Possible Raynaud's Disease in a young woman

Patient

Q: A couple of years ago I noticed that my fingers would turn white and go numb after cold exposure in the winter time. This year it continues but with worse symptoms. Not only does the cold still affect them like that but now they can stay numb for up to an hour. When the feeling and color come back my inge can turn bluish and bright red. A month or so ago my hands started to ache every now and then. Last week if I twisted my hand the wrong way I'd get a sharp almost unbearable pain. Once it hurt so bad I had to drop what was in my hand. At times my toes can also turn white and go numb. The lsat couple of days when I woke up my feet were aching so bad that it was hard to walk and they continue to hurt throughout the day but not so severe. My mom has rheumatoid arthritis but I'm only 30 and I thought that mostly affected older people. I'm a 30 year old female with hepititus c and a history of iv drug abuse and use merina as birth control. Also at times parts of my whole left arm get aches and pain. Sometimes like a burning feeling. As the days go on and the symptoms get wors, I worry more. I'm not sure if this coincides with all of that but at times I get a very sort but very noticable heachache. Sometimes I have a fear of a stroke. I'm also a smoker. Should I be concerned about having raynauds disease or lupus? Is thiscaused by my hetitus or will whatever it is affect my liver more? Could I have diabetes?

Doctor

A:   Certainly, any of those three conditions that you mentioned at the end of your question may cause pain, tingling and numbness of the extremities; also you have additional risk factors: smoking, birth control pills and family history of AR along with Hepatitis C. But according to your description, most likely seems Raynaud’s Disease at this point. Raynaud's disease is a condition that causes some areas of your body such as your fingers, toes, the tip of your nose and your ears to feel numb and cool in response to cold temperatures or stress. In Raynaud's disease, smaller arteries that supply blood to your skin narrow, limiting blood circulation to affected areas. Women are more likely to have Raynaud's disease. It's also more common in people who live in colder climates. Treatment of Raynaud's disease depends on its severity and whether you have any other health conditions. For most people, Raynaud's disease is more a nuisance than a disability. Smoking, medications that affect the blood vessels and exposure to chemicals such as vinyl chloride are associated with an increased risk of Raynaud's. To diagnose Raynaud's, your doctor will ask detailed questions about your symptoms and medical history and conduct a physical examination. Your doctor may also run tests to rule out other medical problems that may cause similar signs and symptoms, as autoimmune diseases or diabetes. There's no single blood test to diagnose Raynaud's. Your doctor may order other tests, such as those that rule out diseases of the arteries, to help pinpoint a disease or condition that may be associated with Raynaud's. Some medications actually can aggravate Raynaud's by leading to increased blood vessel spasm, for example If you use birth control pills, you may wish to switch to another method of contraception because these drugs affect your circulation and may make you more prone to attacks. Talk to your doctor before stopping the pill.

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