A Father's Dying Wish
Source: Mayo Clinic. Raynaud's (ray-NOHZ) disease causes some areas of your body — such as your fingers and toes — to feel numb and cold in response to cold temperatures or stress. In Raynaud's disease, smaller arteries that supply blood to your skin narrow, limiting blood circulation to affected areas (vasospasm). Women are more likely than men to have Raynaud's disease, also known as Raynaud or Raynaud's phenomenon or syndrome. It appears to be more common in people who live in colder climates. Treatment of Raynaud's disease depends on its severity and whether you have other health conditions. For most people, Raynaud's disease isn't disabling, but it can affect your quality of life. Symptoms Hands affected by Raynaud's disease Raynaud's disease Signs and symptoms of Raynaud's disease include: Cold fingers or toes Color changes in your skin in response to cold or stress Numb, prickly feeling or stinging pain upon warming or stress relief During an attack of Raynaud's, affected areas of your skin usually first turn white. Then, they often turn blue and feel cold and numb. As you warm and circulation improves, the affected areas may turn red, throb, tingle or swell. Although Raynaud's most commonly affects your fingers and toes, it can also affect other areas of your body, such as your nose, lips, ears and even nipples. After warming, it can take 15 minutes for normal blood flow to return to the area. Causes of secondary Raynaud's include: Connective tissue diseases. Most people who have a rare disease that leads to hardening and scarring of the skin (scleroderma) have Raynaud's. Other diseases that increase the risk of Raynaud's include lupus, rheumatoid arthritis and Sjogren's syndrome. Diseases of the arteries. These include a buildup of plaques in blood vessels that feed the heart (atherosclerosis), a disorder in which the blood vessels of the hands and feet become inflamed (Buerger's disease), and a type of high blood pressure that affects the arteries of the lungs (primary pulmonary hypertension). Carpal tunnel syndrome. This condition involves pressure on a major nerve to your hand, producing numbness and pain in the hand that can make the hand more susceptible to cold temperatures. Repetitive action or vibration. Typing, playing piano or doing similar movements for long periods and operating vibrating tools, such as jackhammers, can lead to overuse injuries. Smoking. Smoking constricts blood vessels. Injuries to the hands or feet. These include wrist fracture, surgery or frostbite. Certain medications. These include beta blockers, used to treat high blood pressure; migraine medications that contain ergotamine or sumatriptan; attention-deficit/hyperactivity disorder medications; certain chemotherapy agents; and drugs that cause blood vessels to narrow, such as some over-the-counter cold medications. Risk factors Risk factors for primary Raynaud's include: Sex. More women than men are affected. Age. Although anyone can develop the condition, primary Raynaud's often begins between the ages of 15 and 30. Climate. The disorder is also more common in people who live in colder climates. Family history. A first-degree relative — a parent, sibling or child — having the disease appears to increase your risk of primary Raynaud's. Prevention To help prevent Raynaud's attacks: Bundle up outdoors. When it's cold, don a hat, scarf, socks and boots, and two layers of mittens or gloves before you go outside. Wear a coat with snug cuffs to go around your mittens or gloves, to prevent cold air from reaching your hands. Use chemical hand warmers. Wear earmuffs and a face mask if the tip of your nose and your earlobes are sensitive to cold. Warm your car. Run your car heater for a few minutes before driving in cold weather. Take precautions indoors. Wear socks. When taking food out of the refrigerator or freezer, wear gloves, mittens or oven mitts. Some people find it helpful to wear mittens and socks to bed during winter. Because air conditioning can trigger attacks, set your air conditioner to a warmer temperature. Use insulated drinking glasses. Treatment Dressing for the cold in layers and wearing gloves or heavy socks usually are effective in dealing with mild symptoms of Raynaud's. Medications are available to treat more-severe forms of the condition. The goals of treatment are to: Reduce the number and severity of attacks Prevent tissue damage Treat the underlying disease or condition Medications Depending on the cause of your symptoms, medications might help. To widen (dilate) blood vessels and promote circulation, your doctor might prescribe: Calcium channel blockers. These drugs relax and open small blood vessels in your hands and feet, decreasing the frequency and severity of attacks in most people with Raynaud's. These drugs can also help heal skin ulcers on your fingers or toes. Examples include nifedipine (Afeditab CR, Procardia, others), amlodipine (Norvasc), felodipine and isradipine. Vasodilators. These drugs, which relax blood vessels, include nitroglycerin cream applied to the base of your fingers to help heal skin ulcers. Other vasodilators include the high blood pressure drug losartan (Cozaar), the erectile dysfunction medication sildenafil (Viagra, Revatio), the antidepressant fluoxetine (Prozac, Sarafem, others) and a class of medications called prostaglandins.
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