"Cold Hands, Warm Heart" -Raynaud's Disease
This article was featured in the Raynauds Association's Fall 2002 newsletter (Vol 9, Issue 2) (www.raynauds.org)
My mother was wrong! Actually, the warmth of our heart plays a significant role in keeping our hands warm. For the person with Raynaud's however, the warmth of the heart does little to keep blood moving into the hands. What's happening?
The Radiator System of the Body
Just like water flowing through the steam radiators in my old but charming home, our blood flows throughout our bodies bringing warmth. Like the boiler in the basement, the heart pumps warm blood to every living cell. That blood has been warmed by virtue of hanging around the inner core of our bodies. How warm is this blood? Well, it's 98.6 F, our "normal" body temperature.
This warm blood will circulate throughout your body if nothing obstructs the pipes (your blood vessels). When it reaches your hands, it should be able to keep them at about 90F or warmer when you're sitting inside (at normal room temperature; 70F or so).
The Aeration System of the Body
One of the most amazing things I learned in biology was that breathing is not just about what goes on with our lungs. This is only half the picture. It's actually the cells that are doing the breathing!
Here's how it works. When we inhale, our lungs take in oxygen-rich air. Then the oxygen slides through the lining of the lungs and gets picked up by the blood and stored in its storage bins (hemoglobin molecules). The oxygen-rich blood runs through our arteries and delivers the oxygen to the all the cells in our body. The cells use the oxygen to do work (cellular repair, synthesis of materials and energy, even cellular reproduction!!!). The waste material is the carbon dioxide, which is taken by the blood through our veins back to the lungs. It's the same carbon dioxide that we exhale. When the blood is carrying oxygen, its color is red; when it's carrying carbon dioxide, it's more bluish (thus our arteries are red and our veins are blue).
Raynaud's Colors: White, Blue and Red
When a person experiences Raynaud's Disease their small blood vessels that feed the skin constrict through a process called "vasospasm". These constricted blood vessels don't let the blood flow freely into the hands and they turn white (just as your face might turn white when you are frightened...the blood "drains" from your face). As the cells in the hands begin to cry out for oxygen (which the blood was supposed to carry to them), the skin turns blue. After a time, the blood returns to the hands and they turn red.
Biofeedback in the Treatment of Raynaud's
The goal of biofeedback therapy is to put an end to this red, white and blue thing! Thermal biofeedback has a great track record. For people with Raynaud's Disease, thermal biofeedback training is successful 80 to 90% of the time. Effects continue to be shown at one year and three year follow-ups. (These results were obtained in the treatment of primary Raynaud's (Raynaud's Disease). For secondary Raynaud's (Raynaud's Phenomenon), biofeedback has been shown to be helpful in reducing some of the symptoms.)
Here's how it works. You'd sit in a comfortable chair and train the body to vasodilate.
Did you expect more? Well, that's the beauty of thermal biofeedback training. It's elegantly simple. So why isn't everyone with Raynaud's Disease running to their nearest biofeedback therapist? It's because biofeedback is more about training than treatment. There's no "take two aspirin and call me in the morning." The training takes time, motivation, and practice. It takes about 20 sessions as well as home training to accomplish this feat.
Raynaud's Problems/Biofeedback's Solutions
Raynaud's sufferers have two challenges to overcome. The first is to reduce the stress that causes the initial vasoconstriction and the second is to reverse the constriction once it occurs. Biofeedback therapy offers a two-pronged solution: downshifting the nervous system overall and training people to vasodilate their peripheral blood vessels.