In July I received an email from a reader in Fayetteville. She told me she had a condition called Raynaud's and asked, "How do you get regular exercise when the bottoms of your feet hurt?"
Maybe by swimming? As a someone with foot problems, I get a lot out of the water aerobics classes at the Patrick Hays Senior Citizens Center in North Little Rock. But my reader doesn't like to swim or the chlorine smell associated with it.
I tried to be as helpful as I could, giving her some examples of other things I do when I don't want to put a lot of weight on my bad foot. I like to use small handweights or stretchy bands. And there are things you can do lying down like situps, leg bicycles and lifts, and gentle stretching.
But then it dawned on me that I had no idea what Raynaud's was.
According to the website of the Raynaud's Association (raynauds.org), the disease is pronounced "ray-Nodes." It was named for French physician Maurice Raynaud, who first recognized it in 1862. And little is known about the condition, its cause or a cure.
I reached out to the University of Arkansas for Medical Sciences and got some great information from a vascular surgeon, Dr. Guillermo A. Escobar. He's an assistant professor of surgery in the College of Medicine.
When I was doing online research, I noticed Raynaud's being called a disease, a syndrome and a phenomenon. Which is it? Escobar helped clear it up.
In Raynaud's disease, he says, the normal ability of the body to close down blood flow from one area to another is exaggerated and leads to a prolonged and inappropriate lack of blood. Usually this occurs in the hands and feet, and it can be anything from just annoying and painful to a dire situation leading to amputation of the fingers or toes, as in frostbite.
Raynaud's manifests in a variety of ways. It can be a primary condition where the only problem is blood vessels closing down inappropriately and then opening again. Those cases are usually benign and limited to the fingers. They can be controlled mostly by avoiding handling cold things and/or wearing gloves.
Sometimes the disease is not the primary medical problem, and it appears due to another illness. That is secondary Raynaud's, and it can be very aggressive. In those cases, the person not only has to treat the primary disease but may also need treatment for Raynaud's.
The important thing there is to determine whether the person with Raynaud's has only that disease, or if they have another illness that can be associated with Raynaud's. Such diseases include cancer, lupus, rheumatoid arthritis and other autoimmune illnesses that can get worse with time and be lethal if left untreated.
The Raynaud's phenomenon refers to a finger or toe going from looking normal to pale, purple to red, and back to normal.
A syndrome, in general, Escobar says, is when there is a combination of signs and symptoms that alone mean nothing. But when combined they can be a single disease.
He says it's like when someone has a cough, fever and muscle aches and it's called a "flulike syndrome." Cough, fever or muscle aches alone don't mean anything specific.
So how does someone "get" Raynaud's?
First off, Escobar says, Raynaud's disease should not be confused with neuropathy, which is always secondary to something else.
If Raynaud's is a primary condition, it could have come from repeated injury to the hands (like using a jackhammer), repeated or prolonged very cold/warm exposures or having been in an intensive care unit with medications that cause a vasospasm. It can be due to the body being "revved up" from other illnesses such as those mentioned earlier.
In a vasospasm, a blood vessel constricts to make itself smaller, which consequently limits the blood that can flow in. It is a normal response to divert blood away from one area. This commonly happens when we are exposed to the cold. Blood is moved to the core of the body to keep us warm, even if it leads to a loss of blood flow to the fingers, toes or nose, which can ultimately lead to frostbite.
Another example is when someone looks pale if he gets scared. The blood is sent to the brain, heart and muscles so we can think and run, but removes blood from the face.
So what are the treatments?
Certain medications can help treat the frequency, duration and intensity of the vasospasm or pain. Or surgery might eventually be needed. There are other conditions that mimic Raynaud's disease. The main thing, he says, is to ensure that we have the correct diagnosis. A good choice would be a board-certified vascular surgeon or rheumatologist.
I asked about the reader's foot pain. Escobar says that generally Raynaud's should not cause pain in the bottom of the foot. It's more likely that the pain may be caused from long-term Raynaud's, possibly from nerves damaged by prolonged lack of blood flow. Or the diagnosis is wrong and something else is causing the pain.
That's another situation where the right doctor could make the difference.
According to the Raynaud's Association, women are affected nine times more often than men. And even babies can get it. When it occurs in teenagers, mostly female, they tend to develop the disease around the time of puberty but symptoms can disappear when they reach their 20s.
Researchers have not been able to determine if it's hereditary, but in many families, more than one could have the condition.
It seems to be a common condition that's generally unknown. The Raynaud's Association's mission is to raise awareness of the disorder and provide support, resources and credible information. Its website offers a few tips on avoiding a Raynaud's attack:
• Dress warmly and in layers.
• Wear a hat outdoors in cold weather. And try to stay indoors.
• Wear gloves or mittens when exposed to air conditioning or low temperatures, even when handling frozen or refrigerated foods.
• Carry foot and hand warmers such as those found in sporting goods stores.
• Use insulated drinking glasses or mugs.
• Place hands under warm water to warm them quickly. Don't use hot water.
• Don't smoke.
• Swing arms in a windmill motion to get the circulation going quickly.
Email me at:
rboggs@arkansasonline.com
ActiveStyle on 08/25/2014