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Living with Scleroderma

Reflections on the Messy Complexity of Chronicity

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Exposed

Evelyn Herwitz · September 13, 2016 · 2 Comments

For a couple of days recently, I was down to one bandaged digital ulcer—my right thumb, still healing from surgery in June. Every few years, especially when there’s been a long hot spell, this happens. I can actually see most of my fingertips, a bandage vacation.

hand-2It’s very nice while it lasts. I can get going in the morning much more quickly—a couple of minutes, instead of the usual 20, to care for my hands. But it feels very strange. The fingers that have been under wraps for months, sometimes for the entire year, are extremely sensitive to touch. My left thumb, in particular, has some nerve damage that becomes much more pronounced when it goes Full Monty. By the end of the day, it’s tingling almost constantly.

Even still, I’m amazed and glad to be able to take a break from the bandages. Careful as I am to keep my hands clean, they get grubby during the day. The bandages shred at the edges and the adhesive attracts dirt. (I only use fabric bandages, which breathe and remain fairly comfortable, despite daily wear and tear.) Plus, I can’t sense exactly what I’m touching. This is the most frustrating part.

But walking around with almost bare hands can have some unexpected consequences. On one of the days when my fingers were exposed, I bought some groceries. The young cashier asked with genuine sympathy, “What happened to your hands?” I gave my standard reply about ulcers (sometimes, it’s just too much to explain about scleroderma) and went on my way. Only later did I realize that she wasn’t inquiring about all the bandages—there was just one. She was commenting on my oddly stunted fingers, misshapen by resorption of bones in my fingertips. Usually, no one can see, because of all the dressings.

Scleroderma causes a myriad of hand distortions. The oddest visual aspect of the disease, in my case, is that I barely have any fingernails left. This is actually what the cashier was asking about—it looks as if the tips of my fingers have been chopped off.

A missed opportunity for a teachable moment about this disease, certainly. At the same time, however, talking about a personal, physical disability with a casual stranger is murky territory.

My hands are strikingly different. I’ve had this disease for so many decades that I don’t really blame someone from wondering about them. The cashier was not ridiculing me. She was concerned, merely articulating what most people who meet me for the first time may be thinking.

However, I also don’t always feel like having to explain why my hands look strange. My hands are my hands, they are the only hands I have, and they serve me well, despite all the struggles inherent to this disease. They are certainly a distinctive feature. Enough said.

All of this will be a moot point, soon. The weather changed over the weekend from sultry heat to cool breezes by Sunday evening. I’m back to three bandages, and as it gets colder, I’ll have more. My stubby fingertips (the middle fingers on both hands are the most damaged) will hide under wraps again for the better part of the year. Time to find my gloves and pull out the sweaters.

Evelyn Herwitz blogs weekly about living fully with chronic disease, the inside of baseballs, turtles and frogs, J.S. Bach, the meaning of life and whatever else she happens to be thinking about at livingwithscleroderma.com.

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Filed Under: Body, Hearing, Mind, Touch Tagged With: finger ulcers, hands, managing chronic disease, resilience

Flights of Fancy

Evelyn Herwitz · September 6, 2016 · Leave a Comment

What better way to mark the official end of summer this Labor Day than to surround yourself with butterflies? That’s what Emily and I decided to do Monday afternoon after a hectic weekend of social events that included hosting a large, agreeable dog for a young couple who were getting married, friends of Mindi, who was home for the festivities and a big move to a new apartment.

The fall transition is most certainly upon us. But inside The Butterfly Place in Westford, Mass., it was a precious ahhh moment. Enjoy, Dear Reader . . .

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Evelyn Herwitz blogs weekly about living fully with chronic disease, the inside of baseballs, turtles and frogs, J.S. Bach, the meaning of life and whatever else she happens to be thinking about at livingwithscleroderma.com.

