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Living with Scleroderma

Reflections on the Messy Complexity of Chronicity

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mindfulness

48 Hours

Evelyn Herwitz · July 3, 2018 · Leave a Comment

It’s been nearly 30 years since I visited our nation’s capital. This past weekend, Al and I packed in a slew of sightseeing in Washington, D.C., around a family celebration in Virginia. In just over 48 hours, we visited the National Gallery, Lincoln Memorial at night, Vietnam Veterans Memorial (also at night), Supreme Court, Capitol grounds, Newseum, National Gallery Sculpture Garden, National Archives, Hirshhorn Museum and National Gallery East. On Saturday morning, in sweltering heat, we participated in the Families Belong Together protest rally in Lafayette Park, next to the White House.

I walked my feet off. It was worth it. The highlight of DC, for me, was seeing the original Declaration of Independence, U.S. Constitution and Bill of Rights at the National Archives. The parchment is huge, the writing faded, the signatures inscribed by human hands. The ideals endure. I was reminded by an exhibit about women’s suffrage at the National Archives and the chiseled words of Lincoln’s second inaugural address at the Lincoln Memorial of how much struggle and acrimony is embedded in our nation’s history. I felt the power and protection of the First Amendment in Lafayette Park.

Here are some of my favorite images from our trip:

The conclusion of Lincoln’s second inaugural address at the Lincoln Memorial
Lincoln Memorial at night
Seen in a garden on our way to Capitol Hill
Protesters outside the Supreme Court
Heading toward the U.S. Capitol Building
Section of the Berlin Wall at the Newseum
National Gallery Sculpture Garden
Families Belong Together protest in Lafayette Park
Calder sculptures at the National Gallery East
Saul Steinberg, Untitled (A Conversation), National Gallery East
Le Gourmet, Picasso, National Gallery East

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.

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Filed Under: Body, Hearing, Mind, Sight, Touch Tagged With: feet, managing chronic disease, mindfulness, resilience, travel, vacation

Spotlight

Evelyn Herwitz · June 26, 2018 · 1 Comment

This past Sunday, I sang a solo. Our congregation was celebrating our beautifully renovated synagogue. I’m the alto in a quintet that sings on the High Holidays and for special occasions. One of our numbers was a barbershop mix set to the tune of Billy Joel’s “For the Longest Time.” I had the lead.

What a great piece to sing! And it’s rare for an alto to have the main melody. We’ve been practicing for weeks.

But, of course, despite all that preparation and encouragement from my fellow singers, I was nervous. Not just the typical oh-my-gosh-I’m-performing-in-front-of-hundreds-of-people nervous. It was scleroderma-related.

Years of lung scarring have made it harder for me to inhale a full breath, and it definitely affects my ability to hold notes and breathe with appropriate phrasing when I sing. I also have dry mouth from Sjögrens, and when I sing, I never know if I’ll either (a) have to cough at an inopportune moment or (b) collect so much saliva in my mouth that I can’t pronounce clearly. On Sunday, I was constantly clearing my throat before it was our turn—just this side of feeling like my throat would guck up.

Then there was the senior-moment-side of nervous. As many times as I’d reviewed my words, I was afraid my mind would freeze and I’d forget. Since the words were in Hebrew, they were harder to remember, even as the phrases were familiar (the opening prayer of the blessings after meals). Lately, I find that when I’m more self-conscious, my brain can go on the fritz for word recall, as if a file drawer gets stuck and refuses to open until I relax.

As a fallback, I had my music in front of me. But I wanted to make eye-contact with the audience.

Finally, it was our turn to sing. Two of the other members of the group are experienced barbershop singers, which was a good thing, since we were performing a capella. My nerves eased as we swung through the tune. In fact, our voices blended beautifully. I had enough breath, I didn’t cough, and I didn’t lose my place. A good sound system really helped. I felt great. We received many compliments afterward.

Most importantly, we had a wonderful time and added just the right bounce to an already upbeat morning. Music has a way of bringing joy into the world. I may not be able to play an instrument any more, but I’m so grateful I can still sing.

