Keeping body warm can punish fingers and toes
DEAR DR. DONOHUE: I have put up with Raynaud.s disease for many years. Now I want help. Is there a vitamin or medicine I can take for it? I don.t like winter, but Raynaud.s makes it totally unbearable for me. What can I do? -- A.D.
ANSWER: When exposed to cold, arteries constrict to conserve body heat. That prevents warm blood from flowing to places where its warmth would be dissipated. It.s an inborn protective body defense.
People with Raynaud.s disease have overly sensitive arteries. When exposed to cold, their arteries clamp down so tightly that blood cannot circulate through them. The results are seen in the hands and feet. When Raynaud.s people confront the cold, their fingers and toes turn white because arm and leg arteries violently constrict. In a few minutes, blood trapped in the fingers and toes loses its oxygen, and they turn blue. Finally, when the constriction relaxes, blood rushes in, and the fingers and toes turn red. It.s a patriotic blue, white and red response.
The entire event can be most painful.
No vitamin can help you. If the attacks are frequent and painful, medicines might. Nifedipine, a blood pressure and heart medicine, can often keep Raynaud.s arteries from overreacting. Nitroglycerin ointment applied to the hands, fingers, feet and toes works for others. This is the same nitroglycerin used by people with angina. It dilates their narrowed heart arteries, and it can dilate the narrowed arteries of Raynaud.s disease.
I am positive that you already take preemptive measures when you know you.re going to face the cold. Wearing mittens instead of gloves keeps the hands warm and arteries open.
If you haven.t already done so, you should have your doctor look into the illnesses that sometimes are associated with Raynaud.s disease. Rheumatoid arthritis and similar conditions sometimes trigger it.
DEAR DR. DONOHUE: When varicose veins are removed -- something I face -- how does blood leave the legs and get back to the heart? Is there a circulatory problem after they.re gone? I have never seen this discussed. -- B.K.
ANSWER: There are two systems of leg veins. One is near the surface -- the superficial veins -- and it is these veins that become varicose and are removed. That leaves the deep veins of the legs, veins you can.t see. They take over the entire task of getting blood from the legs back to the heart when the superficial veins are gone.
Surgery is only one option for treating varicose veins. The veins and their treatment are discussed in the booklet on that topic. Readers can order a copy by writing: Dr. Donohue -- No. 108, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient.s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I thought I had a simple case of laryngitis. My voice was quite raspy. It didn.t go away, so I saw the family doctor, who sent me to an ENT doctor. I have spastic dysphonia. I.ll bet your readers have never heard of it. I hadn.t.
I have had a Botox injection, and my voice has come back. Does that mean I am over and done with it? If not, how long does the shot last? -- C.D.
ANSWER: Spastic -- or spasmodic, as it is more commonly called -- dysphonia is one of a group of illnesses with the family name "dystonia." Dystonias feature involuntary, sustained muscle contractions. In the case of spasmodic dysphonia, the involved muscles are voice box muscles.
Contraction of vocal muscles makes the voice hoarse, gives it a breathy quality or makes it give out when a person speaks.
Botox doesn.t cure. It.s a dilute solution of a bacterial poison that can release the intense muscle contraction caused by dystonia. A Botox shot for spasmodic dysphonia lasts from three to six months.
I am sure most readers haven.t heard of this condition, but your story is a warning to people not to dismiss hoarseness that has not gone away in a week or so.
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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.
(c) 2004 North America Syndicate Inc.
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