"Blue" fingernails...

I don't think anyone is trying to be a doctor. Just like when someone asks about their breathing and ask questions, we give our input. IT IS HELPFUL but does not replace going to the doctor. Fingernails turning blue is not normal, no matter what the first doctor says and he came to the forum to seek help. What does every agree on? That he should seek a second opinion and many give the reasons why.
And, It's an interesting topic !

"There are those who will be reading your speculations that will give it more credence than its worth (which is NONE)."

Some posters here do have medical backgrounds, if you would take the time to check their profiles.

You are correct though a medical examination is the way to go.

Anyone with a medical background would find these speculations about illnesses as far ranging as a fava bean based metabolic disorder to be irresponsible and abhorrent. These speculations should be enterred into only between patients and their doctors as part of a competently conducted diagnosis. They should NOT be engaged in on a unmoderated public forum where they might adversely influence uninformed readers who might be drawn to making baseless conclusions or experiencing unwarranted worries. Or else, might be impelled to either seek or defer legitimate consultation.

Student's syndrome was a chuckle for most of us, but is NOT a benign phenomenon.

Chuck

GoofyUT wrote:Diagnosis has NO place in an internet forum such as this, and is irresponsible in a setting that doesn't permit EXAMINATION of the patient. I know that you'll say that you're simply trying to be helpful, and that you're offering SPECULATIONS about what his apparently cyanotic condiition might otherwise be. But, what you're doing is, in fact, baseless, alarming and irresponsible and ought to stop immediately. There are those who will be reading your speculations that will give it more credence than its worth (which is NONE).

Chuck

Now, I know that you mean well, Chuck. To presume and espouse, however, that physicians are the only individuals capable of making informed and competent medical diagnoses (excuse me for being blunt) is absurd. What you have said is just another variation on the big lie, Chuck. In fact, the track record for making correct diagnoses by physicians is abysmal, as is evident in this thread already.

What would be irresponsible is not speaking up to offer alternative opinions, suggestions, recommendations and, yes, even diagnoses when it is clear, as it appears here, that the physician has not done an adequate job in relieving either this patient's symptoms or anxiety.

Don't be bellyaching about irresponsibility of the posters here, Chuck. IMHO, the information being provided on this forum tends to be more consistent, reliable, and accurate than what most folks usually get when they visit a physician's office.

Regards,
Bill

Sorry I didn't respond sooner. Things have been happening while my server was down.

To clarify my intent-I am advocating getting a diagnosis from a qualified health care provider. Sure I can meekly say, "Yes I think you should get a second opinion". It is more likely he will if I can back it up with reasons. I am presenting arguments for SEEING A DOCTOR WHO HAS THE LEGAL AUTHORITY TO DIAGNOSE AND TREAT.

Goofy UT-Josh asked questions and indicated he was feeling like a hypochondriac-I can give him some reasons why he doesn't need to feel that way-and why he should continue trying to get a definitive diagnosis. When a doctor tells you everything is "normal" it is easy to go away and think nothing is wrong. Well if Josh or anyone one else has a chemical exposure-it should be avoided-it needs to stop. This is easily treated if that is what is wrong. It doesn't need any prescription except avoid the chemical. And I gave some chemicals to look for at work that might be present in a printing facility and a site to find more. If they are not there he can forget it.
You recently had an in depth discussion of your CPAP therapy with SWS in this same forum-it got highly technical-and often speculative-some people think you should talk to your sleep doc about that. Is your objection based on the fact I am a woman and a Grandmother??

speculations about illnesses as far ranging as a fava bean based metabolic disorder to be irresponsible and abhorrent

G6PD deficiency is probably more common that diabetes-millions of people have G6PD deficiency and eating the humble fava bean has the distinction of being diagnotic for the disorder.
PS GoofyUT you can always delete this as spam-or not read it if you find it abhorrent.

Guest-You are right-I thought about that last night-it is for everyone-that was poorly said. What I meant to say was that if you want to discuss my wanting to “impress” we can do that in private messaging because that is somewhat insulting. If you want info I'm willing to put what I "know" out there with my name, a profile, and a photo of my self-you on the other hand hide behind Guest status. You may be highly qualified-but who knows. If "cryoglobularenama" was a test of my knowledge-assuming it is spelled correctly-I do not know precisely what it is. I do think it is related to cryoglobulinemia-and that isn't snowballs in your bloodstream. Cryoglobulin is an abnormal protein in the blood that precipitates when exposed to cold. But Josh didn't relate his blue tinge to cold and since he lives in NH I thought he would have noticed if cold bothered him-so I let the Raynaud's connection go. If I was the provider doing his medical history I would ask more about his reactions to cold.

