New Year, New Hands

Last Thursday, I finished my 40th dive in the hyperbaric oxygen chamber. My grafts have healed. The Wound Center staff gave me a “certificate of completion” decorated with pictures—a fountain pen and typewritten words, a graphic for all the podcasts I listened to while bandaging up my fingers after my dives, an image of a Fig Newton, my favorite post-dive snack. Everyone signed with good wishes. I promised to come back and visit.

It seems amazing to be through. I still have bandages on my thumbs—the right as it continues to heal and the left, to protect a chronic pit that waxes and wanes. I’m moisturizing the grafts during the day, leaving them exposed to the air so the skin toughens up but remains pliable. I’m learning to interpret the sensations from the flap on my right middle finger. And I’m touch-typing away, thank goodness.

Christmas weekend, I took my daughters to see my sister and her family in the Midwest, my first trip since Al and I traveled to Norway in August. A good visit, anticipated for months, certainly not as strenuous a journey as this summer, but a bit of a psychological hurdle, given how my hands fell apart when we were abroad. I took extra care to protect my fingers, which paid off. No new ulcers, no damage. Just a rotten head cold on the way home, which mostly cleared by the end of the week.

So, here I am, starting 2018 with “revised” hands, all ten fingers. There is adjusting to do. I need to relearn what I can and cannot tackle, given that left index and right pinky are fused at the joint, right middle is stubby like a cigar, and left middle no longer bends at the partially amputated, grafted tip. The grafts have no nerve sensitivity, which requires mindful awareness of what I place where. Most of my fingers no longer move the way they used to. I’ve made an appointment for Thursday to see an occupational therapist in my hand surgeon’s office, to get some exercises to strengthen my grip, increase flexibility and discuss what I need to adapt.

Still, I’m feeling upbeat. I can do for myself again. Even temperatures here in the deep freeze for another week are only a temporary annoyance. Tucking hot packs into my wrist warmers staves off numbness. Staying cozy beneath the covers for an extra hour in the morning, now that I don’t need to push to get to the hospital, helps, too.

I could never have imagined, on New Year’s last, that I would be celebrating having all my fingers today. It’s just as well that we can’t see into the future. Too terrifying. If 2017 has taught me anything, it’s been how to stay very focused on the present, to measure progress in small steps, to be grateful for little victories that add up with persistence, to not let my fears keep me from taking reasonable risks for my health.

So, here’s to 2018. Bring it on. Just let me keep my fingers, please.

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.

My Everest

Much has happened in the weeks since I last wrote. I had hoped to share a simple, upbeat travelogue about our wonderful August vacation to Iceland and Norway upon our return a week ago, Sunday. The trip was, indeed, magnificent. But life is not simple, especially with scleroderma. My severe ulcers that I have written about for months took a serious turn for the worse. As I write on Sunday afternoon, I am facing major hand surgery Monday morning. Here is what happened:

For more than three decades, I have been managing digital ulcers on multiple fingers. I have gone through infections requiring IV infusions, more rounds of antibiotics than I can remember, and months — sometimes years — of waiting for ulcers to heal. I have learned how to compensate and find creative solutions for handling daily tasks. I have learned to live with people’s reactions to my oddly shaped, bandaged fingers. But this spring, something went terribly wrong. My ulcers on five fingers formed large scabs, or escars. They were hard and thick and dark; when tapped, they felt like turtle shells.

As I have been documenting in this blog, for the past three months I’ve been trying to find a way to get them to heal. As the escars have receded, part of the natural healing process, I have sought out state-of-the-art wound dressings and consulted with wound specialists, with varying degrees of success. When I didn’t understand, however, was the real risk for the ulcers to work their way down to bone.

The Wednesday night before we were set to leave on our trip, I was changing my dressings as usual. But suddenly, the escar on my right pinky (the ulcer that had been infected a few months ago) lifted up to expose the knuckle bone beneath. I was terrified. We called the hospital’s Wound Center and spoke to a nurse practitioner who was covering for the night. She suggested that unless I started running a fever, it was safe to wait until morning to get medical attention. This was good advice, because the last thing I wanted to do was spend five hours in the ER.

