What to Bring to a Scleroderma Consultation: Reflux, Swallowing and Raynaud’s Notes

The night before the appointment, Dana sat at the kitchen table with a mug of tea she couldn’t quite hold without her fingers going white. Three months of odd things had piled up: the burning behind her breastbone after dinner, the bread that seemed to pause on the way down, hands that turned the color of candle wax in the grocery store freezer aisle. Now a rheumatologist wanted to see her, and she had no idea what to say first.

Preparing for a scleroderma rheumatology visit is less about memorizing medical words and more about arriving with your own evidence. Scleroderma is a condition in which the immune system drives overproduction of collagen, stiffening skin and sometimes internal organs. Its story unfolds slowly, across seasons and meals and cold mornings, and no fifteen-minute recall can capture that.

A notebook can. This guide walks through what to write down, what to carry in, and which observations tend to change the conversation in the room.

What actually happens at a scleroderma rheumatology visit

A rheumatologist is a physician who specializes in autoimmune and joint conditions, and the first visit is mostly listening. Expect a long conversation before anyone touches a stethoscope. The clinician will want the sequence of events: which symptom came first, how it has changed, and what makes it better or worse. Raynaud’s phenomenon, in which small blood vessels in the fingers or toes clamp shut in response to cold or stress, is often among the earliest signs of systemic scleroderma, so the timing of your first attack matters more than you might expect (Mayo Clinic).

The examination follows. Your hands will be studied closely: skin thickness, puffiness of the fingers, tiny dilated blood vessels called telangiectasias on the face or palms, and any sores at the fingertips. Some clinics use a magnifying lens or a small camera to look at the capillaries at the base of the nail, a technique called capillaroscopy, because the pattern of those vessels can hint at systemic disease. The clinician will listen to your lungs for the fine crackles that can accompany scarring, check your blood pressure, and press gently along your joints and tendons.

Blood tests usually come next. Autoantibodies are immune proteins that mistakenly target the body’s own tissues, and specific patterns, such as anti-centromere or anti-topoisomerase antibodies, help distinguish subtypes of scleroderma and shape which organs are watched most closely (Mayo Clinic). Depending on what the history and exam suggest, imaging of the lungs, breathing tests, an echocardiogram of the heart or studies of the esophagus may be arranged.

None of this can be rushed, and none of it is a verdict. Systemic sclerosis, the medical name for scleroderma that reaches beyond the skin, is diagnosed by weighing the whole picture over time. Your job is to make that picture as complete as possible.

Preparing for a scleroderma rheumatology visit starts with a timeline, not a list

Most people arrive with a list of complaints. What helps far more is a timeline. Scleroderma tends to reveal itself in stages, and the order of those stages tells the rheumatologist something a list cannot.

Take a single sheet of paper and draw a line across it. Mark the year, or even the season, when each new thing appeared. When did your fingers first change color in the cold? When did the skin on your hands start to feel tight or puffy in the morning? When did heartburn move from occasional to nightly? If swallowing became effortful, roughly when? Add life events that might matter: a pregnancy, a period of intense stress, a new job with a cold storage room.

The gap between the first Raynaud’s attack and the first skin change is one of the clues clinicians use when thinking about the two main forms of systemic disease. In limited cutaneous scleroderma, skin involvement stays mostly on the hands, forearms, lower legs and face, and Raynaud’s may have been present for years before anything else. In diffuse cutaneous scleroderma, skin thickening spreads more widely and more quickly, and other organs may be affected earlier (NHS). Your timeline helps the team sort which pattern you may fit and how urgently to look at the lungs and kidneys.

Photographs strengthen the timeline. If you have pictures of your hands during an attack, or of a skin patch six months ago compared with today, bring them on your phone. Scleroderma affects women more often than men and most commonly begins between the ages of 30 and 50, but its pace varies enormously from person to person (Mayo Clinic). Dates and images turn a vague sense of “things getting worse” into something a clinician can measure against.

How to keep a Raynaud's symptom diary your rheumatologist can use

A good Raynaud’s diary answers five questions for every attack: what set it off, which digits were involved, what colors you saw and in what order, how long it lasted, and whether anything was left behind afterward.

Triggers first. Cold is the classic one, but note emotional stress, handling frozen food, air conditioning, or gripping a steering wheel, since these details help distinguish a purely cold-driven pattern from one that fires at ordinary room temperatures. Record which fingers changed. Involvement of the thumb, both hands or the toes tends to interest clinicians more than a single finger on one side.

