When it comes to comfort, the human body temperature thrives at 37 degrees Celsius. At that temperature, the main organs are protected from damage and operate at best efficiency. As the air warms and cools, the body accommodates itself to maintain 37 degrees.
As the body’s environment cools, Dianne says a whole lot of things start happening. Receptors in the blood and on the skin tell the brain whether it’s warming or cooling outside. Sufferers of Raynaud’s, says Dianne (and that’s 95% of people who have scleroderma), have extreme reactions to cold.
When receptors defend against cold, Dianne says, their signals arrive at an almond-sized part of the brain called the hypothalamus, which is situated just above the brain stem. The hypothalamus controls body temperature, hunger, important aspects of parenting and attachment behaviours, thirst, fatigue, sleep, and circadian cycles (24 hour clock).
The hypothalamus, triggers some automatic and some voluntary responses. It calls on other parts of the brain, the cortex and limbic system to reduce heat loss. They are partly why you might rub your hands to generate friction when you’re cold, pace and draw nearer a heater.
The body’s metabolic rate increases and warms up until the crisis is over the and hypothalamus calms down and reduces its heat-producing signals.
In scleroderma and with Raynaud’s in particular, Dianne says, blood vessels become damaged and narrow. The pattern of blood flow to extremities changes. First the cells that line the blood vessels become damaged and the basement membrane thickens. Then the middle thickens and finally the outside layer becomes excessively fibrous.
With narrowed blood vessels, Dianne says we are already a step ahead of people who do not have scleroderma and it doesn’t take much to constrict our blood vessels when cold signals race off to the brain. Raynaud’s phenomenon describes these episodic constrictions in the fingers and toes. In some people it may also affect the tip of the nose and earlobes. Exposure to cold triggers attacks or it may be even a smaller drop temperature, emotional stress, and vibration.
Raynaud’s consists of two types: Primary which means no underlying disease and secondary which is a complication of scleroderma and other medical conditions. So it’s possible to suffer from Raynaud’s without scleroderma but if you have scleroderma, it’s almost forgone that Raynaud’s will appear too.
The secondary variety that goes hand-in-hand with scleroderma is clinically more severe than primary and tends not to develop in people under 30, However, it’s more severe, attacks more often, is prolonged and painful.
It is frequently associated with lesions caused by inadequate blood supply (ischaemic) and death of tissue in the fingers and toes.
Dianne’s advice is to get warm and stay that way. Use gloves before you feel cold. Warm your house to 22 degrees, even the loo and eat well and eat enough to keep your blood sugar levels constant.
- Exercise daily to improve circulation and:
- Use thermal gloves, socks, and boots to prevent both the drying effects of weather and Raynaud’s attacks – look for wool, sheepskin.
- Try technology warmers like silver gloves and silver socks
- Use hand and foot warmers – invaluable in cold weather
- Choose shoes and boots with thick soles
- Exercise a lot to improve blood supply to the skin
- Wear rubber gloves to protect the hands with thin cotton gloves inside them to prevent the skin sweating
- Use barrier creams and use skin cream after washing
If Raynaud’s attacks:
- Place hands/feet in lukewarm water
- Rub hands/feet briskly
- Drink a large hot beverage
- Shake arms and legs
- Walk around indoors
- Put your hands in your armpits
- Curl your hands and blow on them
- Take a hot bath
- Get really warm all over