On Thursday, Al came with me to see, first, a nurse practitioner in the Wound Center (no surgeons were on that day), and later in the afternoon, an excellent orthopedic hand surgeon/plastic surgeon. He looked at my pinky with its exposed knuckle bone and gave me the news straight up: because of my scleroderma, options such as skin grafts would not work, and the only solution was amputation.

I was in shock, as was Al. Never in my wildest dreams had I anticipated this path. He said the escars on my other fingers were “classic scleroderma,” and that they were covering dead skin. I do not know if there had ever been any hope for real healing once the damage had been done. I asked him if it was still possible to travel. He said yes, so long as I kept the wound clean, moist and protected, and was on appropriate antibiotics. It would not change the prognosis nor make things worse.

By the time we got home, I had made up my mind to take the risk and go ahead with the trip. Even though it was insured (this time, I had met the deadline for getting travel insurance that would cover us for pre-existing conditions), we had been planning this wonderful trip for months, and I just wanted to go. But then I changed my dressings that evening. Suddenly, the escar on my left index finger began to recede to expose the back of the knuckle. I was in hysterics. How could this be happening? I told Al that I couldn’t imagine traveling now. He said he would go with whatever I decided. He went to sleep, and I went downstairs to sit on the living room couch and try to think.

I emailed a couple of friends for help to sort it out. I realized after a few hours of agonizing that I was channeling my mother, who was a very anxious woman who never took risks.  She came to this country from Germany in 1936 at age 14, escaping the trauma of the Holocaust, but never free of what might have been. Her fears of danger kept me from exploring the world when I was young, with the exception of a two-week tour of Europe that my mother’s mother paid for when my sister and I were in college — my grandmother’s way of exposing us to the world that she missed so much.

Facing the inevitability of losing at least one finger and maybe more, I knew that I needed the inspiration of beautiful landscape in order to face what was to come. I wrote an email to the hand surgeon and asked him if the risk of exposed bone was additive with more fingers involved, and if the prognosis would change if we went ahead with the trip. I received a thoughtful email back in the morning that explained that each finger had to be considered independently, and that the risks and prognosis remained the same. I also checked with my ID specialist about antibiotics, and he said that what I had already planned to take with me was appropriate. I told Al that I wanted to go. He gave me a big thumbs-up and a big hug.

And so, we went, first to Reykjavík for two days, and then on to Norway. We spent five days in Bergen, on the southwest coast, home to some of the country’s most famous fjords, then took a scenic 7 1/2 hour train ride to Oslo, stayed overnight, and flew to Tromsø in the Arctic Circle. There we stayed for three days, and then wrapped up our trip in Oslo for our final weekend.

The scenery was everything I’d hoped for and so much more. Iceland is in constant formation, with active volcanoes, geysers, thundering waterfalls and visible tectonic plates. The mountains are sharp, craggy and snowcapped, a visible reminder of the earth’s power to force rock skyward. We saw puffins and glaciers, smelled the sulfur of hot springs, watched Icelandic horses and sheep cropping emerald grass, marveled at moss reclaiming lava fields.

In Norway, we immersed ourselves in beauty, from towering green and rock mountains bordering calm saltwater fjords to the art of Edvard Munch (MOOnk). We drove through the world’s longest tunnel (25 km) with its sapphire blue lighting, stared slack-jawed at thousand-foot waterfalls nearly everywhere we turned, rode the scenic Flam railroad up and down a mountain. Staying in wonderful Air B&B flats, we ate many of our meals at home to save some money (restaurants are very expensive in Norway), but treated ourselves to four exquisite dinners out.

