Living with Scleroderma

Reflections on the Messy Complexity of Chronicity

travel

Swell

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I turned 62 on Monday, one of those in-between birthdays that aren’t a major milestone. But this time around, instead of wrestling with the feeling that I’m just getting older, I decided to do something I’d never done before. Every year is a chance to experience new things. Despite living an hour’s drive from the Atlantic, I’ve never been whale watching, and I’ve always been curious to see live whales in their ocean habitat.

The season opened this past weekend, so we planned a trip for Sunday. I found a great company, a family owned business in Gloucester that has a marine biologist as a tour guide and that participates in whale conservation efforts. I found a discount coupon online. I found a nice restaurant nearby. The weather looked promising.

Only one glitch—when I called about reservations, I learned that there were going to be gale force winds off the coast on Saturday (despite great weather here), so it was best to check back on Sunday morning to find out if the waves had eased. Fortunately, the report was promising on Sunday—still swells, but okay for sailing—so we set out for Gloucester.

We made it with minutes to spare before departure, after getting lost along the way. But the sun was shining, everyone was helpful and friendly, and we found a good seat along the starboard side of the ship. I came prepared with all my winter gear—warmest coat, hat, mittens, leg warmers—to beat the sea breeze chill. As our ship powered beyond calm Gloucester Harbor and began to hit some swells, I was fine, enjoying the ride, like a kiddie rollercoaster.

It took about 45 minutes to arrive at the edge of the Stellwagen Bank National Marine Sanctuary, where we had a good chance of seeing humpback whales feeding. Sure enough, as we drew closer, our guide informed us that there were at least two humpbacks off the port bow at about 11 o’clock. But when I got up with Al to move around and take a look, all of a sudden I felt terribly dizzy. I immediately sat back down and tried to regain my bearings, but the ship was dipping and swaying. I felt just awful.

Fortunately, one of the crew saw me and offered to help me walk to the stern, which was more stable, and sit down. She brought me a small cup of ginger ale, half a Saltine and a plastic bag, just in case. Al was right by my side. To my surprise, the food actually helped a bit (neither of us had eaten more than breakfast, and the fact that we’d arrived so late precluded any lunch—a good thing, as it turned out).

But I was still very dizzy, so we found a space on the starboard bench, and I lay down with my head in Al’s lap. The whales, however, remained on the port side. Not an auspicious beginning to our expedition. Then they swam under the boat and began to spout near enough so I could lift my head and see. With a graceful flip of their flukes, they slipped beneath the waves. We were able to note the distinctive black-and-white patterns on the flukes’ undersides, which, our guide explained, is as unique to each humpback as a human fingerprint. These two he recognized from file photos as Mend and Evolution, familiar visitors to the Stellwagen Bank.

I felt badly about depriving Al from seeing the activity on the port side, but he reassured me we didn’t want to try to move over there. Two big, beefy guys were losing their lunches. Later, we learned that we had been in the midst of eight foot swells. Lots of people got sick. So I actually held my own better than I’d thought.

As our ship motored to a better viewing location, our guide explained more fascinating facts about humpback whales—including that it’s the males who sing, and that their songs are unique to each breeding ground. One whale will start singing, and then another picks up the melody and modifies it a bit, to demonstrate his prowess to the females. This continues throughout the breeding season like a game of telephone, so by the end of the season, the whale song is completely different.

I closed my eyes (which helped my dizziness) and did my best to relax with the boat’s rocking, which also helped, and listened to the guide’s narration. Then, our tour group got lucky. A juvenile humpback breached halfway out of the water and flopped back. Of course, it was on the port side. But then the whale (we dubbed it Hubert Humpry in honor of this presidential election season—yes, we’re dating ourselves) swam toward the bow and breeched again. This time, I managed to stand up on tiptoes, hugging Al tightly to steady myself, to see the action.

Our guide explained that humpbacks breach for four reasons: to rid themselves of parasites, like barnacles; to help their digestion; to signal other whales with the sound of their hitting the waves (sound travels farther under water); and to play. Hubert, I decided, was definitely playing, because he was putting on quite a show, smacking the waves with his huge flipper and breaching at least a half dozen times, all around the ship. Magnificent.

