Dear Dr. Donohue: My daughter, 34, has been trained as a pianist. For the past three years, she has been troubled with Raynaud's phenomenon, which has put her piano career on hold. What can you tell me about her condition? - Mrs. W.W.

Dear Mrs. W.W.: Raynaud's (ray-NOSE) phenomenon is a clamping down of arteries - usually in the hands, but sometimes in the feet - upon exposure to cold.

It is not the normal artery narrowing we all experience under cold circumstances. Raynaud's narrowing is exaggerated and often disabling.

At the onset of a Raynaud's attack in a finger, the skin first blanches from the diminished blood flow. The finger turns dusky as the blood loses its oxygen. Finally, as the attack abates, a sudden gush of blood courses through the reopened arteries, the skin regaining its healthy appearance. Great pain occurs throughout the changes.

Most patients are advised to avoid cold exposure, even to the point of wearing gloves to shop in a market's frozen-food section.

Nicotine and caffeine can aggravate a vessel-narrowing situation.

Your daughter might consult a vascular surgeon. There are alleviating therapies available. For example, if the patient swings her arms in a windmill fashion, blood might be forced into the blood-deprived hands. If the attacks are severe and frequent, drugs such as nifedipine might help.

Dear Dr. Donohue: I am a woman, age 41, who for two years has had pain and aching on the inside of my right knee. For a month, I have developed a fluid with the pain in my knee, also a feeling of stiffness. An arthritis specialist said I have bursitis. I can no longer ride my bike. Also, I have pain in my hands and in the left knee. Do I have arthritis or bursitis? - Mrs. D.R.

Dear Mrs. D.R.: You probably have both. The general joint pains and aches point to arthritis, and the knee fluid buildup can indicate bursitis.

The bursitis might be what you might have seen referred to here as a "Baker's cyst."That involves buildup and trapping of fluid in the bursa behind the knee. It's a common ailment.

The fact that some of your other joints are in pain raises the possibility of rheumatoid arthritis.

Ask your doctor to give you medicine to relieve the pain and the inflammation. For the Baker's cyst, surgery can be considered, and cortisone injected into the bursa might help.


Copyright © 2020, Sun Sentinel