For all this, however, travel was very strenuous for me. It took about two hours in the morning and the same at night to change my dressings. Our supplies included 700 cloth bandages, 32 sheets of silver alginate dressing, a cream I had discovered online that includes hyaluronic acid and is intended for radiation burns, lidocaine gel, Q-tips and more. Along the way, three more ulcers receded to expose bone. It was as if all my ulcers had hit a tipping point within the same week. Sometimes changing the dressings was so painful, it reduced me to tears — and I am not one who cries easily. Al was my rock, so attentive and supportive. He would read to me of Norse mythology as I went through the tedious process of tending to my fingers, help me get dressed, take my arm to make sure I didn’t fall, comfort me when fears overwhelmed me.

Throughout the first week, as my ulcers deteriorated, I agonized over whether I had made the wrong decision. Al said let’s take one day at a time. Even though we often didn’t get out until afternoon, we made the most of each day. New friends in Bergen gave us a grand tour of the fjords and invited us to their home for Shabbat dinner. When I dropped my wallet without realizing it, in the pouring rain as we were getting on a bus, a young man tapped me on the shoulder and returned it to me.

My self-doubts finally dissipated when we reached Tromsø. The idea to go there had been mine, a major challenge with my Reynaud’s. The Gulf Stream keeps temperatures in the 50s Fahrenheit in the summer — not the warmest climate for me, but still an opportunity to get as close as I ever will to the North Pole. Our first full day there, the rain that punctuated our entire trip cleared as we were riding a cable car to the top of a small mountain that overlooked the city, which is on an island. As I walked out on the top of the mountain, with its spectacular view of huge, jagged, snowcapped peaks in the distance, I was suddenly overwhelmed with emotion. I had made it, here to the Arctic Circle, with my aversion to cold and my crazy hands. This was my Everest. In that moment, I regained my courage. I knew I could face what was coming next.

The following day, the sun was bright and the temperatures in the 60s. We had signed up for a five-hour tour of a neighboring island, and with luck, ended up as the only passengers on the trip. Our tour guide, Pedro, who had come from Lisbon to Tromsø in search of the Northern Lights (only visible in late fall and winter), proved to be a wonderful companion and conversationalist. We covered everything from Norwegian geography to European views and fears of the Trump presidency. The highlight of our day was eating lunch on a cream-colored coral sand beach (there is a coral reef in the Arctic — who knew?), talking politics, drinking rice milk hot cocoa and eating delicate Finnish homemade cookies.

As the end of our travels drew near, my apprehension began to mount again. Fortunately, our seven-hour flight back from Gatwick, London, was on a Boeing 787 Dreamliner, the newest and most advanced jet in the sky. Better humidity, improved air pressure changes and even comfortable seats in economy made it a much easier flight than I had anticipated.

This week, reality hit home hard. We saw the hand surgeon late Monday afternoon, and his assessment was that I would need what’s called a hand “revision” that would involve trimming five of my fingers. His goal was to leave as much length as possible. But, in all probability, my right pinky and left index finger would be reduced to one digit stumps. The other three — left middle finger, right middle finger and right ring finger — would involve trimming exposed bone and leaving open wounds in the hopes of preserving length as skin regenerated. As it turned out, however, his OR schedule was booked through September. He referred me to an experienced colleague with similar credentials, who had an opening on Monday.

We met the second hand surgeon on Thursday. He is meticulous, thoughtful and thorough. With a very sober face, he told me that this would be the first of “many surgeries” because of the complexity of the damage. He described my situation as “serious scleroderma.” He is concerned about healing with my poor circulation and suggested the possibility of having a sympathectomy done at a later point to increase blood flow to my hands. He agreed with the first hand surgeon that I should have hyperbaric chamber treatment in the wound center to help improve oxygenation with my blood and speed healing. On Monday, he will debride all the ulcers, trim back exposed bone, and determine the best way to deal with my two broken knuckles. He will also take pictures and share them on a list-serve for hand surgeons to get more input about next steps.

