Living with Scleroderma

Reflections on the Messy Complexity of Chronicity

finger ulcers

Into White

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This is quickly turning into a record-breaking winter here in Massachusetts. On Monday, Ground Hog Day, we got another foot-plus of snow on top of our record nearly three feet from last week. And it looks like there’s more to come.

I feel like I’m stuck in an endless loop of snow storms.

It wouldn’t be so bad if I didn’t feel so confined by the mounds of white stuff. I can’t shovel, and I can’t use a snow blower, even if we had one. I simply can’t stay out in the cold that long, and the temperatures are sinking into the single digits, with sub-zero wind-chill.

The (thankfully) warm but dry air in our home is wreaking havoc on my digital ulcers—up to eight on as many fingers. I’ve been on antibiotics for more than two weeks, now, as two messy ulcers slowly clear. Last week, I ordered a shipment of 1500 bandages (that’s 15 boxes of 100 each), but I’m now wondering if they will arrive before I finish my last box, given all the snow and inevitable delays.

All of this prompted me to do some research about long-term weather forecasts. Not that it will make any difference.

It doesn’t look good for February.

According to meteorologists who follow world-wide weather patterns, at least two factors on the other side of the globe are controlling our snow fall and temperatures here in New England:

  • A pool of warm water that started off around Hawaii three years ago and migrated to the Gulf of Alaska is now gradually shifting into the extreme eastern Pacific. This pumps warm air up into the atmosphere (if I understand this correctly), which then forces arctic air down across Canada and into the U.S.
  • Then there’s the amount of snowfall over Siberia. Apparently, there was a lot more snow cover in that part of the world than normal last October—more than an additional million square kilometers—and that affects the amount of snow we get in this part of the world, right around this time of year.   

There’s a lot more to it than that, but I won’t even attempt to summarize, especially if you don’t share my weather geekiness. Basically, it all comes down to physics, and the fact that our lives and circumstances are much more intertwined around this planet than we realize.

Bottom line: Our average annual snowfall here in Central Massachusetts is 64 inches. We’re now up to 57 inches, just in the past 10 days. And we’re supposed to get more snow on Thursday and again on Sunday to Monday.

A part of me wants to scream and head someplace sunny and mild (assuming I could actually get a flight despite all the snow). But this is New England, and we’re supposed to be hardy. So I will do my best. I will take necessary safety precautions and try to enjoy the journey into white. And I will continue to remind myself that—long range forecasts notwithstanding—the most important lesson from a winter like this is that control is an illusion. The only thing we can manage is the moment we’re living in, one snowflake at a time.

 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.

The Right Tools

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My dad had a saying: “Any problem can be solved if you have the right tools.” He was something of a tool geek. In the basement of our home, hanging on a pegboard over his workbench, he had every kind of tool imaginable: crescent wrenches, socket wrenches and pipe wrenches, neatly arranged from small to large; flathead and Phillips head screw drivers; a carpenter’s hammer, tack hammer, ball peen hammer, rubber mallet; an electric hand drill with a full set of wood and dry-wall bits; rulers for every task.

Then there were his electronics bench, with its oscilloscope, soldering iron and various pliers; the table saw, with a variety of sharp-toothed steel discs hanging nearby; the drill press; the radial saw. Wooden shelving he’d built was filled with nuts, bolts, screws and nails in baby food jars, each labeled and ordered by size and type. And that’s just the short list.

I found it fascinating. I was his little helper, handing him the right transistor to build his latest Heathkit or the proper socket wrench to adjust his tractor snow-blower.

I learned a lot about how to make things (and how to get out of his way when he inevitably made a mistake and started cussing) and a deep respect for the value and care of good tools. Although my hands don’t work well enough to be able to build my own bookcases or tables or chests of drawers, I understand what’s required and how to envision the project and its implementation.

I also learned an approach to problem solving that has carried me a long way in dealing with scleroderma. Just because my hands don’t work properly doesn’t mean I can’t do what I need to do. I just need to figure out a different approach. And, sometimes, get the right tools.

Dad died five years ago, this past week, on the fifth night of Hanukkah. And so it was exceptionally fitting that in the mail on Saturday, a large box arrived from my Virginia brother-in-law, with a Hanukkah gift—a tool I’d been needing for years.

