When you have an episode or flare-up of Raynaud's phenomenon, the most important thing is to stay calm and gently re-warm your fingers or toes as soon as possible. Movement, such as wriggling your fingers or toes, swinging your arms, or walking briskly, increases blood circulation. Placing your hands under your armpits often helps.
As soon as possible, run warm (not hot) water over the affected area. You can also drink something hot, but avoid caffeinated drinks. Hot cider or broths are especially good during a flare-up.
Try to keep up a daily routine of gentle exercises to keep your blood circulating.
Your doctor is the best source of information on the drug treatment choices available to you.
Surgical interventions are normally reserved for the most severe cases of RP. The success of procedures is highly dependent on the experience of the surgeon. Sympathectomies are procedures in which the goal of surgery is to disrupt the nerves that cause the vessels to contract. One such procedure, which is performed in the nervous system near the spinal cord (proximal sympathectomies), is more effective with primary RP than with secondary RP. Sympathectomies performed closer to the affected arteries in the hands and feet (digital sympathectomies) are more effective than proximal procedures in secondary RP.
Occasionally, microsurgery is attempted to bypass diseased blood vessels. If diminished blood supply over time leads to gangrene, amputation of the affected digit may be necessary.
Aviators with RP may be denied medical authorization to fly. The severity of Raynaud's phenomenon is very important to aviators. Permission to fly as a pilot may be denied if the FAA determines the condition to be severe enough to threaten safety. Aviators with Raynaud's phenomenon should take special precautions to remain warm during pre-flight, flight, and post-flight activities.
Intravenous fluids being administered to patients with RP should be pre-warmed. When patients with Raynaud's phenomenon require intravenous therapy (e.g., saline, medications, blood products, etc.), the fluids should be pre-warmed before administration.
RP is a chronic condition with a highly variable outcome; however, most patients learn to minimize its effects, and do not develop serious complications.
Fortunately, the majority of patients with primary RP do not develop the more severe complications of the illness. However, patients with secondary RP have a far more variable course, as they may have underlying illnesses that further impair arterial function and blood flow.
Long-term studies show that no more than 10% of patients diagnosed with primary RP develop an underlying illness that leads to secondary RP. If this happens, however, it may not occur until many years after the initial symptom of RP. Therefore, a physician or a rheumatologist should continue to monitor patients diagnosed with RP in order to minimize complications.
It is important for anyone with any form of Raynaud's phenomenon to be alert for symptoms, take immediate countermeasures if symptoms occur, and keep in touch with a healthcare provider.
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