I was very frightened and distressed after this meeting, even as I feel fortunate to have such an expert taking care of my hands. He has  an excellent reputation, especially for follow-through, and is in high demand. The last few days have been an emotional roller coaster ride, softened by love and support from family and good friends.  I wax and wane between fear and grief over losing part of five fingers and just wanting to be rid of these painful digits that no longer work.

My surgery is scheduled for first thing Monday morning. By the time you’re reading this, it will all be over. I do not know if I will be up for writing what happened by next week, but I will certainly share the next chapter when I am able. Let the healing begin.

Post-op P.S.:  Thank goodness, the procedure went better than expected. My circulation exceeded the hand surgeon’s expectations. Still have all 10 fingers, for now. He put temporary pins in my right pinky and left index finger to stabilize them and buy me some time. He is sharing pictures of my fingers on an international list serve for hand surgeons, so we will have input from the best of the best for next steps. Pain management will be the next challenge, but I am so grateful and relieved to have made it through this procedure. Thank you for sharing my odyssey, and thanks to Al for being my post-op scribe and life’s partner.

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.

En Route

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.

In 3-2-1

I stay up way too late most nights watching late night comedians. Since we live on the East Coast, this means I’m getting to bed around midnight. My evening routine is prolonged by tending to all the bandages on my fingers—up to six ulcers at present, plus one on my left ankle—so my excuse is that the shows keep me company while I’m taking care of my hands. But in all honesty, I rely on satire to keep my sanity.

My favorite is Stephen Colbert. Al’s, too. So when Al suggested that we mark our anniversary this year by a trip to NYC to see a live taping of The Late Show, I readily agreed. We were married in December 32 years ago, but due to scheduling conflicts, our first opportunity to go was last week.

And go, we did. We decided to make a mini vacation of it, booking a four star hotel on Park Avenue at a January discount, scoring half-price tickets to a Sunday afternoon off-Broadway show, enjoying great food and wonderful art museums on Monday and Tuesday. But the highlight of the trip was our pilgrimage to the Ed Sullivan Theatre for Colbert on Monday afternoon.

Now, as children of the ’60s, it was exciting enough to be at the very spot where the Beatles made their American debut. The theatre features architectural filagree that gives it a period flare. It’s located on Broadway between West 53rd and 54th Streets–the latter also designated as Señor Wences Way, a throwback to that wonderful, corny feature act on the Ed Sullivan Show that we loved as kids.

But it was also fun just to be with other Colbert fans as we waited outside, joking and speculating about the program as we stamped our feet and huddled against the cold. The priority ticket line formed at 3:00 p.m. We arrived shortly after and quickly made our way through the check-in, staffed by friendly red-jacketed twenty-somethings armed with iPads and headphones, who made occasional announcements about what to do and where to go. A nice couple offered to take our picture in front of the marquee, and we returned the favor.

By 3:45, rehearsal was over and we were finally allowed to enter the warm theatre lobby. More waiting and waiting in a long, snaking line beneath large TV monitors playing excerpts from previous shows, though the sound was muted. From time to time, one of the staff would fill us in on next steps and rules: turn off all cell phones, no food allowed in the studio theatre, and—around 4:30—now’s the time to use the bathroom, because once you’re seated, there are no bathroom breaks.

Wait, what? I’d figured that, if I had to go, I’d be able to do so during a commercial. But, no, only if it was an emergency—and no guarantee you could be reseated. Now, this was potentially a major issue for me. I can no longer go long stretches without a trip to the bathroom. My bladder just doesn’t empty efficiently. So I joined a line of other women, waiting for a stall in the Ladies’ Room, and hoped I could squeeze out the last drop. Fortunately, we’d eaten lunch about two hours earlier, and I hadn’t had much to drink.

Back in line, I distracted myself by chatting with some of our neighbors, flexing my ankles and feeling grateful that I was wearing compression knee socks, so that my feet wouldn’t swell from all the standing around. Finally, shortly after 5:00, it was time to be seated. The red jackets were very experienced at crowd control, and we efficiently filed into the main floor. Lo and behold, the center section was full, so Al and I found ourselves guided toward the third row of the right-hand section, directly in front of Jon Batiste’s Steinway concert grand piano. Al was in heaven.

