Medical Question

[justwannano]

For about three weeks now the index finger on my right hand has been cold. It feels cold and is cold to the touch. When pressing hard where you normally get a white looking fingernail my right one is very slow in turning pink again. I suppose it is circulation problems but why? I didn't injure it. A blood clot?Collapsed artery? My heart was healthy when I had surgery in april.I had no problem giving blood in March.
Any Ideas???

[Stupendous man]

The nailbed test is a definate indication of poor circulation.
Rather than waiting for your finder to shrivel up and fall off, perhaps you should get to the doctor as soon as you can.

[tshirts]

See (call) a doctor. If you've been treated this year, you must have one.

But also, don't get yourself worked up with a self-diagnosis.
I did that once, read up on pains in the leg and went to a vein doctor sure that I had phlebitis (blood clot or vein injury). He said I was nuts and sent me to a nerve doctor who said I had an inflamed nerve and gave me a steroid shot.

[Another County Heard From]

You should definitely see a doctor for this.

The combination of coldness & paleness are suggestive of a circulatory problem. Likely possibilities would include a blood clot or inflammation of one or more blood vessels called vasculitis. Regardless of the actual cause here, it is unwise to assume that your finger is the only body part affected, or that since it is not really bothering you now, that it does not need attention.

See a doctor soon. An internist or family practice doctor would be a good place to start.

[handy]

While waiting four weeks for your doctors appt, try warming the finger up in the bath & getting more exercise so you pump more blood around. I get this sometimes but its usually okay after a bath.

[kinoons]

Shoot from the hip, but the worst case is a clot is freefloating in your circulatory system. Its good it got stuck in your finger and it wasent large enough to get stuck in your lungs. Go see your doctor. If you happen (VERY SMALL CHANCE, DONT GET WORKED UP OVER THIS) to feel severe pinpoint chestpain before seeing the doctor, call 911 and go to the hospital immediately. That pain could very well be a pulmonary embolis (clot in the lungs) and those can kill you.

The above is the worst case, its probally not that. Go see your doc.

[Another County Heard From]

kinoons - you're confusing venous bllod clots and arterial blood clots.

Brief (to the point of ridiculous) review of the circulation:
L heart -> arteries -> veins -> R heart -> lungs -> L heart

The OP suggested a blockage in arterial blood getting to one finger.

Venous blood clots most often form in the leg; then when pieces break off, they go through the R heart into the lungs and cause a blockage there. Embolus is the term for anything which travels through blood vessels and ultimately causes a blockage. A pulmonary embolus occurs when this blockage occurs in the lung vessels. Fat and air can also rarely cause emboli.

It would be exceedingly rare for a venous clot to get through the R heart and lungs, and back through the L heart to get into the arterial circulation. But not impossible, because a few people do have an opening between the L atrium and the R atrium of the heart called a patent foramen ovale. Generally though, even here, any blood movement goes from L to R due to higher pressures in the L heart than the R side.

[kinoons]

Another country heard -- I am very familiar with the heart and the circulation of the blood through the body. Yes, it would be extreamly rare for a clot to go through the lungs but it would be possible. Also, if he is getting clots in the arterial system (much more difficult due to the higher pressure in the arterial system) it would be possible for him to throw clots in the venous system, and his recent surgery history only adds to this chance.

[kinoons]

Also, the foramen ovale is a structure (or lack there of) of a fetal heart -- it very rarely stays open in the adult heart and leads to significant complications if it does. I feel confidant that our fellow poster does not have this problem

[barbitu8]

None of youse guys mentioned the possibility of Reynaud's syndrome. A possibility. Years ago, when I played handball, I had the same symptoms in my right index finger, from mishitting (watch the syllabification) the ball. The thread starter did not mention if he plays handball or if there was other similar trauma to his index finger. My symptoms disappeared when I gave up handball for racketball.

[kinoons]

Barbitu8 -- I am not familiar with reynaud's syndrome, and I am at work and am unable to get to my resources to look it up -- could you elaborate for me please?

[justwannano]

Thanks for the comments folks.
I guess my best bet is to go see my doctor.
I have recently found that my invincibility is slipping.Things don't get well by themselves any more. A bruise on friday night still hurts on monday unlike in my football playing days.
I guess old age is better than the alternative.;)

[Another County Heard From]

kinoons -

About the only way for a venous clot to cross over to the arterial side is for the patient to have a patent foramen ovale or a shunt in the pulmonary vessels preventing the blood (with the clot) from having to go through capillary beds which it could not cross. Yes, these foramen ovale are supposed to close around the time of birth, but a small percentage do not.

Here are some links:
http://www.gulftel.com/~scubadoc/pfo.htm

http://www.drkoop.com/conditions/ency/article/001113.htm - this link from Dr. Koop says as many as 1 in 5 people can have this. But I suspect this is a high estimate, many of these would not be cliically relevant.

http://thirdage.adam.com/ency/article/001113.htm

http://cpmcnet.columbia.edu/dept/cardiology/echo/picss.html - this one describes a study currently underway to determine in patent foramen ovale may be a major explanation for strokes (usually due to blockages in the arteries to the brain) in young adults who would not be expected to have the usual risk factors for strokes.

The other possibility you are alluding to here:
Also, if he is getting clots in the arterial system (much more difficult due to the higher pressure in the arterial system) it would be possible for him to throw clots in the venous system, and his recent surgery history only adds to this chance. is referred to in medine as a hypercoaguable state.

One such state is bedrest or inactivity because blood can pool in the legs, resulting in a venous clot (aka DVT for Deep Venous Thrombosis). However, since the OP's surgery was 6 months ago, s/he would really be outside the window where the surgery would be considered to be a major risk. Also from my Hematology (Internal Medicine specialty dealing with disease of the blood & blood clotting) rotations, I learned that while there are blood abnormalities that predispose to arterial clots, and abnormalities that predispose to venous clots, but the lists have almost nothing in common.

[Another County Heard From]

Regarding "Reynaud's" Disease or Phenomenon, you'll find more info by looking up Raynaud's. I'm not trying to be the S&G Police here, but search engines are not very tolerant of misspellings.

here is a useful site from the NIH: http://www.nhlbi.nih.gov/health/public/blood/other/raynaud.htm#what

The reason I didn't include Raynaud's in my earlier discussion is that I understood from the OP that this has been a more or less permanent state of affairs for him/her for several weeks. That kind of incomplete information is why MBs can't serve as definitive health care providers. Raynaud's attacks, typically last on the order of a few minutes to an hour.

Glad to hear that you're planning on seeing a doc soon for htis justwannano!

[kinoons]

Thanks for the links -- some good info to bring to my paramedic class.

[handy]

The weather is pretty cold so I went for the obvious, cold hands.

[justwannano]

Hey thanks gang.
Preliminary diagnosis(Dramatic Pause) Raynauds.
Strangely you cannot diagnose Raynauds until the symptoms have been happening for two years. I have 101 weeks to go.
The Dr said in 33years of practice he has not seen a Raynauds case before so he is a little hesitant.We still have blood tests to do etc.
I'm off to visit a Raynauds website. The Dr showed me one with pictures.Sure hope thats not whats wrong.