Frost Bite/Nip

Discussion in 'Health and Fitness' started by ruby2shoes, Mar 14, 2006.

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  1. Any advice out there on frost bite or frost nip? Apparently the doctor has said it's more like frost nip... what's the difference? I'm asking for my son who's away at the moment. Army medics don't seem overly worried about it but it's bothering him. Loss of feeling generally in both big toes which returns in the form of tingling occasionally (especially when he's at home and warm) and then disappears. Been going on quite a few months now.

    Will it disappear over a period of time? Anything he can do to help it?

    If this has been covered elsewhere, my apologies and please point me to the thread.
  2. Frostbite is caused by the loss of blood flow to the affected area. This, in turn, results in the death of tissue (gangrene). A medic may correct me, but if your son can still count to 21 (22 including his nose, or 24 including his ears), then he probably hasn't got frostbite. Sounds like a circulation problem that may rectify itself, though given the duration, I'd harass the medics - could ingrown toenails be the problem? (Or boots slightly too small?)
  3. If the M.O has OKed him, he should be fine. Frostnip is a milder form of frostbite, and can be painful for up to a year after onset. Circulation is the key, mostly to prevention, but also to recovery. Anything that stimulates circulation is good ie: aspirin, garlic and ginger (though not neccessarily together 8O )
    If he's going to make a habit of visiting alpine/polar regions, he needs to make sure that his cholesterol stays low and his blood thin.
  4. It happened in the Brecons and someone else came down with it so bad (as well as hypothermia) that he's about to be medically discharged.

    May be a stupid question but should the garlic & ginger be ingested or rubbed on? I hadn't thought of aspirin but it sounds like a good idea.

    Re: improving circulation, I'm aware that massage is bad for frostbite but would it work for frostnip?

    It's definitely not ingrowing toenails or bad boots. He's particularly careful about boots and was wearing Lowa's, I think, as well as sealskin socks. His diet is excellent and he thinks about what he's eating so I can't imagine his cholesterol is a problem.

    I agree that he should harass the medics (and, as his mum, I harass him about that!) but he's away at the moment for quite some time.

    It's helpful to know that frostnip can take a long time to heal. Thanks for your advice.
  5. cpunk

    cpunk LE Moderator

    I had my toes frostbitten/nipped in what I suspect are similar circumstances to your son's a little over twenty years ago, having fallen asleep in the back of a Landrover in severe weather conditions. The net result was an immediate loss of feeling more or less below the knee which lasted for several hours which gradually receded, leaving me with very little feeling in my foot for a week or so, and then a burning or tingling sensation on and off for several months. All of my toenails also fell out, which was rather exciting.

    Since then, it has caused a few minor problems, generally in cold weather, and for the first four or five years after it happened, my toenails didn't grow much and occasionally dropped out in prolonged spells of cold weather. The problem gradually went away, though the worst affected toe would sometimes ache when it got cold.

    More recently however, I've developed arthritis in the joint of my big toe. This is currently uncomfortable rather than debilitating though my doctor tells me there may eventually have to be some kind of surgical intervention. It doesn't currently affect my ability to do stuff, though I do have a running prescription for super-strength Brufen which is handy for hangovers.
  6. They are useful if ingested. I don't know if topical application will have much effect.

    Ginger "tea" is pretty good. It's said to improve your circulation as well as strengthen your immune system. I always drink a lot of it during the cold season or when I'm starting to feel sick. Basically, take a litre of water, add a few large chunks of ginger and boil for about 20-30 minutes. Strain and drink. Depending on preference, you can add honey or lemon, but I've heard that adding things reduces the benefits.

    There's also roasted garlic. It's a few heads of garlic drizzled with olive oil and roasted in the oven. It comes out so soft that you can squeeze it out like a paste. I like to spread it on good bread. A quick internet search will probably yield recipe results.
  7. Frostbite is the death of tissue due it freezing. No blood flows to the frozen site and so the cells die from lack of oxygen. This is called necrosis, gangrene is when the necrotic area becomes infected and spreads.

    It sounds like this is frost nip, it is a milder form of frostbite as others have said. The difference being that the tissue does not freeze and die altogether. Often there is some damage to nerves in the area, but the tissue survives when warmed up. The damaged nerves lead to the loss of sensation and can take some time to heal. It may be that full sensation is not restored. I have suffered from frostnip (also in the Brecons!) and still have some parasthesia (reduced sensation) in my index fingers.

