Scleroderma Awareness Month

 

Year-round, researchers are gaining ground in the fight against scleroderma.  Doctors who have studied scleroderma and have extensive experience treating patients, are traveling all over the  world to teach doctors, and medical students.  Patients are gathering in support groups to learn about scleroderma, and share ways they cope.  There is much being done, and all of this needs funding.  All of the activities I just listed, are supported by donations, grants and volunteers.  Every June, we unite to support the research, education and patient assistance.  We share memes, we wear teal, write letters to the editor and/or  we gather in parks and walk to raise funds for research of scleroderma.

So if you stop reading this post here, you have read the most important part of it.  Thank you 🙂

I started writing about my journey with scleroderma and sarcoidosis, with a blog called Scleroderma, Sarcoidosis and Box Wine.  I changed the name to The Mighty Turtle in 2012, for easier name recognition. (I know fellow patients can relate.) Since that time, I have had experiences both good and bad.

Back to being sick and tired of writing about being sick and tired…  So here we are, starting a month of Facebook, Instagram and Twitter, flooded with teal, along with the colors of other diseases.  Look, there are just not enough colors in the rainbow for diseases that are rare, not-so-rare and uncured.  In spite of my frustration, I look forward to reading posts, and seeing pictures of fellow patients.  I look forward stories of hope, memorium, and humor where we can find it.

You might be thinking two questions:  ”

1.  Karen, how can I possibly laugh at a time like this?

2.  Are you high?

The answer to your first question is that at the most serious of times, I have found a way to find humor.  Laughter is the icebreaker to deadening silence when hope is lost, and no one is sure what to do next.  It’s not easy, for best results humor should be inappropriate, or at the very least,slightly offensive- because let’s face it, scleroderma is offensive by just being present.  On the science side, laughter also releases endorphins, and helps our brain cope with situations.  Laugh at what scares you.  It will only make you stronger.  (Go ahead, research how laughter is the best medicine.  Millions of Reader’s Digest readers can’t be wrong.)

My answer to your second question:  No, I’m not high. (As far as you know.)

I do mean it when I say I am sick of scleroderma awareness.  There are great organization making breakthroughs in treatment, and clues to a cure.  If you haven’t already, please make the time to learn about these orgs. Sponsor or share fundraisers and make a wish for a cure.  Our lives depend on it.  Thank you.

 

Scleroderma: Part of The Adventure

Three children and a woman.

I recently announced my scleroderma may be in remission.  According to Merriam Webster,  remission (is)  a period of time during a serious illness when the patient’s health improves.

Remission was my word, not my doctor’s.  I have also heard from other patients who will not use remission as well.  The general consensus is, although the definition of remission does fit, and it doesn’t say permanent or temporary, remission is accepted as ceasing of the symptoms.  It fits when referring to cancer.  The cancer is somehow eradicated by treatment, and while in remission, patients do not experience symptoms of cancer.  The difference with scleroderma is, that scleroderma may run it’s course, or symptoms may be controlled by medication, but blood work, and symptoms show scleroderma is present.  The best term I have heard so far in reference to this is referred to as a “holding pattern” by patients and their doctors.

For me to say that I may be in remission is incorrect.  Symptoms will flare.  I will still have good and bad days.  When I spoke with my doctor I was elated that I may have lived long enough to be through the worst of scleroderma, I threw around the word remission, carelessly.  I apologize to you, who are kind enough to read my work regularly, and new patients looking for information.  I was talking about scleroderma incorrectly, and  I am s very sorry.  Of course, I still have sarcoidosis, but it’s symptoms are very mild for me.  I write more about scleroderma, because it’s just more aggressive in me than sarcoidosis.

I was very swept up in the possibility.  One of my best and worst coping mechanisms, is denial.  Like all patients with a chronic illness, I do not want to be sick, labeled as sick or live my life as if scleroderma defines me.  It works well for me, until I get swept up, as I did with the word, “remission”.

The last few weeks, I have been working through depression.  It is something that affects me more than scleroderma, in body and mind.  Scleroderma is a life-long commitment no one volunteers for, but we can choose how we cope with it.  A friend of mind gave me a name for my technique, he told me I am like Lt. Dan, from Forrest Gump.  I liked that comparison because it felt like it rang true.  Like Lt. Dan, I am angry about what life has handed me.  I never ever want to be referred to as handicapped or disabled, and don’t get me started with God.  I of course will not climb up on a shrimp boat mast and curse God during a hurricane, but I am certainly not going to worship God or pray.  (That’s a whole other post.)  For me, accepting scleroderma will always be a part of my life is a sore spot, but I do it.  That may be why I have a great deal of patience with everything else. Traffic or long lines seem like minor things, and a waste of time to get angry about, because eventually a long line will move.

