Strange Afflictions – Raynaud’s Phenomenon

Raynaud-hand2This is first in a series of posts where I’m sharing what I call my strange afflictions. I guess all afflictions seem “strange” when we face something that we consider to be “not normal” in our own bodies. They can be congenital (from birth) or be the result of an injury, or sometimes just inexplicably appear, like Raynaud’s Phenomenon.

This is my experience: In 2005, I started a part-time job working as an usher at the Ryman Auditorium in Nashville. I couldn’t wait to be on my feet, showing people to their seats while listening to incredible live music. I was in my mid-30s; it had been awhile since I’d worked a job like this (standing for several hours straight), probably not since my days as a waitress in college. I was thrilled to be out from behind a desk. I wanted action!

I forgot that “on your feet” jobs can sometimes include long periods of standing in one place, which is tough on the knees, feet, back. And I wasn’t 20 anymore. The very first week, I noticed something strange going on with one of my toes by the end of my shift.  My second toe was red and swollen. I was convinced it was a spider bite (a painful, itchy blister forming at the tip). The next night I had to wear hiking boots to work, as these were the only shoes wide enough to fit over my swollen toe.

I figured, like any bite, it would subside in a few days. It did. But then my middle toe “caught the bug.” That’s when I knew this was no spider bite. But what could it be? I went to the foot doctor, who promptly said, “I think you have lupus.” Ack! What?

He referred me to a rheumatologist who thankfully did not concur. He said, “You have Raynaud’s, but I don’t think you have lupus.” Ok, good. Now, what was that again? What is this thing I have? And how do I get rid of it?

Not my toes, but a good look at chilblains.

Not my toes, but a good example of chilblains.

The doc gave me a few maintenance suggestions to avoid chilblains (the itchy swollen toe problem that is a common symptom of Raynaud’s) and sent me on my way. I supplemented that with internet searches. It’s common for Raynaud’s sufferers to see their extremities (especially toes/fingers) turn patriotic colors (red, white, blue) during colder weather. It can feel similar to frostbite, though the temps do not have to dip too low to cause a reaction. I figured out that wearing socks that are too thick (which in turn make my shoes too tight) will trigger it. Baths that are too hot will trigger it. Sometimes my entire feet will turn blue or red without much provocation. More than once (in yoga class) I’ve had someone say to me, “Um, why is your foot blue?” It’s not cool having smurf feet.

I’ve been living with Raynaud’s for nine years now. I’ve been able to keep my toes fairly in check; not many flare-ups lately, though I still see tale-tell signs of poor circulation (puckering of the skin and dry, brittle toenails). Then the other day I noticed what looked like bruising on the lower part of my index finger. Very bluish – as if the blood vessel underneath had burst. Hey wait a minute, didn’t I see the same thing on my ring finger a few weeks ago? Oh….

Top hand shows loss of heat with Raynaud's

Top hand shows loss of heat with Raynaud’s

It’s not as if circulation problems in my fingers are anything new. I’ve had issues with RSI (repetitive strain injury) for years. Repetitive motion and connective tissue diseases are linked to Raynaud’s. That bluish discoloration I’m seeing in my fingers seems to be a result of a recent pinched nerve (literally someone pinched my hand trying to steady me from falling). And by recent I mean three months ago. It didn’t hurt much at the time, but since then I have felt weakness and numbness in that hand. The Mayo Clinic mentions RSI or Carpal Tunnel Syndrome as a secondary cause of Raynaud’s: “This condition involves pressure on a major nerve to your hand (ulnar nerve) producing numbness and pain in the affected hand. The hand may become more susceptible to cold temperatures and episodes of Raynaud’s.”

It’s important to see a doctor to find out if you have primary or secondary Raynaud’s. While the primary version is benign, there are several more serious conditions that can lead to secondary Raynaud’s (scleroderma, lupus, rheumatoid arthritis and Sjögren’s syndrome, as well as diseases of the arteries). In addition to a doctor’s visit, I recommend reading about it on the Mayo Clinic site, Wikipedia and this Q & A article from the New York Times.

And here are my own personal tips for keeping Raynaud’s episodes to a minimum:

1. Exercise – this is a circulation problem after all; target range-of-motion exercises in the fingers/toes; yoga is an excellent choice (going barefoot brings circulation to the toes).

2. Wear proper foot gear – most importantly, avoid tight shoes. Thin socks with minimalist-soled shoes works well for me when I’m walking around the city (again, allows for more circulation). I love my Brooks.

3. Avoid standing for long periods of time. If you cannot avoid it, then use pressure-relieving mats and shift your feet often (back in my ushering days, I developed an ants-in-the-pants sort of jig when I had to stand on the hard tile floor).

4. Keep joints comfortably warm (socks, gloves) indoors/outdoors. Fingerless gloves when working on the computer can ease discomfort in the fingers. Avoid quick temp changes (such as grabbing something out of the freezer – use a mitt or dish towel).

5. Ease yourself into a bath instead of jumping into a full tub – allow your toes to warm up slowly under lukewarm water from the faucet before increasing the temperature.

6. Use a Rubz ball on the feet and hands – a small rubber ball with acupressure points. It can help break up scarring/adhesions of the fascia (connective tissue that surrounds the muscles).