Raynaud's in Medical school/OR

[NicMouse64]

Hi all,
Admins--delete if inappropriate as I am not looking to get medical advice but maybe considered borderline.

I am a medical student and recently had some time in the OR. I realized that my hands would get super cold from the temperature being set. I was wearing long sleeves and had gloves on. Does anyone have any tips on how to dress appropriately or handle raynauds in the context of cold hospitals/OR. I am worried about how this could be perceived on my surgical rotations in the future (I am a second year MS).

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[nimbus]

If it only happens with gloves on try bigger gloves.

 

[NicMouse64]

If it only happens with gloves on try bigger gloves.

No, I have cold hands with or without gloves. It is worse without gloves on.

 

[Tenk]

Only thing you can do is double glove outside of taking drugs which seems overkill.

 

[NicMouse64]

Only thing you can do is double glove outside of taking drugs which seems overkill.

Do you guys know if surgeons would judge me for wearing a sweatshirt or heavy scrubs? That seems to help my hands from getting cold.

 

[Tenk]

Do you guys know if surgeons would judge me for wearing a sweatshirt or heavy scrubs? That seems to help my hands from getting cold.

Some will, most won’t. Just wear an OR jacket and if asked say you get cold easy or something. No big deal.

 

[Smurfette]

Do you guys know if surgeons would judge me for wearing a sweatshirt or heavy scrubs? That seems to help my hands from getting cold.

If not scrubbed in, a scrub jacket is fine. You can wear thermal shirts under scrubs as well as it helps; some people wear 2 scrub tops.
When scrubbing in, you can't have any clothing below the elbow. I guess if you are still cold while scrubbed---usually being too warm is the problem when under the OR lights and leaning on bair huggers though---you could ask for sterile sleeves to put on over the gown, although it would be a strange request.

 

[NicMouse64]

If not scrubbed in, a scrub jacket is fine. You can wear thermal shirts under scrubs as well as it helps; some people wear 2 scrub tops.
When scrubbing in, you can't have any clothing below the elbow. I guess if you are still cold while scrubbed---usually being too warm is the problem when under the OR lights and leaning on bair huggers though---you could ask for sterile sleeves to put on over the gown, although it would be a strange request.

the sterile below the elbow thing is what is most worrisome. If directly under the light then I should be okay, if I'm not I guess I can not be sterile. Thanks!

 

[nimbus]

I tend to be very cold in the OR and I wear a synthetic puffy jacket under under my scrub jacket most of the time. But I’m an anesthesiologist and not scrubbed into the field.

If you are scrubbed in, I don’t think anything beyond a short sleeved T-shirt under the scrub shirt or multiple layers of scrubs would be allowed.

 

[Smurfette]

the sterile below the elbow thing is what is most worrisome. If directly under the light then I should be okay, if I'm not I guess I can not be sterile. Thanks!

Er...you'll have to be sterile and scrubbed in when on your surgery rotation. However, room temperature feels very different when simply in the OR vs. scrubbed in.

 

[LoGo]

Depends if you’re talking true raynauds or just cold hands. If true raynauds, see a doctor.

 

[NicMouse64]

Depends if you’re talking true raynauds or just cold hands. If true raynauds, see a doctor.

I've had a history of repeated frostbite, but the PA I saw diagnosed it as raynauds. They suggested calcium blockers but Idk if this is overkill for a surgery rotation or not.

 

[LoGo]

I've had a history of repeated frostbite, but the PA I saw diagnosed it as raynauds. They suggested calcium blockers but Idk if this is overkill for a surgery rotation or not.

See a doctor, not a PA.

 

[Keona]

Talk to a doctor about the possible raynauds. They're going to also completely understand what you’re getting into with 3rd year and be able to help determine if treatment is necessary.

 

[katiedew]

I have Raynauds as well. One thing that sometimes helps is a little bit of exercise prior to being in the cold environment. Once an episode starts exercise can make it worse but if I exercise before it helps keep it from happening as fast. Try and stay warm before going in the OR and do some jumping jacks or run in place before going in.

 

[Dantrolene FC]

If you have a documented diagnosis of Raynaud’s, and if it causes you serious discomfort/pain, I would consider talking to your school’s disability office regarding an accommodation for your surgery and OB rotations.

I could see 3 possible solutions for you that would have minimal impact on your education. (a) You don’t scrub in, and you just watch surgeries from the periphery. This would allow you to wear long sleeves and keep your hands warmer. b) You could do a lot of robotic cases, where you just sit in the corner of the room and watch on the monitors. (c) You could do mainly burn surgery where they keep the room at 80 degrees.

If your school gives you the accommodations above, I don’t see how your quality of learning would suffer. The only thing I think you’d miss out on would be suturing skills, which you could do on pig’s feet anyway.

If you do go down this route, I would contact your disability office a couple months in advance so they would have time to find a solution and figure out all the logistics. Your school may not be used to these types of accommodations. I bet 99% of their accommodations are related to test anxiety and ADHD.

If you did this, you obviously wouldn’t get a good letter of recommendation on your surgery rotation. But you probably wouldn’t choose to be a surgeon anyway if your hands hurt all day.

 

[Dr G Oogle]

If you’re not scrubbed in get some of those hand or foot warmers skiers and other winter sport enthusiasts wear and put in the pockets of a scrub jacket. It’s fine to bring those in.

 

[NVO]

i have cold urticaria where my hands get red and itchy when theyre cold. Always happened in the OR. My solution was to always have a long sleeve under my scrubs (can just pull them above elbows when in surgery). During surgery your hands tend to be warm due to being under the OR lights and having to do things. When not scrubbed in, wear a scrub jacket.

 

[Animalcules]

Raynaud's can be treated if it impacts your life. Keep your core warm. Ask your PCP/rheumatologist about medications if not enough.