FWD:RSD World News- Article on Renauld's

I saw THIS ARTICLE in one of our main papers and though it failes to mention RSD it does seem to mimic some of the effects. As a result I did a Google search on one of the medecines used and linked it to a search for RSD and was very surprised that it was being used at this time in RSD treatment. So for those who want to read it, here it is and I will publish the result of the RSD search after this post.





Cold hands? Don't blame it on the weather: How icy fingers could be a sign of something more serious...

By Moira Petty
Last updated at 12:08 AM on 10th February 2009

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Cold hands are not only a sign that the weather's bitter - they could be a symptom of something more serious.


There are at least a dozen conditions which cause chronic cold hands, including peripheral vascular disease and ME.


But for an estimated nine million Britons, cold hands are a sign they have Raynaud's.



The condition causes the small blood vessels in the fingers, toes, ears and nose to constrict when their temperature drops.


Although it's usually worse in the winter, even in warm weather patients can suffer in the slightest temperature drop, such as moving into an air-conditioned atmosphere.


During an attack the skin visibly whitens and the area becomes numb or extremely painful. Sufferers often develop sores and patches of hard skin, which makes walking painful; because of poor blood flow their skin is also prone to ulceration and infection.

Even a moment's exposure to the cold can leave sufferers in agonising pain. As Alison Wright, a sufferer, explains: 'Just opening the front door is enough for an attack - you feel as if glass is being scrunched in your hands.'


'People assume Raynaud's is "just" about numb hands,' adds Alison, 37, from Portsmouth. 'In fact, you're unable to use your fingers at all. Getting coins out of your purse, keying in your pin number, unscrewing jars or just putting the key in the door become impossible.'



Chilly: Having cold hands could be a symptom of something more than the bitter weather (picture posed)

Nine out of every ten sufferers are female - it's thought that oestrogen makes the blood thicker, slowing down its flow in the tiny vessels (the symptoms often first appear with puberty and attacks can be worse at certain times in the monthly cycle, sometimes tailing off after the menopause).


The severity of the condition varies with the patient.



But the key is that the condition is diagnosed early, says Chris Denton, Professor of Experimental Rheumatology at University College London and a consultant at the Royal Free Hospital.


Not only because patients can be given treatment to reduce the debilitating effects - but, more importantly, to identify if it's secondary Raynaud's, which is potentially far more serious.


An astonishing half a million Britons are thought to have the secondary form - where their symptoms are a sign of an underlying problem.


It can be a side-effect of certain medication (such as migraine treatments, betablockers and the Pill), or exposure to chemicals or a virus.


More worrying, their symptoms could be caused by an auto-immune disease, such as rheumatoid arthritis, lupus or scleroderma.


Some of these conditions are potentially fatal; one form of scleroderma, for instance, is linked to lung disease and problems with the kidneys, gastrointestinal system and the heart.


Raynaud's symptoms are often the first sign of the more serious health problem, says Professor Denton. For this reason it's important anyone with symptoms should be tested.


'By screening for these serious complications at the earliest stage, it means we can treat them.'


Alison Wright has secondary Raynaud's, although this wasn't discovered until her condition rapidly worsened. She was diagnosed with Raynaud's five years ago, but when treatment didn't help, a GP referred her to a rheumatologist four months later.


Don't blame the weather: A street in Glasgow last week - the cold weather is not the only reason you may get icy fingers

Blood tests revealed she has a form of scleroderma.


Her body produces too much collagen, the tissue used for building the skin, blood vessels, joints and organs. Some forms of scleroderma can cause inflammation of the skin, or growths of thickened skin.


'As well as Raynaud's symptoms, the skin on my fingers is permanently taut, shiny and can get very red,' says Alison. 'They're difficult to move. My hands are also puffy and I've had horrible ulcers on fingers and toes. It's a progressive disease and they can't tell how bad it will get.'


There is no treatment for her form of scleroderma, and she has her heart and lungs checked annually as the condition can damage the organs.


But at the moment it is the Raynaud's, not the scleroderma, which gives Alison the greatest discomfort.


'If I go into the chiller section at the supermarket, my hands go white from fingers to palms.


'At the cashier I can barely pick up the food from my trolley let alone get my money out of my purse. Even getting from the car to the house can bring on an attack so bad I cry out with pain.'


Alison, who is married to a lieutenant commander in the Navy, is keen to start a family, although she worries about the practicalities of daily life with a condition which means she can't use her hands.


Raynaud's used to be treated with surgery to the sympathetic nervous system (the nerves from the brain to the hands and feet). But because the effects are temporary and there is the risk of complications, such as nerve damage, surgery is rarely offered these days.


The most common drug treatment is with vasodilators such as ACE inhibitors or calcium channel blockers - these work by relaxing the blood vessels.


Prozac is also used - this blocks the hormone serotonin, which constricts blood vessels.


In severe cases, iloprost may be offered; this has similar properties to the natural hormone prostacyclin, which opens up the blood vessels and prevents the blood flow becoming sluggish.


'Because of the side-effects, we reserve it for the severe sufferers,' says Professor Denton. 'Many patients might have it once a year to get them through the winter.'


The risk of unpleasant side-effects with drug treatments - including severe headaches - means that those with a mild version of the condition are advised to keep fingers and feet warm with silk or thermal gloves and use hats and scarves to cover the nose, mouth and ears, as well as keeping warm generally.


Sufferers are also advised to use portable heat packs, and to keep a hot water bottle or flask of hot water in the car. Simple exercises can get the circulation going.


'Studies have shown ginkgo biloba to be helpful,' adds Professor Denton. 'And we have anecdotal evidence that ginger may help, too.'


But unfortunately for those with more severe Raynaud's, there are other problems. An infection or cut can be more serious as poor blood flow means these take longer to heal.


Also any ulcers on the fingers or toes will not heal on their own and require antibiotic treatment - even then, healing will be slow.


In the past Alison has been given courses of iloprost and also takes nifedipine, which helps reduce the pain of her attack.


But as other sufferers with severe Raynaud's find, the medication cannot prevent the attacks completely.


'I don't get much sympathy because people don't understand what's wrong with me,' says Alison. 'But the real worry is that many - but especially those who might have it - don't know about the condition.


. RAYNAUD'S and Scleroderma Association, 0800 917 2494, www.raynauds.org.uk