Here we were, with a great view of the Late Show set, so familiar from our TV at home. We gawked and chatted with our seat mates (mine was a Lutheran pastor from Saskatchewan, here with friends for her first visit to NYC), listened to more instructions about our role as audience (enthusiasm and energy are essential for the performers as well as the 2.5 million folks watching later tonight), practiced standing and cheering, warmed up to the warm-up comic, clapped and bopped to the outstanding jazz of Jon Batiste and Stay Human, and then, finally, screamed our heads off, just like those Beatles fans fifty years ago, when Stephen Colbert ran out on stage to greet us.

He was genuinely warm in person, very down-to-earth, as he fielded a few questions from the audience with his quick, dry wit. Then it was time for the taping to begin. We could watch the cold open on the video monitors, then Colbert ran out on stage again, this time as part of the show. The boom camera swept the audience, and we were off to the races.

Time zipped by. There was a surreal quality to the experience, watching Colbert perform for the four cameras that surrounded him in his opening monologue, even as he fed off our energy. There was a pause for him to switch from his suit jacket to a Dad sweater for a skit with guest Leslie Mann, another pause because one of the lights wasn’t working properly, casting a shadow on the couch where they were to sit. “The Russians must have hacked our set,” he quipped.

The band played on during commercial breaks (how I wish that were the case when you watch on television–they are such amazing talents). Lewis Black and Dan Levy rounded out the program. We stood and cheered on cue (when the stage manager waved his rolled-up script in the air). Colbert’s wife made a surprise appearance to roars of approval.

And then it was over. I’d been so absorbed, I’d forgotten all about any bathroom jitters. Al and I looked at each other. We didn’t want it to end. Despite the cold, we walked all the way from Times Square back to a little Italian restaurant near our hotel, where we enjoyed a fine dinner and live piano music. Later, we watched the show again in our hotel room, to see how it was edited and, of course, to see if we made it onto the tape. And there we stood, cheering in the crowd after one of the early commercial breaks! I finished bandaging my fingers, and we went soundly to sleep.

All in all, it was a wonderful anniversary celebration—a great break, a much-needed chance to recharge, a gift of resilience. And, oh, did I mention? The Colbert tickets were free.

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.

Think Warm Thoughts

It’s really cold out. My hands are not happy. Six ulcers on my fingers and a tenacious one on my left ankle tingle and smart. The good news: even though we’re in the teens today, by Wednesday, it’s supposed to go up to the 50s. Welcome to New England.

As I await the warming trend, it’s nice to remember our long New Year’s weekend in St. Petersburg, Florida. Were we really at the beach one week ago? I have the pictures to prove it. So, I share with you, Dear Reader, some highlights of our trip. I hope these bring a little warmth into your day. Enjoy. . . .

At the Dali Museum, which features the works of Spanish surrealist painter Salvador Dali, a special exhibit explored the life and paintings of Frida Kahlo, a 20th century Mexican artist who broke new ground for women painters. I found her life’s story especially moving: she suffered a serious accident at 18 that caused her great pain and many surgeries over her lifetime, but her art enabled her to find meaning in her struggles and to express herself in a universal language.

While Dali’s paintings of melting clocks and dreamscapes are his best known works, I preferred these two examples of his early paintings.

Outside the Dali Museum, visitors tie their entrance wristbands to a bedecked tree. The strips of colored tags luff in the breeze.

The Morean Arts Center includes a collection of glass sculptures by Dale Chihuly. His exuberant use of color and form creates a mesmerizing, whimsical kaleidoscope.

Around the corner, the Center includes a glass blowing workshop. We enjoyed the demonstration, which resulted in a free form glass bowl.

We met ibises in the afternoon . . .

. . . and pelicans at sunset.

St. Pete Beach offered a chance to relax and pretend that winter didn’t exist.

