How do I know if something is helping my Raynaud’s?
This might be a dumb question to some of you, but as a nurse, I really want to measure what is my BEST treatment. Some things work better together, and I would never know if I wasn’t measuring. Other things could drop my blood pressure to dangerous levels if I did not demonstrate caution. Further, too many clinicians walk in and say, “Why yes, those are very cold hands. Is this normal for you?” I want to be able to answer, “this is worse,” or “actually it’s better than it’s been.”
Measuring Blood Flow
In nursing, one way to measure circulation and blood flow is by checking capillary refill. Capillary Refill Time (CRT) is a measurement of the time it takes for the color to return to the nailbed after applying pressure: pinch down on the nailbed until it turns white and count to three. If color returns in <3 seconds, it is good blood flow. If it takes longer, there is poor circulation.
Note: Do not pinch fingertips that have wounds or it will be painful. That’s experience talking right there.
Regular Blood Pressure Checks
Raynaud’s is a blood-flow disorder, and it is married to your blood pressure. If you take medications that affect your blood pressure, or you just want to track your vascular health, I highly recommend a personal electronic blood pressure cuff. High blood pressure is bad of course, but low blood pressure is also dangerous, and some Raynaud’s treatments cause vasodilation to improve blood flow to the hands and feet. If the blood pressure drops too low it will worsen overall circulation and your hands will not be the only problem. Having blood pressure readings written down will also help your physician know if you can increase your dose to help your hands without dropping your blood pressure to dangerous levels.
Take pictures of your best days, your worst days, any wounds you have, etc. Showing a before and after picture (this is before winter, this is after; this is before I started taking Med A, this is after) will help you get the best possible treatment by giving a clearer picture of what is really going on with your hands.
These are a few of the ways that I check how well a treatment is working. This is not a complete list and will not substitute a physician’s monitoring, but it really helps when you can report accurate measurements to your physician.