Tis the holiday season… Thanksgiving, Chanukah, Christmas, New Year’s Eve and all the usual activities that goes along with it… except for the freakish blizzard that pummeled the Northeast over this past weekend.

I recently drove home to Ohio from New Jersey to spend some quality time with my new wife and her family. Near the end of my mini vacation, I packed up my car and heard about the bad snowstorm. I left for New Jersey on Monday, Dec 27^th. The 500 mile trip along the toll roads was great, a little snow and lots of wind, but that was all. It wasn’t until I was within 25 miles of Howell, NJ when I got off the turnpike that I realized how bad the snow was; it was easily 2 ½ to 3 feet.

As I was driving cautiously through the blizzard, I kept thinking about a patient I had encountered a while ago in Iowa. The snow out there was terrible, and with the wind chill, it was 35 degrees below zero. The patient had been shoveling snow outside wearing his work boots for several hours. After he was done, he went inside to relax.

We saw him in our hospital about one month later. When he came in, his right big toe was all black and necrotic (dead tissue). When we asked him what had happened, he told us and that he thought his toe would get better on it’s own… it didn’t.

For the sake of this blog, I will not get into the different types of frostbite, rather I will focus on what you can do to avoid getting it in the first place.

Frostbite Prevention 101:

1. Predisposing factors:

a. Minimize your exposure to the environment

b. Know what the wind chill factor is

c. Wetness – keep your feet dry; change your socks frequently

2. Individual factors

a. Age – the older we get, the less time we should be outside

b. Nutritional status – are you well nourished? Do you have the energy storage necessary?

c. Physical and mental condition – do you exercise regularly? Cardio training?

d. Alcohol and smoking habits –

i. Alcohol might make you feel warm, but it takes away body heat

ii. Smoking constricts blood vessels, making it harder for blood flow

If you have been outside for a long duration of time; skiing, snowboarding, walking, or shoveling the driveway, you might be at risk of getting frostbite. Some warning signs to look out for:

1. Extremity may feel hard, appear pale or purplish

2. If you squeeze your toes with your fingers, it may take longer for the color to return than usual (we call this capillary refill time – you can try this by squeezing your thumb for a few seconds, letting go and count how long it takes for your thumb to return to normal color)

3. Within 24 hours, blisters will develop, swelling occurs, and more reddish-purple discoloration appears

4. After several days, the blisters enlarge and become blood blisters

The list is more extensive than this, but if you suspect that you might have frostbite, it is a medical emergency for you to see your doctor right away (within 24 hours). If it is frostbite and depending on how soon you are seen for it determines the course of treatment. The course of treatment is ONLY to be performed under the direct supervision of a physician! You can do more harm than good by treating it yourself.

Don’t forget, if you suspect you might have frostbite and you live around the Howell, NJ area, feel free to call our TEAM at Affiliated Foot & Ankle Center at (732) 905-1110. If you are located around the Edison, NJ or Monroe, NJ areas, please call our office at (732) 662-3050. In the meantime, stay warm, stay safe and have a very Happy New Year!

By David Hunnicutt