Between the two of us, we managed to capture it on video. I include the edited version, above, for your enjoyment. (If you can’t see the embedded video, click here for another view.) But there is nothing like seeing these extraordinary creatures in person—even risking motion sickness to get there.

There is so much to learn, to see, to do. I’m 62.

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.

If I Had a Billion Dollars

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Al and I were sitting at the dinner table Sunday night, finishing our meal of salad plus macaroni-cheese-and-tomato-sauce casserole. “The Power Ball is worth over a billion dollars,” he said ($1.4 billion, to be exact—but who’s counting).

rainbow-1393626-639x391“Really?” I said. “What would you do with a billion dollars? I mean, whatever was left after taxes?” (Even if it was less than half, that would still be a whole lot of money.)

We agreed that our first priority would be to pay off all debts—our mortgage, the equity line, the girls’ college and grad school loans. We’d make sure their futures were financially secure. And we agreed that our second priority would be to set up a charitable foundation.

“Who would you give the money to?” Al asked.

I began enumerating—certainly I’d donate to scleroderma research, also our favorite charities and our synagogue. I’d give a lot of money to climate change research, like how to desalinate sea water, alternative methods of farming during droughts, better ways to control coastal flooding. I’d fund interfaith dialogue and Middle East peace initiatives. Grants to fledgling artists and writers. For starters.

“What else?” he asked.

“Well, I’d fix up the house, do all the projects we’ve put off. Maybe I’d want to sell it and downsize.”

“Downsize? With all that money?”

“Sure. Then we could buy vacation places around the world. Except they’d be a lot of upkeep.” (So much for downsizing.)

“It wouldn’t matter,” said Al, caught up in the game. “We’d have enough to pay for a home on Block Island.”

“Okay, then we could also have an apartment in Tel Aviv and a place on the French Riviera. And I’d want to travel. First class. Go to Antarctica.” (I could certainly afford to buy whatever gear I needed to stay warm, there or here, for that matter.)

Al smiled. He began to clear the dishes.

I imagined buying custom-made shoes for my hard-to-please feet and any clothes I wanted.

“You could get a personal trainer,” he said, picking up my empty dinner plate.

“Yeah,” I said, “and I’d want to put aside enough money so we’d be able to afford in-home care, 24/7, for when we get older, so we’d never have to live in a nursing home.” (Might as well be a little practical about the future with all that imaginary money. Certainly no more worries about medical expenses!)

What about work? We agreed we’d have our hands full managing our foundation, even if we hired staff to run it for us. We’d also be busy traveling. The rest of the time, I’d want to write my novel.

“Better buy some tickets,” I told him. (I can dream, can’t I?)

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: Yarik Mishin

Fallout

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IMG_0121When I was in grammar school, in the mid ‘60s, we used to have air raid drills. We would file out of our classrooms, line up along the hallway, crouch down facing the walls and place one arm under our foreheads and the other over the backs of our heads.

We had to stay there, silently, for a few minutes, until our principal gave the all clear. Someone would inevitably get a nose bleed, and someone else would be reprimanded for talking, but most of us did as we were told, without questioning. When it was over, we’d troop back to our desks to practice cursive writing on blue lined paper or recite multiplication tables, not giving it much more thought.

For our teachers and parents, of course, these drills were deadly serious—albeit a totally ineffective effort to protect us children if the H-bomb ever dropped on New York City, just an hour to the south, or on the nearby ConEd nuclear power plant at Indian Point on the Hudson.

One neighbor down the street built a fallout shelter and proudly gave us a tour. I thought it looked like a fun adventure to live there, in the well-equipped underground room, with its bunk beds and stocks of canned food. It inspired me, for a class project, to build a model fallout shelter out of sugar cubes and Elmer’s glue, with furniture made out of colorful construction paper. This was how I processed the insanity of those times, not understanding the implications—and, very, very fortunately, never having to come to grips with the reality that the fallout shelter represented.

Our neighbors were the only ones to go to those extremes. I don’t recall their names, but the parents were from France. It was a mere 20 years since World War II had ended.