Scleroderma has taught me to live in the now.  I am not in remission.  I may be in a holding pattern, but I will need infusions and medication for the rest of my life- and it will not be cut short.  That may seem unrealistic, but to me that is one thing that is not.  Scleroderma, childbirth and a severe head injury have thrown a lot at me these past 43 years.  I have a lot of life left, and there is treatment for my symptoms.  I will continue to work hard to stay healthy, which we all need to do, scleroderma or not.   I have not yet reached mid-life.  I have a ten year old son, and I plan to see him walk on Mars, and meet his children.  Life is full of obstacles. I choose to make obstacles, part of the adventure.

Thank You, Queen Latifah. That Was A Perfect Amount of Scleroderma

When it was announced Queen Latifah would be talking about her mom’s diagnosis about scleroderma on her show, I was skeptical.  First, I’m going to tell you why I liked it, hoping she will read it or someone will tell her about it.

 

Scleroderma does not only devastate the patient.  I have watched my family, watch me go through procedures, unknown prognoses and loss of abilities.  I see how scleroderma hurts their heart and soul.  I comment Queen Latifah for keeping the news to herself, and focusing on her family, especially her mom.  And if you are reading this post, Queen Latifah, thank you for not only sharing with your audience and the world about scleroderma; thank you for showing them that as hard as it may be, there is more to you and your mom than scleroderma.

 

Now, what I loved about her segment:

 

It was short.  She relayed a heart-felt message and went forward with her show.

 

She  said, “There is treatment.”  The last 20 years, every time scleroderma is mentioned, there are real pictures of people with scleroderma enduring the most painful, awful parts- not that it is bad- but because there is treatment, I believe damage can be prevented.  So often, patients with scleroderma are portrayed as victims with no hope.  And yes, I’m a realist, I know that no hop can be very real for many patient with scleroderma, but we need to stop that and create hope.  For example, when my hands were cur;ling, I was received occupational therapy once a week that helped me manage pain and keep range of motion.  When I moved, and got a new occupational therapist, she informed me I was not worth the funds required to keep me moving and I should just sit back and face my fate.  I will never know if I could have maintained my hands, because she never gave me a chance.  Currently, I have scarring in my lungs from pulmonary fibrosis.  Doctors believe that exercise is helping my lungs work better.  Luckily, I can exercise my lungs and I don’t need assistance, like I needed with my hands.

 

Look, as a patient, I don’t need a long segment about the worst of scleroderma.  It will get the channel changed.  Let’s face it, we are a shiny, “happy” culture that has the power to shut off the ugly in life.  Scleroderma is not rainbows and unicorns.  Queen Latifah gave an effective message, mentioned that it could be treated and gave her audience a place to find more information.

 

Queen Latifah’s mom is fighting for her life.  How she did her message was perfect.  No one should be expected to speak through tears on camera.  Thank you Queen Latifah, for sharing a piece of your journey and  making scleroderma a topic of conversation around the world.

Harold Ramis Died Today. Here’s Why This Matters To Me.

Early Monday morning, we lost one of the greats.  I grew up in the 80’s.  I spent many days after school and during my summers watching movies by Harold Ramis.  I had a major crush on him and Bill Murray in Stripes.  My dad once told me when he heard I was going in the Navy, he thought of me as Private Benjamin, but I thought myself more like the characters John and Russell, played by Bill Murray and Harold Ramis, respectively,  in the movie Stripes.

 

I was not the type to wish for a manicure and lunch.  Yes, I was a manicurist, but before I started beauty school at age 16, the only manicurist I pictured was the one Bugs Bunny played in that great cartoon with the orange monster.    Yes, I once aspired to be a hairdresser, but that was not for me because I could not roll a perm.  So, I chose to skip the hair and go straight to the nail license.  But I still wanted more.

 

 

 

 

While in beauty school, I loved learning about the different combinations of chemicals and how they worked together on a molecular level, so I looked into starting my general education requirements toward some kind of science degree.

 

 

 

 

Back when I was in the 4th grade, I wanted to be a doctor, but was told I could not be, because I had no penis. It was 1981 and I was seriously misinformed, but part of a large Italian family where women were groomed to think popping out a few kids and marrying a man who will take care of you, to be a life goal.  It never sat well with me.  In the 7th grade, I discovered my grandmother’s typewriter.  Back then, they had typing classes and a lot of my writing started out as typing drills, but even before that I wrote short stories.  My favorite author at the time was Stephen King (Pre IT.)  My writing was pretty dark and it got darker in my teens.  I didn’t share it with any one.  I was afraid of being laughed at.

