RAYNAUD'S PHENOMENON |
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DESCRIPTIONRaynaud's phenomenon is a circulatory-system disorder affecting fingers and toes that is a complication of an underlying disease or emotional disturbance. This is different from Raynaud's disease, which is a primary disease. Symptoms arise suddenly with Raynaud's phenomenon. With Raynaud's disease, they appear slowly over several years. The small arteries to the hands and feet are involved. It affects both sexes and all ages, but is most common in young women.
Appropriate health care includes:
Self-care after diagnosis.
Doctor's treatment.
Surgery to sever sympathetic nerves to the child's affected extremities. Surgery sometimes relieves symptoms for 1 or 2 years before they recur.
SIGNS & SYMPTOMS
Early symptoms:
Fingers that turn pale when exposed to cold or stress. Paleness is followed by a bluish tinge and then redness. Numbness and tingling accompany the color changes, and the child's symptoms are relieved by warmth.
Late symptoms:
Ulcers on the child's fingertips caused by lack of normal blood flow to the fingers.
Chronic infections under and around the child's fingernails and toenails.
CAUSES
Spasms of arteries that supply blood to the child's fingers and toes. Spasms may be caused by:
Scleroderma, lupus erythematosus, or other connective-tissue disorders.
Buerger's disease.
Cor pulmonale.
Certain medications, including ergot preparations, antihypertensives, alpha- and beta-adrenergic blockers, and calcium-channel blockers.
RISK FACTORS
Stress.
Smoking.
Cold, wet weather.
Activities that involve working with heavy equipment that vibrates forcefully, such as a chain saw or pneumatic drill.
PREVENTING COMPLICATIONS OR RECURRENCEInstructions for your child:
Don't smoke.
Avoid exposure to the cold.
Obtain medical treatment for diseases listed as causes.
Avoid exposure to cigarette smoke from other people.
OTHER
Because of the similarities between Raynaud's disease and Raynaud's phenomenon, an accurate diagnosis between the two may require years of observation.
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory blood studies.
X-rays of the child's hands and feet.
POSSIBLE COMPLICATIONS
Permanent weakness and numbness in the child's toes and fingers caused by blockage of the blood supply.
Gangrene that necessitates amputation, caused by loss of blood supply (worst cases only).
PROBABLE OUTCOME
Curable if the underlying cause can be cured.
TREATMENT
HOME CAREInstructions for your child:
Don't smoke.
Avoid exposure to cold in any form. Wear mittens and gloves outdoors and when handling ice or frozen food.
Wear comfortable, roomy shoes and wool socks. Don't go barefoot outdoors.
Avoid stressful situations whenever possible. See Appendix 19.
Move to a warm climate, if possible.
MEDICATION
Your doctor may prescribe:
Vasodilator drugs to dilate small arteries and improve the child's circulation.
Sedatives to relieve the child's tension and anxiety.
ACTIVITY
No restrictions, except for your child to keep warm and to avoid chilling, which may happen following any active recreational sport.
DIET & FLUIDS
No special diet. Alcohol dilates blood vessels and may temporarily improve circulation slightly. An occasional alcoholic beverage may be helpful to your child if the doctor suggests this.
OK TO GO TO SCHOOL?When appetite returns and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of Raynaud's phenomenon.
Discomfort worsens, despite treatment.
Ulcers appear on the child's fingers or toes and do not heal.
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