Frostbite/foot Questions

[bigwalling]

On a recent trip to the Bugaboos I developed a foot problem. I spent 14 days on a wall and my boots and socks were less than adiquate! My feet were totally numb and still are, they also felt quite hot to the touch. Right now, several days later they are in massive pain. As in I can't sleep and have puked due to the pain. Just looking for some help. I know nothing on this subject but please ask questions to help me be more detailed.

 

Also anyone know a good doctor to go and see for something like this?

 

I'll post a trip report later too... lots of pics!

[MountaingirlBC]

Get yourself to the hospital now. YOu really don't want to mess with this. How is your color? Do you have circulation in your feet/toes? Do you have swelling? blisters? If you have serious frostbite you should not be walking or even moving your feet around. You probably don't anyway but DON'T SMOKE. Asprin is best for the pain as it also improves circulation. You may have an infection which will require antibiotics.

 

Please get someone to take you to the hospital asap. I'm no expert by a long shot. I've just taken a wilderness first aid course but that was enough for me to know that frostbite can be extremely serious, especially when it isn't treated properly.

[ivan]

hope this is a troll - you're probably a dumbass if not, as you describe problems so utterly and obviously bad they clearly would need immediate medical attention

[bigwalling]

It's not a troll, if it turns out to be frostbite, it is the very early stage. I'm hoping it is nothing but, I'm goin to see someone. I have swelling, but no blisters.

 

Ivan, I don't just run out and see doctors if I can avoid it. I haven't even been in the states till today. My moms friend just called and gave me a doctors name that I will go and see tomorrow.

 

Also, most of you have probably spent more time hiking hills than me. Have you ever had really painful feet and figured it was caused by your toes slamming into the front of your boots?

[ivan]

i hope it all works out okay, man! worst i've ever done is get a couple of my fingertips numb for a couple of days and that scared the shit out of me. extreme pain and prolonged numbness sounds serious - go see a doctor NOW!

[dylan_taylor]

take a picture of your feet and post it here for all to see...

[iluka]

I think there's reason for some concern here but not the alarm that some have raised in prior posts. It could be frostbite, but getting it checked out in the AM will be fine... there isn't much they're going to do at this point since you're fairly far out from when it started. This does need to be checked out by a physician, the sooner the better.

 

A few questions. What were the conditions like when you were out. Were you on snow? Freezing temperatures while you were climbing? Did you have a harness that was on pretty tight and restricting arterial flow to your legs or perhaps limiting return from your veins. Did your feet get wet and stay that way for a while. The question someone raised in a prior post about blisters is a relevant one. Do you have any blue or gray discoloration now?

 

Depending on what the answers to some of those questions look like, this could be frostbite. Sometimes, after frostbite resolves and the tissue rewarms, you can have a lot of pain that persists for a while. It's call neuropathic pain. There can be numbness and tingling associated with that as well. You can get similar sensations, however, from something like nerve compression. Although it's unlikely from the design of the harness, if you were sitting in the harness for long periods hanging on your rope, you may have developed some nerve compression that is causing the numbness and tingling.

 

If this is frostbite, it needs attention. If your feet have already rewarmed, as it sounds like they've done, that's about what you need right now so I wouldn't rush to the ER this very second. There is nothing else they would do acutely, although there is some talk in the literature about using antibiotics to prevent infection in some cases (althought without blisters, I don't think this is usually done). Don't let your feet get cold/frozen again in the interim. I agree with the previous post about not smoking. I doub the aspirin will be of much use. It prevents blood clots by blocking platelets from doing their job but that doesn't play a role in frostbite so it doesn't offer you much advantage here. Instead, take a good dose of Ibuprofen... 800 mg every 8 hours for a few days.

 

Andy

[Bug]

And drink LOTS of water with that Ibuprofen.

[bigwalling]

Thanks guys! I went to a doc today and found out that it is a minor case of frostbite. He said that all my major circulation in my feet is fine and that it was some of the more minor areas blood flows that were affected. What sucks is I will have pain for 4-6 months and will be more likely to get frostbite in the future.

 

Lessons learned... the Bugaboos are more extreme than I thought and yosmeite footware and socks is not acceptable! Also if you do cold weather big walls... be sure to bring a belay seat so you can keep circulation flowing. This is what fucked me the most.

[ivan]

heal well, senor - and keep dem feet warm for the restof your life or your nickname becomes "stumpy!"

 

we gon' see your pix on the 'boos soon?

[arentz]

Good to hear you are doing better.

 

Not to belabor the point, but there is data for both vitamin C and asprin if taken for the first 5-7 days after frostbite exposure. A drug called pentoxifylline, which is only available by prescription in the states, might also be worth asking your doctor about IF you keep having problems in that limb every time you are out in the cold. Probably helps most with more severe frostbite, but overall it decreases the area affected. Also might be true for ibuprofen and other stuff you can buy at a drug store, but I don't think the data is as strong for that.

 

Frostbite is much more common at altitudes over 5000 meters/17,000 feet, so be extra careful on those big climbing trips to asia.

 

Lastly, if you ever see blisters, especially bloody ones, bypass your doctor and go to the emergency department.

 

I'm a physician. I've done high altitude research and been an expedition doctor over in Nepal. If you want a recomendation on a local doc that knows more about high altitude/mountaineering problems, pm me.

 

cheers,

arentz

[mtn_mouse]

I got frostbite once, got back to the car, turned the heater on, and what pain!!! I could barely walk for a week or two, couldn't even lay a sheet over my toes at night. All my toenails fell out. They returned eventually, except for my two big toes. They look like crap. I did go to a doctor a day or two afterwards. He said he could not do anything, they had already thawed out, and oh, by the way, $65 please.

Might get some good advice from folks here, but best advice, is don't let it happen again. Get better boots etc. good luck

[Dechristo]

I can vouch for the ease with which frostbite increases in severity when clothes (footwear) become wet.

 

Jack London had it right in "To Build A Fire". Keep dry. The higher the altitude/colder the climate, the more efficacious are VB socks.

[jkeller]

I frostbit my two big toes years ago and they have never been the same.

 

The toenails look like shit and fall out every couple of years. My feet are also way more sensitive to cold than they used to be.