Last week did not go as planned.
I’d been successfully managing two infected finger ulcers with my usual skin care regimen, plus an antibiotic that normally clears up any such issues within a few days. On Tuesday, I was on Day 10 of that medication and thinking I could probably discontinue it by Day 14. (My docs trust my judgment, given four decades of managing this disease.) But by that afternoon, the ulcer on the inside crease of my right thumb began to smart.
At first, I thought that my dressings had simply dried out and needed to be redone. But after my evening shower, I discovered that my thumb was not happy—not by a long shot. It was swollen and so painful that I ended up taking hydrocodone to try to control the cycling nerve shocks (you really have no clue how many nerves are in fingers until something like this happens). The pain woke me in the middle of the night, requiring a second pill. Even still, the pain persisted in the morning.
Now, I really hate the side effects of narcotics. They make me woozy, my mouth even drier than normal, and I just feel off. And in this case, the hydrocodone didn’t help all that much. Fortunately, by Noon I was able to reach my ID specialist, who prescribed another antibiotic that I’ve used before, which attacks a different spectrum of bacteria. Clearly, I had picked up something, somehow, that was new.
I was able to manage the pain during the day by alternating acetaminophen and ibuprofen, and took two doses of the new antibiotic by the time I went to bed. More interrupted sleep, but I was determined to not take anymore narcotics because I had to drive to Boston the next day and see my rheumatologist for a long scheduled appointment.
During the exam, we discussed pain management, and my issues with hydrocodone and related drugs. He mentioned that a number of his patients have had good results with cannabis medications to control pain. This had never occurred to me. Armed with that new idea and a prescription for lidocaine ointment, I went home.
A small drop of the lidocaine helped block the pain when I changed my dressings that night. I had a better sleep. But by morning, the pain came roaring back. I have not experienced anything this severe since I had major ulcers several years ago. Even with the ointment, I could not stop the nerves from zapping. I was really at a loss after bandaging my thumb.
Then I remembered a jar of hemp oil ointment that Al had gotten a while back for some joint pain. I’ve used it successfully for lower back pain on occasion. So I dipped a cotton swab in the jar and painted a line of hemp oil around the base of my thumb, just below the bandage. Within minutes, the intractable pain ceased.
Really, it was a miracle. And it lasted all day.
Needless to say, I’ve been applying it the same way since Friday. Between that, the lidocaine, and my usual skin care, plus the new antibiotic at last kicking in, my thumb (knock on wood) is finally healing again. I also discovered that the hemp ointment helps with another occasional discomfort—phantom itching of my right middle finger, about an inch above what’s left of it after surgery several years ago. It’s an extremely odd and annoying sensation, because I can’t scratch it to relieve it. There’s no there, there. But a little of the hemp ointment completely eliminated the itchy feeling. Who knew?
Which is a long way of saying that I am extremely grateful for CBD therapeutics and my wonderful medical team.
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. Please view Privacy Policy here.
So sorry to hear about this ordeal, Evie, but relieved that you discovered a new way to manage the pain. My chiropractor recommended CBD cream several years ago for my arthritic joint pain and it works wonderfully well, just as you describe. It even eased the pain of a bad bruise I got on my foot after stumbling into a table. I use it only infrequently, maybe once or twice a month at most, although I am not aware of any negative consequences of more frequent use. The one caution my husband has expressed: any time a person masks pain, they may be masking a condition that they need to attend to. But in the case of your painful thumb and other joint issues, Evie, it’s clear that you know what’s going on and address it medically. In my case, one goal is to postpone joint surgery as long as possible, a goal approved by my rheumatologist. Good luck to us both!
Indeed!
Re masking pain . . . there’s an important distinction to be made between masking pain, as in blocking the sensations without addressing the cause, and managing pain, which is my focus here. I’ve learned from very hard experience with infected ulcers over the decades that you have to get ahead of the pain and stay on top of it with whatever means are safe and effective, or the pain becomes much more intense and harder to control. I agree, pain is the body’s warning system, but once you identify and deal with the cause, the pain requires careful management until the problem resolves. To all readers who struggle with this issue, I hope my experience is helpful.
Thank you so very much for your in depth stories of the past two weeks. I have known the pain of nerve ending spasms. Your writings are so extremely helpful.
So glad to hear that, Linda. I hope you are doing well.
I can’t imagine what you are going through with your ulcers. I know you have great doctors. My experience with ulcers–I haven’t had any since I started taking meds for my pulmonary arterial hypertension…nifedipine, sildenafil, opsumit and uptravi. But, of course, you don’t want PAH.
Thinking of you.
Thanks, Janet. I hope your PAH is manageable. That’s really interesting, how those meds have stopped your ulcers. Such difficult tradeoffs. Be well!
The first two drugs I had taken before I got PAH. The last two are newer drugs for PAH. All four drugs open up the blood vessels including my fingers. I am still careful in keeping my hands and body warm but have not had any sores on my fingers since. My PAH has been in control for the last 3 years. I have had scleroderma for 8 years.
Good to know. Thank you!
This was a providential posting for me. The major pain issue for me is not really due to any of my Sclerodema/RA/Sj0grens problems but these attacks do make all of the AI symptoms worse. When you mentioned your husband found relief from back pain with CBD cream I was astonished. I have been dealing with attacks of severe lower back pain since lumbar fusion surgery in 2018 which has been labeled as “failed back surgery”. I’ve been on the medical mystery tour of doctors and ensuing tests since 2018 with no cause determined for these attacks and no treatments except narcotic pain medications that cause nasty side effects. Recently my PCP(who is great) suggested acupuncture. No one has mentioned trying topical CBD cream. So, thank you for this posting!!! It can’t hurt to try this first.
Patricia, I hope it helps! Acupuncture can also be a big help. I hope you get some relief! It’s always good to read the clinical research about therapies. Here’s a link to a 2020 NIH review of CBD research for controlling chronic pain: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7204604/. Take care.