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Raynaud’s Syndrome

The first time I noticed I had Raynaud’s was in the kitchen. My hands felt kind of funny and I looked down and they were green. Not a little green. Like GREEN. And entirely numb.

I started to move them and they completely spasmed. No pain. Just bright green hands that were spasming. Then they were fine again.

It started happening several times a day – usually triggered by some kind of vibration (the mixer, holding a steering wheel) or by cold. When I was in the bathtub or a hot shower, they turned purplish black. My doctor and I both googled ‘green hands’ and came up with Raynaud’s. (Is it validating or disturbing when your doctor googles your symptoms in front of you and gets the same answer you did?)

But for both of us the answer was comforting because, although we researched and ran down many other potential causes for my symptoms, Raynaud’s was by far and away the easiest to deal with and the least serious medical condition.

What is Raynaud’s Syndrome?

Raynaud’s syndrome (or Raynaud’s phenomenon) is a condition caused by an exaggerated reaction of peripheral blood vessels to a stressor. Many people get pale when they’re shocked or cold or stressed or sick. They turn blue with cold. So do people with Raynaud’s. Only we do it in a BIG way to SMALL stressor. It’s especially noticable in folks like me who are very pale anyway.

The constriction of blood vessels (veins, arteries, and tiny capillaries) is called a ‘vasospasm’. Raynaud’s isn’t a disease per se, it’s a very strong (overly strong) effort of our body to keep our body temperature in check.

That’s why Raynaud’s is most often triggered by cold. Your blood vessels constrict so you don’t lose all that valuable heat by running blood near to the surface of your skin. When you have Raynaud’s, blood vessels clamp down (a vasospastic attack) to protect you from heat loss.

Because blood carries oxygen to your peripheries (fingers, hands, toes, and feet), they first turn blue or purple because your red blood turns blue when it’s low in oxygen. If the vasospastic attack becomes more extreme, the affected area turns white or chalky because there’s no blood to pink it up. Then, when your circulatory system opens up, blood floods in and you flush red.

Who is affected by Raynaud’s

Some people are more likely to get Raynaud’s than others.

  • 80% of those who get it are women
  • Thinner people are more likely to get it than those who are heavier (probably because we also get colder)
  • Most people first get it when they’re between 12 and 30 (although I remember being embarrassed by it without knowing what it was in first grade)
  • It runs in families

Among those who are vulnerable to Raynaud’s, lifestyle factors can be triggering. Caffeine, and some food and some drugs like Ritalin affect vasoconstricton and can exaggerate the effects of Raynaud’s.

I found I always got Raynaud’s during my week-long semester breaks. Why? I spent a lot of time being a couch potato. For ME (maybe not for others), being sedentary lowered my already low blood pressure enough that a mild Raynaud episode become strikingly extreme. Because I was also eating a diet very high in tyramine, my peripheral circulation was very reactive.

People with Raynaud’s have ‘twitchy’ – highly reactive – systems. When diet, exercise, drugs, or disease pushes them towards their edge, the effects of Raynaud’s is exaggerated.

Primary and Secondary Raynaud’s

I have primary Raynaud’s. My circulatory system is fundamentally healthy – it’s just twitchy.

Secondary Raynaud’s is much more serious. It is a secondary reaction to another more serious disease that damages the circulatory system, causing it to overreact. The problem with the blood vessels is caused by damage from the primary disease.

People with schleroderma, lupus, and other diseases that damage the blood vessels can also cause Raynaud’s phenomenon. That’s why it’s important to check those out before you dismiss the symptoms as just another of those weird quirks that all of our bodies have. The list below are some symptoms that should prompt you to check in with your doctor.

And do be careful

My Raynaud’s is primary. Most of the time, it’s no big deal. But it CAN be dangerous. Because my circulation becomes severely restricted with cold, I have to be very careful about frostbite.

And cold can be relative. My dog and I walk all winter in northern Ohio. I wear good boots and warm socks. Still, for the last five years, I have had chilblains on my middle toes from January to late May. Those blistery wounds can easily become infected – just like the feet of people who suffer from diabetic neuropathy. I haven’t had problems with my hands, but I have had trouble driving. Spasming hands make a difficult to hold a steering wheel steady – and Raynaud’s can come out out of the blue (as it were).

So, bottom lines:

  • Primary Raynaud’s phenomenon is a rare, but not dangerous, vascular pecularity most common among younger, thinner, women.
  • Primary Raynaud’s can usually be managed with stress reduction, exercise, and avoiding cold and dietary triggers,
  • If you have another disease that affects the vasculature or nervous system, Raynaud’s may be a sign of disease progression. It should be reported to your doctor immediately to prevent and minimize further damage. Don’t ignore it!
  • Be mindful of injuries common to folks with circulatory problems. Watch your feet, in particular, as it is easy for small wounds to get infected and out of control.

References:

Boston Children’s Hospital has an excellent introduction to Raynaud Syndrome.

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