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Living with Scleroderma

Reflections on the Messy Complexity of Chronicity

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mindfulness

Sinkhole

Evelyn Herwitz · August 1, 2017 · Leave a Comment

Late Monday afternoon, just after I’d finished work for the day, the water main on our street broke. Water started bubbling out of cracks right in front of our next-door neighbor’s house. By the time I went to investigate, maybe a half-hour later, it was gushing down the street, into the gutters.  A couple of DPW trucks drove by, then drove by again. All the neighbors came out to comment and gawk at the river in the middle of the road. By the time the water was shut off for the whole street, a chunk of asphalt had formed a sinkhole.

Now, as I write, around 8 o’clock in the evening,  a work crew is milling about outside. We’ve been told it may be 8 to 10 hours before the water main is fixed. It’s going to be a long, dry night.

My first thought, when I realized that we had no water, was how am I going to wash my hands tonight? Fortunately, we have some distilled water in the house. I also just received a shipment of saline wound wash. So I should be able to take care of my ulcers, thank goodness.

This follows a day in which I learned that, contrary to what I’d been led to believe about procuring the high end wound dressing I’ve been seeking, that I did not need a prior authorization, given that this dressing is considered to be a durable medical supply. I just needed to have my rheumatologist fax the prescription to the supplier. (This, after I learned from several phone calls to various sources, is possible because I can get said durable medical supplies out-of-network without penalty from my insurance company.) All of this would be great news, except for the fact that I have lost weeks in a wild goose chase for prior authorization, when I probably could have had the dressing by now, saving much pain and frustration.

All of this is compounded by the fact that we are leaving for vacation soon. I’m still hoping for a miracle that somehow all the approvals will go through and I can get the dressing before we go. But each day makes that less likely. So I’ll just need to do the best I can with what I have.

The one thing I have control over is how I respond to the situation I find myself in. I started doing some guided meditations about pain management. It’s really quite fascinating, because the focus is not on trying to avoid the pain, but rather on changing how I understand and respond to it. It’s very easy to fall into the hole of fear and anxiety about what is happening to my fingers, given that the healing process is so excruciatingly slow. The pain triggers those fears. I look at the deep wounds when I change my dressings and don’t know how to interpret what I see and feel.

What I have learned is that the more tense and stressed I am, the worse the pain becomes. The more I’m able to relax and sit with the pain, the less overwhelmed I am, and the pain itself becomes more manageable.

Not easy to remember when my fingers start going crazy as my medication wears off by the end of the day. But I’m trying. What other choice do I have?

Now the DPW work crew is banging and rattling about. By morning, I hope the sinkhole will be repaired and that we will have running water again. Thank goodness these men are willing to work through the night to take care of our street. Every day brings the unexpected. How we deal with it is up to each and every one of us.

I’ll be taking a break from my blog for the next few weeks, back at the end of August. I hope, Dear Reader, that the rest of your summer is free of sinkholes and full of good health and pleasant journeys.

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

En Route

Evelyn Herwitz · May 30, 2017 · Leave a Comment

Traveling always involves a lot of logistics. Last week, all the more so. Months ago, I had planned a three-day, Sunday-through-Tuesday business trip to NYC. The first two days were devoted to board meetings for a philanthropy of which I am a trustee, including a day of strategic planning that I had helped to organize. The third was a full day meeting with clients. I had piggy-backed that third day onto the first two in order to save myself physical wear and tear from traveling to Manhattan twice in one month.

What I had not been able to anticipate, however, was the state of my hands and my back (of which I have written a lot in recent posts). What to do? I couldn’t/didn’t want to cancel out, but I wasn’t sure how to manage. Would I be able to handle my luggage? How would I keep my hands from getting more damaged or protect myself from picking up yet another infection?

My initial plan to protect my hands from lugging a suitcase on and off trains and through subways—use a backpack—was unworkable. With all the supplies I needed to bring for hand maintenance, personal hygiene, medications, etcetera, even packing very lightly for clothing and using Al’s nylon backpack, the thing was way too heavy and unwieldy for my slow-healing, strained back. So I switched over to my wheeling carry-on. But what to do about getting around?

