12/8/09 1:14 PMA Sunny Day Can Mean All Sorts of Distress - New York TimesPage 3 of 4http://www.nytimes.com/2006/06/19/health/healthspecial/19immune.html?_r=1&oref=slogin
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Mrs. McCausland, 75, had a biopsy taken of a sore on her arm. Doctors confirmedscleroderma as well as pulmonary hypertension, a common result of the disease's affecton the kidneys, she said. She takes a combination of medicines to treat her bloodpressure as well as an antihistamine and gabapentin to treat the pain and itching. She isalso treated with oral chemotherapy and an immunosuppressant.Mrs. McCausland said that covering her arms while driving to avoid exposure to sunlightor using her backyard pool was nearly impossible because the sores on her arms makethem sensitive to touching."If you saw my arms, you would say, 'Oh, my God, there's something wrong with her,' "Mrs. McCausland said. "You know when you put a blood pressure cuff on your arm? My arms look like they have been squeezed, and it's forcing the muscle out to my elbow andshoulder. It's very painful and itchy."Covering the entire body, even in the heat, is critical for scleroderma patients becausethey have greater susceptibility to skincancer. And since the blood vessels can also become sclerotic, or thickened, full coverage helps protect people from the shock of entering an air-conditioned environment."The problem is that in the summer these patients go from dramatic warm to cold, andthey can become very symptomatic from that," said Dr. Chris T. Derk, an assistantprofessor of medicine in the rheumatology division at Thomas Jefferson University inPhiladelphia. "It's exceedingly rare, but we have people with Raynaud's of the heart vessels, and they can go into spasms and give you a small heart attack. You have to coverthe whole body because if they can't rewarm the hand, they can break it."Mrs. McCausland said she coped by keeping her house temperature warm and wearingIsotoner gloves to the grocery store, even during the summer months."People think I'm some kind of nut," she said. "I have never been sick a day in my life,and I had to come up with this. "
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A Sunny Day Can Mean All Sorts of Distress(June 19, 2006)