DRHOOK- Cold facts: Frostbite, frostnip, pernio-- all winter woes

the handsome doctor John Hong of Charlottesville

Freezer burn is a tradition in every household. We visited a friend's mother-in-law's house a while back. There was a huge freezer in the basement, and I thought about all the shows and movies where people hide a dead body in the freezer. So as a joke I opened it up, ready to pretend I found a dead body in there. 

I did end up screaming— just not at a body. I was horrified to see a chicken package with an expiration date of June 1996. Thirteen years expired! To make things worse, the uber-frozen chicken was on top of a pile, so Lord knows how old everything else was. 

But what happens when a live person gets frozen?

Frozen tissue is frostbite. Tissue, not in as Kleenex, are cells of the body that include the fingers, toes, nose, cheeks, and ears. When tissue becomes frozen, the cells die, and inflammation causes more harm.

Jack Frost can cause different levels of frostbite while nipping at your nose. Frostnip (sounds like catnip) doesn't leave any permanent tissue damage when the appendage is warmed up again.

A tingling, pins-and-needles sensation occurs with frostnip.

Pernio is a little worse than frostnip– it creates red or violet swollen lesions that can be quite itchy and/or painful. It doesn't have to be below 32 degrees F for someone to get pernio since damp cold can do the trick.

Trench foot was a problem in WWI in troops wearing tight-fitting boots in the damp cold— and it was also seen during the Falkland War of 1982. The feet become numb and/or very painful, red, swollen, and riddled with blood-filled blisters. (Horrible!)

General William Tecumseh Sherman is reported to have said, "War is hell," and the 2.2 percent of the military in Finland who get frostbite every year would probably agree.

When the hands or feet start to become frostbitten, they can become difficult to use. (When my hands are cold, I can't write well. I become clumsy. And talking is diii— ffiiii— cuuuuult from a cold jaw.)

Amputations occur when the frostbite goes deep enough to kill muscle and bone. Also, dead skin and tissue are prime sites for infection that can lead to amputation.

The homeless are at risk for frostbite, especially of the feet. Mountaineers and folks who love to be exposed to the cold blustery outdoors are at risk. Interestingly, protective ointments on the face increase this risk. Holy facial products, Batman! Approximately 37 percent of mountain climbers suffer frostbite each year.

Talk about a "sight for sore eyes"! Even the eyes can be frostbitten by strong cold winds. 

"Ice, Ice, Baby." (Remember Vanilla Ice?) You can get frostbite from overexposure to cold compresses, especially when they're applied directly to the skin or used for longer than 15-20 minutes.

Here's another a chilling fact: folks who inhale halogenated hydrocarbons to get "high" can get frostbite of the airways, face, and esophagus. 

Air conditioners and refrigerators/freezers use Freon, and a splash of that on the hand can cause extremely bad frostbite down to the bone.

Removal of wet clothing and warm shelter are vital treatments. The armpits or warm (not hot) water just above body temperature are effective ways to warm things up. Warming up is the essential thing to do as soon as possible. However, thawing the frozen body part is not recommended if there's a chance it might be frozen again. And taking weight off those frostbitten feet is important to prevent more damage. Thawing a frostbitten body part is painful, so pain meds might be needed. 

Brrrr– what a scary, chilling subject. So everyone, stay warm and be ready to face any challenge or chance of being exposed to the cold (and wet). You can't be a spring chicken in the freezer!


Dr. Hook cracks a joke or two, but he's a renowned physician with an interesting website, drjohnhong.com. Email him with your questions.