"Cold Hands, Warm Heart" - Raynaud's Disease

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“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.)

Temperature Biofeedback Digital Numeric Thermal Trainer

with small bead thermistor for biofeedback on middle finger

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.

Biofeedback trains you to induce voluntary control of physiological processes that have been altered by pathological disorders. I recall memorizing the function of the Autonomic Nervous System by saying “the Autonomic Nervous System is the automatic nervous system”. It was spontaneous and beyond conscious control. Then East met West and everything changed. Our western scientists began studying the yogic masters in the East and discovered that they were in fact consciously controlling the automatic system. After years of collaboration, the West was able to mechanize and computerize the process of training that allows you to take conscious control over “automatic” bodily processes.

Stress is More Than a Feeling

You've often heard the phrase “I feel stressed”, and most of us know exactly what is meant. We feel overwhelmed and out of control. Often we experience physical symptoms like an upset stomach, headache, fatigue and...cold hands. It's the Sympathetic branch of the Autonomic Nervous System that helps prepare the body to meet emergencies by “fight or flight.” In an effort to meet the energy and strength requirements of an emergency, our digestion slows down, our muscles tighten, and we expend energy and the blood vessels near the skin contract.

Some of my patients swear they are not feeling stressed when they experience stress related symptoms. Then I ask, “How much sleep are you getting? What have you been eating? Have you been sick in the last few months?” Ah, here's the culprit--biological stress.

Biofeedback training accomplishes two very important tasks for Raynaud's sufferers. First, it helps them train to vasodilate their peripheral blood vessels so their hands can stay nice and warm. Second, it teaches them to reduce the impact of stress so their blood vessels will be less likely to constrict in the first place! Warm heart; warm hands...what a perfect match!

Professional Help

If you suffer from Raynaud's disease, ask your doctor whether you are a possible candidate for biofeedback treatment, or contact Dr. DeBease at the BioNeuroFeedback Treatment Center in Bala Cynwyd, PA.

Dr. DeBease is a certified biofeedback therapist and a medical psychologist, practicing in the Philadelphia area, working to improve the quality of our community's lives...without the use of medication!