“Scleroderma,” the rheumatologist said after examining my stiff swollen arms and legs. “Unfortunately, given your biomarkers, it’s likely to get worse before it gets better, but you never know.” She gave a quick rundown of what I might expect—rapidly progressive skin and joint tightening, GI symptoms, high likelihood of multi-organ involvement…. “Let’s hope for the best.” She paused, then asked if I had any questions.