Raynaud's Disease

[Copperhed51]

Hey Doc, I'm not sure how familiar you are with Raynaud's Disease, but I'm 99% sure I have it. I don't know if it's primary or secondary but I assume it's primary. My question is, do you know of any good treatments for this? I am a pretty avid cyclist and live in KS which means very cold temps for half of the year. I tried to just get on my bike with good gloves and shoe covers last year but I'd be outside for less than 10 minutes and my fingers/toes were white and in pain. I hate not being able to get out and ride in the winter here since I lose every bit of fitness I gain in the summer.

Should I go to a doctor and get an official diagnosis? Are there any medications or alternative medicines that could help deal with this while still allowing me to keep my 1st class medical? What do you recommend I do? I miss being able to go outside in the winter. Even the thickest gloves seem to be no help.

[utamav]

As there hasn't been a reply from a Flight Surgeon, let me expound on Reynauds for you. For your comfort, I am a registered nurse who is certified in Critical Care, and Trauma Flight Nursing.
1. Reynauds is a vascular disease, your symptoms are suspect for Reynauds Disease, but your first step is getting a confirmational diagnosis from your physician or practitioner.
2. If in fact you are diagnosed with Reynauds, remember the following to avoid: Reduce your alcohol intake, some studies have shown however, that red wine reduces flareups of reynauds.....If you smoke....STOP. Nicotine is a vasoconstrictor, meaning it shrinks the diameter of your vasculature and microvasculature....which cause the discoloration in your distal fingers/toes. STOP SMOKING (If you do smoke). Avoid the cold as much as possible, again the cold causes vasocontriction and reduces blood supply to the affected fingers and toes. Keep those didgets warm. You see the pattern here....Reynauds is a Peripheral Vascular Disease.....it accompanied by vasoconstrition and thus lack of oxygen supply to your fingertips and toes.....you said that your finger tips are white.....keep it going and you could be looking at necrosis and arterial ulcers. Reduce your intake of all vasocontrictors: Caffeine, Alcohol, Smoking, and reduce activies that causes decreased blood flow to your fingertips and toes: being in the cold, squeezing your handlebars too tightly, etc.......

Just remember, Reynauds is one of those diseases in which a majority of cases can be controlled with lifestyle changes (as mentioned above). Maybe a FS can get on here an give you some more advice....but I think I've covered the bases for you. I can't tell you how it relates to your 1st class airman, but if you don't hear anything back from one of JC's Flight doc's, you can PM if you have any questions.

As far as medications go, usually what is prescribed are Calcium Channel blockers such as Nimotop, Nifedipine. These drugs reduce the possibility of vasospasm and also dilate the blood vessels. Another group of drugs being prescribed are a group of druges called Angiotensin Receptor Blockers or ARB's such Losartan, they basically work by blocking angiotensin1 receptor sites resulting in vasodilation and a reduced secretion of intrinsic vasopressin in the body. Vasopressin is a vasoconstrictor so you would want to limit its secretion into the body. I don't know how taking these would affect your 1st class though, that would be for the FS to answer

I'd stick with the less invasive interventions first like lifestyle changes and precautions in the cold, etc, etc.....Good Luck!

Forgive the grammar, it's late and I'm on call.
UTAMAV R.N, B.S.N., CCRN, CFRN

[My Flight Surgeon]

The nurse is correct. In addition, you can use beta blockers. Cabella's has some heated gloves you might try. None of these drugs nor Raynaud's should DQ you.

I lived in Kansas 20 years and yes it is chilly in the winter though not as cold as North Dakota.

[utamav]

Didn't know about the beta blockers doc....good call! BTW you call Kansas chilly??!?!? That place is a frosted tundra after october! I'll keep it in Texas where its nice and warm, and turbulent

UTAMAV

[My Flight Surgeon]

Warm is Phoenix where I live. It has been 114 this week

[utamav]

Oh jeez man.....you can have it doc. My sister in-law lives out there. There is only one thing I look forward to when I visit. What's that, you ask? My second trip to sky harbor sittin on an MD-83


UTAMAV

[Copperhed51]

Thanks Nurse and Doc. I'll see how things go as the temperatures drop. From what I understand, Raynaud's can disappear as quickly as it appeared so we'll see. Definitely want to try to treat this though as it limits my ability to live comfortably. Great to know that the drugs and disease/syndrome will not DQ me. Thanks again.

[Bandit_Driver]

Originally Posted by My Flight Surgeon

Warm is Phoenix where I live. It has been 114 this week

But it's a dry heat, right lol

[JEP]

Originally Posted by Bandit_Driver

But it's a dry heat, right lol

Yeah, so is my oven...

[My Flight Surgeon]

WHen January arrives, we don't need a shovel

[utamav]

You guys are nuts