Saul had visited us in October. While he was here, he noticed I was having trouble opening cans. It’s ridiculous, really. I know I’ve needed an electric can-opener for years, but just never got around to buying one.

Sure enough, when we opened the box, inside was a sleek, black-and-chrome electric can-opener with an easy-lift handle. I tried it out Sunday night. Voila! No more sore fingers from struggling with a manual can-opener, ergonomic design notwithstanding. The can of plum tomatoes turned quickly and quietly, the lid came off easily, and there was no messy blade to clean.

It’s amazing how this device has instantly made my life easier. Especially when I have intransigent ulcers, as I do right now, opening cans has become quite an ordeal. If my fingers slip, it’s extraordinarily painful. Sometimes I’ll turn the manual crank all the way around the can, only to have to repeat because the blade didn’t cut all the way through the metal lid. There have been many times I’ve had to use rubber gloves or a towel for extra padding on the handle, to be able to manipulate the can-opener. Sometimes I just can’t open the can at all, and I have to wait for Al to be available to help.

Why it took my brother-in-law’s thoughtful gesture to turn this around, I’m not sure. Sometimes you just get so immersed in the way you’ve always done something that it’s hard to muster the energy or awareness to fix it.

So, I repeat, in Dad’s memory: Any problem can be solved if you have the right tools. And I’ll add this caveat: It helps if you’re paying attention. Thank you, Saul.

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.

Time to Stop Typing

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I’ve been having trouble sleeping the past few nights. My finger ulcer keeps waking me up. Usually when this happens, I have an infection. But that’s not the case this time. The skin is just too raw on the tip of my right ring finger, but I need to type and do other tasks, and the ulcer keeps getting irritated.

Now, I should be grateful that, at least so far, I don’t need to start antibiotics. I hate taking them. But the good thing about infections, much as they hurt: antibiotics provide significant relief within about 48 hours.

My problem at present is that there’s no quick fix for this particular variant of ulcer pain. It’s like having a headache in my finger. The only cure is time.

Our fingers have an extremely dense concentration of nerve endings. According to a recent article in The Guardian, our fingers have so many nerve endings that our brains actually outsource some neural computations about object orientation and movement to our fingertips.

All of those nerve endings make it possible to distinguish a baby’s cheek from a scruffy beard, stovetop heat from freezer chill, a satin sheet from flannel. When you think about it, the range of our fingers’ neural intelligence is really quite astounding.

That neural density also accounts for why it hurts so damn much when we get a paper cut, or smash our thumbs with a hammer. . .or develop digital ulcers.

The only encouragement I feel right now is that I’ve had two other recalcitrant ulcers in the past few weeks that gave me the same trouble, which are now, thankfully, past the achey stage. I’ve noticed over the years that there is some kind of tipping point in the healing process, when my damaged skin cells seem to wake up and repair themselves in large enough numbers that the pain level recedes. This can happen overnight.

So I’m going to cut this short, give my sore finger a break, take some Ibuprofin and Tylenol (they work differently), redo my bandages, and—I hope—get some sleep. Maybe tonight’s the night my body will work its magic, once again.

Photo Credit: JonathanCohen via Compfight cc

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.

‘Tis the Season

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Thanksgiving snuck up on me this year. Not that there weren’t enough hints. Two weeks ago, as I sat in my optometrist’s office, Christmas carols wafted through the waiting room. Since then, I’ve noticed Santa statues guarding the aisles at CVS, holiday wreathes decking the doors at Home Depot and Black Friday sales clogging my email.

Oh, wait, was I talking about Thanksgiving?

Hard to know which season it is, or to remember what the holiday is supposed to be about. You don’t even see those hokey turkey decorations anymore in stores—you know, the ones with the cardboard heads and tails connected by honeycombed crepe paper bodies—or garlands of fake autumn leaves. As soon as the pumpkins and Halloween candy go on mark-down, the Christmas decorations come out. Given the commercial Black Friday competition, I’m betting it won’t be long before we’re confronted with holiday mega-sales starting November 1.

The weather is no help, either. Although we avoided the crazy snow that whomped Buffalo this past week, the polar vortex that swept through New England threatened to turn November into January. I now have seven ulcers on my fingers and one persistent sore on my inside right ankle. I am going through bandages like confetti. Some of these ulcers developed weeks before the freezing weather, but several emerged in the past few days, despite my best efforts to protect my hands. Way, way too cold for this time of year, and my fingers are not happy.

