George Banker keeps a pair of hand warmers in his car in case he needs to go grocery shopping. Without them, walking down the freezer aisle would turn his fingers white and numb. Rita Cognion has at-home “kusits,” polyurethane foam sleeves used to cool beverage bottles and cans. In his case, he wraps his hands around a cold glass to protect himself from the cold.
Banker, of Fort Washington, an operations manager for the Army Ten Miler, and Cognion, a data scientist in Alexandria, Va., both have Raynaud’s phenomenon (also known as Raynaud’s disease). Cold blood vessels in the hands and feet constrict, causing the fingers and toes to turn white or blue and numb. When warm, they are often red and sore.
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Attacks occur in winter and cold climates. But they can happen at any time, even when it’s hot outside.
“Raynaud’s doesn’t take summer off,” says Marie Denise Gerhard-Herman, MD, a cardiovascular medicine specialist at Brigham and Women’s Hospital and an associate professor of medicine at Harvard Medical School. “This condition can be easily triggered in summer situations that involve cold exposure, such as going to a cold ocean or the freezer aisle of a 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 known cause, while the secondary form usually accompanies other health conditions, often autoimmune diseases such as rheumatoid arthritis, lupus, or scleroderma. The second-degree type can be more severe, sometimes causing scarring, tissue damage, and even amputation, experts say.
According to the Raynaud’s Association, 5 to 10 percent of the population has Raynaud’s disease, the vast majority of which is the primary form.
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Primary Raynaud’s disease is more common in women than men and usually begins in the younger 30s, most often in adolescence. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), it can run in families, suggesting a genetic link.
For most people, primary Raynaud’s is not only a nuisance, but it can cause people to quit certain jobs or avoid cold-related activities.
“Some people don’t think to talk to their doctor about it,” says Maureen Mayes, M.D., professor of internal medicine and the Elizabeth Bidgood Chair in Rheumatology at The University of Texas McGovern Medical School. “They think, ‘Oh, I must be sensitive to the cold.'”
The second type can be caused by environmental exposures, or certain medications, including hypertension, migraines, or attention deficit/hyperactivity disorder, among others, and work-related exposures, such as frequent use of vibrating machines, and certain chemicals. According to NIAMS, or even a cold can start it.
Sarah Hoddinott, a self-employed software and fundraising consultant in Belleville, Ontario, learned she had Raynaud’s when she was diagnosed with rheumatoid arthritis a year ago. “To quote the doctor who first used the word Raynaud’s: ‘Honey, when you have an autoimmune disease, it’s like eating pizza — Raynaud’s is one of those foods you get,'” he recalls, often describing it as a “side dish” for rheumatoid arthritis. as “.
Even some situations that are normal for the non-sufferer can become problematic for people with Raynaud’s. But they find ways to deal with them.
“I was recently at the airport trying to get my bags through the kiosk,” Banker recalls. “My fingers were so cold I couldn’t use the touch screen. I had to ask the attendant for help.”
When Cognion eats out and forgets to bring a koozie, he wraps a dinner napkin around his glass. “If you have Raynaud’s, you have a friend,” she adds. He spends part of his time in Hawaii, where it’s easy to work with Rhyno. Still, even there, he takes steps to keep Reynaud under control.
“I wear fingerless gloves in very air-conditioned offices,” he says. “I wore them in my office on the mainland before I started working remotely. The downside to typing gloves is that the fingers stick, but this is the best I can do.”
He says it can feel as cold as 70 degrees when he is indoors and settled. He feels bad when he opens the freezer or washes food under cold water because he is uncomfortable eating a lot of fresh fruit.
“I try to be quick when moving things around in the fridge,” she says. Also, “Even when it’s 70 degrees, I wear more layers indoors than most people,” she says.
When it’s below 70 degrees, he relies on gloves when running outside – they keep fingers warmer than mittens – and when it’s below 62 degrees outside, he wears air-activated chemical hand warmers in the gloves. “They were lifesavers,” he says.
Hoddinott also uses heated gloves and mittens and wears them every time he goes outside for more than a minute or two. “Last summer, when the temperature … dropped to 64 Fahrenheit, I had to wear them because my toes would freeze and turn white four or five times a day,” she said. “When I’m on a conference call, I keep a little heater on my desk so I can warm up my fingers a little bit. Otherwise, they’re numb until I run them under warm water for a few minutes.”
Hoddinott, a former Rockville resident, avoided air conditioning when he lived in the suburbs near D.C. despite the hot weather. “The shock of being too hot and too cold was always uncomfortable, so I would [set] my air conditioner is at 85 [Fahrenheit] and I feel very comfortable,” she says. “But I’ll go into a heavily air-conditioned space any time I want. . . My fingers start feeling right away.”
Gerhard-Hermann advises her patients to avoid caffeine, or one cup of coffee a day, and to avoid ADHD medications that stimulate “constriction of the arteries in the fingers and toes,” she says.
Mayes, who also directs the university’s scleroderma clinic, recommends keeping the core warm so as not to draw heat to the extremities to protect the core, a vital reflex. “In the summer, add an extra layer—a sweater or jacket,” she says.
There is no cure for Raynaud’s disease. 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 open up blood vessels and improve circulation. “The problem is that they can lower blood pressure and make people feel lightheaded and dizzy,” says Mayes.
For people with severe Raynaud’s disease, a doctor may recommend sympathectomy, a procedure performed by cutting or injecting nerves that destroy the nerves that cause blood vessels to narrow. This may improve symptoms, but may need to be repeated in a few years, according to NIAMS.
Finally, experts encourage Raynaud’s patients to ignore insensitive comments from people who wear gloves and other strange behaviors during the summer.
“I’ve had one patient say to me that one person shook his hand and the other said, ‘What happened to you, are you dead?'” Mayes says. “It was terrifying,” Mayes says. .”
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