Color is the heart of the diary. Many attacks move through white (blood flow cut off), then blue or purple (oxygen-poor blood pooling), then red (blood rushing back), often with tingling, throbbing or pain during the recovery phase. Not everyone sees all three phases, and saying so is useful. Attacks can last from a few minutes to a few hours (NHS), so jot a rough duration rather than guessing at the visit.

Aftermath matters most of all. Look at your fingertips in good light after an attack. Any small pits, cracks, sores that will not heal, or a patch of skin that stays dark should be written down and photographed. A digital ulcer, meaning an open sore on a fingertip caused by poor blood supply, is a sign the team will want to hear about promptly rather than at a routine review.

Finally, note any medicines you take that might narrow blood vessels. Some blood pressure medicines, certain migraine treatments, stimulant medications and over-the-counter cold remedies can worsen Raynaud’s (Mayo Clinic). Do not stop them on your own; simply flag them so the prescribing clinician can weigh the trade-offs.

Scleroderma reflux and swallowing: what to write down about heartburn

The esophagus, the muscular tube that carries food from the throat to the stomach, is the part of the digestive tract most often affected in scleroderma (NIH NIAMS). Scarring can weaken the muscle that normally keeps stomach contents down, so acid reflux, meaning the backward flow of stomach acid into the esophagus, becomes common and can be surprisingly stubborn.

Describe your heartburn in terms a clinician can compare across visits. Record how many nights a week it wakes you, whether it is worse lying flat or bending over, and how soon after eating it starts. Note the character: burning behind the breastbone, a sour taste in the mouth on waking, a persistent cough or hoarse voice in the morning that has no obvious cause. Reflux in scleroderma sometimes shows up as those quieter throat and chest signs rather than classic burning, and people often do not connect them.

Food and posture details help. Large meals, late dinners, alcohol, caffeine, chocolate and fatty foods are commonly reported triggers. Write down what you have already tried on your own, such as raising the head of the bed, eating smaller portions or avoiding eating in the two or three hours before lying down. If you have used any over-the-counter antacids or acid-reducing products, list them by name and how often, so the team knows what has and has not helped.

If a proton pump inhibitor, a class of medicine that reduces the stomach’s acid production, has already been prescribed by another clinician, bring the box or a photograph of the label. The rheumatologist may coordinate with a gastroenterologist, a specialist in the digestive system, about whether further testing such as an endoscopy, in which a thin camera examines the esophagus, would add useful information. That decision rests with them; your notes make it a better-informed one.

Describing swallowing trouble: where food sticks and when

Dysphagia is the medical word for difficulty swallowing, and it is one of the symptoms people most often under-report because it creeps up gradually. You start cutting food smaller, drinking more water with meals, choosing soup over steak. By the time someone asks, it feels normal.

Break it into parts for the visit. First, texture: does trouble happen with solids only, with soft foods, or even with liquids? Trouble that begins with solids and progresses is a different story from trouble that appears with liquids from the start. Second, location: point to where food seems to pause. A sensation at the notch above the breastbone, mid-chest, or low near the stomach each suggests something slightly different to a clinician. Third, frequency: is it every meal, once a week, or only with certain foods like dry bread, rice or meat?

Watch for the accompanying details. Do you need to sit upright for a while after eating? Have you regurgitated undigested food hours later? Has a piece of food ever become truly stuck so that you could not swallow saliva, even briefly? Have you coughed or choked while eating, or noticed food coming back up into your nose? Write each one down plainly.

Weight is the number many people forget. If you own a scale, note your weight now and compare it with a reading from a year ago on a medical form or a fitness app. Unintended weight loss alongside swallowing difficulty deserves attention (NHS), and a clear figure is far more useful than “I think I’ve lost a little.”

The team may consider an esophageal manometry study, which measures pressure and muscle coordination in the esophagus, or a barium swallow, an X-ray taken while you drink a chalky liquid. Whether those are needed depends on what your notes and examination show.

Skin, hands, joints and the other symptoms worth a line

Reflux, swallowing and Raynaud’s are the headline items, but a rheumatologist is assembling a wider portrait, and a few extra lines in your notebook can save a return visit.