Back home, there is snow on the ground and ice on the sidewalks. It will all be gone by week’s end. I know there’s more on the way. I just need to remember . . . think warm thoughts.

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.

Come Fly with Me

There was a time when air travel used to be fun—glamorous, even. The ability to arrive somewhere far away in a few hours was still novel when I was growing up. Flying was a special treat, comfortable, efficient, with plenty to eat and room to relax.

stocksnap_ev0wq57le6No more. Post 9/11, in the era of long security lines and maximizing revenues at the expense of travelers, flying—especially domestic routes—is an ordeal to be endured.

Last week I made a short trip to Chicago on business and was struck, once again, by how unpleasant flying has become. The only plus: on both legs, I had the good fortune of TSA Pre-Check; hence, less fumbling with my bags and belongings, which spared my hands a bit of strain. After that, however, things went downhill.

My trip from Boston started with a 15 minute delay, as we waited for our flight attendants to disembark from another “live flight” (the lingo is remarkable, in itself—what was the alternative, to arrive on a zombie flight?).

Just as the crew finally filed through our gate (without taking a break—they appeared and sounded bedraggled) and it looked like we would be boarding momentarily, one of the customer service reps answered a phone call and became a bit agitated. Uh-oh, I thought. He was shaking his head while speaking to his colleagues, until, thank goodness, a pair of pilots arrived on the scene. Turns out our original pilots had timed out, and this new pair was pulled off a flight to LA to take us to Chicago.

What would have happened if they hadn’t been available? And what happened to the passengers on the LA flight? It boggles my mind. There is no way to count on leaving on time.

En route, there were the obligatory free sodas and little snack packages that I find nearly impossible to rip open. I had consumed my peanut-butter-and-jam sandwich while still at the airport, to avoid risk to a potential seat mate with a nut allergy. I passed the time writing, which took my mind off the fact that I felt like the proverbial sardine squished in a can. There is simply no room to maneuver in an economy seat—and I am small. I did my best to ease strain on my knees by resting my feet on my backpack under the forward seat. We arrived about a half-hour late. It was a relief to get out of there.

Coming home was even more aggravating. My mid-afternoon flight on Friday was on schedule when I left the Loop for O’Hare. But by the time I arrived and passed through security, it was 12 minutes late. Not a good sign. Soon, we were pushed back a half-hour, then an hour. It was raining hard in Boston, and Logan was slowing down incoming flights. Any hopes of getting home in time for Shabbat dinner with my family were dashed—especially once I had to check through my carry-on bag due to lack of overhead storage (of course).

We finally were allowed to board 90 minutes late, only to sit on the tarmac for another half-hour, waiting for permission to take off due to Boston weather. I called the limo service that was to bring me home, to alert them to the latest delay and my need to go through baggage claim, and found out that I now couldn’t get a ride until 10:30. I called Al, and he said he’d come and pick me up.

All through this, I was trying to be philosophical. Really, this was no one’s fault. Bad weather is bad weather, and it was safer to leave later. As long as this flight crew didn’t time out, we’d be okay. But the process of waiting was just, well, draining. The airport was crowded. The food options were overpriced and not very good. Everyone sat around with their noses in their smartphones or laptops (myself included). There was some minimal esprit de corps, snippets of conversations, but mostly a sense of soldiering on. Really, everyone knows air travel will be just a royal pain of delays, screwed up plans and stress. We’ve all lowered our expectations, and unless you can afford first class seats and amenities, the pretense of a pleasant flight is only that—a pretense.

Once in the air, I immersed myself in Patti Smith’s exquisite memoir M Train, which proved the perfect escape from all the aggravations of air travel—until we hit some serious turbulence approaching Logan. I had no idea how bad the weather was until then. Lightening flashed in distant clouds. Otherwise, you couldn’t see a thing. The pilot directed the flight attendants to go to their jump-seats. They asked us to wake fellow passengers as we began our final decent, because they could not walk the aisles.

