Light Therapy Restores Blind Patient's Independence
"This is Fred," said Marcia Trawinski, extending her white cane. "He works for me."
So does the University of Chicago Medicine. Trawinski visits the medical center each month to don safety goggles and bathe her hands in a healing pool of bluish light. While the blind activist can't see the lightbox, she can feel the soothing warmth of the Ultraviolet A (UVA) rays and the smoothness of her healthy skin.
She can feel something else, too: the world around her. "It's working," she said during a recent treatment. "I have the use of my fingertips and hands again."
Born with a congenital ocular disorder, Trawinski was legally blind by age 12. A self-reliant sort, she attended mainstream schools, traveled, and worked as a crisis counselor at Bishop Noll High School in Hammond, Indiana. Though retired, she's still involved in several municipal Americans with Disabilities Act advisory committees, as well as the Older Women's League.
Yet her independence was threatened two years ago when her hands became so scaly that "I couldn't even bend my fingers," the 60-something Bronzeville resident said. "They were literally puffed up like sausages."
At her first medical center appointment in late 2010, her hands were so inflamed that Trawinski was unable to read Braille, button a shirt or grab Fred the cane. Each finger "was very red, very puffy, with deep cracks," said Katie Burke, LPN.
A sighted person would have been frustrated. For Trawinski, forced to wear cotton gloves to pad her sore fingertips, it was devastating.
"I identify everything tactilely and could barely feel anything," she said. The vision-impaired "use our fingers for everything. It's not just reading Braille. It's feeling the fabric of the clothes I want to wear and packages of food to determine what I want to cook."
Trawinski was diagnosed with a severe case of contact dermatitis. Physicians were reluctant to prescribe steroids, which can thin the skin over time; instead, Trawinski started psoralen plus Ultraviolet A (PUVA) light therapy.
As the months passed, the itching and pain began to subside and her blistery rash faded. Today Trawinski has progressed from thrice-weekly visits to once every two weeks to keep the dermatitis at bay. She's regained 80 percent of her mobility.
"I'm certainly able to manage now," she said.
Scientists are unclear why, but light therapy is an effective treatment for a number of inflammatory skin conditions marked by red, sometimes intensely itchy skin.
Psoralen is an agent that enhances photosensitivity to the healing rays.
Trawinski pre-soaks her hands in a psoralen solution for 30 minutes during each visit. Lightbox controls regulate the exposure time and dosage of therapeutic UVA radiation.
She and the nurses -- she recognizes each one by voice -- chat about everything from sports to the latest Goodman Theatre drama during treatments. "We have a good relationship," she said.
The dermatology staff is equally fond of their scrappy regular, who arranges her own rides to and from the medical center and navigates the clinic with an ease borne of familiarity. When her insurance company questioned her treatment, several caregivers phoned and wrote letters on her behalf. "We won the battle," Burke said.