DEAR DR. DONOHUE: My 17-year-old son has Raynaud’s phenomenon. Cool temperatures turn his hand and fingers blue, then white and then sometimes orange. The episode is painful. He had a difficult time functioning at school. He wears gloves with the fingertips cut off as well as using hand warmers.

The doctor recommended blood pressure medicine, which I would like to avoid since he doesn’t have high blood pressure. Any ideas? — P.G.

ANSWER: When exposed to cold, everyone’s arteries constrict to preserve body heat. Constriction shunts blood to deeper body parts, where it stays warm.

People with Raynaud’s (ray-NOSE) have arteries that overreact to cold exposure. The hand arteries and sometimes the feet arteries shut tightly. With no blood flowing to them, the hands and fingers turn white. As oxygen is lost from the trapped blood, they turn blue. And finally, when the arteries open and blood rushes in, they turn reddish. Emotional stress causes the same reaction cold does. These are painful episodes.

Why are the fingertips of your son’s gloves cut off? It would be better to keep them. In fact, his whole body needs things to keep body heat intact. Thermal underwear and sweaters would help him stay warm.

At the onset of an attack, quick action can abort it. Letting warm water run over the hands or swinging the arms in a circular motion like a windmill keeps blood flowing to the hands and fingers.

Some of the medicines used for Raynaud’s control are also used for blood pressure control. Medicines often have more than one use. In your son’s case, the medicines will not affect his blood pressure, but they will keep the arteries open. Nifedipine (Procardia) and Norvasc (amlodipine) are two such medicines. Nitroglycerin ointment applied to the hands and fingers at the onset of an attack keep arteries dilated.

TO READERS: The booklet on headaches provides information on the different kinds of headaches and their treatments. Readers can order a copy by writing: Dr. Donohue — No. 901, 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: I am presently taking Plavix and a baby aspirin daily. Someone, not my doctor, advised me that you cannot take these two medicines with Cialis, Levitra or Viagra. Will you tell me if this is correct? — D.C.

ANSWER: Ask that someone where he got this information. I can’t find any reference that states incompatibility between aspirin and Plavix taken with Cialis, Levitra or Viagra. Was he thinking of nitrates, medicines most often used for angina, the chest pain that comes with blocked heart arteries?

DEAR DR. DONOHUE: I recently had my annual physical examination, with blood tests. I was disturbed that my lymphocyte count was 19.7 percent, when the normal should be between 20 percent and 47 percent. My white blood count was 3,800, and the normal is 4,500 to 10,500. Furthermore, the total protein should be 6.4 to 8.3 g/dL, and mine was 6.3. The doctor said these are not a concern. — H.H.

ANSWER: I agree with your doctor. Your values are so little removed from the normal values that they don’t indicate an illness or future trouble with any illness.

In addition, you have no symptoms. That, in itself, is proof that you are well.

DEAR DR. DONOHUE: Your dental advice isn’t as good as your medical advice. I hate it when you allude to doctors and dentists. You should say physicians and dentists. Both are doctors. — L.N., DDS

ANSWER: I won’t let it happen again, Doctor.

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.

Copy the Story Link