The explanation of the terms sometimes gets worse than the terms themselves and I thought I gave adequate explanation without getting overly technical. So here goes. I type slowly so be patient. Hemoglobin binds with oxygen, carries it to cells, and releases it. Normally hemoglobin can bind 4 molecules of oxygen. It needs certain enzymes to carry out the chemical reaction to bind and release O2. One of these is G6PD (glucose 6 phosphate dehydrogenase) which happens to be the enzyme missing or deficient in G6PD deficiency (aka favism or Mediterranean anemia) When the hemoglobin is unable to bind to the full complement of 4 oxygen molecules.-methemoglobin is formed-that gives the bluish cast to the skin. This is congenital and severity depends on whether one parent or both carried the gene for it. People with only one gene (from one parent) might not ever know they have it if never exposed to an chemical that “activates” the syndrome. it is a very interesting condition in that it confers some protection against the malaria parasite because the parasite prefers hemoglobin with the full complement of 4 oxygen molecules please.

There is also an acquired methemoglobinemia, usually from exposure to chemicals that interfere with the binding of oxygen to hemoglobin; cyanide, nitrates & nitrites, ammonium chloride (chloramines), analine dyes, chromates, sodium hypochlorite (helps form chloramines), and a number of other chemicals which might be used in the printing process. I don’t know enough about the printing process-what kind of printing they do-what he does at work. What I do know is that pigments, dyes, the chemicals to clean up the inks, etc can be highly toxic and many can be absorbed through the skin or by inhalation. If Josh is getting some chemical exposure at work-why would it just be him? Maybe he carries only one abnormal gene so doesn’t have the full blown syndrome and was never “challenged” by something like a chemical exposure or eating fava beans until now. Maybe he doesn’t have the gene but rather does something at work that causes a heavier exposure-like spraywashing screens with sodium hypochlorite.
Why methemoglobinemia? He describes a classical cyanosis usually a sign of low oxygen levels. But then says the doctor tested his O2 levels and they were normal. There aren’t many conditions causing cyanosis with a “normal” O2 level. Public health officials once traced an “outbreak” of methemoglobinemia to a hole-in-the-wall restaurant where a worker filled the salt shakers with sodium nitrite instead of sodium chloride (table salt). Dialysis units used to clean equipment with sodium hypochlorite-one didn’t flush it out well enough afterward and the next day they had an outbreak.

a1 Chymotrypsin is a substance in the lungs helps break down an enzyne (elastase) that damages elastic fibers in the lungs.

Cryoglobulin (if that is what you were referring to)is an abnormal protein in the blood that prcipitates when the blood is cooled. People with Raynaud’s disease get blue hands when exposed to cold because the precipitate interferes with the microcirculation. I’ve also seen it used as a test for cancer-it isn’t very specific in that it doesn’t tell you presicely what kind of cancer or where it is-I do not know what actually causes the protein to form.

To give some of my background-I am a retired nurse practitioner and I would not actually work without a refresher course after 10 years of retirement. My Mother cleaned office for a doctor. I used to go with her and while she worked I read the medical books and journals in the doctors library. It was slow going at age 8 and sometimes I had to look up every word in the medical dictionary-I got faster though. At age 10 convinced my Dad to see a doc about his indigestion as it might be heart disease-it was. Went to a doc one time for symptoms I thought were due to a brain tumor-he said NAH-but as I was leaving he says lets do a scan anyway-it was. As a nurse practitioner student I went over my physician supervisions head once when he missed meningitis in a child. I am fascinated by microbiology, parasitology, and the "odd" syndromes. I left a doctoral program for nurses after they would not agree to my doing an advanced clinical degree. So why didn't I go to medical school?? In 1959 I didn't think I could be a good doctor and a good Mother at the same time. And I would have wanted to be a good doctor, but #1-I wanted to be a good Mother. You can get me on that bias GoofyUT.

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP, Prescription, clean

Even webmd.com has an area where you can type in your symptoms. Nobody confuses that type of symptom-based idea generation as being a physician diagnosis either.

http://www.webmd.com/diseases_and_condi ... hecker.htm

Krousseau, you are guilty of being more caring and efficient than webmd! .