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 Credit: Israel Palacio

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Filed Under: Body, Hearing, Mind, Taste Tagged With: body-mind balance, lungs, managing chronic disease, mindfulness, Sjogren's syndrome

Lacrimoso

Evelyn Herwitz · May 29, 2018 · 10 Comments

My grandfather’s violin is 108 years old. I learned to play it when I was in grammar school, and it has accompanied me everywhere I’ve lived for more than fifty years. This week, I am donating it to our public school system. Here’s why:

It was the summer between third and fourth grade when I first placed a violin under my chin. Our community was blessed with a robust summer music program. You could pick any instrument, borrowed from the school district, take lessons and play in a music ensemble. To the best of my knowledge, my parents only paid for private lessons. The rest was covered by local tax revenues. A long, long time ago.

I was among the shortest kids in my grade, and the violin I borrowed was a half-size. It was a hot summer, and I practiced those first scratchy notes in our unfinished basement, trying not to knock over my rickety collapsible music stand onto the concrete floor, playing for my father’s drill press, tool bench and table saw. Supposedly this was a way to stay cool, but I suspect my mother also didn’t want to listen to my novice efforts. It was creepy down there and not conducive to developing a love of the instrument, but I was an obedient kid and stuck with it. Plus, my older sister had already learned to play the flute, and I was not about to let her outdo me.

Persistence (and a dollop of sibling rivalry) paid off. By the time I had grown enough to manage a full-size violin, my father gave me his father’s instrument. Inside was a small, yellowed label that recorded its creation by one Samuelis Henricus Scheib in Nashville, Tennessee, on February 11, 1910. I played many pieces on that violin, auditions, solos, in chamber groups, All County Orchestra, and as first chair in our school orchestras as I got older.

For my sixth grade graduation, I played a solo accompanied by my teacher, Mr. Errante, on the piano, Meditation from Thaïs by Massenet. Near the end of the piece, there is a pause following a high harmonic, played pianissimo. The audience of parents, faculty and students broke into enthusiastic applause, and I can still see Mr. Errante beaming at me from his seat at the baby grand. I started laughing, but I managed to get through the final phrase, to a second rousing round of appreciation.

There were other memorable performances on my grandfather’s violin, including the first movement of Vivaldi’s Concerto for Two Violins and Strings in A Minor, played with my friend and orchestra seat-mate, Judy Parker, one summer with our student orchestra. I loved the bowing on that piece, a real workout.

Eventually, when I became concert mistress for our high school orchestra, Mr. Errante let me borrow the best violin that the school owned, and I set my grandfather’s violin aside. The tone was so far superior to what I had been able to produce on the family heirloom that I didn’t want to play it anymore. My senior year, I worked my way up to Mendelssohn’s Violin Concerto in E Minor. And that is as far as I got.

One of the reasons I chose the University of Rochester for undergraduate studies was my dream of taking violin lessons at the Eastman School of Music. But I never followed through. I played my grandfather’s violin in a chamber group on the River Campus a few times during my first semester, then set it aside. There were many complicated reasons why, including a romantic involvement with a guy who disdained the humanities as a waste of time—one of my great regrets. But I lacked self-confidence and was far too easily swayed by his strong opinions.

Even though I wasn’t playing it anymore, however, my grandfather’s violin travelled with me, a vestige of my former identity as a talented musician, a promise that I could always pick it up again. From Rochester to Pittsburgh to Springfield, Illinois, to Worcester, Massachusetts, it has moved with all the other trappings of my life and rested in its blue-velvet-lined case under my bed.

Over decades of neglect, the tuning pegs loosened, the bridge fell and the sound peg rolled around inside. When Al and I got engaged, he had it repaired as a gift. That was the last time I tried to play. Soon after, scleroderma claimed my fingers, and it was too late.

Still, I’ve held onto it, along with my favorite sheet music, for decades. It was just too hard to let it go—until Al recently made a decision to have his father’s viola, another family heirloom, repaired, for donation to the public schools through our local NPR affiliate. We’ve been listening to their PSAs for years, promoting the idea of giving unplayed instruments to the school system for students who can’t afford their own and want to learn. Nothing like a good role model.

Even still, I was hesitating to follow his lead, until one day about a week ago, when I woke up and looked at my post-surgery fingers and decided the time had come. We had it tuned with a set of student strings and the bow re-haired. When Al brought it home last week, I gently plucked the strings and held it under my chin one last time. Then I set it back in its case and said good-bye.

What’s the point of holding onto an instrument that makes no music? I have no more delusions that I will ever play the violin again. It’s time for my grandfather’s violin to find a new home. I hope it goes to a student who would otherwise never have had the chance to learn. And I hope whoever sets it beneath her chin will take good care of it, and pass it on when it’s time.

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.