Aha! Obviously, I had to rethink ground transportation. Time to rely on taxis or Lyft or other options. Saving money was not as important as saving my health. And if I did use the subway, I decided I’d only do it if there was elevator access or easily walkable ramps.

As for pulling my bag along Manhattan sidewalks, I planned to keep that to a minimum, not only because of the crowds, but also because many of the streets and sidewalks in Midtown are either under construction or aging and in need of repair.

Sometimes I improvised. When one of the trains I took had split upper and lower deck seating, I stayed in the middle on a jump seat to avoid lugging my luggage and made friends with the conductor, who helped take my bag off the train to a lower platform.

Everything worked out better than expected. From my Monday meeting, located at a Wall Street law firm, I was able to get a courtesy car ride to my Midtown hotel. On Tuesday, I simply checked my bag at the hotel, went to my meeting in Chelsea, and picked it up on my way back to Grand Central, which was a five minute walk down Park Avenue. Train transfers were relatively easy. The one time I used the subway, I only had to carry my bag up and down about six steps.

As for my back, I wore a thermal heat pack all three days and brought my deflatable back pillow to every meeting. I made sure to keep up with regular doses of acetaminophen and ibuprofen. And I took meticulous care of my hands.

It was a long trip on my own when I wasn’t feeling my best, but successful in the end. As my train pulled into New Haven, where I had parked in the overnight garage, I was exhausted and relieved. I couldn’t wait to get in my car and drive home. But. The one thing I hadn’t planned for, the inevitable travel glitch that had nothing to do with my health issues and everything to do with mindfulness or the lack thereof was this: I’d left an interior light on in my car when I’d parked three days prior, and the battery was dead. An hour later, AAA arrived and charged it right up, thank goodness, but I was not a happy camper during the wait.

Successful travel, especially when you deal with chronic health issues, requires a lot of advance planning. But the unexpected is inevitable. You can be certain I will always check interior light status whenever I leave my car from now on. But the other lesson reinforced from my trip was that I can’t anticipate everything. Nonetheless, when traveling alone, I can trust myself to solve it.

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, Touch Tagged With: body-mind balance, finger ulcers, hands, managing chronic disease, mindfulness, travel

Small Courtesies

Evelyn Herwitz · March 21, 2017 · 2 Comments

Amidst the chaos of wire tapping accusations, North Korean ballistic missile tests, proposed budget cuts to so many important federal programs—including the National Institutes of Health, which fund, among other things, research for cures to diseases like scleroderma—amidst all that and more, plus the minor annoyances of daily life, such as discovering that this blog did not publish properly last week (apologies if you subscribe and received a duplicate of last week’s post), I am trying to focus on something positive to keep my blood pressure from spiking.

Like the fact that the guy behind me in the supermarket check-out line smiled and nodded thanks when I placed the metal spacer bar after my food on the conveyer belt, to make room for his groceries.

Or the way that people I don’t know held a door open for me as I was leaving a building this the weekend.

Or how someone graciously allowed me to make a left hand turn from a side street, across busy city traffic, to get in line in front of him for a stoplight.

Small courtesies, the ways that we acknowledge each other’s needs and feelings without fanfare, are essential to keeping sane. More than that, little acts of consideration are the warp and weft of a civil society. When leaders flaunt basic social norms—like honesty and respect for others with different points of view—it falls to the rest of us to strive even harder to be, yes, polite.

Maybe this sounds silly, trivial, like a schoolmarm’s chiding. Etiquette is one of those subjects that has been shoved into the back closet, mocked as an arcane, snobbish concern over which fork to use at a fancy dinner. Those rules are not my concern here. Rather, I’m referring to the deeper meaning of the word. At this time, in this country, with so much social strife and dissension, it’s well worth remembering the wisdom of etiquette maven Emily Post:

“Consideration for the rights and feelings of others is not merely a rule for behavior in public but the very foundation upon which social life is built.”

Amen to that.

