Since becoming a vascular sonographer
I have served as a guinea pig to those wanting to learn about Raynauds
testing. I think it was a very WISE idea not to do the cold emersion
test because for Raynauds patients it is frightfully painful keeping your
hands or feet in cold water (for even 15 seconds), with wounds even worse.
She would have most certainly cried. When I was in school in Norfolk,
VA (10 yrs ago) there was a physician (and his name eludes me) from Norfolk
Sugical Group that was very experienced with Raynauds, as he used to live
and work in Alaska. He had made a booklet about it and rules patients
should follow, I thought it was very helpful. FYI.
Nicole
Nicole Ball, RVT
President for NNEVS
Frisbie Memorial Hospital
Vascular Lab
Rochester, NH
Wow 7 that is so young. I think that she
has been exposed for too long and that's why she has lesions now. I didn't
do a cold immersion test because of the awful appearance of toes, resting
ppg's seemed very vasospastic.
Thanks,
Jodi
-----Original Message-----
From: Nicole Ball <[log in to unmask]>
To: [log in to unmask]
Sent: Thu, Jan 21, 2010 11:42 am
Subject: Re: 5 yrs old with Raynaud's
Raynauds can affect young children. I myself was diagnosed with it
at 7 yrs old and Dr. told me some simple things to do and that was the
end of it. If she has it, she has a severe case or has been exposed
to cold too long. Ulcers are very worrisome. Frostbite certainly
seems plausible also, had a gentleman who took an extensive walk with his
dog in sneakers (up here in NH) in the snow and his feel got cold and wet,
he ended up with frostbite and ulcers on all digits. Was a cold emersion
Raynauds test done?
Nicole
Nicole Ball, RVT
President for NNEVS
Frisbie Memorial Hospital
Vascular Lab
Rochester, NH
It is my understanding that, while rare, Raynaud's can affect children.
In any case, an autoimmune process should be considered. If
anyone knows any rheumatologists, particularly a pediatric rheumatologist,
I think that would be who to ask. Have the color changes, red, white
and blue been observed? That might be significant.
________________________________
From: UVM Flownet on behalf of Jodi Zannino
Sent: Wed 1/20/2010 10:38 AM
To: [log in to unmask]
Subject: 5 yrs old with Raynaud's
Hello All,
I had an interesting case this am. A 5yr old girl , yes 5, with symptoms
of discolored upper and sever lower extremity digits. Now has sores on
the 3rd toe, bilaterally R>L. She was recently treated for Lyme's.
The patient also lives in an old farm house- wood flooring and does
not wear socks or slippers in house. This is the northeast and as you all
know....it's been a cold winter so far!
The order was for Raynaud's of the lower extremity as they are the most
symptomatic and she was referred by a podiatrist. The Brachial pulses were
normal with normal pressures bilaterally(and ankles too).
Normal bilateral TBI's. PPG waveforms in the bilateral lower extremity
digits were either normal or vasospasm in appearance (R>L) throughout.
I'm thinking this is some kind of autoimmune disease causing this. Have
any of you seen a patient so young with this presentation? What are your
thoughts?
I welcome your input?
Thanks,
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