 

I repeated the 8th grade and found I had a love for performing live theatre.  I was in a play about pirates.  The whole drama class wrote it. We did the script, made our own costumes and  I had a pretty big part.  I was kidnapped by pirates.  I had a big scene where I screamed on stage and was chased by pirates through our school’s multipurpose room.  It was the biggest thing I had done in my young life- not bigger than holding my younger sister and brother on their way home from the hospital.  (it was the 70’s) So it was the third most important thing I had done.  And my dad took pictures of everything.  I was so excited that my big theatrical moment would be recorded forever on Kodak Paper.  But my dad forgot to bring his camera.

“Convicted?  No, never convicted.”

 

I don’t know if that was a turning point for me, but I did go back to smoking the sweet stinky weed that got me held back to repeat the 8th grade. So,  I went back to smoking copious amounts of pot, but very briefly. I quit  in 9th grade, after I met the most wonderful teacher I would ever meet.  Sure, there

were some great teachers, but Mr. Hoctor, well, he made me want to show up to school.  I would actually ditch other classes to sit in on his other classes.  He’s retired now.  His classes made me want to be a better me. In one class, I did a scene from Annie Hall with this really cute guy I had a secret crush on and got to kiss during rehearsal and on stage.   I had to kill a spider- the size of a Buick, for his neurotic character.  I had so much fun, I wanted more.  Then Mr. Hoctor did a class trip to see Second City perform.  Leaving the theatre, I thought, “I want to do that.”

 

I wanted to do what they did on stage.  I had no idea how, but it’s what I wanted to do.  Mr. Hoctor began teaching improvisation and a show was created.  I tried out for it and got a part as one of the players.  I was so excited, but then, I let my head get in the way.  I eventually dropped out, claiming stage fright before opening night.  I have to say not only was that a douchetastic move by me to to my fellow actors and my drama teacher,  I also hurt myself the most buy not believing in myself.

 

So buried myself in other goals.  I finished ROP classes to get my manicurist license, graduated high school one year early (or on time if you don’t count the being held back part) and tried to be a responsible adult.  I realized I did not want to be a manicurist forever and looked to college.  That’s why I joined the Navy.  I wanted to “get out of Dodge” and earn money for college.  A friend of mine recently earned his B.S. in biology and I wanted to earn my B.S.  I was sure what science, I just knew that I loved science in general, but more than anything, I wanted to have the initials B.S. after my name.  So, I joined the Navy.

 

I finished up my “hitch”, got out got diagnosed with scleroderma, then sarcoidosis.  I spent my mid twenties up until now, in doctor’s offices and hospitals.  Sure, I worked as much as I could, but my “career” title was really: Professional patient. Yes, I could be called professional because the Veteran’s Administration paid me a pension because I am 100% service connected.  -and yes, that is a whole other post.

 

My point?  Decades after I first saw the movies Stripes, Animal House, Caddyshack and Ghostbusters- they are still my go to movies.  I spent lots of time in hospitals, on bed rest or just plain alone, in excruciating pain no doctor understood or knew how to treat for 16 years.  Lines from these movies inspired me to make fun of my pain.  My high school drama teacher inspired me to customize my speech therapy to songs and exercises, and be fearless about singing.  I probably can’t carry a tune in a bucket, but Mr. Hoctor once told our class:  Anyone can sing, you just have to commit to it.  So, I sing in the shower, in my car and take amazing chances endangering anyone within earshot.  Except for my son, who thinks I have a beautiful voice. And really, his ears are the ones that matter most.

 

Today, I read that Harold Ramis had an autoimmune disease.  I never knew that.  Harold Ramis will not be remembered for his illness.  He will be remembered for the great joy and laughter he brought to millions.  For me, it was very personal.  I never met the guy, I just loved his work.  It inspired my sense of humor.  Today, he inspired me to be remembered not for my illness, but the joy I want to bring others with laughter.  I love to write.  I also love to stand in front of a group of people and see if I can make them laugh.

 

I want to get people to stop paying attention to the way my hands look and hear what I have to say.  I want to make them laugh and forget themselves.  I want to be so good at it,  they forget about my hands and allow me to make them laugh.  I want to be remembered the way Harold Ramis will be remembered; for the way he made people forget themselves, enjoy their day, and just laugh and be happy, if only while I had their attention.

