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December 28, 2006
Raynaud’s disease
Q
A friend of mine has Raynaud's disease. What should he do about it? He only takes aspirin for it.
A Nature gave us a mechanism to conserve body heat. Upon exposure to cold, skin arteries clamp down so the body doesn't lose heat by circulating blood to its surface.
People with Raynaud's disease – and there are many of them – have a heat -conservation mechanism that is too sensitive. If they reach for something in a freezer, the arteries to their hands and fingers clamp down so violently that the fingers get no blood. Initially, the fingers turn white. In a short time, they turn blue, because the blood trapped in them before artery closure loses its oxygen. When the artery spasm relaxes, a rush of blood into the fingers turns them red. The episode can be quite painful.
If your friend smokes, he must stop. He should go easy on or eliminate caffeine. It causes vessel constriction. He must be careful about using decongestants, since they do the same thing. He has to dress warmly and wear mittens or gloves when he knows he's going to deal with the cold.
A low dose of aspirin, 81mg a day, can help some Raynaud's patients endure the cold with less trouble. Calcium blockers, used for heart disease and high blood pressure, can also prevent artery spasm. Two such medicines are nifedipine and diltiazem.
In more than half of Raynaud's patients, the illness goes away on its own, but that can take as long as seven years.
The hands and fingers are not the only places where Raynaud's occurs. It can happen to the feet, toes, ears and nose.
In a few individuals, Raynaud's is associated with another illness. Rheumatoid arthritis, lupus and scleroderma are examples.
Q Will you settle an argument? Let's say person A, who is a dog lover, has access to spoiled, rotten food right out of the garbage. Person A believes that washing the food, placing it in a container and then storing it in the refrigerator makes it safe to use for dog treats. Person B believes this is not safe. Is person A foolish, or is person B paranoid?
A Rotten food should not be eaten by humans or animals. Rot comes from bacteria and fungi invading the food. Those germs can cause sickness in humans and animals. No amount of washing is going to get rid of them. Person A is foolish. Person B is not paranoid. Person C, Donohue, has spoken.
Q My husband was recently diagnosed with MGUS. We know it has something to do with too much protein in his blood. Will you tell us more about it?
A “MGUS” is the abbreviation for “monoclonal gammopathy of uncertain significance.” The name is unfamiliar and unusual, but the condition is not rare. About one per cent of people over 50 have it, and after age 75, 10 per cent have it. That's a good number of people.
“Gammopathy” refers to an abnormally great production of gamma globulin. Gamma globulin is a protein. It is the stuff antibodies are made of. The gamma globulin in MGUS, however, serves no useful purpose.
“Monoclonal” signifies that the gamma globulin comes from one single cell, a plasma cell. That single cell keeps dividing and dividing, forming an army of similar cells. Plasma cells function as antibody making cells, but here the process has gotten way out of hand.
“Uncertain significance” means just what it says. Doctors don't know why this happens, and they don't believe it is a dangerous condition. On average, people with MGUS live about two years less than do others of similar age who do not have this quirk.
There is a note of caution about MGUS. A small number of patients eventually develop multiple myeloma, a cancer of bone and bone marrow. Doctors, therefore, keep a close tab on MGUS patients, looking for any sign that multiple myeloma might be evolving.
Dr Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write to him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853Readers may also order health newsletters from www.rbmamall.com.
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