Skin comes first. Puffy fingers that feel tight in the morning, skin that no longer pinches up easily over the knuckles, or a shiny, waxy look to the hands are classic descriptions (Mayo Clinic). Note whether tightness has spread beyond the hands to the forearms, chest or face. Some people notice the mouth opening feels smaller, or that lipstick lines and facial expressions have changed. Small white lumps under the skin, called calcinosis, are calcium deposits that can appear at the fingertips or over pressure points; mention any you have found. Patches of darker or lighter skin, and the fine red marks of telangiectasias on the face, lips or palms, are all worth recording.

Joints and tendons next. Stiffness in the mornings, aching in the wrists or ankles, or a creaking, grating sensation when you move a tendon can accompany scleroderma. Note which joints, how long the morning stiffness lasts, and whether it interferes with tasks like opening jars or typing.

Then the general symptoms that are easy to dismiss: fatigue that is out of proportion to your activity, dry eyes or a dry mouth, itching without a rash, or hair thinning over affected skin. Bowel changes belong here too. Bloating, alternating constipation and diarrhea, or a feeling of fullness after small meals can reflect the gut muscle being affected further down.

You do not need to decide which of these matter. Write them all down, briefly and with rough dates. The clinician will decide which threads to pull.

Breathing, blood pressure and kidneys: the quiet questions

The two organs that shape long-term monitoring in systemic sclerosis are the lungs and the kidneys, and neither announces itself loudly at first. This is the part of the notebook most people leave blank, and the part the rheumatologist most wants filled.

Breathlessness is the key lung question. Interstitial lung disease is scarring of the delicate tissue where oxygen passes into the blood, and pulmonary hypertension is raised pressure in the blood vessels supplying the lungs. Both can develop in scleroderma and are among the more serious complications (Mayo Clinic). Early on they show up as subtle things: needing to pause on a flight of stairs you used to climb without thinking, a dry cough that lingers for weeks, or feeling winded carrying groceries. Compare yourself with a year ago and write the difference down honestly. Note any chest tightness, palpitations, or swelling of the ankles by evening.

Blood pressure is the kidney question. Scleroderma can affect the kidneys, and one form of kidney involvement is marked by a sudden rise in blood pressure (Mayo Clinic). If you own a home monitor, bring a short log of readings taken at rest. If you do not, a single reading from a pharmacy machine, with the date, is still useful as a baseline. Headaches, visual disturbance or sudden swelling should be reported the same day rather than saved for the appointment.

Bring any previous test results that touch these organs: a chest X-ray report, a breathing test, an echocardiogram, or blood work showing kidney function. A dated set of prior results lets the team see direction of travel rather than a single snapshot, which is often the more important thing.

Your medicine, supplement and allergy list, written the way clinics need it

Medicines in scleroderma care often come from several prescribers: a primary care clinician for blood pressure, a gastroenterologist for reflux, perhaps a dermatologist for skin. The rheumatologist needs to see the whole set in one place, because some medicines used for one problem can affect another.

List every prescription by its name exactly as printed on the label, along with who prescribed it and why. The clinic will read the strength and frequency from the label itself; your task is completeness, not calculation. Include medicines you take only sometimes, such as a rescue inhaler or an occasional sleep aid, and anything you were prescribed but stopped, with the reason. Stopping because of side effects and stopping because it “didn’t seem to do anything” are different pieces of information.

Then the over-the-counter layer: antacids, pain relievers, cold and allergy products, sleep aids. As noted earlier, some decongestants and other vessel-narrowing products can aggravate Raynaud’s (Mayo Clinic), so they belong on the list even if they feel trivial. Add every supplement and herbal product, including fish oil, vitamin D, turmeric or anything bought for “circulation” or “immunity.” Herbal products are not tested for interactions with immune-modulating medicines, and the team cannot flag a concern they do not know about.

Record allergies and reactions with what actually happened: a rash, swelling, breathing trouble, or nausea. “Allergic to antibiotics” is far less useful than “hives after a specific antibiotic in childhood.”

If the rheumatologist raises immune-modulating treatment, such as immunosuppressants that damp down the overactive immune response, or a calcium channel blocker that relaxes blood vessels to ease Raynaud’s, your list is what makes that conversation safe. Any decision to start, change or stop a medicine belongs to the prescribing clinician, and a complete list is how you help them make it well.

Scleroderma appointment checklist: what to bring, at a glance

The table below gathers the practical items. Treat it as a packing list for the folder or phone album you carry in; the rest of this article explains why each one earns its place.

