Cold exposure makes for painful fingers in Raynaud’s

DEAR DR. DONOHUE: Winter is a hard season for me. If I don’t wear a couple of pairs of gloves, my fingers turn white and hurt when I’m in the cold. This year it worried me enough to prompt me to see a doctor. She says I have Raynaud’s disease. The “disease” bit scares me. She also said arthritis is common with it. Does that mean I am going to get arthritis? — S.T.

ANSWER: “Disease” is too strong a word for this condition. How about Raynaud’s phenomenon? Many are substituting that word for “disease.” It’s an exaggerated response to cold. Everyone’s arteries constrict when they’re cold. It’s the body’s way of saving heat. People with Raynaud’s have arteries that overdo the constriction thing. Blood can’t reach the fingers and sometimes the toes. The fingers blanch. After a few minutes they turn blue, because oxygen is consumed from the trapped blood. And finally, when the constriction eases, they turn red as blood surges into them. During this event, the fingers are quite painful.

Raynaud’s affects from 3 percent to 20 percent of women, and from 3 percent to 14 percent of men. Summertime isn’t entirely pain-free for these people. Putting their hands into a freezer to retrieve an item brings on a Raynaud’s attack.

Mittens are better protection for the fingers than are gloves. Keep your entire body well-insulated, and that means wearing a hat. A drop in body temperature, not just hand temperature, triggers hand-artery spasm. Smoking is verboten. You can sometimes end an attack by swinging your arms in windmill fashion. That motion drives blood into the fingers.

For severe attacks, medicines can prevent artery constriction. Calcium channel blockers like nifedipine and diltiazem work. So does nitroglycerin.

Some people with rheumatoid arthritis and lupus come down with Raynaud’s, but not all Raynaud’s patients suffer from those illnesses.

TO READERS: The booklet on restless leg syndrome and nighttime leg cramps explains these common conditions and how they’re treated. To obtain a copy, write to: Dr. Donohue — No. 306, 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: My right big toe has an ingrown nail. It hurts. Will you please suggest a treatment? — L.F.

ANSWER: Soak your foot in warm water for 20 minutes. Soaking softens the nail and makes it easier to manipulate. Hook a piece of dental floss under the corner of the nail that’s penetrating the adjacent skin and lift it up. Wedge a rolled-up piece of cotton under the edge. Do this every day. It can take a couple of weeks before the nail edge is completely freed from the skin.

Don’t wear tight shoes. Cut your nails straight across. Don’t round the sides of the nail.

If this doesn’t bring a good result, then visit a podiatrist, who can free the nail for you.

DEAR DR. DONOHUE: I am a 76-year-old male in reasonably good health. I take a multivitamin-mineral supplement formulated for seniors. Each tablet contains more than 30 vitamins and minerals. How do they put all those ingredients in one small tablet? Are the doses on the label correct for a person my age? Do all of the ingredients retain their potency for the stated shelf life? Do I need to take such a tablet? — D.J.

ANSWER: The amount of vitamins and minerals is minute, smaller than a speck of dust. It’s no trouble getting them all into one tablet.

The doses on the label are correct for someone your age. That’s why it’s marketed for seniors.

All the ingredients retain their potency for the stated shelf life.

Many older people don’t eat a balanced diet. This kind of tablet is a boon for them.

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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