The Ultimate Guide to Frostbite from Arnot Health

As you head off to the slopes, send the kids out to play in the snow, or simply make a wintery trek out to the grocery store, keep this in mind- it can only take a few minutes for frostbite to occur. Exposed skin can develop frostbite at 20ºF with winds at 20 mph in less than five minutes. You don’t have to be stuck in the wilderness for hours; it can happen in your own front yard.

When exposed to cold temperatures, the body begins to move blood away from the extremities, pulling it towards the core to protect vital organs and systems. This leaves fingers, toes, ears, the nose and eventually hands and feet more vulnerable to damage, known as frostbite. Frostbite occurs when ice crystals form in the cells, damaging the tissue. Frostbite can range from effecting the top layer of skin all the way to deep tissue damage.

Signs and Symptoms:
Here are signs and symptoms to look for while you’re in the elements:

• Tingling and numbness
• White, yellow, or grayish coloration
• Waxy look to the skin or skin that feels abnormally hard to the touch

When rewarming or returning indoors:

• Flushing
• Blistering
• Burning sensation
• Black scab which can form several days or weeks following exposure

Next Steps:
If you believe you may have frostbite, seek medical attention as soon as possible. If medical help is not immediately available, here are a few steps you should take to minimize damage:

• Warm the area by submerging the area in warm, not hot, water
• Avoid dry heat such as fires and radiators, and avoid direct heat
• If blisters form, leave them intact- they are sterile, biological dressings that form to help mend damage and avoid infection
• Do not apply pressure or rub the affected areas; if the toes/feet are effected, avoid walking as this can increase damage

What can increase your risk for developing frostbite?
While everyone can develop frostbite under the right conditions, several circumstances can increase your risk. Some of these include:

• Cardiovascular disease
• Diabetes
• Smoking
• Consumption of Alcohol or other substances
• Damp clothing
• Previous frostbite

Long-term Effects:
If you experience frostbite, some of the lasting effects may include:

• Increased sensitivity to cold
• Numbness
• Stiffness
• Pain
• Gangrene
• If the effected tissue has died, amputation of the affected area/body part may be necessary.

Avoiding frost bite is important whenever you’re outside in the winter.

Frostbite can be a fast-acting and serious condition. Make sure when you head out into the elements this winter you know your environment, your limits, and your risk. IF you suspect you may have frostbite, seek medical attention as soon as possible. Stay safe out there!

A few extra tips for our winter sports enthusiasts: Frostbite isn’t the only cold weather injury to be concerned with. To keep yourself safe, use the buddy system, know yourself and your limitations, stay hydrated, and be sure to warm up your muscles and tendons prior to heading out for optimal range of motion. Have fun and stay safe this winter!

Dr. Dollinger: Pregnancy & Exercise

We’ve come a long way in understanding the best way for a woman to take care of herself during pregnancy. This doesn’t mean, however, that we are free from lots of conflicting advice. One of these controversial topics is exercising during pregnancy. There are old myths like: don’t raise your hands above your head (for fear of causing the umbilical cord to wrap around the baby’s neck) and don’t watch sporting events (because it may cause you to become too excited). But these are easily dismissed as unscientific extremes. But still, what about regular old exercise?

Doctors have a much better understanding of women’s health during pregnancy, and one of the things they have found is that women who have a higher level of fitness, good core strength, and a strong back have an easier time during pregnancy, in terms of back pain, and an easier time during labor and delivery. These women can also safely continue a level of physical activity and exercise during pregnancy that is close to their previous usual level. Of course, use common sense: no contact sports, no exercise that brings the heart rate up too high (it may redirect too much blood away from the fetus), no excessive exercise, and no scuba diving, rollerblading, or skiing. That said, there’s no reason not to continue your usual level of exercise almost to your delivery date, as long as it is the proper type (perhaps modified), the proper amount, and still feels good to you.

On the other hand, if you are not used to exercising regularly or only usually have a low level of physical activity, it is not a good idea to start up a new fitness regimen or take up a new sport when you are pregnant. The best advice for you is to continue at that level or simply take it easy.

Of course, always talk to your OB/GYN doctor about what he or she thinks is best and safest for you and your pregnancy. Arnot Health also offers childbirth & maternity classes, and you can learn more by following this link.

To schedule an appointment with Dr. Beth Dollinger, click here to find her contact information listed in our provider directory.

Dr. Dollinger: Shin Splints

With warmer weather finally appearing, these first few weeks of spring have people giddy to get outside and get active again. For many runners, the temptation is to go from 0 to 60 much too quickly after being fairly inactive for the winter. For many, this leads to an increase in cases of annoying and painful shin splints.

Shin splints are simply a stress problem: the muscles and tendons along the inside of the tibia bone in your shin become inflamed, which also causes the periosteum (a membrane that lines the outside of the bone) to become inflamed, which can be fairly painful, since there are a lot of nerve endings in the periosteum. This pain can be sharp or dull and can occur during or after physical activity. Chronic shin splints can actually cause stress fractures in the tibia. Even worse, continued exercise beyond safe limits can lead to chronic exertional compartment syndrome, which may require surgery. Clearly, shin splints need to be taken seriously.

Immediate treatment of shin splints includes taking ibuprofen or aspirin, rest, and ice for 20 minutes. In addition to short-term treatment, it is best to avoid being overly ambitious and to go back to your physical activity very slowly and gradually. Adding in lower impact activities such as swimming or cycling, or cross-training can help you achieve a higher level of activity more quickly with a lower risk of shin splints.

So, if you have been cooped up inside for the last four months and then decide to go for a 5-mile run, you risk getting shin splints. If you usually run flat routes and suddenly change to hilly routes, you are at risk. If you have either flat feet or very high arches, you are at risk. And please do not run barefoot. Although many claim it is more natural for a human to run barefoot, most of us go running on man-made surfaces, like roads and sidewalks, where there may be debris or broken glass. These surfaces are much too hard and have too much impact on bare feet, as opposed to a dirt ground or grassy meadow. Besides, most of us have been wearing shoes from a very young age, so our feet are more adapted to shoes at this point in our lives.

Thankfully, it is relatively easy to keep shin splints at bay. Always warm up and stretch before and after exercise. Be sure to buy the right kind of shoe for your activity and replace your shoes regularly, before the support is worn out. If you are at a high level of exercise, have two pairs of shoes, alternating between them. If you have flat feet or high arches, wear orthotics. Lastly, slowly and gradually increase the length of time and extent of your exercise. It’s better to run for only a modest amount at first, as opposed to running too much and finding yourself right back on the couch, which is the last place you would want to be for these first weeks of spring.

To schedule an appointment with Dr. Beth Dollinger, click here to find her contact information listed in our provider directory.