Bring	What it should include	Why the team wants it
Symptom timeline	Season or year each symptom began, in order	Sequence helps distinguish limited from diffuse patterns (NHS)
Raynaud’s diary	Triggers, digits, color sequence, duration, any sores	Attack pattern and fingertip changes guide urgency (Mayo Clinic)
Reflux and swallowing notes	Night-time frequency, foods, where food sticks, weight trend	Esophagus is the most commonly affected gut segment (NIH NIAMS)
Breathing and blood pressure log	Stairs test compared with last year, cough, home BP readings	Lung and kidney involvement can be quiet early on (Mayo Clinic)
Medicine and supplement list	Every prescription, OTC product and herbal item by name	Some products can worsen Raynaud’s or interact with treatment
Previous results	Blood work, imaging reports, breathing tests, echocardiogram	Dated results show direction of change, not a snapshot
Photographs	Hands during attacks, skin patches, fingertip sores	Visual record of episodes the clinician cannot witness
Questions and a companion	Three to five written questions; someone to take notes	Long visits are hard to remember alone

A few practical additions. Wear layers and sleeves you can push up easily, since the hands and forearms will be examined and a cold room can trigger the very attack you have been describing. Skip hand cream on the morning of the visit if capillaroscopy is possible, because it can blur the view of the nail-fold vessels. Bring your insurance and referral paperwork if your system requires it, and allow extra time; first rheumatology consultations run longer than most people expect, and being rushed at the end is where good questions get lost.

Who needs this level of preparing for a scleroderma rheumatology visit, and who is usually asked to wait

This kind of detailed preparation is aimed squarely at two groups. The first is anyone with suspected systemic sclerosis: a person whose primary care clinician has noticed Raynaud’s alongside skin tightening, puffy fingers, reflux or an abnormal autoantibody test, and has referred them for specialist assessment. The second is anyone already diagnosed who is returning for a scheduled review, where the notebook shifts from “what is happening” to “what has changed since last time.” For both, the notes are the raw material the team works with.

Some people will find their path runs differently. Localized scleroderma, which includes morphea (firm, discolored patches of skin) and linear scleroderma (a band of thickened skin along a limb or the face), affects the skin and tissue beneath it but does not involve internal organs in the way systemic disease can (NIH NIAMS). People with these forms are often cared for primarily by a dermatologist, and while a symptom log still helps, the reflux, swallowing and lung sections may simply not apply.

Primary Raynaud’s, meaning color changes in the cold with no underlying disease, is far more common than scleroderma and usually does not require rheumatology at all (NHS). A primary care clinician will often monitor it and refer only if features appear that raise the possibility of a connective tissue disease, such as sores, asymmetry, abnormal nail-fold capillaries or a positive antibody test. If you have been asked to wait and watch, keeping the Raynaud’s diary described earlier is still worthwhile, because it is exactly the record that would prompt a referral if things change.

Nobody with red-flag symptoms should wait for a routine slot, however carefully prepared. A fingertip that has gone dark and stays that way, food truly stuck in the throat, sudden breathlessness, or a sharp jump in blood pressure are reasons to seek care now, as the final section explains.

What the weeks after the visit usually look like

Few people leave a first scleroderma consultation with a tidy label. What they usually leave with is a set of tests and a return date, and understanding that rhythm keeps the waiting from feeling like neglect.

Blood tests are typically drawn the same day or soon after. Autoantibody results and markers of inflammation, kidney function and blood counts come back over days to a few weeks depending on the laboratory, and your team will tell you how they prefer to share them. Some results arrive piecemeal, which can be unsettling; a single abnormal value rarely means much on its own, and the rheumatologist interprets the pattern rather than the parts.

Organ studies follow. Breathing tests measure how much air your lungs move and how well oxygen crosses into the blood. A high-resolution CT scan of the chest looks for early scarring. An echocardiogram uses ultrasound to estimate pressures in the heart and lung circulation. If reflux and swallowing dominated your notes, an endoscopy or manometry may be arranged through gastroenterology (Mayo Clinic). Each of these is booked separately, so the calendar fills gradually rather than all at once.

Keep the notebook running through this period. Log Raynaud’s attacks, reflux nights and swallowing episodes exactly as before, because the follow-up visit will compare them with the first record. If any treatment has been started, note what changed and when, including side effects, so the prescribing clinician has a clear account rather than a general impression.

