17
Feb
2012
jloomis

Frostbite

Now that my toes are almost back to normal nearly a year later, I figured it was time to tell my story and share pictures of my frostbitten toes and their subsequent long recovery. It's not an experience I would wish on anyone, so hopefully this will serve as a warning to help others avoid frostbite.

On Friday, April 22, 2011, I made my first successful ascent of Mt. Hood via the popular South route. I was well prepared, except I did not pay enough attention to my feet. My feet have always grown cold easily, but on my climb in April the temperatures were especially cold (around 5-8°F) for the Oregon Cascades. I was wearing uninsulated, heavy duty hiking boots (with thick socks and liner socks) that would have normally been fine for a warmer spring climb. Unfortunately this was not the case on this sunny April day.

The climb went pretty well despite the deep snow and cold temperatures. I noticed my toes getting cold about half way up the climb, but didn't think much of it as it was a normal occurrence for me. What I failed to realize is that this climb was the longest I had ever been out in such cold temperatures. We continued to climb and my toes remained cold. I also noticed that my socks felt like they were slightly bunched up in my boots. Again, I didn't pay much heed and continued climbing. The smart thing would have been to stop, take my boots off, warm my toes, and fix my socks. While time consuming, this likely would have prevented frost bite from ever occurring.

On the climb down, I noticed my feet warming up, but also sharp tingling pains in my toes that I had not experienced before. When I finally made it back to Timberline Lodge, I took my boots off and had my first glimpse at my frostbitten toes. I was very surprised to observe that the tip portion of both my big and middles toes were blue in color and had little feeling. I could not feel direct, sharp pressure, but only a painful throbbing/tingling sensation. Initially I was not concerned as it was only four toes. I figured it might get better with time and color would return to my toes.

Frostbitten Toes Day 1
Frostbite on Big Toe and Middle Toe - Left Foot (Day 1)     Frostbite on Big Toe and Middle Toe - Right Foot (Day 1)

Unfortunately it did not get better. At the lodge, I ended up visiting the onsite medical center. It is really hard to determine frostbite damage initially. I was told it was likely due to loss of circulation (due to my bunched up socks) and the cold temperatures. I was advised to simply watch it and that it would take time to determine the extent of the damage. Keep in mind it is always advisable to seek medical attention for frostbite injuries. Do not allow warmed frostbitten tissue to re-freeze as that can cause even more severe damage, leading to amputation of damaged tissue.

Over the next couple days I had uncomfortable pain in my toes, but still no feeling. It affected about half of each of my big toes and a third of each of my middle toes. There was also a very small amount of frostbite on the tips of my second toes. The color changed from blue to purple, black, and yellow. My left big toe blistered. My wife and mother-in-law are both nurses, so they talked to a surgeon well-versed in frostbite care. They were told there isn't much that can be done until the damage can be assessed about a month down the road. I was advised to keep my feet elevated and take it easy for awhile. Fortunately my frostbite was only 2nd degree, and eventually healed on its own.

Degrees of Frostbite

The pain continued for a week or two before subsiding. The numbness and loss of feeling persisted for several months. The pictures below illustrate what my toes looked like after two weeks, at which point the dead tissue began to peel off. The flesh under the toenails on my big toes really began to change color at this point.

Healing Frostbite - Left Foot (Day 15)     Healing Frostbite - Right Foot (Day 15)
Healing Frostbite - Left Foot (Day 15)     Healing Frostbite - Right Foot (Day 15)

Almost all the dead tissue had fallen off just over a month after my frostbite injury occurred. Feeling began to return, but was still dull. The flesh under my left big toe still looked bad, with a greenish, black, and yellow hue depending on the spot. My right big toe was only half as bad as the left.

Healing Frostbite - Left Foot (Day 33)     Healing Frostbite - Right Foot (Day 33)
Healing Frostbite - Left Foot (Day 33)     Healing Frostbite - Right Foot (Day 33)

After three months, all the dead frostbitten tissue had fallen off and feeling was back to about 80% of normal. My left big toenail detached at this point. My right big toenail stayed attached.

Healing Frostbite - Big Toenails (Day 95)     Healed Frostbite (Day 95)
Healing Frostbite - Left Big Toenail (Day 95)     Healing Frostbite - Right Big Toenail (Day 95)
Left Big Toenail Coming off from Frostbite Injury (Day 95)     Left Big Toenail Removed After Frostbite Injury (Day 95)

Finally, 10 months after getting frostbite on four toes I almost completely healed. Feeling is back to nearly 100%. My left big toenail just finished growing back and my right big toenail has grown out. There are still some weak spots on my left big toenail where it has separated from the flesh near the edges, but I suspect it will improve over time. The only permanent damage is that I am even more susceptible to cold toes now. I have noticed during the past few winter months how my toes get colder more easily and stay cold longer. I have been combating this with warmer boots and battery heated insoles which help. My advice is to protect your extremities. Frostbite is not fun and takes a long time to recover from. Pay attention to your body and take the time to correct any issues before they become real problems.

Healed Frostbitten Toes (Day 301)
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16 comments

Ben, Sat, 12/08/2012 - 03:12

Thanks for the heads up. Im looking at frostbit because someone close to me has within the last 2 days developed small round black dots on a toe or 2. So Im tryin to learn what i can to help out.

