Raynaud’s disease – The Washington Post


George Bunker keeps a pair of hand warmers in his car in case he needs them on his trips to the grocery store. Without it, walking down the freezer aisle would turn his fingers white, then go numb. Rita Cognion has a supply of in-house “koozies,” polyurethane foam bags used to keep beverage bottles and cans cool. In her case, she stretches them to fit an ice glass, protecting her hands from the cold.

Banker, of Fort Washington, Md. , and Director of Operations for Army footraces Ten Miler, and Cognion, a data scientist from Alexandria, Virginia, have Raynaud’s phenomenon (also called Raynaud’s disease), a condition in which exposure to cold. It causes the blood vessels in the hands and feet to constrict, making the fingers and toes white or blue and numb. When they warm up, they often turn red and pulsate with pain.

Attacks are more likely to occur in winter and in colder climates. But they can occur in any season, even when it is hot outside.

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“Raynaud doesn’t take summer vacation,” says Marie-Denis Gerhard Hermann, MD, a specialist in cardiovascular medicine at Brigham and Women’s Hospital and assistant professor of medicine at Harvard Medical School. “This condition can easily be triggered in summer situations that involve exposure to the cold such as going to the cold ocean, the freezer aisle of the grocery store, or an air-conditioned theater.”

There are two types of Raynaud’s phenomenon – primary and secondary. Experts say the primary form has no identifiable cause, while the secondary form usually accompanies another health condition, often autoimmune diseases such as rheumatoid arthritis, lupus or scleroderma. Experts say the secondary type can be more severe, sometimes leading to ulcers, tissue damage, and even the need for amputations.

An estimated 5 to 10 percent of the population has Raynaud’s, the vast majority of the primary type, according to Raynaud’s Association.

Primary Raynaud’s affects women more than men, usually affects those under 30, and often begins during the teenage years. It can run in families, suggesting there may be a genetic connection, according to National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).

For most people, primary Raynaud’s disease is nothing more than a nuisance, although it can cause people to quit certain jobs or avoid cold-related activities.

“Some people don’t even think about talking to a doctor about it,” says Maureen Mays, MD, professor of internal medicine and Elizabeth Bidgood Chair of Rheumatology at the University of Texas McGovern School of Medicine. “They just think: ‘Oh, I must be sensitive to cold. “

The secondary form can also occur from environmental exposure, or from certain medications, including those for high blood pressure, migraines or attention-deficit/hyperactivity disorder, among others – and work-related exposure, such as frequent use of vibrating machinery, in While some chemicals or cold, too, according to NIAMS.

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Sarah Hudennot, a self-employed program consultant and fundraiser from Belleville, Ontario, learned she had Raynaud’s when she was diagnosed Rheumatoid arthritis a year ago. To quote the doctor who first used the word Raynaud’s: ‘Honey, once you have an autoimmune disease, it’s like eating pizza – Raynaud’s pies are just one of the extras you might get too,'” she recalls, adding that she often describes it. Side Dish for Rheumatoid Arthritis.

Even some situations, common for the unaffected, can become problems for people with Raynaud’s disease. But they find ways to cope.

“I was at an airport recently trying to get my bags using a kiosk,” Banker recalls. “My fingers were so cold that I couldn’t use the touch screen. I had to get help from an attendant.”

When Cognion is having dinner outside and forgets to bring koozie, she wraps a dinner napkin around her glass. “When you have Raynaud’s, stemware is your friend,” she adds. She spends part of her time in Hawaii, where Raynaud’s is easier to deal with. However, even when she is there, she is taking measures to keep Raynaud’s under control.

“I wear fingerless printing gloves in heavily air-conditioned offices,” she says. “I wore them in my office here on the mainland too before I started working remotely. The bad thing about the writing gloves is that the fingers are protruding, but that’s the best I can do.”

She says that when you’re indoors and sedentary, even 70 degrees can feel cold. It is worse when you open the freezer or wash the product under cold water, which is inconvenient because she eats a lot of fresh fruits and vegetables.

“I try to be quick when moving things around in the freezer,” she says. She also says, “Even at 70 degrees, I probably wear more layers indoors than other people.”

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They rely on gloves when running outdoors if the temperature drops below 70 degrees – they keep fingers warmer than gloves and put air-activated chemical hand warmers inside the gloves when the outdoor temperature drops below 62 degrees. “They were life savers,” she says.

Hoddinott also uses heated gloves and mittens and wears them every time she goes outside for more than a minute or two. “Last summer when the temperature dropped to…64 F, I had to start wearing them because my fingers were numb and went white four or five times a day,” she says. “I also keep a small heater on my desk so I can warm my fingers up a bit if I’m on a conference call. Otherwise, they stay numb until I run them under warm water for a few minutes.”

Hoddinott, a former resident of Rockville, Maryland, avoided air conditioning when she lived in a suburb near D.C., despite the often frigid weather. “The shock of extreme heat to very cold was always annoying, so I would have done it [set] My air conditioner is at 85 [Fahrenheit] And you feel totally comfortable.” “But any time I step into a very air-conditioned place away from the heat…my fingers instantly start to go numb.”

Gerhard Hermann advises her patients to give up caffeine or stick to one cup of coffee a day and avoid medications that lead to ADHD that prompt “narrowing of the arteries in the fingers and toes,” she says.

Mays, who also directs the university’s scleroderma clinic, recommends keeping the central body warm to prevent the body from drawing heat away from the extremities to protect the heart, a survival reaction. “Put an extra layer—a jacket or jacket—even in the summer,” she says.

There is no cure for Raynaud’s. But some treatments can help. Although there are no approved medications for Raynaud’s, doctors sometimes prescribe medications used for other conditions, such as vasodilators, which improve blood circulation by opening blood vessels. “The problem is that it can also lower blood pressure, and people can get dizzy and lightheaded,” Mays says.

For people with severe Raynaud’s disease, a doctor may recommend SympathectomyIt is a procedure performed through an incision or injection to destroy the nerves that narrow the blood vessels. It can improve symptoms, but may need to be repeated after several years, according to the NIAMS.

Finally, experts are also urging Raynaud’s patients to try to ignore the insensitive comments of others who find wearing gloves in summer and other behaviors strange.

A patient told me that after I shook hands with someone, he said to me: What is wrong with you? are you dead?’ That was awful to say,” Mayes says. “I tell my Raynaud’s to say, ‘I’m sensitive to cold’—and leave it at that.”

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