 

I owe so much to Harold Ramis and my high school drama teacher, Mr. Hoctor.  I couldn’t write this without mentioning my drama teacher. He planted so many seeds.  Harold Ramis’ work, prepared the soil.  It only took me 25 years to water the garden.  I also feel very fortunate to have parents with a pretty cool video library, and friends with the same great taste in movies.

 

 

 

 

Thank you for reading.  Now please, go watch a Harold Ramis Movie and have yourself a good laugh!

 

Back To The Beginning, Again. An update about my exercise activity with scleroderma.

This a follow up to a post I wrote in 2012.  I almost started fixing typos, but realized what it really needed,  was an update.  I have sarcoidosis in addition to scleroderma, but sarcoidosis is contained with medication.  There was a great deal of damage done to my body, including my lungs that are scarred, known as pulmonary fibrosis.  


Lesson Learned.

After spending 45 days in the hospital to save my foot, I am now faced with the challenge of returning to exercise on a routine basis.  As much as I would like to go back to Krav Maga class, this will not be happening anytime in the near future.  I blame the horrid infection of my foot on just thinking about training for a 5k.  All kidding aside, the infection was bound to occur, but it may have been prevented from such a drastic course with proper shoes.  I thought because I was feeling so great, I could take a chance and wear something more stylish.  That was my mistake.   Now, I have this wonderful reminder to not push that good feeling.  Message received, Universe.  Message received.  (You can’t see this, but I just looked at the sky, raised my hand, and impotently shook my fist in rage.)

 

 

Back to one, deep breath

One of my biggest lessons, of many from this past hospital stay is there is no such thing as a last chance for me.  I changed my way of thinking of my hospital stays.  I have always understood that they will be part of my life, but when I would leave, I would think, “This stay will be the last time.”

 

This time, I had enough time to realize that there were so many things I could not anticipate, that I cannot think of any time in the hospital as my last time, and my recovery my last chance.  Yes, after 20 years I understand that I will get knocked down, but I’ll get up again.

 

Hope helps, but knowing I’m going to recover helps more, because it’s not a matter of “if” it’s “when” I feel better.

Of course I cannot predict the future, but I can have a positive outlook.  Not unrealistic, just more than hopeful.   never hope I’m going to get well.  I know I am going to get well.  And even though we never really “know” everything, it doesn’t hurt to act as if I will have a full recovery.  People would say to me  “I hope this gets better for you.”  My reply was usually, “I know it will get better.”

 

Positive thinking helps, but I must do the work it requires to get better.  There is nothing wrong with being stubborn, and I am living proof.

 

So, about the exercise…

I’m working with a trainer to build my strength from the inside out.  Along with strengthening the large muscles, I must work on the small ones as well, especially my core and upper body. Right now, I am using light weights and rubber bands.  These exercises may look small, but I can feel he work I’m doing.  The exercises I do are no impact where my feet are concerned, and since I have lots of work to do on my core, there is plenty to keep me busy until I can do a full plank again.

 

It’s not easy, it probably won’t be the last time I need to restart, but starting again is so worth it.

Paraffin and Scleroderma: Comments on an article about scleroderma.

There is an article about a woman with scleroderma in the United Kingdom all over Facebook and too many social networks to list here. I have a few comments to make. Her methods of skin care work for her and kudos to her for having the time and resources to have a full body paraffin bath every day, but I have a few comments and some alternatives.

picture of oils for skin moisturizing in various   containers

Oil feels nice, but the type of oil used may create more work.
Applying oil can appear to be helpful, but many oil based products only coat, and do not penetrate to moisturize skin, especially petroleum based products. As someone who has used olive oil, Kama Sutra oil and too many moisturizers to name here, I can say honestly that oil coats the skin, leaves marks everywhere and leaves (me, it may vary for others) a dry skin surface in about 15 minutes. Many products claim to have “essential oils”, but if they come in a plastic container, they are not true essential oils.

Undiluted essential oils should  only be stored in glass containers, because a true essential oil will may break down the plastic. The right essential oil can  nourish moisture starved skin because it will penetrate, not coat.  Essential oils can appear more expensive, but you need less of the product.  To find the best essential oil for you, don’t be shy about asking for samples or asking for a low priced sample to take home and try a few days.

Essential oils are not your only option.
A great non-petroleum based cream or lotion works well if you can find one.  I have had great luck with Aveeno Moisturizing cream oil with sweet almond oil and Eucerin.  Currently, I use Votre Vu’s Snap Dragon on my body and their hand cream Duette for my hands because I love it, and I sell it (for full disclosure) so I get a great deal on it.    If you have something that works, don’t go searching for an essential oil.  (If it ain’t broke, don’t fix it.)