Anonymous, Sat, 01/12/2013 - 22:12

This was very helpful. Thank you for the heads up. It's amazing how easily this can happen while we're hiking/having fun and thinking "oh, my toes are numb" but it doesn't really hurt enough to stop us. Your story serves as good warning... anytime anything on your body is numb; pay attention and treat it!!!
Thanks!

Jennifer, Tue, 12/03/2013 - 21:02

Since the weather has begun to get cold again, my toe has started to hurt again. Last winter I started having Pain in one of my middle toes, seemed to have gotten cold the pain has come back. Does this sound like frost bite to you?

jloomis, Wed, 12/04/2013 - 16:46

I am not a doctor, so I can't really say. My toes hurt when they get cold, but they feel fine as soon as I get them warmed up. If your toes hurt even when warm, then you may want to see a doctor and have them looked at.

Claire, Tue, 01/14/2014 - 19:09

Thanks for this post! I went skiing a couple weeks ago and when I took off my boot my big toe was blackish blue on the end. I tried looking up frostbite information and couldn't find anything helpful. My toenail looks similar to yours after about a month. I'm so happy to hear you have healed. I was afraid I would have to have it amputated! Haha! :). This is very helpful with all the photos and info. Thanks!

Tom, Sun, 01/26/2014 - 16:55

Hello, thanks for the information, it really helps to hear about it from someone who has already gone through it! I was out on a long run today in about 10 degree weather and seem to have contracted some frostbite on my left big toe and nowhere else thank god. I went to the doctor today and they pretty much told me the exact same thing as they did you, just wait and see. Now I am a highschool athlete and I still have a large portion of my season coming up. Would you advise continuing to run or no? Thanks for the input and again great article !

jloomis, Sun, 01/26/2014 - 17:03

I would advise checking with your doctor regarding continued running. My biggest concern would be any possible re-freezing of the damaged tissue if you run in freezing weather again. Waiting till the weather warms up above freezing may be a better idea.

For anyone who is reading this page for help and advice, my doctor from the Inuit above the Arctic Circle that is now a truly good and legitimate, well-rounded and intelligent with lots of funny jokes ER doctor in Saskatoon gave me this information:

The excruciating pain encountered during the thawing of the toes is a very good sign, this means that the blood is circling through the tissues and nerves. If you didn't feel unbelievable pain after a few hours of being warm then you know you have actually damaged them.

Also try not to wriggle them around too much or rub them a lot once they are actually frozen as the ice crystals can slice up the inside of the toes and its best to just carefully and scientifically submerge them in gradually warmer and warmer water and maybe take a bath to warm up slowly but surely or wrap them up in a warm friends belly if you have one.

As for my toes, there are black spots on seven. I removed the calloused outer skin from my toes because it had blistered and torn off on its own anyway. The black parts still have their callouses and will just come off in a week or so. The brand new soft pink toes are totally sensitive.

Heather gould, Fri, 02/14/2014 - 12:12

I was out playing in the snow now my toes are so sore then they got itchy now there cold again people are saying just leave it and it will go away but I doesn't look like and I can't keep any heat in my feet

geo, Mon, 02/17/2014 - 18:37

ok you will know if you have frostbite it is not hard to tell
you will be able to feel how bad you hurt yourself
ok
onward forward

Sam, Tue, 04/08/2014 - 19:10

Thank you so much for posting your frostbite story here - it helped a lot, and made me feel a lot better. I got frostbite in Georgia, of all places, this past January (January 2014). Both of my big toes look just like yours . . . and just like you, I lost my left big toenail this morning. I am praying that it will grow back - and it gave me a lot of comfort to see that yours has. Thank you so much!

Jake, Thu, 01/08/2015 - 18:04

Hey, went skiing today and it was only 10 degrees Fahrenheit. My right big toe now is stinging, burning and throbbing. Now under the whole nail is blue. None of the skin is different in color but it looks exactly like your nail. Any advice?

jloomis, Thu, 01/08/2015 - 18:08

I would recommend keeping your toe warm (re-freezing is worst thing you can do) and watching it carefully the next couple days. If it gets worse or feels worse, I would see a doctor just to be safe.

Tom Shaver, Mon, 01/12/2015 - 02:12

How much movement did you have in your toes in the days immediately following your frostbite? Over the weekend I develop frostbite in relatively the same places that you had it... I definitely don't have a total loss of sensation... Only a few places where it feels really numb... The ER doc only spent about 10 minutes with me, and didn't seem overly concerned... I guess I'm just looking for a little more insight from someone who's actually experienced it. Your article was a great find, as you told a very reassuring story. Are there any signs that you know of that I should watch for during the recovery process that would signal it's headed south instead of the road to recovery? Thanks again for the insight you have shared any extra that you can share

jloomis, Mon, 01/12/2015 - 17:43

I didn't have any movement issues, just a loss of feeling/numbness in the frostbite affected areas. I would just watch for any changes and monitor for any infection. There is not really anything that can be done for mild frostbite cases. If your frostbite is bad enough you will lose skin/nails, so don't be alarmed. Just don't re-freeze the damaged tissue again.

shannon, Sun, 02/22/2015 - 20:23

Thank you for your article! I went out to Festival Du Voyager last night here in Winnipeg, I suspect my 4 toes on my left foot are frost bitten, they have not changed color but the pain last night when I finally got them warm was almost unbearable. They are really sore today and I have been trying to stay off them. I hope they feel better soon. It was -35c by the way!

Ps. I lost my big toe nail before when it got stepped on by a horse, I was horrified! Don't fret, toe nails do grow back :)

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