The follow-up conversation is where the pieces come together: your timeline, the antibody pattern, the skin exam and the organ tests. Diagnosis in scleroderma is a synthesis of all four, not a single test (MedlinePlus). From there, the team sets a monitoring schedule tailored to which organs need watching. That schedule, like every treatment decision, is theirs to set and yours to help inform.

What people often get wrong about scleroderma visits

“If my hands turn white in the cold, I must have scleroderma.” Most people with Raynaud’s do not have an underlying disease. Primary Raynaud’s is common and usually harmless beyond the discomfort (NHS). The rheumatologist is looking for the company it keeps, not the color change alone.

“Scleroderma is a skin condition, so the heartburn is unrelated.” The opposite is true for systemic disease. The esophagus is the most commonly involved part of the digestive tract (NIH NIAMS), and reflux is often one of the earliest internal signs. Leaving it out of your notes because it seems like a separate problem removes a central clue.

“I should stop my supplements before the visit so they don’t confuse the tests.” Do not change anything on your own. The team needs to see your real baseline, including the fish oil and the herbal circulation product. Bring them, or a list of them, and let the clinician decide.

“A positive antibody test means I definitely have it.” Autoantibodies are part of the picture, not the whole of it. They can appear in people without disease and can be absent in people with it (Mayo Clinic). Interpretation depends on the exam, the history and the organ studies together.

“If I feel fine, I don’t need the breathing tests or the echocardiogram.” Lung and heart involvement can be silent early. Monitoring exists precisely because waiting for symptoms means waiting too long. Attending the tests when you feel well is part of the plan, not an optional extra.

“Everyone with scleroderma gets worse quickly.” The pace is highly variable. Some forms progress slowly over many years, others faster, and the type, antibody pattern and organs involved shape the outlook (NHS). Your rheumatologist can speak to your situation specifically; general statistics you find online rarely can.

Questions to ask your rheumatologist about scleroderma

Write three to five questions before you go, and put the most important one at the top in case time runs short. The list below is a menu, not a script; choose the ones that fit where you are.

• Based on what you see today, which form of scleroderma do you think is most likely, and what would change your mind?
• Which of my symptoms concern you most, and which are you comfortable simply watching for now?
• What tests are you ordering, what does each one look for, and how will I receive the results?
• How often will my lungs, heart and kidneys be checked, and what would prompt you to check sooner?
• Are any of my current medicines or over-the-counter products likely to make Raynaud’s or reflux worse, and who should I talk to about that?
• Which of my reflux or swallowing habits are worth keeping, and is a referral to a digestive specialist something you are considering?
• What signs should make me call the clinic between visits rather than wait?
• Is there a nurse or coordinator I can contact with questions, and how quickly can I expect a response?
• Should my primary care clinician or any other specialist receive a copy of today’s plan?
• If you recommend treatment, what is it meant to do, how long before we would know whether it is helping, and what side effects should I watch for?

Bring someone with you if you can. A partner, friend or adult child who takes notes lets you concentrate on the conversation, and they often remember a detail you miss. If you attend alone, ask whether you may record the summary at the end of the visit, or request a written plan.

Do not be shy about asking a question twice. Scleroderma involves a vocabulary most people have never encountered, and a good clinician expects to explain terms more than once. Your understanding is part of your care, not a distraction from it.

When to call your doctor

Careful preparation is for routine visits. Some changes should not wait for one, however close the appointment is. Contact your care team the same day, or use emergency services where indicated, if you notice any of the following.

Fingers or toes. A fingertip that turns dark purple or black and does not regain color with warming, an open sore on a fingertip, or severe pain in a digit that persists after an attack should end. These can signal a digital ulcer or critically reduced blood flow, and early attention protects the tissue (NHS).

Swallowing and digestion. Food stuck in the esophagus so that you cannot swallow saliva, vomiting blood or material that looks like coffee grounds, black or tarry stools, or rapid unintended weight loss. Persistent vomiting or severe abdominal pain with bloating also needs prompt assessment.

Breathing and heart. Sudden or rapidly worsening breathlessness, breathlessness at rest, chest pain, fainting, or new swelling of both ankles. Interstitial lung disease and pulmonary hypertension are among the more serious complications of scleroderma and are managed most effectively when caught early (Mayo Clinic).

Blood pressure and kidneys. A sudden, marked rise in blood pressure on a home monitor, especially with headache, visual disturbance, confusion or a sharp drop in how much urine you pass. Scleroderma can affect the kidneys and cause abrupt hypertension (Mayo Clinic); this is treated as an emergency.