It was a relief to land safely. As we taxied to our gate at Logan, through the pouring rain, one of the flight attendants made the obligatory announcement that she hoped we had enjoyed our flight. Really? I looked at one of my seat mates, and we both chuckled. It would have been so much more honest if she’d simply said what we were all thinking—glad we made it.

Fortunately, Al arrived safely at the airport, just as I was heading to the baggage claim. The rain eased as we drove farther west on the Pike—a good thing, because only hours earlier, downtown streets in our city were severely flooded.

Needless to say, it was great to get home. Over the weekend, I received an email asking me to rate my travel experience. I’m still considering how to respond.

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: Josh Sorenson

Resilience

Eight days after a bomb shook the Chelsea neighborhood of lower Manhattan, I am in NYC on a business trip, staying in a hotel just a few blocks from where the explosion rocked W 23rd Street. You would never know anything had happened.

I arrived here Sunday afternoon, to be fully rested for a long day of meetings on Monday. I was tired from the train ride, but I didn’t want to lose the day, sunny and clear, with a hint of fall in the air. So I took a long walk to visit to the new Whitney Museum and catch the last day of a powerful retrospective exhibit by photographer Danny Lyon. After a lovely dinner, I walked the High Line back up to 23rd and across 5th Avenue to the east side of Manhattan, passing the site of the explosion without even noticing anything unusual.

New Yorkers are hardy folk. It was incredibly reassuring, after all the horrible headlines, to see how life goes on as normal here. People were out walking their dogs, going on dates, hanging out with friends, taking selfies, eating in restaurants, smoking cigarettes, sitting on benches while immersed in deep conversations. Two men sang their hearts out, busking for the High Line crowd. I passed a man sleeping on the sidewalk. Next to his head, someone had placed a bottle of water and a fresh sandwich wrapped in cellophane.

I must have walked at least four miles, down to the museum and back. Any tension I felt when I set out in the afternoon had completely vanished by the time I returned to my room, a little after eight. There is much more to life than what is filtered through the news. So, come along with me and enjoy the view. . . .

img_2415

img_2419-4

img_2420

img_2424

img_2427

img_2430

img_2429-2

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.

Vacation Override

It’s been a very busy few weeks since the beginning of July. Al and I leave soon for our first-ever trip to Italy, and to prepare, I’ve been drilling through a month’s work of client projects in 10 days. Usually I pace myself very carefully and keep most evenings and weekends free of work—to manage my energy and keep a good work-life balance. But freelancers don’t get paid vacations, so late hours were necessary to make sure I met my clients’ needs and our family budget for the rest of July.

pills-1417417-639x462Now it’s done, and I have to concentrate on final trip preparations. (It’s probably been good to have had so much work to do—a distraction from inevitable nervousness about how I’ll hold up during a long haul trip.) Tops on the priority list is making sure I have enough of my prescription medication to last the journey.

Only one problem: the timing of my most recent refills works out to being a few pills short for when we’re out of the country. Three prescriptions were affected. So last Friday, I went to my pharmacy and asked what to do. They advised me to call my health plan’s pharmacy and ask about a vacation override. Since we would be abroad, there was a good chance I could get the refills authorized.

Monday morning I called CVS Caremark and explained the situation. The helpful person on the other end of the line told me to submit the refills at the pharmacy, which would be rejected as a premature request, and then have the pharmacy call them for the override, which, fortunately, our plan covers. So after I finally finished all my work, I went down to my local CVS on Monday afternoon.

And here’s where the situation got complicated. Two of the three scrips got through the process without a hitch. But a third hit a snag. For whatever reason, the insurer suddenly decided I needed a prior authorization for this particular medication, not only to get the vacation override, but also to get any refill for a med I’ve had authorized for years. It made absolutely no sense.

But this is how health insurance works these days.

