DEAR DR. ROACH: I’m pretty certain that I have Raynaud’s disease. I develop white, burning and tingling hands if I don’t keep warm, even with heavy gloves on. I notice it on the golf course during the wintertime if I’m not bundled up. My doctor up here in Canada agreed with my self-diagnosis but offered little in the way of a treatment or cause.

Is there anything new in this area? I’m a 72-year-old male with my weight under control. I’m active and not on any meds other than Xarelto for a blood clot from six or seven years ago. — S.K.

ANSWER: It does indeed sound like you have Raynaud’s phenomenon (RP), also called Raynaud’s disease, based on the color change of your hands in cold weather. Classically, the hands (sometimes just the fingers or part of the hand) first turn white when exposed to the cold as the blood flow to the hands is abruptly reduced by the body constricting the blood vessels.

This is a normal phenomenon, but people with RP have an exaggerated response. The hands may then turn blue as the oxygen level in the tissues drops. With rewarming, the hands will turn red as the blood vessels open back up. Not everybody will have the classic color changes, but tingling is common. Very severe episodes can sometimes cause permanent damage with ulceration or even gangrene.

The underlying cause may not be able to be found, in which case we say this is “primary Raynaud’s phenomenon.” But it’s important to consider a rheumatological disease as an underlying cause (called “secondary RP”). Scleroderma, lupus, and many other conditions can be associated with RP. Since RP is more common in young women, being a 70-year-old man does suggest a higher likelihood of secondary RP, so your doctor might consider these. Not everyone needs the “million dollar” lab workup.

As you correctly say, your whole body needs to be kept warm, not just your hands, to prevent an attack. I have to say that wintertime golf is not the ideal recreational exercise for a person with RP, but if you can avoid attacks by dressing warmly, then I wouldn’t tell you to stop. You should avoid medications that can precipitate RP, especially over-the-counter cold remedies containing decongestants.

If you are still getting attacks despite these common-sense prevention techniques, there are medications to help. Calcium channel blockers like amlodipine, which are commonly used for high blood pressure, are effective at reducing RP attacks. Other medicines that can be tried include sildenafil (Viagra), nitroglycerine and losartan. Finally, when all else has failed, I have seen fluoxetine (Prozac) work.

Rheumatologists usually have expertise in managing RP, as well as distinguishing primary RP from secondary RP.

DEAR DR. ROACH: I wonder if I could share a possible solution regarding your reader with sleep paralysis. The second time this happened to me, I thought, “Just stop trying to move. In fact, go back to sleep.” This ended the panic attack, and very soon, I was able to move again. — J.S.

ANSWER: This is one of those solutions that sounds too easy to be believed, but I’m printing it because it may help other people with sleep paralysis, which is a common condition where people wake up and are unable to move for a few seconds. It doesn’t need treatment, except in the rare cases where it is associated with narcolepsy.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.