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Filed Under: Body, Hearing, Mind, Touch Tagged With: hands, managing chronic disease, mindfulness, resilience

Phantom

Evelyn Herwitz · May 22, 2018 · 2 Comments

Seven months have passed since my hands were “revised” with skin graft surgery, nearly five months since I completed 60 dives in a hyperbaric oxygen chamber. The weather is warming, the trees are in full leaf, the scent of lilacs lingers. And for unknown reasons, I have begun to experience phantom sensations in my partially amputated right middle finger.

Not pain. Just itching. It’s as if my finger is tingling in a non-existent tip. Quite peculiar. I want to scratch it, but there’s no there, there. Instead, I rub the bulb-like stump that remains, with its confused nerve signals that tell my brain I’m touching the side of my finger when I’m actually feeling what is now the top.

Usually, if I rub the stump for a few minutes, my brain reinterprets the sensation and the itching goes away. I wonder how long this will go on.

There are no ready remedies for phantom limb pain (fortunately, my experience is more benign). Non-invasive therapies include mild nerve stimulation with a TENS device, acupuncture and the mind game of a mirror box, which involves doing symmetrical exercises using the mirror image of your intact limb as a cue, while imagining that your amputated limb is mimicking the same movements.

My phantom itching is so intermittent that I doubt if exploring these or other options is worth the time. But I find the whole experience most curious, albeit annoying. How is it that my brain still thinks I have an itchy finger tip? The location of the itch is always the same, about a half inch above my stump, where the top joint used to be. The finger was actually longer before the surgery. Why that specific location in nothingness?

There is also the strange confusion of how I’m actually touching objects. All these months after surgery, the fact that skin from the side of my finger was used to cover the remaining stump still signals to my brain that I’m brushing objects with that side, even as the skin is now effectively oriented in a 90-degree angle to its original position.

I’m trying to teach myself how to consciously reinterpret what I’m sensing. How odd, to be dealing with this most basic way of interacting with the world at a time when so many assumptions about what is real and true are under siege.

Sensations are hard-wired. Or not. Sometimes they merely shimmer.

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.

Image Credit: Sebastian Spindler

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Filed Under: Body, Mind, Sight, Touch Tagged With: body image, hand surgery, managing chronic disease, mindfulness, resilience

Devil in the Details

Evelyn Herwitz · May 8, 2018 · 2 Comments

I have a small pharmacy’s worth of wound care supplies in our bathroom closet. Various types of gauze, bandages, dressings, ointments, tapes, heating pads, you-name-it, it’s there, the cumulation of decades of experimenting. For my very sensitive finger ulcers, I’ve found one particular brand of bandages that work best—Coverlet. They make a range of sizes, and my favorites are 3/4″ x 3″. They come in boxes of 100, and I order 10 boxes at a time.

Usually, I manage to order more before I run out. But not this past week. I haven’t needed to use as many bandages daily since my hand surgery (fewer ulcers because all the trouble spots have been amputated), so I’ve gotten a bit lax about reordering. I also mistakenly thought I still had some left, because the boxes were stacked on top of some other Coverlet boxes of different sized bandages that I rarely use.

Oops. Big time.

The issue is that these bandages are made of very soft fabric; I have never found anything like them in stores. They breathe and are comfortable all day long. As soon as I realized I had used my last bandage on Friday morning, I ordered another set of 10 boxes and grudgingly paid a steep rush fee. But the soonest I could get a guaranteed delivery was by this Tuesday.

What to do? I spent about a half hour online, researching fabric bandages. Fortunately, I found some decent substitutes at Target. Years ago, I used to buy generic fabric bandages from CVS or Target, but then they changed the specs and the fabric was coated with some kind of stiffening compound that rendered them useless for me. It seems that, in years since, these generics are no longer coated. The offending substance apparently was Latex, which many people are allergic to.

A couple of small boxes of the generic bandages did the trick over the weekend, although my thumb ulcer was not terribly happy with the alternative; the surrounding skin seemed more irritated. Fortunately, my shipment arrived early, on Monday morning, just after I had finished getting ready for the day. It was well worth the extra time to remove the substitute dressings and replace them with my good bandages. Immediately, my thumb felt better.

Before I stored the boxes in the closet, I marked the bottom two: “Second to last/Reorder” and “Last Box!”

Sometimes, the smallest details make the biggest difference.

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, Mind, Sight, Touch Tagged With: finger ulcers, hands, managing chronic disease, mindfulness, resilience

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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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