How do I know if I have frostbite?

Q: I was out in the cold in tennis shoes for a long time. When I came inside my toes were blue and hurt really bad for a few hours. Did I get frostbite?

A: Frostbite occurs when tissue freezes.  The condition mainly affects the fingers, toes, ears, cheeks and nose, but any body part can freeze – even your eyeballs!  When exposed to prolonged cold temperatures, blood flow is decreased to the extremities and diverted to more vital organs, like your heart, lungs and brain.  Unfortunately, this leaves the vulnerable areas even more at risk.

There is a spectrum of severity in frostbite.  Superficial frostbite occurs when the areas of the skin close to the surface freeze. There is often a burning sensation, numbness, or tingling.  Affected tissue becomes cold and white, but maintains some of the elasticity of normal skin.  This type of frostbite can be serious, but is potentially reversible with no loss of tissue or function.

The deeper the freeze, the more serious the disease.  When there is more extensive damage the tissue becomes white and hard, sometimes with superficial blood blisters. Sensation in the tissue is either absent or profoundly decreased. There probably will be loss of tissue, and sometimes surgery is required.

Frostnip is a cold injury to the tissues that is different from frostbite.  In frostnip, superficial tissue becomes cooled, but is not cold enough to freeze.  Skin is usually pale and numb, but recovers fully with gradual warming.

People with frostbite should be seen by a physician as soon as possible.  The area involved should be elevated and gradually warmed.  No rubbing! Clapping, rubbing, or slapping those cold frozen fingers together is only going to cause more damage to already stressed tissue.

Of course, the best way to avoid frostbite is to listen to your mother (and Dr. Vicki) and wear your hat and gloves. Minimize your exposure during severe weather. Be extra careful if you’re sick, have diabetes, vascular disease, or you smoke. Be wary of cold weather and alcohol. Stay warm out there, Buckeyes!

Victoria Rentel, MD (OSU SHS)

Reviewed by Tina Comston, M.Ed.

Suggestions for a Good Nights Sleep

To get a good nights sleep:

  1. Go to bed at the same time every day.
  2. Have coffee, tea, pop, and other foods with caffeine only in the morning.
  3. Avoid alcohol in the late afternoon, evening, and bedtime.
  4. Avoid smoking, especially in the evening.
  5. Keep your bedroom dark, cool, quiet, and free of reminders of school, work, or other things that cause you stress.
  6. Try to solve your problems before you go to bed.
  7. Exercise several days a week, but not right before bed.
  8. Avoid looking at phones or reading devices that give off light before bed.  This can make it harder to fall asleep.

Because of the limited benefits and substantial risks of sleeping pills, Consumer Reports advises that sleep drugs should be used with great caution.  The American Academy of Sleep Medicine no longer recommends sleeping drugs as a first-choice treatment for chronic insomnia, opting instead for cognitive behavioral treatment (CBT).

Patricia Balassone, CNP