Wars, fear of wars, now the brutal face of terrorism, haunt each generation. It is a disease we cannot seem to escape, this instinct to destroy, to dehumanize and crush “the other” to gain power, control. Last week’s horrific attacks on innocents in Paris capped a week of bloodshed around the world, including a bombing in Beirut and a slaughter of university students in Nairobi. It seems endless, and the threat that the Islamic State now poses to the world weighs heavily on my mind, as I am sure the threat of Mutually Assured Destruction kept my mother awake at night.

The Parisian attacks feel particularly close, because the targeted restaurants and concert hall are only a ten minute walk from the apartment where Al and I stayed on our trip in July. I have written to our Air B&B hostess, to express our support and best wishes, but have yet to hear back. I hope her silence is only because she missed my email.

I try to reassure myself that, ultimately, over the course of history, the perpetrators of evil  are undone. But it will take cooperation, shared intelligence and resources, strategic force, justice, courage and a commitment to the greater good of all humanity to cure our global society of this terrible terrorist scourge. Xenophobia has no place here—it only accelerates the spread of the disease. Refugees from terror need asylum, not blame for perpetrating the very horrors they are fleeing.

Eradicating terrorism will require decades of patience and determination. There are no quick, facile solutions, as some of our politicians would have us believe during this season of presidential so-called debates. To fall prey to that delusional thinking is akin to believing that crouching in a school corridor is adequate protection against a nuclear attack.

In response to all the cynicism and bellicosity that pervades the news in the wake of the attacks, I draw on our European travels this summer for an antidote. Everywhere we went, strangers helped us. Just as we thought we were lost, someone would point us in the right direction or give us a lift. When we were tired, someone would offer to carry our bags. Most people are basically goodhearted. Dark as the world feels today, the odds for defeating this latest face of evil are in our favor.

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.

Machu Picchu

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Ever since Al and I went to Europe this past summer, I’ve been dreaming of our next trip. No specifics, yet, just a yearning to see more of the world.

machu-picchu-1369310-640x480Like Machu Picchu in Peru. My podiatrist was telling me about his recent visit while he worked on my corns and calluses and ingrown toenail last week⎯a somewhat helpful distraction, as my feet are incredibly sensitive and this was otherwise not a fun appointment.

He described the ancient Incan ruins in a similar way that I’ve heard from others⎯a very spiritual space, beautiful, fascinating history (albeit tragic, given the fate of the Incas as a result of the Spanish Conquest). And he shared pictures on his iPhone, of extraordinary vistas and smiling llamas. Only a five-and-a-half hour flight from Miami.

Very intriguing. Except for one problem. The altitude is about 8,000 feet. My podiatrist is a big, muscular guy, and had no issues with altitude sickness (for which he was quite grateful). He said he was running around like a little kid, he was so excited to be there. But some people on the trip got very sick and needed oxygen.

How would I manage that altitude (assuming we could even afford the trip, which I haven’t bothered to check) with my scarred lungs? The highest mountain I have visited, as best I can recall, is Mount Washington in New Hampshire, just over 6,000 feet. The body begins to react to altitude right around 8,000 feet. Lack of oxygen can cause fatigue, loss of appetite, trouble sleeping and other issues.

There is also the risk of infection from water supplies that are not treated. I have enough issues with bacteria getting into my ulcers here at home, let alone in a place where you can’t drink the water. How would I keep my hands clean?

Right now, of course, this is all just a pipe dream. I know there are ways to acclimate your body to altitude, gradually, and there are medications that can help. I’m sure there are strategies for hand hygiene, if I were determined enough to figure it out.

But there is also the reality of scaling my travel ambitions to my body’s limitations. There are so many places I’d like to see, on every continent. Even Antarctica. In December, the temperature on the Antarctic Peninsula is about the same as it is here in New England (yes, I’ve checked). Going to Antarctica is the closest you can get to an experience akin to going to the Moon.

Not all of those dreams are possible, health-wise or financially. So, I’ll continue to explore options, right now from the safety of my computer screen. I don’t know where we’ll travel next, and it probably won’t be Machu Picchu. But it will be someplace exciting, inspiring and a push outside my comfort zone. Of that, I am determined. It’s the only way to keep growing.

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: Julio Sedano Acosta

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.