wait it out.

In the midst of all this waiting—for spring, for a vaccine, for sanity and comity to prevail in our troubled nation—I am reading a wonderful book of essays by Katherine May called Wintering: The Power of Rest and Retreat in Difficult Times. Writing through the course of a hard year, when she had to leave her faculty position to deal with an uncertain illness, May reflects on all the ways that slowing down, withdrawing, and quiet are essential to the cycle of renewal.

She writes of the buds on trees that form in late summer and remain dormant throughout winter, conserving energy for spring; of ephemeral traces of the aurora borealis that hover in the sky above the Arctic Circle; of seeing sunrise at Stonehenge on the winter solstice and what it means to pray; of the hibernating habits of dormice.

The latter particularly caught my fancy. I did not know that dormice conserve nutrients in their tiny bodies after gorging in late summer and autumn, then, in October, curl into little balls no bigger than a walnut, drop their body temperatures to match their surroundings and become dormant as tree buds, waking slightly every ten days to flush toxic wastes from their systems, and not fully rousing until May. They are also simply adorable. And endangered by climate change that is shrinking their habitats.

We have much to learn from the natural world about appreciating the gift of darkness and cold, which cues us to rest more, to ease the hectic pace of our incandescent-light-filled-homes and offices, to reflect and see and wonder. The pandemic has forced our collective hand. We’ll all be glad when it’s safe to go out. We’d be wise to take the lessons of this long hiatus with us when we do. But for now, with another winter storm on the way, maybe it’s just fine to curl up in a ball, and sleep, and dream.

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.

Images: Hibernating hazel dormouse found in a birdbox in Central Germany, March 2016, by Zoë Helene Kindermann, Wiki Commons; Dormouse in August, Aosta, Italy, August 2005, by Hectonichus, Wiki Commons.