Living with Scleroderma

Reflections on the Messy Complexity of Chronicity

finger ulcers

Hand-off

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I’ve been dropping things lately. This is largely due to calcinosis in my thumbs that makes it harder to hold on. My dexterity waxes and wanes, depending on how a particular piece of calcium is working its way out through the skin, and currently some shards are on the move.

And so, Sunday night, when I tried to lift a large pot of cooked pasta over to the kitchen sink to strain out the water, you guessed it, the pot slipped and I splashed hot pasta water all over the kitchen floor. Thankfully, not the cooked pasta! And I managed to move out of the way so I didn’t get burned.

But I was really annoyed with myself. Al was home, fortunately, and calmly cleaned up all the water on the floor with old newspapers and towels, while I groused.

Finally I calmed down. And the meal turned out well.

I don’t usually get so frustrated with my hands. I try to take very good care of them and respect their limitations.

Which, of course, are my limitations. It’s a strange aspect of this disease, that my hands can look and feel so alien and disfunctional, but they remain a part of me. Even after four-plus decades living with scleroderma, I sometimes still find this surprising. I see my hands all the time, but there are moments when I’ll catch their reflection framed in a mirror and am shocked at how bizarre they look.

Then I remind myself that they are me, that regardless of how strange my hands appear, I’m still able to do as much as I do. And to be grateful for that. And to forgive myself for getting frustrated. It just is.

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.

The Pits

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Over the weekend, I pulled yet another calcium pit out of the inside joint of my right thumb. It is the third tiny shard that has emerged in the past month-plus. And although I’m not certain, it feels like another one is surfacing.

This makes grasping objects complicated. These tiny charcoal-gray bits of calcium are quite sharp. The slightest pressure, as they work their way out of my skin, is quite painful. And there is nothing to be done but wait until enough is showing that I can grasp it with a pair of tweezers. Not a fun procedure.

Several years ago, I discussed this with my hand surgeon. We looked at X-rays that revealed chains of calcium pits in each of my thumbs that run the length of both digits. He advised against trying to remove them, because of the collateral damage it would cause, but offered to extract one if it became too painful and difficult for my to deal with on my own. The one time I actually scheduled an appointment with him, the offender popped out on its own, which was a relief.

This whole issue is complicated by the fact that I can’t turn my hand around enough to see the opening in my thumb. Not enough rotation in my wrist. So I rely on a mirror, but that’s tricky, too.

No one knows know why these calcium deposits form in scleroderma. There is at present no treatment, only remedial steps to ease the discomfort. According to the Scleroderma Research Foundation, increased blood flow to extremities may help, and lesions may respond to antacids, bisphosphonates, or calcium channel-blockers. But there is no cure.

So, my main goal is to protect my thumb as best I can and keep it clean to avoid an infection. As I type, I am experimenting with wrapping my bandaged thumb in Coban, which is a self-adhering mesh tape that provides some extra padding. Not sure if it’s helping the hole in my thumb, but it feels a bit better when I strike the space bar on my computer—a good thing, because calcinosis often forms at pressure points, and I think another spot may be forming where my thumb hits the keyboard.

Basically, it’s a damn nuisance. Nothing to do but wait it out.

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.

Small Miracles

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For months, at least since March and maybe longer, I’ve had a charcoal-gray pit of calcium sticking in my left thumb. I have not been able to budge it or tease it out with tweezers. It has been lodged there, staring at me as I change my bandages morning and night. Sometimes it hurts, other times not. Sometimes it gets infected. Mostly it just serves as a reminder to handle things with care so I don’t bang it.

That is, until this weekend. I was doing my evening routine of cleaning my ulcers and re-bandaging them when I suddenly realized that the calcium pit was gone. No bigger than a poppy seed, it lay there on a piece of tissue. Really? I wondered, rolling it between thumb and forefinger, you were that small all this time?

More calcium hides beneath the surface in both of my thumbs. In x-rays, they look like long white chains from thumb tip to below the joint connecting thumb to palm. Slowly but inevitably, the pits work their way out of the skin. There’s nothing I can do to get rid of them but wait until they are ready to emerge, then wait until each one dislodges.

There is an obvious lesson about patience, here. I’ve learned to play along, not to aggravate the skin and nerves by jiggling the pit in a vain attempt at extraction. As long as I’m careful with how I cushion it with dressings and use Aquafor ointment to keep it moist (but not too moist) eventually, the calcium will exit on its own.

But there’s something else that fascinates. And that is how my body continually surprises me with its ability to heal, scleroderma or no scleroderma. It doesn’t always happen the way I want it to, or on a convenient timeline, but it does happen. That a calcium pit the size and color of a poppy seed can cause so much discomfort and then, one random evening, bid adieu, is one of the mysteries of this disease and the miracles of the healing process.