Medicines. A new rash, fever, mouth ulcers or unusual bruising after starting any immune-modulating treatment, or any side effect that frightens you.

When in doubt, call. Clinics would far rather hear from you about a symptom that turns out to be minor than learn afterward about one that was not. Your notebook still helps here: read the relevant entry aloud, with the date, and let the team decide what happens next.

Frequently asked questions

What should be on a scleroderma appointment checklist?

A dated symptom timeline, a Raynaud’s diary, reflux and swallowing notes with a recent weight, any home blood pressure readings, a complete medicine and supplement list by name, copies of previous blood work and imaging, photographs of your hands or skin during episodes, and three to five written questions. Add insurance or referral paperwork if your system needs it, and bring someone to take notes if possible.

How do I keep a Raynaud's symptom diary that a rheumatologist can actually use?

Record each attack in one line: the trigger, which fingers or toes changed, the colors you saw and in what order, roughly how long it lasted, and whether any sore, crack or dark patch remained afterward. Attacks can last from a few minutes to a few hours according to the NHS, so an estimate is fine. Photograph your fingertips in good light after attacks and note any medicines you were taking that day.

Why does my rheumatologist ask about scleroderma reflux and swallowing when my main problem is my hands?

Because in systemic sclerosis the esophagus is the most commonly affected part of the digestive tract, and reflux or swallowing difficulty is often one of the earliest signs that the condition has reached beyond the skin. Heartburn, a morning cough, hoarseness, or food pausing mid-chest all help the team judge how widely the disease is acting and whether a digestive specialist should be involved.

What are the most useful questions to ask a rheumatologist about scleroderma at a first visit?

Ask which form of scleroderma seems most likely and what would change that view, which symptoms concern them most, what each ordered test looks for, how often your lungs, heart and kidneys will be monitored, which signs should prompt a call between visits, and how to reach the clinic with questions. If treatment is proposed, ask what it is intended to do and how long before its effect would be assessed.

Should I stop supplements or over-the-counter medicines before the visit?

No. Do not change anything on your own before the consultation. The team needs to see your real baseline, including herbal products, antacids and cold remedies, some of which can worsen Raynaud’s. Bring the containers or a list with exact product names, and let the rheumatologist and prescribing clinician decide whether any changes are advisable and how to make them safely.

Does having Raynaud's mean I have scleroderma?

Usually not. Primary Raynaud’s, meaning color changes in the cold with no underlying disease, is far more common than scleroderma and typically needs no specialist care. Rheumatologists look for the features that accompany Raynaud’s, such as skin thickening, puffy fingers, fingertip sores, abnormal nail-fold capillaries or specific autoantibodies, before considering systemic sclerosis. A diary of attacks is still worth keeping in case those features appear.

What tests are usually arranged after a scleroderma consultation?

Blood tests for autoantibodies, inflammation markers, kidney function and blood counts are common first steps. Depending on your history and exam, the team may add breathing tests, a high-resolution CT scan of the chest, an echocardiogram to estimate pressures in the heart and lung circulation, and, if reflux or swallowing dominate, an endoscopy or esophageal manometry through gastroenterology. Which tests are ordered depends on your individual picture.

Can I be diagnosed with scleroderma from a single blood test?

No. Autoantibodies are one part of the picture, not the whole of it; they can appear in people without disease and be absent in people who have it. Diagnosis draws together the symptom timeline, the skin and hand examination, antibody patterns and organ studies over time. That is why a detailed personal record matters so much at the first visit.

What should I wear or avoid on the day of the appointment?

Wear layers with sleeves that push up easily, since your hands and forearms will be examined and a cold clinic room can trigger a Raynaud’s attack. Skip hand cream that morning if nail-fold capillaroscopy might be performed, because it can blur the view of the tiny vessels. Bring a warm pair of gloves for afterward and allow more time than you think you need.

How do I describe swallowing trouble so the team understands it?

Separate it into texture, location and frequency: whether solids, soft foods or liquids cause trouble; where food seems to pause, pointing to the throat, mid-chest or low near the stomach; and how often it happens. Add whether you regurgitate undigested food, cough while eating, or have ever had food fully stuck, and note any unintended weight change with a figure rather than a guess.

References

• NHS: Scleroderma
• NHS: Raynaud's
• NIH NIAMS: Scleroderma
• MedlinePlus: Scleroderma

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.