Got a great question from Not That Kind of Chronic (whose sense of humor in blog naming I quite enjoy)
Your recent post mentioned not to wear nail polish to a rheumatologist. I always have a manicure. Can you tell me what my nails might show?
The first time you see one, yes. It’s not absolutely necessary to remove your polish, but the condition of your nails can tell your rheumatologist about the state of your health, and many doctors will examine both your fingernails and toenails… It’s particularly important if you are seeking a diagnosis from a rheumatologist, gastroenterologist, or other specialist for a systemic disease!
- Nail Pitting — can be indicative of psoriasis (important for patients with Psoriatic Arthritis), Reactive Arthritis, and other connective tissue diseases
- Spoon Nails (Koilonychia)— can be indicative of Systemic Lupus, Raynaud’s, and anemia
- Yellow Nail Syndrome — occurs in Rheumatoid Arthritis patients or often the result of infection or medications, both of which are relevant to Autoimmune Arthritis patients.
- Splinter Hemorrhages— small blood clots under the nail can indicate Systemic Lupus, Rheumatoid Arthritis, Antiphospholipid Syndrome, Psoriasis, Vasculitis, and Scleroderma (all rheumatology-related).
- Nail Clubbing— can occur with Irritable Bowel Disease (e.g., Crohn’s, Ulcerative Colitis), liver disease, and pulmonary diseases.
- Both Discoid and Systemic Lupus can cause nail changes such as cracking, curling, and even complete loss of nails.
- Rheumatoid Vasculitis or Nail Fold Vasculitis— can cause pitting, sores, redness, and infarcts of the nail-bed (not a pretty picture).
- Nail health can also reveal possible vitamin deficiencies and malnutrition, both important when treating rheumatological diseases.
A terrific summary of nail-related findings of chronic disease, by the ever-excellent “dealing with chronic diseases” blogger Chronic Curve!
Overheard, a patient talking (rather loudly) with a general surgeon in an exam room near my urgent care.
I shudder to think what the cure might be…
Uh-oh. You wake up at 4am with stomach cramps, nausea, and feeling flushed. A few minutes later, you’re kneeling before the Porcelain Altar, retching up your guts. Then just as you’re hoping the worst is over, you feel your bowels clench, and you start The Dance of the Toilet Bowl and Trash Can as everything in your intestinal tract makes for the nearest exit, like some kind of demon-possessed Pushmi-pullyu.
Now, real quick: when you sign in at the Urgent Care, what do you call your symptoms?
Did you say “Stomach Flu”? Well, sorry to inform you, Mr. Ralph Thunderpants, but you’re wrong. It’s not the flu at all.
Dear Constipated Lady:
Yes, being unable to poop is a lousy situation. But I think I would have a bit more sympathy for your situation if the following facts weren’t true about your case:
Let’s do a little size comparison, shall we?