DEAR DR. DONOHUE: My granddaughter is 16 and was a premature twin. Recently she was diagnosed with Raynaud’s disease, and has had a hard time accepting it, since she is active in sports. She has pain in her hands while playing softball and has trouble running because of shortness of breath. She is on an antidepressant and Procardia for the Raynaud’s. Could the antidepressant cause shortness of breath? Is it unusual for someone her age to have this disease? – A.S.
ANSWER: Raynaud’s disease makes people extremely sensitive to cold. It’s a normal reflex carried to the extreme. When anyone’s hands or feet are subjected to the cold, arteries constrict so that body heat isn’t lost from the blood. People with Raynaud’s constrict their arteries so tightly and for so long that circulation to the fingers and toes is shut down. At the onset of artery constriction, fingers (and perhaps toes) turn white. As time passes, veins dilate and the fingers turn blue. Finally, when the arteries relax and blood flow resumes, the fingers turn red. The entire process can be painful. Shortness of breath isn’t a usual Raynaud’s symptom, and it’s not a common symptom of antidepressant medicines. Protection from cooling is the best way to prevent an attack. That means having gloves handy if there’s a chance of chilling the hands (and warm socks if feet are involved). Your granddaughter can try a trick that works for some in stopping an attack. Swinging the arms in a windmill fashion can drive blood into the hands. About 15 percent of Raynaud’s patients improve with time; 35 percent experience worsening of symptoms; and 55 percent stay the same. It’s not uncommon at younger ages.
The cause is unknown. It does run in families, as it appears to be doing in your granddaughter’s (from a deleted part of your letter).
Medicines like your granddaughter’s Procardia (nifedipine) are often prescribed. Nitroglycerin ointment, the same medicine used for the chest pain of angina, is another popular medicine for it.
For some, Raynaud’s is the consequence of another illness, like lupus, rheumatoid arthritis, scleroderma (hard skin) or high blood pressure in the lungs. Those illnesses should be looked for. I don’t have an explanation for your granddaughter’s shortness of breath.
DEAR DR. DONOHUE: What is pseudomonas? Is it catchy? What does it cause? – L.P.
ANSWER: Pseudomonas (SUE-duh-MOE-niss) is a bacterium found just about everywhere – on plants, on animals, in soil and sometimes on human skin. It often lives in peace with us. However, it can cause skin infections, pneumonia, urinary tract infections and many more. It’s a germ that is mostly unaffected by the commonly used antibiotics. Special ones do exist for its treatment.
The topic of vaginal infections is treated in the booklet with that name. Readers can obtain a copy by writing: Dr. Donohue – No. 1203, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: What causes sunspots? They appear even when we have not been exposed to the sun. – Anon.
ANSWER: The sun has nothing to do with sunspots. A fungus is their cause. The fungus depigments patches of skin so they are lighter than the surrounding skin. The sun comes into play only because it darkens the surrounding skin and the spots stand out like a sore thumb.
Selenium sulfide and fungal medicines like Lotrimin, Naftin and Tinactin can usually dislodge the fungus. The depigmented skin stays light for quite some time, and people believe the medicines have not worked. In time, pigmentation returns.
TO J.R.: I am trying to find information on “white lung.” I’m not making much progress.
I very much enjoyed the family E-gram.
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.