Thank you everyone for the advice and concern.
We did not go to the ER last night, I couldnt get difficult child to agree to go, he is almost 21 years old so I finally said the decsion is yours but will you come to the doctor in the morning he said yes.
He was examined and the doctor has diagnosed Reynauds Symdrome here is the description I copied that he gave me.
<span style="color: #3333FF">This is a condition in which the smallest arteries that bring blood to the fingers or toes constrict (go into spasm) when exposed to cold or from an emotional upset. Smoking cigarettes or working with vibrating machinery also can cause these episodes. The small veins are usually open, so the blood drains out of the capillaries (KAP'ih-lair"eez). The result is that the fingers or toes become pale, cold and numb. If there's a spasm in the small veins and blood is trapped in the capillaries, the fingers or toes turn blue as the blood loses its oxygen.</span>
For now he said to keep warm, watch for changes and of course stop smoking. We will go back next week for blood and an oxygen check.
For the past few days difficult child has had bluish lips that almost seem to have a white trim, he had said he vomited earlier so we thought it would go away, it did for about 1/2 a day but now today they are blue again and now he says his hands are cold and he has a pain in his chest.
He did just start a new drug program, but the more I read about it is appears to be a lack of oxygen in the blood. He does smoke cigarettes too.
Has anyone ever seen or heard of this? Can I call his PMD in the morning or do you think he should go to the ER?