Change in circulation in the hands or feet is a normal physiological response, a reflex mechanism that causes the blood vessels to narrow when exposed to the cold. Almost everyone can recall a time when their fingers, nose or toes were painfully cold, but for people with Raynaud's, even minimal exposure can cause the small arteries that supply the fingers and the toes to contract suddenly, cutting off blood flow. During an attack, which can last for minutes or hours, the affected fingers and toes tingle, bum or go numb. (In rare cases, sustained restriction of the arteries causes ulceration.) Aside from unusually cold extremities, Raynaud's is defined by color: Fingers and toes turn white due to a lack of blood, then blue as the blood sluggishly returns. As they warm and normal blood flow is re-established, they turn red.
When such symptoms are the result of a known underlying disorder, such as atherosclerosis, rheumatoid arthritis or lupus, or are caused by long-term use of vibrating tools like jackhammers and chain saws, the disease is known as secondary Raynaud's phenomenon. Primary Raynaud's phenomenon - what my climbing buddy thought I had - has no known cause. "It's not a disease," says Frederick Wigley, M.D., associate professor of medicine at Johns Hopkins University and co-director of the Raynaud's center there. "People with primary Raynaud's phenomenon are perfectly fine."
Though Wigley is technically right, people who suffer from severe cases of Raynaud's view it as more than a nuisance. "I get frustrated," says Barbara Lax, a fund-raiser who works in New York City. "I'm fearful of going outside because I know it will cause me pain." Lax, 42, says her Raynaud's began while she was in her mid-20s. At times during the winter, her feet would become so painful she could barely put on shoes. When she goes outside in the winter, Lax bundles up from head to her often painful toes.
Bunding up when it's cold is perhaps the most obvious advice for preventing an attack. But though winter may be almost a distant memory, for people who suffer from Raynaud's disease, the discomfort of numb fingers may be only as far away as an aggressively air-conditioned office. Bielory has pointed out that although Raynaud's is more prevalent in winter, "it can occur any time in a variety of cold environments, such as the frozen foods section of a supermarket." And according to Wigley, it's not necessarily constant cold temperatures that cause attacks; it's often die shifting of temperatures. "A lot of my patients have the worst time at the changing of the seasons," he says.
Stress also can bring on an attack because it creates the same reaction in the body as does the cold (think of the term "cold feet"). Under stress, blood is pulled from the hands and feet to the brain and internal organs to help one think and act more quickly.
If you have primary Raynaud's - and it's important to undergo a medical exam to make sure your symptoms are not a sign a more serious disorder - there is a lot you can do to help prevent attacks. Keep warm and dry in cold weather. Before going out in the cold, have a warm meal or drink to raise your core body temperature. (Avoid caffeine, however, as it constricts blood vessels.) Run your car in cold weather to warm it up. In all seasons, keep mittens near the freezer to use when handling frozen foods, and use insulated glasses for cold drinks. Drink plenty of fluids - dehydration can aggravate the condition by reducing blood volume - but pass on the booze. Alcohol increases blood flow to the skin, making you feel warm at first, but then cold as the heat is soon lost to air. Avoid smoking as it further restricts blood flow.