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

Just Add Water

Evelyn Herwitz · August 30, 2016 · Leave a Comment

A little over two years ago, Al and I rearranged some art work in our living room to hang a beautiful, large painting over our couch. And for all that time, two unsightly holes in the wall flanked the painting—reminders of the pictures that had preceded it. They weren’t just simple nail holes; no, the paint had flaked off to reveal the plaster beneath.

IMG_2298It was one of those little annoyances you forget about, ignore, live with—nothing earth-shattering, but an irritating reminder of neglected home maintenance. I had pushed it out of my head as something my hands couldn’t handle.

Until Sunday. I woke up with a plan: I was going to fix the holes myself. Al was working at the hospital, and I wanted to surprise him.

Step One was to locate the wall paint. Sure enough, there sat a can on a shelf in the basement, unopened since 1999 when we moved into our home. I brought it upstairs, set it on some newspaper and pried open the top with a screw driver.

Our living room is painted brick red. What was left of the paint, about a third of a can, was purple. Or so it appeared. I found a dowel and began stirring. The red emerged as a marbled swirl, eventually blending to make a perfect match to the walls. It was thick, but viscous enough to paint.

Step Two was an Internet search for how to patch a hole in the wall, followed by a trip to the local hardware store. Channeling my father, who was Mr. Fix-it and had a very precise way of approaching any task, I bought spackle, a putty knife, a plastic drop cloth, a tack cloth and a sanding sponge that would be easy to hold. I considered buying paint thinner but decided it would be a waste of money for the small amount of paint that I needed.

At home, I gathered all my supplies, including some small sponge brushes from another project. To my surprise, I was able to move the couch away from the wall without much exertion. Behind it, there were two gashes in the wall where the couch had rubbed away paint, so i figured I could practice on those hidden spots, first.

Drop cloth in place, spackle container lid removed (with a bit of a struggle), I was ready to go. I scraped off the chipped paint, sanded the edges to make a smooth surface, tacked away the dust and dipped my putty knife into the spackle. And smiled. It was fun! The spackle spread as easily as cream cheese. Within ten minutes, I had two holes and two gashes neatly prepped for painting.

The spackle was supposed to dry in about a half hour, so I set out for a nice walk around the neighborhood. Upon my return, it was time to pour some paint into a plastic cup and finish the job.

However, I realized when I reopened the paint can that I probably hadn’t sealed the lid quite tightly enough. It was even thicker than previously. I stirred some more and poured a small amount into the cup. I stirred it again. I wished I had bought the thinner, but it was too late to go back to the store. So I set out to paint.

And here is where my project got a little messy. The paint had tiny little globs in it, which balled up on the wall. I had to swipe them off with a series of sponge brushes, over and over to catch them all. Then I realized that the spackle had not dried in one of the deeper holes and had sunk a bit. More spackle, more waiting. Grrrrrr. I wanted to be finished, and I wanted it to be perfect!

About this point, Emily came downstairs to investigate my progress. I groused about the clumping paint and my failure to get any thinner.

“Did you look at the label on the can?” she asked.

Duh. I had to admit that I hadn’t. I’d just assumed it was oil-based from the purple oily layer when I first opened the can. But, sure enough, the paint was acrylic. All it needed was a little water mixed in for a nice, silky consistency.

Em encouraged me to wait long enough to let the spackle really dry this time before I tested it. She promised to distract Al if he came home before I was through. Which is exactly what happened as I laid down the final swath of paint over what had been the second hole.

“I have a surprise for you!” I said, walking into the kitchen with my brush and paint cup. And, indeed, he was surprised—and impressed—not only that the holes were finally repaired, but that I had done it myself. I was, too.

The paint has fully dried, now. If you know where to look, you can see traces of my handy-work. But it blends in well enough. And at long last, the painting looks fully at home on its brick red wall. Best of all, I realized that my hands can take on a light home repair project, with good results. As long as I read all the labels.

Evelyn Herwitz blogs weekly about living fully with chronic disease, the inside of baseballs, turtles and frogs, J.S. Bach, the meaning of life and whatever else she happens to be thinking about at livingwithscleroderma.com.