Ahhh, Paraffin.  It is nice…
Paraffin does work, but as a full body bath, the first thing I thought, (okay, second thing I thought…)  was this sounds wonderful, but is an unrealistic and expensive option for most scleroderma patients.  A simple hot bath with immediate application of a non-petroleum based moisturizer while wet, followed by stretching or assisted yoga (after drying off and dressed of course) will provide the same benefits.  A hot bath will warm the muscles, making them easier to move, which is the objective of the paraffin bath.  When I first started exercising again in 2005, I would take a shower before and after.  Warming up those muscles before warming up, is good for body and mind.

The professional manicurist in me speaks up: 
I have been working with paraffin since 1987. First as a manicurist, then as a scleroderma patient. A full body bath in paraffin really does sound awesome, but I would like to offer an alternative for 2 reasons.

1. Patients with raynaud’s have a bigger risk for burns with paraffin. If one with raynaud’s were to place their hands in a paraffin bath that was even slightly too hot, it can cause tissue damage to the extremity, going from extremely cold to hot. And because of impaired temperature sensation, a raynaud’s patient may not be able to detect the bath is too hot. Thermometors can fail.

2. Open sores. One must never use paraffin if there are any wounds because of risk of infection.

Tips for using a parrafin bath for patients with Raynaud’s:

1. Place hand in plastic paraffin bag, then dip bag into paraffin.

2. Scoop hot wax with hand using the bag as a barrier between hand, then turn bag inside out when removing from paraffin wax. (This will take practice. Don’t be discouraged by a little mess)

3. Now, you have a bag of wax and you can feel how hot the wax is through the plastic. Use your forearm or wrist to touch the outside of the bag to feel how hot the wax inside the bag is. If it is too hot for your forearm it is too hot for your hands, feet or whatever it is you are placing in the wax.

4. Once the wax feel cool enough to tolerate COMFORTABLY, place your hand inside the bag.

Never, EVER use paraffin wax when you have an open wound or pressure sore.  Yes, even a paper cut.  Don’t make me show you pictures of infected wounds- it’s nasty!

For more information:

Medscape detailed article: Musculoskeletal rehabilitation in the person with scleroderma.

Pub Med Abstract: Musculoskeletal rehabilitation in the person with scleroderma

Raynaud’s Risks and Prevention

The Scleroderma Society

Tips for Living with Scleroderma, by Scleroderma Research Foundation

To help fund research for scleroderma, visit: Bounce to a Cure

FAQ for Raynaud’s by The Raynaud’s Association

Handy Hints for Raynaud’s by Raynaud’s & Scleroderma Association, UK

Visit The Mighty Turtle on Facebook for more scleroderma organizations.

 

My Letter to Congress to Urge Funds for Scleroderma Research

Picture of the White House

This is just one thing I did this morning, which took about 10 minutes. Okay- probably 20, I’m a slow typist.

Here was the reply I received in my email. I omitted personal information to post to this blog, like my address, etc…

To get started now, click HERE

Here is the response I received and a copy of my letter:

Your Letter to the President and Congress

 

Karen, thanks for taking action on behalf of Petition2Congress. Your messages are on the way.

 

An individual copy of your letter will be sent to each official:

 

August 7, 2013

 

Dear President Obama,

Dear Representative Lowenthal,

Dear Senator Boxer,

Dear Senator Feinstein,

I was diagnosed with scleroderma at age 23 by the Veteran’s Hospital in Madison Wisconsin after having symptoms in the Navy. I am still here because I had access to healthcare and treatment I often had to fight a male-centric healthcare system. The VA has improved the treatment  f female veterans exponentially. However, there are many patients who are not getting the proper diagnosis and treatment I was able to receive. This need to change. It starts with research, and we have lots of work to do. You will be hearing more from me at TheMightyTurtle.com & a page I started to introduce the possibility of surviving scleroderma: Unstoppable Me: https://www.facebook.com/pages/Unstoppable-Me-Karen-Vasquez/217918321693555

 

Loma Linda VA is overcrowded, like many VA’s across the country. I recently relocated to be closer to a VA that could help me manage my care in Long Beach, California. Not every patient has the luxury to be able to move where there is not only a great medical facility, but family and friends nearby.

