I have arthritis in both wrists, and cannot rack the slide on any auto. I recently was in the market for a carry type pistol, and tried a small 357 thinking I could load 38's for it. Couldn't handle that either. Settled on a SP101 in 327, with Hogue monogrips.
I practice with 32 long or light 32 Mag loads I load myself, and carry factory 327's. I figure if I need to use it, a couple rounds would be the least of my worries at the time.
One word of caution though. I found the 32 caliber round so fascinating that I have subsequently started collecting them. I now have five, looking for more.