DEAR DR. DONOHUE: I am a 42-year-old female. For the past 15 years, I have had cold hands and feet, especially my toes. In winter, I have to soak them in warm water to warm them up. First they turn white, and then, as they start to warm, they go from purple to red. I do have varicose veins. My doctor told me I might have Raynaud’s. Is there anything to do for it? – L.W.

ANSWER:
I’ll tell you about Raynaud’s disease, and you can judge whether you fit the picture. Varicose veins have nothing to do with it.

When the hands, fingers, feet and toes are exposed to cold, a reflex constriction of their arteries takes place to conserve body heat. People with Raynaud’s have a reflex constriction that goes over the top. Their arteries clamp down excessively and stay clamped for way too long. Emotional stress triggers the same reflex.

The cutoff of blood turns the fingers and toes white. In a short time, the blood that was trapped in the fingers and toes turns them a blue color as oxygen is depleted. Finally, when the constriction relaxes and blood surges back, they turn red. The episode can be painful.

Keeping the hands and feet warm is the way to combat Raynaud’s. People whose hands and fingers are their greater problem should wear mittens when they have to reach into a refrigerator or a freezer. You, with the feet and toes problem, should not wear sandals or go barefoot. Don’t smoke; nicotine constricts blood vessels. Go without caffeine; caffeine can add to the tendency of arteries to narrow. Twirling the arms like a windmill often ends an attack.

Drugs can help prevent Raynaud’s attacks. Nifedipine and diltiazem are two examples. When placed under the tongue, nitroglycerin – the medicine used by people with angina – promptly relieves artery constriction.

For some, Raynaud’s is associated with an underlying illness, such as scleroderma (hard skin), lupus and blood vessel inflammation. Treatment of the underlying illness often gets rid of Raynaud’s disease too.

DEAR READERS: Some time ago, a reader asked if I knew of any organization that accepts used orthopedic devices like crutches, canes, braces and splints. I didn’t, but I asked readers if they had suggestions. They did. I’ve gathered some of them for publication now and will mention the rest at a later date. I want to thank those who were kind enough to write. The following organizations distribute such devices to people in need:

The Lending Cupboard Society of Alberta, 5406 C 43rd Street, Red Deer, Alberta, Canada, T4P 1C9; Elks Lodges and Senior Centers (many locations); local posts of the Veterans of Foreign Wars; in the St. Louis area check www.equipyourneighbor.org; many local hospices.

DEAR DR. DONOHUE: I am writing to you about my daughter, who has recently been diagnosed with Turner’s syndrome. She is 18 years old, and 4 feet 7 inches tall. She doesn’t have a period unless she takes birth-control pills. The doctor says she will not be able to have children. I have never read anything in your column about this. I am sure there are other people with the condition. Any information will be very much appreciated. – Anon.

ANSWER:
Two sex chromosomes determine gender and foster the development of gender-appropriate body characteristics. (Chromosomes are strands of genes.) Women have two X sex chromosomes. Men have an X and a Y sex chromosome.

In Turner’s syndrome, one X chromosome or part of that chromosome is missing in a girl. That brings about a number of consequences. Most do not menstruate, because they aren’t making enough female hormones. Almost always, they are infertile. Stature is short. Some have knock knees. The main body artery, the aorta, might have a kink in it. The heart’s aortic valve can be misshapen. The thyroid gland is often sluggish.

Female hormone replacement is part of treatment. Growth hormone might be prescribed. Abnormalities of the heart valve and the aorta can be surgically corrected if need be.

Women with the syndrome ought to contact the Turner Syndrome Society of the United States or the Turner Syndrome Society of Canada for information and support. Their respective toll-free numbers are: 800-365-9944 and 800-465-6744.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


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