 

One thing I have learned and has been found in research, is that many diseases have similar symptoms and research of other diseases has led to effective treatment of different diseases. For example, I also have sarcoidosis. I was diagnosed in 2007 after fighting doctors to do further tests to determine my symptoms were not just scleroderma. After my diagnosis of sarcoidosis, I was prescribed Remicade, normally a treatment for rheumatoid arthritis. My symptoms are now under control and I appear to be in remission with medication. I also take viagra 4 times a day, which was originally designed for infants with pulmonary arterial hypertension. I was the very first female at the Loma Linda VA to be dispensed Viagra. Getting Viagra did not come without a fight and months of waiting. Many patients do not have time to wait for approval and are dying as a result.

 

I urge you help. People are dying simply because they lack money and resources.

 

Thank you,

 

Karen Vasquez

 

And now, the formatted letter:

 

Congress, please support this Petition by directing the National Institute of Arthritis and Musculoskeletal and Skin Diseases at the National Institutes of Health to expand research related to scleroderma, development and evaluation of new treatments, research on the relationship between scleroderma and secondary conditions including: pulmonary hypertension, gastroparesis, Raynaud’s phenomenon, and Sjögren’s syndrome. Establishment of family and “childhood-onset” patient registries. Support for the training of new investigators. Direct the Centers for Disease Control and Prevention to establish a scleroderma public awareness campaign highlighting disease symptoms, prevalence, related conditions, and the importance of early diagnosis.

 

This Petition is very important to patients and family members living with Scleroderma. Thank you in advance for your consideration of this Petition.

 

Sincerely,

 

Ms. Karen Vasquez

Long Beach, Ca

 

You can still also have your letters printed and hand-delivered to each official for just $3 each.

 

Thanks again for taking action, and keep this email for your records.

 

Also, be sure to visit http://www.petition2congress.com/ for more important action items.

 

 

 

Help Spread the Call-to-Action: Tweet This

 

Bounce to a Cure for Scleroderma

Man ding trick on a pogo stick

Last year, James Roumeliotis, founder of Bounce to a Cure made it into the Guinness Book Of World Records for The farthest Distance Traveled on a Pogo Stick.  Watch this inspiring video with highlights from James’ Journey through Pogopalooza’s Park at The OC Fair in Costa Mesa.

This year, James will attempt to break another world record at Pogopalooza 10 in New York.  I will be cheering him on from California and sharing about his progress.  Please visit and like Bounce to a Cure’s Facebook page & like and if you are twitter, you can find him @BouncetoaCure.  He is using his talent to help scleroderma patients by raising awareness and funds for scleroderma research, for the Scleroderma Research Foundation.

I admire James and I am so honored to be working with him to help spread the word!

Visit his website, Bounce to a Cure.  He’s working with some partners you might recognize.  I don’t want to give too much away, but you may see a turtle there…

Exercise, Scleroderma and Krav Maga

I look like I’m smiling- that’s the scleroderma mouth thing- she is really pulling my hair. Don’t let our petite frames fool you:  Dynamite comes in small packages.  Photo: Jennifer Jones 

 

I made a video last night after Krav Maga Class.  Short story long: I injure myself more doing daily activities, than when I exercise or train with the supervision of a professional.

 

When my range of motion was lost, I had to relearn simple things like sitting on the floor and getting back up.  It’s a long list and as I become more active, I run into some activity I need to trouble shoot to perform.  Luckily, there are people who are trained to help!

I made a video. Yep, this picture has nothing to do with the content of the video. I just thought a picture with my dog would help me get more viewers. This video is about exercise. I exercise so my lungs keep moving, and my whole body is strong enough to take whatever else scleroderma and sarcoidosis throw at me.

Watch:

Avoid Injury While Exercising by Working with Professionals

 

 

 

Scleroderma Is Not ‘Just A Skin Condition’

 

I recently spoke with a customer service representative at the Social Security Office.  She is tasked with asking questions, and making recommendations for the person seeking help.  So, I did a little research.

Today, I read an article by Agency for Healthcare Research and Quality.  They presented 5 steps to take after diagnosis.  As a patient with scleroderma for 20 years, and diagnosed with sarcoidosis after years of symptoms, these steps sound very nice, but are a bit unrealistic.  Don’t get me wrong, these are great ideas in a perfect world, but the world of healthcare in the United States is far from perfect.  So, I’m going to comment on each step.  Please Note:  This is entirely opinion based on my experience.  If you find my comments useful to keep going, and not be deterred, awesome.  If you would like to tell me to go to hell, awesome.  Let me have it in the comments section.  I make some comments in this post that may incite retaliation.  I’m okay with that.

If you have healthcare where you are never denied a test or medication, this is the perfect plan.  The following steps are verbatim from The Agency for Healthcare Research and Quality.  My comments are in italics.  