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: Andrew Branch

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Filed Under: Body, Hearing, Mind, Sight Tagged With: body-mind balance, managing chronic disease, mindfulness, resilience

Storm Tracking

Evelyn Herwitz · March 14, 2017 · Leave a Comment

I’ve been staying indoors for much of the past few days. First, we were hit with single-digit, bitter cold and wind. It’s sunny out as I write on Monday afternoon, but still too cold for a much-needed walk. And by this time on Tuesday, I expect to be watching snow swirling and piling all around as a Nor’easter sweeps up the coast. We’re due for 12-18 inches, maybe more.

So much for gliding into spring.

My hands have certainly had enough. Four fingers on the right hand, three on the left, bandaged up because my ulcers and cracked skin won’t heal in cold, dry air, even with the heat on and plenty of clothing layers. I really wish I could use one of those Sick Bay gizmos on the original Star Trek, wave it over my hands and make the ulcers go away.

I wish I could do the same to solve the terrible discord in our country. I read and read and read, trying to stay on top of all the news without driving myself insane. Staying informed is the essential first step. Balancing how to manage my health and energy and anxiety level as I debate how to get involved in preserving our democracy has become a major preoccupation.

What to do? What to do? When we were kids, my older sister used to write comics with a stick figure girl (you could tell because she had a triangle for a skirt) who would ask that question and then, in a lightbulb flash, always declare I have it! with a ready solution to the dilemma. I can’t recall any more of the story lines, but they always made me laugh.

No quick solutions to our national crisis of conscience, no magic tricorder for my hands, no way to avoid a Nor’easter hurtling our way. Nothing to do but sit and watch the snow fall. I will remind myself to be grateful for our warm house and secure roof and full cupboards, for doctors who care about me and insurance to pay for it all. I will give myself permission to plan my personal political commitment in my own time, rather than over-reacting to the outrage du jour. And I will seek comic relief.

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: Jude Beck

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Filed Under: Body, Hearing, Mind, Sight, Touch Tagged With: body-mind balance, finger ulcers, hands, managing chronic disease, mindfulness, Raynaud's, resilience, stress

Clued In

Evelyn Herwitz · February 21, 2017 · 1 Comment

All day long, I think about words. For a writer, they are my lifeblood. Sometimes, my head feels so full of words that I need to do something, anything, nonverbal. Walking helps. So does weaving or sewing—making something with my hands, however challenging that may be.

But one of my favorite ways to relax is to immerse myself in words and more words—doing The New York Times crossword puzzle. I used to limit myself to the Sunday crossword because we have a print subscription to the big, hefty weekend edition. Then came the 2016 presidential election. I decided I needed to support a free press more actively and bought a digital subscription to the Times (as well as The Washington Post).

My Times subscription came with an added bonus—a reduced digital subscription to the crossword app. Why not? I thought. I need a break from all the bad headlines.

Doing the daily crossword has now become something of an addiction. There’s the Monday crossword, an easy start to the week that I can finish in about ten minutes. Tuesday is usually a snap, too. The puzzles get harder by midweek and can be a real challenge by Friday. Saturday’s puzzle is almost always a stumper. Sunday is a crapshoot. Sometimes I get the theme right away; others can take a few days to finish.

Aside from being a welcome distraction from upsetting news (which I certainly understand better, now that I’m reading more comprehensive coverage, but wish this weren’t such a disheartening civic responsibility), the crossword’s digital version has an added bonus: It’s so much easier to complete with a stroke of my laptop keys than to write in with pencil. My hands don’t get as tired. I don’t have to struggle with a smudgy eraser (no, I’m not one of those pen-wielding crossword purists).

This is especially true for the Sunday puzzle. A few years ago, the Times switched format to a semigloss paper stock, which I find incredibly difficult to write on. It requires far too much finger pressure to inscribe anything legible on it, and the light reflection off the paper makes it hard to see what you’ve written. Fine for magazine photos, not for Number Two pencils and bifocals.

The downside of the digital version: It’s much more tempting to cheat and look up answers on the Internet.

To avoid that downfall, I’ve invited Al, my crossword ninja, to do the puzzles with me. He has an uncanny ability to decipher clues. And it’s a fun way to relax together in the evening.

Who knew that “fake news” wars could have such a delightful side-effect?

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: anxiety, body-mind balance, 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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