    If this is the case, your son does not need to worry as the sensation ought to improve over several months/a year. He should be prepared for the possibility that he might never have the same level of sensation in his toes, but there is no serious damage to be concerned about. I would suggest that he pay close attention to his feet and ensure that he keep them warm/mobile/dry when possible in cold climates. I would not suggest that he start taking aspirin as it can cause gastrointestinal ulcers and affects platelet aggregation, thereby reducing the ability to form blood clots. The only people who need to take aspirin are those who have had or are at risk of heart attack or ischaemic stroke, and that doesn't sound like your son!

    Hope that helps.
  8. Brecon seems to be an absolute bugger for this kind of thing (and he's possibly back there again in a couple of weeks).

    I'm going to suggest that he wriggles his toes as much as possible.

    Thanks for all your kind help.
  9. I've had frostnip in my hands from an incident in the Balkans, didn't think it was much of a problem at the time and it was my own fault (I removed gloves for several hours to make a task easier, even though it was snowing and wet).

    Some time after I began having pain in the knuckle joints, the pain could last anything up to a month and was triggered by cold exposure. The attacks became less frequent but this lasted about three years. Eg, if I accidentally put my hand in cold water, this would trigger a nagging pain in the joints for days/weeks after. I was told this was nerve damage, but I'm not convinced as it's not happened for years now so I must have recovered.

    The Navy Medical Institute in Pompey (Alverstoke ?) can assess cold weather injuries, but this probably isn't required for your son if the medics have already seen him. My advice is for him to keep his feet warm - wool slippers (not kidding) around the block and tell him to invest in good socks (wool lined sealskins) and boots (Altberg or Lowa/Hanwag) for field use in cold/wet conditions.

    There's a good SSVC video on cold injuries, tell him to touch base with his Training Wing and borrow a copy.
  10. Thanks, GR, but see above - he wears both Lowa boots and sealskin socks and was wearing them at the time. It's a good idea for around the block though, which he probably doesn't do at the moment. It sounds like it's a long haul to recovery and I'll let him know that.
  11. Just remembered that when he returned from that Brecon stint a cold weather consultant/senior doctor was brought in to investigate his friend who is probably going to be medically discharged and looked at my son's toes at the time. He didn't think there was much of a problem and said they'd get better with time. Quite rightly, he was more concerned about the other bloke than my son's big toes.
  12. Fair one ruby, that doc was probably from the Navy as they tend to be the experts in cold weather injuries/cold water survival.

    He won't like the slippers idea, but I reckon he'll be having problems with his toes for some time. The important thing is that if this happens again the damage will be even greater so it's important to keep the feet/toes warm and dry whenever possible and not just in the field.
  13. Perhaps I should have made it clear in my original post, the garlic and ginger are of course to be ingested, not applied topically. I dont have any circulatory problems, but I dont believe in taking chances, so a regular part of my diet is a powerful ginger drink called Rochester Ginger, its three quid a bottle from Holland & Barrett. They advertise it as having a kick like two angry mules, they're right.
    To the uninitiated, its quite a shock, as its alchohol free but burns like drinking neat spirits.
    As for the slippers, he could invest in some "hut boots" from a climbing shop, they're better than slippers and considerably more ally.
  14. Right, you've all geared me up to a "mummy talking to" when he gets back!

    He has big sweaty feet and can be prone to athletes foot so I've taught him from a young age to go barefoot whenever possible. But this frostnip is more of a problem than athletes foot so I'm going to talk to him about the hut boots (my partner knows what they are) and buy him some if needs be.

    He may, for once, listen to advice because I know this frostnip is really getting on his tits now; his toes swing from being either numb or constantly tingling.

    He initially seemed to be recovering after Brecon but was then sent to Thetford and it got worse again.

    Some very sound advice... thanks once again to you all.
  15. I've seen some rancid stinking feet on blokes coming back from Norway, Oman, etc. I tend to use foot cream instead of foot powder and I get fewer blisters - the cream keeps the skin supple and stops hard skin developing (which would harbour fungal/bacterial infections). If I get blisters they are easier to deal with because the skin isn't thickened.

    Tell your son to scrub his feet in hot water (using a nail brush) and keep them in the hot water until they sweat. Then use medicated foot cream (or powder if he prefers) before putting the slippers/socks on (this prevents the slipper becoming a breeding ground for fungal/bacterial infections). Obviously flip-flops instead of slippers if he's gonna be in Iraq/Afghan summer.

    Good call on the hut boots sandmanfez, very useful.