Winter as an Ohio Podiatrist: Talking about the Weather and Toes
“Don’t knock the weather. If it didn’t change once in awhile nine out of ten people couldn’t start a conversation.” ~Kin Hubbard
One thing I didn’t know about Ohio until I moved here is that the weather is crazy. It’s unpredictable. It’s interesting. It can go from 60 degrees and sunny to 30 degrees and snowy in one afternoon. I am still in awe of these peculiar meteorological conditions, and I find myself discussing them with my patients daily. This winter has seemed looooonnnnggg and chilly, and I have seen a record number of patients with a common foot problem that has ties to this cold weather. It is a condition known as Raynaud’s (pronounced ray-NOHZ) disease, and 1 out of every 10 Americans suffers from it.
The reason most patients with Raynaud’s come to my office is that they have noticed their toes turning colors. In this condition the toes first turn white, then blue, then red. These color changes can be associated with discomfort like tingling, burning, numbness, stinging, or throbbing. The reason for this is that in Raynaud’s the small blood vessels that supply blood to your skin clamp down in response to cold temperatures or stress. Often just one or two toes or fingers are involved, and not everyone experiences all three colors. In most patients Raynaud’s is more of an annoyance than a disability.
Raynaud’s can be broken up into two types, primary and secondary. Both types are nine times as likely to affect women. Primary Raynaud’s is the most common type and is not associated with any other type of disease. This type is usually discovered between the ages of 15 and 30 and may have a genetic link (a parent, sibling or child may have it as well). It occurs more in people who live in cold climates (think Ohio from October or November to April or May).
Secondary Raynaud’s (aka Raynaud’s phenomenon) is associated with certain diseases, occupations, and chemicals. Autoimmune diseases like Lupus, Scleroderma, Rheumatoid arthritis, and Sjogren’s syndrome are linked with Raynaud’s as are other conditions such as carpal and tarsal tunnel syndromes, and thyroid dysfunction. Jobs that involve working with vibrating tools and repetitive motions like playing the piano for long periods of time can also cause a type of the phenomenon. Smoking and caffeine are also known triggers. I wonder how many of my patients on a blustery winter day find solace in a cigarette and a nice hot cup of coffee?
Most of the time people with Raynaud’s don’t really develop any complications, but occasionally I will see patients who develop blisters or sores on the tips of their toes. Very rarely Raynaud’s can lead to gangrene and result in amputation.
If you think you may have Raynaud’s come visit our offices at Advanced Foot and Ankle Care. First of all, we will try to find the reason you have this condition whether it be smoking, your body’s response to stress, a compressed nerve, or an underlying autoimmune disease. We may rule out causes of secondary Raynaud’s with vascular testing, blood tests, and nerve blocks. You may be referred to a rheumatologist or your primary care physician if we feel that your problem is serious enough that you could benefit from medication to open your blood vessels and promote circulation.
Most of the time Raynaud’s can be treated by dressing warmly and avoiding situations in which your hands and feet come into direct contact with the cold. Wearing a hat outside in the winter is important because a lot of body head escapes through your head. I recommend that my patients wear socks to bed and put an extra blanket at the foot of the bed. I may recommend that they avoid over the counter cold medications that contain pseudoephedrine, birth control pills, and beta blockers (for the latter two, after consulting their ob-gyn and family physician). And then there’s everyone’s favorite recommendation: Moving to the Caribbean. On Doctor’s orders, of course J