Cold hands and feet and Raynaud’s Phenomenon

WS patients often experience cold hands and feet. At first glance this does not seem to be a very disturbing complaint. However, it can be quite troublesome at times. It can be the cause of a great deal of self-consciousness or embarrassment. Several patients that I have seen have stated that they are actually embarrassed and self-conscious to shake people’s hands because of how frequently people will exclaim about the coldness of their hands. People will sometimes tease them and make comments about them having a cold heart, being an ice cube or glacier, or being dead. These comments, and others can be a great source of embarrassment and self-consciousness. Cold feet seem to be most often disturbing in relation to sleeping with one’s mate. Patient’s spouses will often complain about the coldness of the patient’s feet in spite of many blankets and covers. The coldness sometimes literally jolts the patient’s spouse. Patients themselves often find it very disturbing that their feet feel extremely cold in spite of being dressed warmly, wearing socks, and doing whatever they can to keep their feet warm.

One of the most severe incidents of this type of complaint that I have seen was in patient who had been diagnosed as having Raynaud’s Phenomenon. Raynaud’s Phenomenon is a condition characterized by vasoconstriction or vessel tightening in response to exposure to cold. It can cause impaired circulation for a period of time resulting in skin color changes. The patient that I had seen, upon exposure to cold, would experience her hands turning blue. The discoloration would sometimes extend thorough her forearms and even halfway up her upper arm. There often would be quite a line of distinction between the color of her normal skin and the bluish discoloration of the affected skin, looking almost as if she was wearing a long blue stocking glove extending up past her elbow. This cold sensation, of course, was quite uncomfortable and disconcerting. It was recommended that she change her occupation, which was that of a surgical assistant. Because she was an operating room assistant, the cold conditions of the operating rooms aggravated her condition. However, with proper thyroid treatment, her tendency to develop cold hands and to experience the blue discoloration of her arms resolved and it was not necessary for her to change her occupation. In fact, the patient was a scuba diver, and whenever she entered significantly cold water, she would experience this disturbing complaint, but now when she puts her hands in cold water, she no longer develops the symptoms that had been previously associated with Raynaud’s Phenomenon.