And so, until the next one appears, I will tend the hole in my thumb as it fills and be grateful for the reprieve.

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.

Image: Victoria Tronina

Enter Fall

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It is rainy and chilly and dreary as I write on Monday afternoon. Here in Central Massachusetts, we were fortunate to avoid the worst of Hurricane Lee over the weekend, and the rest of the week looks sunny. But I’m feeling the chill in my hands today, knowing that fall officially begins this Saturday.

Already, the days are notably shorter, the transition even more striking since we came back from the Baltics, where the sun sets later because it’s farther north.

And so, it’s time to make my annual adjustment, mentally and physically, to inevitable colder weather. I should be used to it by now, but I always hate to bid summer adieu. Time for lined leggings and sweaters and wrist-warmers, heavier coats and gloves and hats, more effort to get dressed and out the door.

Sigh.

At least there is fall foliage to look forward to. That, and crisp air, and fewer mosquitoes, and the way that autumn light etches shadows. Even as leaves begin to drop and trees harden off for winter, new buds are forming. My hands will adjust as I remind myself: Only three more months until the pendulum swings and the days grow longer, once again.

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.

Rhapsody in Teal

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I haven’t sewn a garment for myself in quite a while, not since December 2021, to be precise. That project was an alpaca wool jacket, which came out fine, but I haven’t worn it too often because the fabric is a bit itchy. Oh, well. One of the challenges of making your own clothes is learning to pick the right fabric for the right project.

I have a lot of fabric in my stash, accumulated over decades. This is a common challenge for people who enjoy sewing—inspiration and purchase, followed by lack of time, energy, or whatever excuse to actually sew the garment. Call me guilty, as charged. But recently, I decided that if I wasn’t going to sew something or make use of all those fabric scraps from prior projects, I should at least find a way to responsibly recycle them.

Turns out our composting service will recycle textiles for a minimal fee. So I dug through my fabric stash to see what to eliminate. Not easy. I have a lot of nice textiles. Still, it was time to be realistic. After filling a bag for recycling with scraps that I will never use, I examined several yards of beautiful teal rayon. I must have purchased it not long after Al and I married, so it’s nearly 40 years old. But still in excellent condition.

Then I dug through old patterns, many of which I will never sew because I no longer like the styles, and bagged a bunch to recycle. But I found one, a simple caftan, that held promise for that gorgeous fabric.

Rayon is a tricky fiber. It drapes beautifully, but ravels easily and is slippery to sew. With two thumbs in bandages at present and limited dexterity, I knew it would be a challenge. That’s probably why I’ve avoided it all these years.

I read up on sewing techniques for rayon and set to. First I zigzagged the ends to prevent raveling, washed the rayon on delicate to pre-shrink, then air-dried it and pressed it on low (no steam). After testing the pattern with left-over muslin for the front and gingham for the back (more leftovers), I made some adjustments. Then I went to the fabric store and bought a better rotary blade cutter than my old ones, which I could no longer hold properly, some rayon thread, and some extra sharp needles for my sewing machine (recommended for rayon).

The rotary cutter was worth it, because I was able to cut out the pattern quickly and neatly, without hurting my hand. Theoretically, you’re not supposed to use pins other than those intended for silk, or they’ll leave permanent holes in rayon. I tried mini binder clips to hold the seams when I stitched, but they were too clunky and hard to open and place properly. Turns out, fortunately, that this fabric was fine with pins.

I took my time. I experimented with seam binding, but that didn’t work. I couldn’t serge the seams, because the serger destroyed the delicate fabric. So I stitched the seams on my trusty old Huskvarna, trimming them and zig-zagging the edges. For the neckline binding, I had enough fabric to cut bias strips, found some stretchy iron-0n interfacing in my stash, and made custom bias tape, which worked great.

Finishing the sleeves and hem was the hardest part of the project, because the pattern called for pressing under a quarter-inch of the edge, then folding it again and stitching down. Like I said, the fabric is slippery and I don’t have the ability to nudge a narrow, raw edge with my fingertips, which no longer exist. Stitching a quarter inch from the fabric’s raw edge gave me a guide for the first fold, which I pressed. Then I made the second fold, pinned and lightly pressed. But the big aha was realizing I could top-stitch the hem from the wrong side, thus easily controlling the narrow folded edge, and no-one would know the difference.

The finished dress earned a “Wow!” from Al, the desired response. I’m really pleased with it. It’s cool and comfy and fun to wear. All these years later, I finally found the right project for that beautiful teal rayon. I can still sew. And there is so much left in my stash. . . .

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.