Step 1: Take the time you need. Do not rush important decisions about your health. In most cases, you will have time to carefully examine your options and decide what is best for you.
– In 1994, there were very few treatment options for scleroderma.  I was given a leaflet and a nifedipine prescription and sent on my way.  My choice was to quit nursing school based on no information, move back to California from Wisconsin and get lots of rest, or stick with nursing school with no idea what to expect.  It took two years to get diagnosed with scleroderma.   Luckily, I was in the Navy for one year and half of that time.  I did not miss a paycheck because I needed to stay home sick or go to a doctor.  How would that work for someone else with no job, because they called in sick so many times while trying to get diagnosed with weird symptoms like blue hands, swelling and nerve pain.  Sure, my diagnosis was 20 years ago, a lot has changed because of research, but people in remote areas are having trouble getting the right diagnosis and care.  Just do a google search of scleroderma blogs and you will read how patients are trying to get a diagnosis or care, or getting denied disability benefits because they do not have the proper diagnosis yet, because their doctor is unfamiliar with scleroderma and thinks it’s ‘just a skin disease’.  In a recent conversation with a representative of Social Security researching adaptations for patients with scleroderma, she asked, “Why would someone with scleroderma need adaptations?  It’s a skin condition.”  I explained to her that scleroderma was not.  She was very receptive to the information I provided her, but she is one of many, who are trained to speak with people in need of life saving benefits and she thought Scleroderma was a skin condition.  We have lots of work to do! 

Step 2: Get the support you need. Look for support from family and friends, people who are going through the same thing you are, and those who have “been there.” They can help you cope with your situation and make informed decisions.

Lovely.  In a perfect word where family and friends understand that a chronic illness cannot be seen, this is a great idea.  The truth is, many patients suffer for years before diagnosis, because they feel crazy telling people they trust their symptoms and they are met with responses we have all seen in memes all over the internet.  Oh, where to begin!  Here are a few:
1.  You don’t look sick.  Check out The Spoon Theory by Christine Miserandino. It’s a great post about “Not looking sick”
2.  It’s all in your head.
3.  You need to exercise more.
4.  Then, there is the gossip some experience:  She’s a hypochondriac.
5.  Scleroderma sounds like a skin condition.  It’s in the name, so it must not be serious.
Okay, enough of that, you get my point.  First, we have to explain what scleroderma is to our family, while we try to grasp what it is, without panicking during every search on Google because people post wort-case to get attention for awareness.  I can’t blame them for trying, but it leaves little hope to newly diagnosed patients.  More and more patients are surviving scleroderma, but only those who have access to the best healthcare and educated providers.  

Step 3: Talk with your doctor. Good communication with your doctor can help you feel more satisfied with the care you receive. Research shows it can even have a positive effect on things such as symptoms and pain. Getting a “second opinion” may help you feel more confident about your care.

Speaking of doctors… When I moved to Murrieta, doctors here had only heard of scleroderma.  They mistook my syptoms of sarcoidosis for scleroderma symptoms because they knew nothing about sarcoidosis or scleroderma.  First, a patient has to find a doctor willing to do more than give the diagnosis and “wait and see”.  Make sure you are seeing the right specialist, a rheumatologist.  Not to mention getting baseline tests of lungs, heart and upper GI.  Now, if you are newly diagnosed, have a full time job and have “Golden Insurance”, this is not a problem.  I have a request: If you have an experience to share, share it in comments to encourage other patients not to give up.  This is a journey riddled with roadblocks by people paid to keep cost down.  We have to become our own best advocate.  And by we, I mean you who are reading it who are frustrated.  I have to drive 2 hours one way to get the proper treatment for my hands.  It sucks, but it is what it is.  I bring my dog and stop at the beach after.  I do it because since 1999, OTs at two nearby Veteran’s Hospitals would not work on my hands.  I was told I was a lost cause.  Since stopping the OT I received through the Wisconsin Veteran’s Healthcare System, my hands have since atrophied and now we are working to get some range back.  

Step 4: Seek out information. When learning about your health problem and its treatment, look for information that is based on a careful review of the latest scientific findings published in medical journals.

Visit at a hospital, or medical school library and ask the librarian for help.  Medical journals often post only abstracts of a study online, which is a short blurb about findings.  Google it without experience and it’s the perfect way to diagnose yourself into thinking you are dying.  Before you research, ask your doctor for the proper keywords and journal names.  I don’t want to deter you, I want to encourage you to find research foundations that research your specific condition.  For Scleroderma in the United States, I recommend The Scleroderma Research Foundation.   Their funds go directly to research and education.  They have one office.  As far as fundraising goes, they are nationwide.  The Scleroderma Foundation is a great place to go for support groups, education and research as well.  They have chapters all over the United States with many offices around the country.    Many are all volunteer, some have paid staff amd some are simply support groups.  They provide great services, and funds are raised for each region.  

