Health Matters

DEBBIE JACKSON

Q My doctor wants me to see a specialist, and I would

like a different specialist. What can I do? My

doctor says this is the only one he would use. I

don’t want to travel that far to see a doctor. --

L.T., Anderson

A This is not unusual. I urge you to discuss your

concerns with your doctor. The specialist who is far

from your home may be the best in the field. But that

may not be enough if you miss receiving support from

family and friends during your treatment.

There often are good physicians in the community

or at a teaching hospital who may be able to help you,

but most referral centers require your doctor to refer

you to their center. Request that your doctor

carefully consider your concerns and in return,

carefully consider his concerns for your treatment

plan. If the two of you are unable to reach an

agreement, consider finding another doctor who is

willing to work with you. Also, you may want to talk

with someone who has been treated at the center your

doctor recommends. While no two people have the same

experiences, you may gain insight into what it would

be like to be at that center, and what support would

be available to you there.

I realize this is not easy. Your doctor wants to

help you, so try to listen and weigh all your options

before making a decision. The important thing to

remember is that you need a treatment plan that

includes all of your needs and will be covered by your

health insurance. This is important if the health plan

has preferred providers. Another cost issue is travel

-- yours and your family’s, if you must stay for a

prolonged period in another city. Also, you want to

make sure your local physician stays in contact with

the specialist in case something happens between your

trips to the treatment center.

Q Can you give me a simple definition of Raynaud’s

disease? -- M.J, Seneca

A The Arthritis Foundation defines Raynaud’s

phenomenon as an arthritis-related disorder in which

the hands, fingers and feet are extremely sensitive to

cold, caused by narrowing of small blood vessels. It

is most noticeable in the fingers.

The walls of blood vessels contain small muscles

that constrict and relax to control blood flow through

the body. When a person has Raynaud’s phenomenon, cold

causes the muscles to tighten, closing off blood

vessels. Blood flow is reduced, preventing nutrients

and oxygen from getting to the tissues. During an

attack, fingers turn white due to lack of blood flow.

Sufferers complain of their fingers feeling numb,

tingling and chilled. As the hands warm up,

circulation returns but the fingers are swollen,

purple and painful. Small sores may develop on the

fingertips.

The Arthritis Foundation reports that while the

cause of Raynaud’s phenomenon is not known,

researchers have found several links. Anxiety and

stress may aggravate symptoms. Raynaud’s can indicate

vasculitis, an inflammation of blood vessels.

Raynaud’s also can be an early symptom of other

disorders, particularly scleroderma and lupus.

However, everyone who has Raynaud’s does not develop

those diseases.

Send your health questions to Debbie Jackson, PhD, MN

Clemson University, 302 Sikes Hall, Clemson, SC

29634-5155 or e-mail her at dbj@clemson.edu