Raynaud’s Disease – The Washington Post


George Banker keeps a pair of hand warmers in his car in case he needs them when he goes grocery shopping. Without them, walking down the freezer aisle would turn his fingers white and numb. Rita Cognion has at-home “kooji” polyurethane foam sleeves used to cool beverage bottles and cans. In his case, he wraps his arms around a cold glass to protect himself from the cold.

Banker, of Fort Washington, and Cognion, an operations manager for the Army Ten Miler race and a data scientist in Alexandria, Va., both have Raynaud’s phenomenon (also known as Raynaud’s disease), a common cold condition. causes the blood vessels in the hands and feet to constrict, causing the fingers and toes to turn white or blue. When warm, they often become red and painful.

Attacks occur in winter and cold climates. But they can happen at any time, even when it’s hot outside.

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“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 at Harvard Medical School. “This condition can easily occur 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 leading to 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.

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 form can also be caused by environmental exposures or certain medications, including hypertension, migraine or attention deficit/hyperactivity disorder, among others, and work-related exposures, such as frequent use of vibrating machines, and certain chemicals. it’s possible. According to NIAMS, or even a cold can start it.

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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 just one of the foods you get,'” he recalls, often describing it as a “side dish” for rheumatoid arthritis. .

Even some situations that are normal for those who don’t suffer 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 recalled. “My fingers were so cold I couldn’t use the touch screen. I had to get help from the attendant.’

When Cognion eats out and forgets to bring a coozie, he wraps a dinner napkin around his glass. “When you have Reynaud, the stand is your friend,” he 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 over-air-conditioned offices,” he says. “I wore them in my office here before I started working remotely. The downside to typing gloves is that the fingers stick out, 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 I’m 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.

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When it’s below 70 degrees, he relies on gloves when running outside — they keep fingers warmer than mittens — and he puts air-activated chemical hand warmers in the gloves when the temperature outside is below 62 degrees. “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 start wearing them because my toes would freeze and turn white four or five times a day,” he says. “When I’m on a conference call, I keep a little heater on my desk to warm up my fingers a little bit. Otherwise, they won’t hear 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 from being too hot to too cold was always uncomfortable, so I would be too [set] my air conditioner is at 85 [Fahrenheit] and feel very comfortable,” she says. “But when I step into a heavily air-conditioned space from the heat…my fingers immediately start to feel it.”

Gerhard-Herman 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.

“A patient told me that when he shook someone’s hand, the other said: “What happened to you? Are you dead?’ “It was very scary,” says Mayes. “I tell Rayno patients to say, ‘I’m sensitive to cold,’ and leave it at that.”

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