Rahl,
I also have mctd and had a severe, life threatening case first diagnosed in 2005. Lupus and an extreme case of polymyositis which left me a quadriplegic who could not swallow. Fortunately, my docs were able to treat me and sent me to a rehab hospital where I made a remarkable recovery. Also have several other secondary conditions, including raynauds and barretts esophagus (acid reflux caused by weakening of the spincter muscle at the top of the stomach).
Rheumatolgists are the best type of doctor to treat mctd. Find one who has experience at least treating lupus which is very similar and is part of mctd. What are you taking to control your immune system?
Raynauds is also treatable. Are you taking any meds for it? It sound like it has been neglected since you mention gangrene. That does not have to happen if treated properly. It takes both suppressing your immune system and taking a med to counteract the effects of raynauds. Pain killers are not a treatment that will help in the long run.
Where do you live? What kind of a doctor are you seeing? What meds are you taking for mctd, acid reflux, raynauds?
Bill