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Filed Under: Body, Mind, Sight, Touch Tagged With: hands, managing chronic disease, mindfulness, resilience

Speak for Yourself

Evelyn Herwitz · August 23, 2016 · 2 Comments

"Cat and Mouse" (1975) by Robert A. Nelson, on exhibit at the Worcester Art MuseumOne evening last week, during a seemingly endless stretch of hot, muggy days, I was reading at the dining room table with the widows wide open when I heard a cat crying outside.

Our neighbors have two cats, and they often prowl around our back yard now that Ginger is gone. I looked out the window and saw the yellow tabby curled contentedly in their upstairs window, enjoying the meager breeze, silent.

Mrroww, mrroww, mrowww, cried the mystery cat.

Where could it be? This didn’t sound like your ordinary cat commentary. I went out the kitchen door and looked around. No cat.

Mrroww, mrroww, mrowww, cried the mystery cat.

I walked up the path to our front drive. No cat. I walked back to the kitchen door. No cat.

Mrroww, mrroww, mrowww, cried the mystery cat.

Then I realized that the cry seemed to be coming from our garage. I opened the back door. There was our neighbor’s white cat, hiding among my older daughter’s furniture, in storage until she moves to a new apartment in September.

It did not take much to coax the cat out of its self-imposed prison. I have absolutely no idea how it got in, since I’m not parking in the garage while the furniture is there. A mystery, indeed.

The cat ran back home, and I was quite thankful that I’d been around to hear its cry.

So, you may wonder, what does this have to do with living with scleroderma? Well, Dear Reader, it’s all about speaking out when you need help. That kitty knew how to get attention (how long it waited to complain, I have no idea—it probably snuck inside somehow to escape the heat) and kept asking for attention until someone paid attention.

Speaking up for yourself when you need help, without any shame or embarrassment, is a crucial skill when you live with any kind of disability, including the physical limitations that are part and parcel of scleroderma. In this Sunday’s New York Times, Rosemarie Garland Thomson articulates it beautifully in her essay, “Becoming Disabled”:

As we manage our bodies in environments not built for them, the social barriers can sometimes be more awkward than the physical ones. Confused responses to racial or gender categories can provoke the question “What are you?” Whereas disability interrogations are “What’s wrong with you?” Before I learned about disability rights and disability pride, which I came to by way of the women’s movement, I always squirmed out a shame-filled, “I was born this way.” Now I’m likely to begin one of these uncomfortable encounters with, “And these are the accommodations I need.” This is a claim to inclusion and right to access resources. . . .

Becoming disabled demands learning how to live effectively as a person with disabilities, not just living as a disabled person trying to become nondisabled. It also demands the awareness and cooperation of others who don’t experience these challenges. Becoming disabled means moving from isolation to community, from ignorance to knowledge about who we are, from exclusion to access, and from shame to pride.

Unlike Garland Thomson, I wasn’t born with my disabilities. I can still remember what it felt like (barely, it’s been so many decades) to have fully functioning hands. It’s taken me many years of living with scleroderma to assert myself with strangers when I need help. But I’m no longer afraid or ashamed to ask. Much as I want to do for myself, I also realize my limitations. It’s good to know, more often than not, there’s someone willing to open that door, pop that tab on a soda can, or hoist that carry-on bag to the overhead luggage rack—who’s glad to be of assistance.

If a cat knows how to get the help it needs, when it needs it, then surely, so can I.

Evelyn Herwitz blogs weekly about living fully with chronic disease, the inside of baseballs, turtles and frogs, J.S. Bach, the meaning of life and whatever else she happens to be thinking about at livingwithscleroderma.com.

Image: “Cat and Mouse” (1975) by Robert A. Nelson, on exhibit at the Worcester Art Museum

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Filed Under: Body, Hearing, Mind, Sight, Touch Tagged With: hands, managing chronic disease, mindfulness, resilience

Immersion

Evelyn Herwitz · August 2, 2016 · 6 Comments

Could it really be that Al and I were in Pisa, Italy, on Sunday? And in Venice, Florence and the Isle of Elba over the preceding two-and-a-half weeks? Air travel makes it possible to be halfway around the world in the morning and back home late the same night (depending on which direction you’re traveling). But my mind is somewhere in-between. And I want to hold onto the memories of our journey for as long as I can.

