Cold Hands

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(nicedream)

(nicedream)

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Patient after patient says I have cold hands. It's virtually always the first thing they say to me, starting with when I shake their hand. It's been suggested I wash my hands with hot water before seeing them, but it's not really realistic to do that every time. Anyone else have this problem or suggestions?
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I have Raynaud's and usually have very cold hands. I haven't found anything that works for me so I just warn & apologize each patient before I touch them. I've found that, if warned, patients are quite gracious about it.

Aside from that, washing your hands in warm/hot water may make a difference from you and its a simple thing to do.
 
I have the same problem. I warm my hands with warm water before doing breast exams, but other than that I usually just warn the patient ahead of time. I was considering bringing a hand warmer packet in my coat pocket every morning before I check on my patients.
 
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Same problem here. I usually try to rub my hands together before touching the patient, but that usually has a minimal effect. I think the most helpful thing I do is to warn the patient and make a joke. It does make the abdominal exam a bit difficult when the patient keeps tensing up from the cold, so if I really need a good abd exam I'll make more of an effort with the hand rubbing.
 
I saw some gadget being tested on TLC to help survival in extreme conditions.

The guy in the experiment had both hands and feet exposed in sub zero temperature and they remained warm and comfortable. Don't remember further details.
 
The hand warmer packets with the little sand stuff in there works wonders (at least when I go snowboarding) but it would be really expensive to use those daily. I have the same, awful problem. I just warn the patient as the previous posts said and they usually understand (particularly the women, since many have the same problems).

Also, if I know I am going to do a abdo exam, I will try to rub my hands together from when I think of it until I get to the ward/bed. It does OK.
 
Or you might try one of those heating patches before you see a patient....might work
 
Go get a heating pad from the nurses station, and keep it in one of your coat pockets. B4 you see a pt, just put yer hooves in yer pocket for a sec, and you should be good to go.
🙂
 
lvspro said:
Go get a heating pad from the nurses station, and keep it in one of your coat pockets. B4 you see a pt, just put yer hooves in yer pocket for a sec, and you should be good to go.
🙂
Click to expand...


But my coat doesn't have electricity...should I run an extension cord?
 
(nicedream) said:
But my coat doesn't have electricity...should I run an extension cord?
Click to expand...

I see the dilemma... well here are some options

1. Attach solar panels to your lab coat, and hope the light from the halls powers them up properly.

2. Attach a generator to your thighs, and use each step as a power-generating step to be stored in the capacitor in one of your other coat pockets.

3. This is prolly the most difficult, and least feasible; get one of those chemically activated heating pads that are activated when you crush an inner pouch. They usually last about 8 hours. Almost every hospital I've seen has them, so I don't think availability is a problem. 😀
 
I normally have very cold hands -- I solved that problem (unintentionally) by getting Grave's disease. Now I get comments on how warm my hands are. 😉
 
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As you walk into the room have both of your hands down your pants. Explain to the patient that you are just trying to warm them up before you palpate their abdomen.
 
I also have this problem and I do think the warm water is a help. Patients like to see you wans your hands, as well. Another thing that I have done is to try and carry a pocket tube of hand lotion. Put a little on and rub it in. That has been very helpful. Besides that, I tell the patient my hands are cold but that I have a warm heart. That usually works. Also, go in the room and talk to the patient for a minute. Sometimes that gets you more comfortable and lets go of that sympathetic response.
 
Dr. Mom- I have Raynaud's too and its really bad. I'm only a second year but I'm so afraid for next year with this problem. My standardize patients now complain so much even after I warn them. I always get picked on because I wear so many layers and even during the summer I will wear jeans and a long sleave shirt or sweatshirt.
 
COLD HANDS...............WARM HEART.

I think washing your hands would be the simplest "treatment" for the condition. However, warming packs are much more exotic.
 
Smile80 said:
Dr. Mom- I have Raynaud's too and its really bad. I'm only a second year but I'm so afraid for next year with this problem. My standardize patients now complain so much even after I warn them. I always get picked on because I wear so many layers and even during the summer I will wear jeans and a long sleave shirt or sweatshirt.
Click to expand...


Almost all of my patients have been very gracious, although some are still caught off guard by *how* cold my hands sometimes are.


For me, washing with warm/hot water doesn't significantly help unless I can have them in the water for 5+ minutes each time. (and its not like I get hot water immediately at most hospital faucets) just not feasible.
 
Those heating pads only last like 90 minutes before they have to be recharged right?
 
I learned about these hand warmers from a optometrist buddy who sells them in his practice as income replacement for hot rag eye compresses.

http://www.hotsnapz.com

I have found the larger ones great for doing the job of warming up my hands a bit. Base on a simple Water/Sodium Acetate crystal reaction.

They last for 90 minutes generally and nice thing is that they are reusable. Children like to see them work too! The company recommends boiling water to reactivate them, (which I found a bit tedious) but I did discovery a method to microwave them after speaking with someone at the company.

They don't recommend a microwave procedure because of the variability of microwave ovens and people over microwaving them. Boiling water maintains ~100C most everywhere I guess; plus or minus a few degrees, so I guess I can understand their reasoning.

I just keep a few pair on hands to get around the duration issue.

Contact me about my microwave procedure if you ever give these a try and are curious to microwave them for reuse, instead of boiling.

Thanks,
Eddie
 
Why not just put on gloves? There... problem solved 🙂
 
JJNY said:
Why not just put on gloves? There... problem solved 🙂
Click to expand...
Which gloves do you mean?
Exam gloves? won't block the cold for me or the patient
Regular gloves? Around the hospital or clinic? I can't imagine how this would go over with attendings. Also, gloves keep your hands protected from outside cold, but if you have something like Raynauds, gloves don't actually keep your hands any warmer.
 
DrMom said:
Which gloves do you mean?
Exam gloves? won't block the cold for me or the patient
Regular gloves? Around the hospital or clinic? I can't imagine how this would go over with attendings. Also, gloves keep your hands protected from outside cold, but if you have something like Raynauds, gloves don't actually keep your hands any warmer.
Click to expand...
What are you guys talking about? Up here in Minnesota we always wear our gloves around the hospital... you guys don't? When you talk about the white coat, I thought you guys would understand. Is this not the versoin of the wihte coat you speak of? This is my team making rounds.

I'm so confused!
 
(nicedream) said:
Patient after patient says I have cold hands. It's virtually always the first thing they say to me, starting with when I shake their hand. It's been suggested I wash my hands with hot water before seeing them, but it's not really realistic to do that every time. Anyone else have this problem or suggestions?
Click to expand...

Rads/Path
 
I'm famous for my warm hands. I get lovely comments, especially in the winter, from little old ladies!

In fact, I'm really heat intolerant - I love the idea of moving to a cold country...

Don't have any other Sx/Signs of hyperthryroidism though...
 
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