A reader recently suggested taking a vacation in Hawaii. This idea has some appeal.

Even as frigid temps made me cranky last week, however, we’re now enjoying a mild interlude before a Nor’easter that could bring at least a half-foot of snow by Wednesday evening. Thank goodness I already put the snow tires on my Prius.

Snow or no snow, I’m looking forward to the approaching holiday. Every year, we get together with our cousins for a wonderful meal, football games on the flatscreen TV and the comfort of family and friendships. And I have much to be grateful for. . . .

Our daughters are both thriving in their respective graduate school programs.

I have a full plate of work for wonderful clients.

We have a beautiful home on a quiet street with good neighbors who wave and say hello as I walk Ginger around the block.

Ginger is 16 and still has “pep in her step,” as our vet notes, with amazement.

Al has made it through yet another sale of the hospital where he is a social worker, and despite the less-than-desirable health insurance provided by his new employer, we have managed to cover our deductibles for my medical expenses (at least, so far).

I’m holding my own with my health. It never gets easier, but I have enough experience with scleroderma that I can figure out work-arounds when my hands aren’t cooperating or my feet need extra support or my body just needs more rest or time to do whatever it is I’m trying to do.

I am blessed with loving family, good friends, a supportive synagogue community and enough resources to live a modest, comfortable life. I have access to some of the best medical care in the world, right in my own backyard. I work for myself, set my own pace and own my own time.

And I can write.

Time for Thanksgiving, indeed.

Photo Credit: smilla4 via Compfight cc

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.

Clean Hands, Warm Heart

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Somewhere I once read that Donald Trump’s aides carry alcohol wipes for him, so he can clean his hands after every handshake. I don’t know if it’s true, but he has a reputation as a germophobe, so I wouldn’t put it past him.

sanitizerMuch as I don’t want to have anything in common with The Donald (although the equivalent of even a small percentage of his fortune would certainly be nice), I, too, am in the habit of cleaning my hands frequently when I’m in public.

In my case, however, I have a good excuse. I have far too many digital ulcers that provide super highways for bacterial infections, if I’m not careful.

So I am. Careful. Almost to the point of being obsessive/compulsive.

Recently I’ve been using mass transit more often when I have commitments in downtown Boston. Driving and parking can take up to an hour-and-a-half each way, sometimes even longer, depending on traffic. Taking the train enables me to get work done instead of wasting all that time driving. It’s also much more relaxing. But I never travel without my little bottle of antiseptic hand-cleaner.

I’m always cognizant of when my hands touch surfaces that many other hands have touched—like door handles between train cars or escalator handrails on the way to the T (Boston’s subway) or those straps or metal poles that you need to grab in order to stay upright when the subway jolts and jerks. When I arrive at my destination, out comes the hand-cleaner.

Other points of contact that make me wary: ATM consoles, those ubiquitous ball-point pens that are always handed to you for signing your credit card slips, doors to public buildings and magazines in doctor’s waiting rooms. Once I’m back in my car, out comes the hand-cleaner. I also keep my own pens at the ready.

Public restrooms, of course, are high on the list. I recently saw a video clip of The Doctors talk show that discussed where the most germs reside. It’s not the first stall, by the way. We all avoid that one. It’s not even the toilet seat. It’s the toilet paper dispenser. Think about it. Then there’s the door handle on your way out. So, my latest solution is to pour some hand-cleaner in my palm as I leave and rub it into my hands as I walk. (Washing my hands with soap and water doesn’t work because I have too many bandages.)

If all of this sounds a bit paranoid, well, maybe so. But I have had far, far too many serious bacterial infections in my fingers over the years. The pain can be excruciating. Sometimes I have ended up on IV antibiotics for months. Thankfully, it’s been a long time since that’s happened, and part of the reason, I am certain, is that I’m so careful.

My method is not foolproof. And I go through a lot of hand-cleaner. But the bottom line is that it certainly doesn’t hurt. And as long as I’m not insulting anyone by whipping out my hand-cleaner after a handshake, then why not? Minimizing infections—and excessive use of antibiotics—is well worth being a tad obsessive. Just because you’re paranoid doesn’t mean that bacteria isn’t out to get you.

Photo Credit: coolmikeol via Compfight cc

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.