So back home I went and wrote an email to my BMC rheumatologist’s nurse who handles refills and rescued me from yet another refill emergency last week—when I tried to refill an essential medication, I was suddenly told that I was correct that refills remained on the scrip, but, unbeknownst to me, despite checking last month, the scrip had expired. Unbelievable. She worked her magic and the prescription was on its way from a specialty pharmacy that afternoon. It arrived on time on Saturday.

No way to know if we’ll be able to get through the prior authorization process for this med before we leave, but if anyone can make it happen, she can. And if it takes longer than I can wait, I’ll just have to skip a few doses every other day at the end of the trip. Certainly not ideal, but not life threatening, either. Fortunately. This is a pill that helps my hand circulation, but we’ll be in a warm climate, anyway.

Time to get packing. I’ll be taking a vacation from this blog for a few weeks, too. I wish you, Dear Reader, a lovely, restful deep summer (north of the equator—to those of you down under, I hope your winter isn’t harsh). Be well.

Image Credit: Cathy Kaplan

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.

Come Sail Away

Last Tuesday, I was living on a boat. A sailing yacht, to be specific, harbored in a marina in Oakland, California. We were on the West Coast this past Memorial Day weekend for my niece’s wedding, and Al and I had extended our stay by a few days to do some touring.

We found the boat through Air B&B, which has become my favorite resource for traveling. Forget hotels. You can find some really special places, save money and meet really interesting people.

IMG_0561For the first three days of our trip, we stayed in a lovely apartment in Oakland, not far from Jack London Square, a convenient BART stop and the ferry to San Francisco. That was a perfect location for getting to the wonderful wedding, which took place amidst a cathedral-like grove of redwoods at the UC Berkley Botanical Garden, Saturday night.

The next day, Al and I moved on to the sailboat, which had been lovingly restored by our host. A British expat, he had lived all around the world, ended up in Oakland by a series of events that started with not being able to bring a puppy back to England without quarantining his pet for six months, and eventually bought the boat from another sailor who had intended to take it on a worldwide journey, but had given up his dream when his marriage fell apart.

Our host showed us the before and after pictures—from a nicotine-stained, trash-filled (literally—tons of trash) hulk, he had transformed it to its current pristine state. The living quarters (I’m sure there’s a sailing term for it that I don’t know) are finished with teak. The sails are made of classic, brick-colored canvas.

The marina was very calm, and our floating home rocked gently. Al never noticed it, though I continued to feel the boat’s movement even when we were on dry land. But it didn’t bother me (contrary to my experience with whale watching back in April).

What struck me most about the boat, however, was how it forces you to be mindful—of space, of water use, of storage. Close quarters required me to step carefully. Once I learned the ship’s contours (and banged my shin a couple of times), I could get around and up and down the ladder to the deck quite easily.

I figured out all the wooden latches for the closets and the trick to opening the bureau drawers (all this was built into the walls), which, to my amazement, did not fight my fingers. I even learned how to take a hand-held shower in the little bathroom. And all three nights, we slept soundly in the cozy bed built into the cabin at the boat’s bow.

But the best part of our stay was the morning we chartered our floating home for a sail around the Bay with our host and a mate. Our host is a very experienced sailor, as well as a great conversationalist, and he was more than happy to answer all of my questions about the art of sailing, in-between raising and lowering the sails, tacking, coming about, and skillfully avoiding other boats whose pilots knew less about rules of the waterways.

As we neared the island of Alcatraz, the wind was stiff and the water quite choppy. But even as we got splashed, sailing at nearly a 45 degree angle, it was a treat. There is something magical about being powered only by the wind, gliding past a sea lion bobbing in the water as pelicans sail overhead.

Our host let us off at one of the piers along San Francisco’s waterfront, and we went on our way, exploring the city. When we returned to our sailboat later that evening, I felt like I was coming home to an old friend.

We were sorry to leave. The one consolation was our plan for July, when we venture to Italy for the first time. No boats for lodgings, but so long as we both stay healthy enough to travel, we’re ready for more adventures. Once the travel bug bites, there’s no turning back.

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.

Swell

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.