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Venice has been a lifelong dream—ever since my father showed me a series of small, black-and-white photos of the canals from his military service in Italy during World War II. Those images made a big impression on me as a little girl. So much so that in first grade, when I had to answer a test question, “True or False, All cities have streets,” I marked it false. My teacher, Miss Kelly, called me up to her desk and asked me why. I explained that Venice has canals. She laughed, and she didn’t mark my answer wrong.

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Whatever I imagined as a child, however, could not compare to the wonder of Venice—a magic puzzle box of winding pedestrian passageways, bridges and canals. Around each corner is yet another stunning, surprising view. We heard jazz and Vivaldi, saw fireworks and Kandinsky, ate delicious meals, drank wonderful wines, and continually got lost and found. We stayed six days, and it wasn’t enough.

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For four days in Florence, we marveled at art, ancient to modern. I could have stared at Botticelli’s The Birth of Venus for hours, were it not for the crowds in the Uffizi—for all the images I’ve seen, and the memes, there is nothing like witnessing a major art work in person. Michelangelo’s David, too, is breathtaking. So is the view of the city and Tuscan hills from Forte di Belevedere, across the Arno, and so much more.

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Our final stop, Pisa, has also been a source of intrigue since childhood. My sister and I had a wall map of the ancient world when we were young, which included a small drawing of the Leaning Tower to indicate where Pisa is located in Italy. How could a building lean like that and still stand? I wondered.

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Well, now I’ve seen it with my own eyes. It does lean and stay standing (thanks to some extraordinary feats of engineering), and the architecture is exquisite. There is much more to the city, of course, which is full of surprises—from the serene Botanical Garden of the University of Pisa to an exhibition of book illustrations by Roberto Innocenti at the Palazzo Blu.

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But our favorite adventure was our four days on Elba, an island off the west coast of Italy, part of the Tuscan Archipelago. Truly, one of the most, if not the most beautiful place I have ever seen. Panoramic mountain views overlooking azure seas, crystal clear water, beautiful hiking trails, salmon sunsets. It was a vacation in the midst of our vacation—calming, quiet, a time to get away from the crowds and contemplate.  

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And, best of all, I went swimming in the Mediterranean—the first time I have been able to swim in at least a decade. The water was warm and so clear and clean that, for once, I was not worried about risking an infection in my fingers. Indeed, the salt water seemed actually to help my ulcers to heal.

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All of this, plus the fact that I was able to tolerate the long plane rides, walk and walk in intense heat (high 90s most of the trip), eat new foods, get enough sleep most nights, and avoid any scleroderma complications—all of this, on top of being able to swing the trip in the first place, was a great gift.

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I’m glad to be back home, where the scenery is familiar. I know where to find just about everything in our house. Family and friends are close by. It was very good to sleep in our own bed once again. But there is so much more of the world to see. As long as we both are healthy enough and able, we hope to keep on traveling. My “Next Trip” list is already in the works.

Evelyn Herwitz blogs weekly about living fully with chronic disease, the inside of baseballs, turtles and frogs, J.S. Bach, the meaning of life and whatever else she happens to be thinking about at livingwithscleroderma.com.

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About the Writer

When not writing about living fully with chronic health challenges, Evelyn Herwitz helps her marketing clients tell great stories about their good works. She would love to win a MacArthur grant and write fiction all day. Read More…

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I am not a doctor . . .

. . . and don’t play one on TV. While I strive for accuracy based on my 40-plus years of living with scleroderma, none of what I write should be taken as medical advice for your specific condition.

Scleroderma manifests uniquely in each individual. Please seek expert medical care. You’ll find websites with links to medical professionals in Resources.

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