Living with Scleroderma

Reflections on the Messy Complexity of Chronicity

hands

Exposed

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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.

Just Add Water

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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.

Speak for Yourself

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"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

Handy

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When you live in a home long enough, stuff breaks. A doorknob loosens, a faucet drips, a burner element wears out on the stove, a toilet leaks, a chair leg cracks, a lock fails. The list is endless.

tools-1553469-640x480If you’re handy, fixing stuff around the house can be a satisfying hobby. If you’re not, it’s a cumulative nuisance. And if you can figure out how to fix it but your hands won’t cooperate, it’s truly irritating.

I used to have extraordinary fine motor coordination in my hands and could do just about any kind of detailed manipulations. I watched my father fix all kinds of objects around the house and build bookcases to hold thousands of tomes, and I imagined being able to do the same someday. But now that I have my own home, I can’t do the kinds of repairs that I wish I could because my hands simply won’t cooperate. Al, by his own admission, is not Mr. Fix-It.

So it was with great satisfaction that we finally found a handyman who can do just about any repair for a reasonable price. Our list has been growing for a long time, but the problem that finally drove us to seek him out was the ladder to the attic, which broke about a year ago, making it impossible to access our luggage. We are planning more travel in a few weeks, this time to Italy, and we needed to get up there.

And so, over the past few days, Marc has been fixing stuff: He replaced the ladder, fixed the impossible leaking toilet, repaired the drippy kitchen faucet and spray hose, reattached the spring on the outer front door that fell off the other day, wired a new front light, replaced some shakes that had been bored through by woodpeckers, and mended two broken chairs and the leg on our coffee table.

As these things go, nothing was as simple as it seemed. Bees were investigating the holes bored by the woodpeckers. The toilet needed several adjustments, as did the kitchen faucet. The attic ladder was a challenge because the original door had been built in the wrong place relative to the upstairs hallway and staircase. But Marc figured it out, spicing his efforts with some colorful language that reminded me of my dad’s cursing when things didn’t go right, and demonstrated an admirable ability to sort through the challenges and solve each one.

While he was working here on Monday, I was faced with a different kind of fix-it problem—trying to get the scanner on my printer to work again. I had an important document to scan, and the printer would create the image, but continually refused to save the file. I tried reinstalling the driver twice, only to have the same result. I groused to Marc, who cracked a sympathetic joke.

I was ready to give up and take the document to an office service store, when I took a break for a late lunch. Marc was up in the attic, adjusting the length of the new aluminum ladder after a particularly difficult battle with the old wooden one, which had twisted and tangled in its ancient spring. If he could persist and figure it out, so could I.

So I read through old printer documentation, tried a different way of getting into the scanner software, and—lo and behold, found the problem—a save option that had not been activated. The scanner worked. “I did it!” I shouted to Marc. He cheered.

I may not be able to do what Marc does with fixing stuff with my hands, but I sure learned a good lesson about persistent problem-solving. When he left Monday afternoon, he told me to start making “another little list.” I already have a few items noted down for after we get back.

Image Credit: Ciska Wesselius

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.

 

New Tricks

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mr-fluffy-1358436-639x426In our back yard, a supposedly squirrel-proof bird feeder hangs on the trunk of a Norway maple. For the past year-and-a-half, it has confounded the squirrels. They’ve climbed all around it, certain it contains something good to eat. All that spilled seed near the tree’s roots must mean those birds are onto something, right? There just has to be a way to get some, too!

Then, last week, one wily squirrel finally cracked the code. Hanging down over the roof of the feeder, it managed to push down on the spring-loaded perch, swing around, climb up and sit on the ledge of the seed tray. There it curled its bushy gray tail into a question mark—You gotta problem with that?—and gobbled up black sunflower seeds.

I stepped outside to shoo it away, but in a short while, the squirrel was trying once again to remember the combination of acrobatic moves that had been so rewarding. No luck, at first. Next morning, I looked out the window and discovered it happily munching away again at the feeder.

At first, I was annoyed. But I was also impressed. That was one smart squirrel! Clearly, it was capable of learning from trial and error to get the reward—just like a lab rat learning how to push the right levers to get sugar water.

Since then, however, I haven’t noticed the wily squirrel at the feeder (which doesn’t mean it hasn’t been there). Birds continue to visit, so at least I know there’s still plenty of seed left.

Meanwhile, I’ve been learning some new tricks of my own, out of necessity, since my hand surgery a couple of weeks ago.

For years, I’ve been cutting bandages in half, the long way, for dressing my digital ulcers. I lap and contour them over my finger tips, then secure them in place with a full bandage wrapped around the finger. And I’ve always used a pair of cuticle scissors to cut the bandages. They’re small and sharp and light to handle.

But with my right hand out of commission for well over a week, I needed to recruit some help. My left hand just isn’t as coordinated, and I couldn’t cut the bandages. So I asked Al to do it for me. Another time, when he was at work, I asked Emily, who is home for the summer, for assistance.

Both followed my instructions—but both also inspired shortcuts that I had never considered. Al devised an easier way to cut the bandages—just shy of the peel-open end—so you can peel the wrapper and release both halves at the same time, instead of having to peel each half bandage separately.

Both Al and Em asked me why I insisted on using the cuticle scissors. I had to admit, they don’t cut a straight line very easily and can get stuck in the adhesive. Also, I realized, the reason I can’t use them right now is the holes in the handle are too small and press against my thumb sutures. So I fished out a spare pare of rubber-handled kitchen sheers from the junk drawer and tried them out. Voila! Easy, painless and quick way to cut my bandages in a snap, even with my healing right hand.

Which brings me back to the wily squirrel.

It’s so easy to get stuck in one way of doing things, even when the approach really is not working all that well. You can keep on looking at a problem the same way, circle round and round, trudge along. Or you can stand on your head and open your mind to a new perspective. Even if you’re not an acrobat—or a squirrel—the view is worth the effort.

Image Credit: Piotr Ciuchta

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.