It's Not That Cold... but...

The weather has been great recently. Beautiful mild, clear and sunny days. Pity I've been at work for most of them. The biggest change I've noticed recently is it is now much colder in the mornings before the sun has had a chance to wake everything up. Now I know in the big scheme of things it isn't that cold. There have only been a few mornings where I've had ice on my car. It doesn't ever snow here. But to me, the relative drop in temperature makes a big difference. My hands hurt.

I know it sounds soft, but there is a reason I'm whinging about my hands. I have Raynaud's Disease, otherwise known as Primary Raynaud's. It is a condition that results in reduced blood flow to the extremities including hands, feet, nose and ears. In my case in mainly affects my hands, but also my feet. The reduced blood flow results in my hands first turning white, and sometimes going blue in extreme cases, developing "pins and needles", then numbness and reduced sensation, plus at times stinging pain, that can become almost unbearable.

My condition is classified as Primary Raynaud's because it is not associated with any other underlying medical condition. The cause is what is termed idiopathic, which means no one knows what the cause is (idio as in idiot). Secondary Raynaud's otherwise known as Raynaud's Phenomenon is associated with an underlying medical condition that causes the symptoms such as rheumatoid arthritis, schleroderma, lupus or as a response to certain medications. I have none of these.

It isn't fully understood, but the mechanism of Raynaud's attack is thought to be an overreaction of the blood vessels in the extremities to cold and stress. When the body is exposed to cold temperatures, the extremities lose heat. Blood flow is slowed to the extremities to help maintain core body temperature. This is achieved by narrowing the small arteries under the skin near the extremities. In people with Raynaud's this response is exaggerated.

There are a few things that can increase the likelihood of attack or it's severity. These include:

• A relative drop in temperature (in line with the recent weather)
• Exercise (hard to avoid when training for an Ironman)
• Smoking (don't smoke)
• Caffeine (I am a coffee-holic)
• Vibrational Trauma (My symptoms were worse for a couple days after using the jack-hammer)

It is something that affects me mainly during exercise. I could comfortably walk around in shorts and t-shirt when it is cool, but during a run I'll have to wear long sleeves and a good pair of warm gloves. Cycling is worse. I often wear what can be seen as an excessive amount of clothing during my rides. Training partners have commented in the past about me wearing thermals and a windbreaker, while they are just in a short sleeve jersey and knicks. I also usually double-glove on the rides. When riding in the rain, even with good quality gear, I can find it a struggle to remain warm enough, so I do often opt-out and spend my time on the turbo-trainer.

It isn't too major, more of an inconvenience than anything else. But if I turn up to a training session with gloves or all rugged up, when no one else is, at least you'll know why.

"You see, one thing is, I can live with doubt and uncertainty and not knowing. I have approximate answers and possible beliefs and different degrees of certainty about different things... It doesn't frighten me." - Nobel Laureate Richard Feynman