Nov. 01, 2011

Education forum: Circulate Yourself

As temperatures begin to fall, people with lupus may experience color changes, numbness, tingling, and pain in fingers and toes. These are symptoms of secondary Raynaud’s phenomenon, an autoimmune disease that causes a temporary tightening of the blood vessel wall and a spasm of the small arterioles (little arteries). This secondary form of the disease often occurs in individuals who have an overlying disease, such as lupus. Bitter-cold winters make life miserable for many people with Raynaud’s, but attacks can occur even in warmer climates, on breezy days, or in air-conditioned spaces.

This “baker’s dozen” of tips will help keep your blood flowing, whether or not the weather is cold.

1. In cold weather, dress warmly and in layers, wear a hat, and use mittens instead of gloves.

2. Carry hand and foot warmers (found in many sporting goods stores and ski shops).

3. To warm chilled hands or feet, run warm (not hot) water over them.

4. To aid circulation, avoid long periods of sitting and standing. Take a walk for at least 10 minutes every hour; rotate your ankles and feet whenever possible; point and flex your toes to promote circulation in your legs and feet.

5. Maintain an appropriate body weight for your frame. Obesity can strain the circulatory system. If you’re unsure of your ideal weight, talk to your doctor.

6. Wear loose-fitting clothing. Tight garments can restrict the flow of blood to and from the legs.

7. Don’t smoke: Smoking narrows blood vessels even more.

8. Avoid cold, stress, and caffeine.

9. Avoid decongestants (e.g., phenyl­eph­rine, Sudafed®) and any amphetamine-type medication (e.g., Provigil®, Adderall®).

10. Avoid crossing your legs. Leg crossing constricts veins and increases venous pressure.

11. Get regular exercise. Come up with ways to get yourself moving 30 minutes a day or at least three times a week. Suggested activities—that can be done outdoors or inside at the gym—include walking, running, swimming, and bicycling.

12. If your symptoms are severe, talk to your doctor about calcium channel blockers, medications given to people with high blood pressure. These drugs work to open up or dilate the blood vessels so the blood circulates more freely. (You may not be able to take these if your blood pressure is already low.)

13. See your doctor right away if you develop skin infections or skin ulcers, because long-term damage to the blood vessels can occur if treatment is delayed. Topical antibiotics or nitroglycerin paste or patches may be prescribed to protect against infected skin ulcers.

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