March 27, 2012
Yesterday was a rough pain day. Nothing would help. I was to start a Ti Ch Chi class and didn't know how I would manage. I decided I could at least listen to the instructions. It was a chilly but sunny afternoon. We were able to get in the first two basic steps. Since I had taken the class a year ago, I started to remember the steps. In doing a couple of the steps I was able to remove myself from the pain.
I am glad we had an early spring. Recently I had a birthday. I remember as a child looking at the calendar and seeing that March 21 was officially Spring. I always wanted a birthday party outside because it was "spring". Even in the Mid-Atlantic States it is still cold this time of year and often raw. This is the earliest spring I can remember. Even the lawnmowers are out. What a wonderful birthday gift. I have been discouraged with all the events that happened last fall. I have been having too many days lately where I barely had the energy to clean, run errands, combined with appointments and my part-time job. Ever since I was able to return to work I had this dream of rising above this life of poverty. So I am taking a closer look at my birthday gift. Every new leaf, each new flower or each new blade of green grass carries with it hopes of a new dream and new possibilities.
My struggles with Raynauds occurs most of the year. Winter time is especially hard as I watch my fingers turn white almost instantly. When I try to take something out of the fridge, like a bottle of water or cold glass, it feels like touching a hot pan and it burns. My fingers will turn white down to the knuckles. Raynauds interferes with being able to fix meals using food out of the Fridge because of the cold meat and dishes. Fixing a meal takes extra time. Even damp clothes out of the washer can cause an episode.
Raynauds can be better on a sunny day and worse on a cloudy day especially if it is chilly damp day. Sometimes I have to wear wool mittens inside and to bed because it can take up to 20 minutes for my fingers to return to normal. As they return to normal they will turn blue and then a bright red. It use to just be a nuisance. Now I take medication for it and it hardly helps at all. I do not like to use a stronger dose because one of the side effects is dizziness and the other constipation.
What Is Raynauds?
After an exposure to changes in cold or even hot temperatures an abnormal spasm of blood vessels causes a restricted blood supply to the local tissues of the fingers and toes. This results in the color change in the digits. After a prolonged lack of oxygen the fingers can turn blue. When the blood vessels open and blood returns the color is bright red. Raynauds can occur by itself as a primary disease or with other diseases as a secondary disease. By the time I had developed Raynauds I already had Sjogren's. Raynauds has a number of conditions associated with it including rheumatic diseases, lupus, and hormone imbalance, and nicotine.
What Causes Raynauds?
The causes are still unknown. However, the abnormal nerve controls of the blood vessel diameter and nerve sensitivity to cold are suspect as being contributing factors. The narrowing of the blood vessel is due to spasms of tiny muscles in the wall of the vessels.
Symptoms, Signs and Diagnoses of Raynauds
The symptoms of Raynauds depends upon the severity, frequency and duration of the blood vessel spasms. A mild case will present only skin discoloration under cold conditions. The person may also experience mild tingling and numbness of the digits. Once the color returns to normal the tingling will disappear. Sustained blood vessel spasms cause the sensory nerve to become irritated by the lack of oxygen and can cause pain in the fingers. In rare cases poor oxygen supply to the tissue can result in ulceration and even gangrene.
Other than the characteristic sequence of color changes in the skin, there are no blood tests to diagnose Raynauds. Capillary nail folds are frequently found. A doctor may request other blood tests to rule out other rheumatic disease.
There is research that reports finding a substantial genetic contribution both to the symptoms of Raynauds and the blood vessel changes.
Treatment for Raynauds
Treatment is more about management of Raynauds by protecting the fingers and toes from cold, trauma, and infection. Regardless of the severity, the prevention measures are the same. Warm clothing is essential. I have found that mittens work the best for me. You have to guard against direct trauma and wounds. Any wounds or infections need to be treated right away. Biofeedback is also recommended. I have not tried this. Tobacco smoke can cause blood-vessel constriction. Care for nails carefully. Nitroglycerin ointment can sometimes increase blood supply and heating when used along the sides of severely affected digits. I want to find out more about this.
Medications that Aggravate and Medications That Help
The symptoms of Raynauds can be aggravated by medications that can increase blood vessel spasm. These include cold and weight control medications including Actifed, CoTylenol and Sudafed. Medicines used for high blood pressure and heart disease can also worsen Raynaud's phenomenon.
I take a medicine that opens or dilates the blood vessels. These are called calcium channel blockers. I have taken both Cardizem and generic diltizem, Cardene or Procardia. There is a medication called Trental that makes the red blood cells more pliable and thus improving circulation. I have not taken this.
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