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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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    Over weight, hands feels uncomfortable and cold. What is the cause? Looking for treatment

My almost sixty year old, overweight friend often walks with me, usually a brisk, hour-long walk. For the last few months, she s complained that her left hand gets noticeably and, sometimes, uncomfortably colder as she walks. I can easily tell the difference in the temperature of her two hands; the right is pink and warm and the left is cold and not pink. What are likely causes? Should she seek medical help? From whom.
Fri, 13 Jul 2012
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Cosmetic & Plastic Surgeon 's  Response
Hi Jjdmcook
thanks for posting your query on healthcare magic
the pathology that your friend is having is known as Raynaud's Phenomenon
Raynaud's phenomenon is a vasospasm response which occurs due to cold or emotional stress. It causes constriction of the peripheral blood vessels, leading to tissue hypoxia. In prolonged recurrent cases of Raynaud phenomenon atrophy of the skin, subcutaneous tissues, and muscle can also occur. In rare cases it can cause ulceration and ischemic gangrene of the fingers
The usual color changes occur as pallor or whiteness , if there is less oxygen or depletion then cyanosis or blue discoloration and then return of flow may cause redness .

There are two divisions :
1) Primary Raynaud's disease - which is idiopathic
2) Secondary Raynaud's which may be associated to various conditions like
- Connective tussue disorders eg SLE
- Obstructive disorders eg atherosclerosis,Buerger's disease,thoracic outlet syndrome
-Drugs
-Occupation involving vibration eg. drilling
-Other causes such as trauma sustained in auto accident or other traumatic events
or carpal tunnel syndrome
I would suggest you to visit your physician to determine the causeget you investigated accordingly and give you medication for the same such as calcium channel blockers (nifedipine) or diltiazem or Angiotensin II receptor antagonists like Losartan or sildenafil for vasodilator effect
If they dont help then surgical intervention such as sympathectomy or microvascular surgery for enhancement of blood in vessels , or accesory 1st rib excision , can be done by a plastic surgeon
recently Botox has also be used to decrease pain and increase the vascularity to heal complications such as ulcers
Ill suggest donot neglect the problem and see a physician for the same
I hope i have answered to your query
If you have any further doubts do post again
God Bless
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