Watch your back, Jack.  There are some online patient communities that offer counseling services without licensed counselors or ask you to donate to participate.  I am sure they do some good, but they claim to offer counseling services by unlicensed counselors.  I once worked with a former mentor (emphasis on the word former) placed plants in her closed groups in the early days.  And I have noticed there is a bot that initiates contact with people who tweet certain diseases, on behalf of my former mentor’s newly formed foundation.  But, don’t take my word for it- or anyone else’s for that matter.    If you find yourself in a group and it doesn’t feel right, go with your instincts.    If you see a group going after an individual or shuns members, that is a huge red flag. 

Step 5: Decide on a treatment plan. Work with your doctor to decide on a treatment plan that best meets your needs.

Great idea.  A treatment plan is an awesome idea!   Now the trick is to find a doctor who knows more than a thing or two about scleroderma, or your condition in your area.  You may have to travel, but it is worth it.  This is a chronic illness and your life depends on how well your care is managed.  I know scleroderma, so I will refer the two organizations I trust to help patients without requiring a donation or membership.  These organizations count on donations from people other than patients. If you pick up the phone and call these foundations, they will give you information over the phone for free.  
1.  The Scleroderma Research Foundation Contact Info and Downloads for newly  & not so newly diagnosed patients
2.  The Scleroderma Foundation  Contact info and Downloads for newly & not so newly diagnosed patients.   

Patient Communities:
Very helpful.  I recommend the following:
1.  Treatment Diaries   
Outstanding community founded by cancer survivor, Amy Ohm.  They will not ask you for money to join, and it’s a great way to connect with fellow patients.
2.  Inspire:  Another great online patient community that will not ask you for money to join.  

So, those are my comments about those 5 steps based on 20 years with scleroderma.  Many autoimmune diseases have similar symptoms to fibromyalgia, lupus, rheumatoid arthritis and drugs used to suppress the immune system for cancer treatment, like methotrexate are often used in the early stages of scleroderma.

I would like to add that If you are newly diagnosed or seeking better care because what you are doing, don’t be afraid to look at how people with other diagnoses are coping.  We share the same experiences like loss, grief, anger depression and so much more.  My diagnosis of sarcoidosis was accidental.  I went to 4 different ER’s before UCLA took my trouble breathing seriously and and did the tests  that lead to a lung and lymph node biopsy that provided the sarcoidosis diagnosis.  Until I was given Remicade because of the sarcoidosis, my symptoms were progressing of both the scleroderma & sarcoidosis.  I had to fight for the recommended Remicade and bypass 3 other medications that needed to try and fail before using remicade because of cost.  Since 2007 and receiving Remicade with Methotrexate, the pulmonary fibrosis in my lungs has stopped progressing.  Fighting for care sucks, but it’s exactly what we have to do to get what we need when someone says “no” due to cost.  If you take anything away from this post, I urge you to keep fighting.  It’s hard.   I;m not going to lie, there were times I wished for death. I would tell myself, “I wish this was over.”  Until I realized my scleroderma was not going away and over, meant death.  I made it through the worst of it.  I think it is luck I am not dead because many die from scleroderma every day.  I’m here because it was not my time.  I continue to heal and become stronger because I am my own best advocate.  There are times I put my foot in my mouth and make mistakes.

If you skipped to the end:

Advocating for yourself is on the job training, even with help.  And there is no shortage of people looking for minions for financial gain or to fulfill some messianic fantasy.  So, watch your back, Jack.  Rest between battles, because you won’t win every single one.  Somedays, your only goal needs to be to live to fight another day.  Most important, the best possible outcome may not be what you want.  It may take compromises, like giving up certain foods and activities and worst of all (at least for me) asking for help.  If you have to give things up because you can no longer do them, take time to grieve, but try not to let it consume you and it times, it might but you can crawl out of the jaws of what’s consuming you.   There are no guarantees in life, but there is hope if you look for it.    Keep looking for hope.  We all have limited time here, cherish what you get.  I never said this would be easy.  I still struggle at times, I take antidepressants, I see a psychiatrist to manage my meds for anxiety and have a checklist of depression red flags for me.   Exercise and writing are my outlets.  My happy place is time with my son.  My dogs get me out of bed every morning.  Find you tools, then fight.