Trench (Immersed) Foot!!??? OUCH

Trench (Immersed) Foot!!??? I've got it. Pics.

*edit* I have been diagnosed with Immersion Foot, a non-freezing cold injury, and am doing well. Here are some pics of the condition. I have posted a full trip report with pictures from this hike.

Pics of my swollen feet and why you don't want to end up like this:

http://community.webshots.com/album/563430964vKqsGi

*original post below*

I was out in the Adirondacks: The ADK Loj to Tabletop, Marcy, Skylight, Lake Colden, Avalanche Lake, back to the Loj on 5-11 to 5-12 and was exposed to cold damp boot conditions after breaking a snowshoe and getting my change of boots wet again. My feet were cold, not frozen, at different intervals for approx 24 hours. I stayed the night under skylight and warmed them up rather than hike out quickly because the snow depth was much worse on this side of the traverse. I hiked about ten miles with swollen feet the next morning after warming my feet somewhat near a fire overnight. The situation repeated itself on the hike out.

With the swelling and numbness that was and is still present today on 5-14 I am concerned.

I went to the ER in Lake Placid in the wee hours of 5-13 after a few hours of sleep upon exiting the backcountry after getting up with increased swelling, but decreased numbness. This situation is basically unchanged 36 hours later.

The doc examined my feet, checking for a pulse in all areas, found it to be well , said my feet were exposed to prolonged cold, but not in anyway frost bitten. The swelling he said was result of the extensive hiking combined with the swelling that occurred with the lowered temperature of my feet and the pressure it created within my boots. He said just to follow up with my family doc in a few days which I am tomorrow. He said he had seen plenty of frostbite/exposure cases in his day and that I should be fine.

However, I am concerned that I have this trench foot, which by it's definition, I fit quite well: wet and cold feet for an extensive period of time with no frostbite.

Anyone ever have this? I can walk but it is uncomfortable. A visual inspection of my feet looks and feels like two badly sprained ankles. Any info greatly appreciated...I doubt my family doc is very familiar with these sorts of conditions.

Thanks,

Dom

Here is a good article from NOLS. I think I had a mild cold injury to my feet earlier this year which also sounds like this. My toes were numb and sometimes mildly painful for a couple of months. No long term injury. Having your doctor look at your feet would be a good idea. That way if you need to go back to him, he will know what your feet looked like in the first place.

My doc appt is at 2:45 today. My feet seemed to have improved with rest and keeping them warm and dry. Kinda expecting some longer term nerve damage in my toe tips. What seems better is the skin. It has become softer rather than leathery and looks healthier; no evidence of dying skin.

Woody48 said:

Here is a good article from NOLS. I think I had a mild cold injury to my feet earlier this year which also sounds like this. My toes were numb and sometimes mildly painful for a couple of months. No long term injury. Having your doctor look at your feet would be a good idea. That way if you need to go back to him, he will know what your feet looked like in the first place.

Click to expand...

Thanks for the link. I read that the other day. It is a good article on the injury. As the article states, in my case with all the walking and strain, it will be difficult to tell how much of my injury if from the cold, wet condx and how much is due to the pounding my feet naturally experienced on the trail. I guess the question is: how much of the swelling is from 20 miles of terrain and how related is it to the cold, damp conditions my feet experienced. Plus swelling from the cold injury causes more swelling with activity. Luckily i have kept my feet clean, warm, and dry for several days now and things are looking better. I still have significant swelling and numbness in my toe tips. The limited edemas I had seem to have gone away.

-Dom

Excerpt from "Medicine for Mountaineering", Wilkerson, ed:

Nonfreezing cold injury...

Treatment is simple. It consists of keeping the subject warm with his feet dry, elevated, and protected from bedclothes. Nothing more. Nerve damage can cause persistent pain... Sensitivity to cold is usually lifelong...

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Any serious hiker should have this book in his library.

Doug

Well it's official. I have 'Immersed Foot' Will have to wait and see how long it takes, if ever, for my feet to be entirely normal in cold condx again. Luckily my skin is in good shape and color which is a good sign my recovery will be better than average. The numbness is minimal also and much of it has gone.

dom15931 said:

Well it's official. I have 'Immersed Foot' Will have to wait and see how long it takes, if ever, for my feet to be entirely normal in cold condx again. Luckily my skin is in good shape and color which is a good sign my recovery will be better than average. The numbness is minimal also and much of it has gone.

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I must have 'immersed fingers'!

dom15931 said:

I have 'Immersed Foot'

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Not to nitpick, but...
The proper name is immersion foot. Another name is trench foot.

(Ref Wilkerson, 5th ed, p 276.)

Also http://en.wikipedia.org/wiki/Immersion_foot

Doug

DougPaul said:

Not to nitpick, but...
The proper name is immersion foot. Another name is trench foot.

(Ref Wilkerson, 5th ed, p 276.)

Also http://en.wikipedia.org/wiki/Immersion_foot

Doug

Click to expand...

Doug, you're right! I typo'd my own diagnosis! Thanks for pointing that out.

I got trench foot several years ago while spending 8 days trapped in an emergency snowcave. They never froze but stayed wet in very cold conditions.

My wife and I both lost feeling in our toes. The doctors said that much could come back in the following 6 months. She now has feeling in all hers but 3 of mine have permanent nerve damage. You can literally push a needle into mine. Ultimately, it is no big deal and I have not noticed any greater risk of frostbite or trenchfoot, etc.

Sounds like you'll be fine. Best of luck
Jeff

dom15931 said:

Doug, you're right! I typo'd my own diagnosis! Thanks for pointing that out.

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Well immersion foot by any other name is still a bummer. I wish you all the best for a speedy and complete recovery.

- Steve (MonadnockVol)

MonadnockVol said:

Well immersion foot by any other name is still a bummer. I wish you all the best for a speedy and complete recovery.

- Steve (MonadnockVol)

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Ditto that. Get well soon Dom. We've had too much bad news on this forum lately.

Thanks

Solitary said:

Ditto that. Get well soon Dom. We've had too much bad news on this forum lately.

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Thanks for all the support guys. My feet are getting better day by day. The vast majority of the swelling is gone. I have only minor nerve damage according to the doc, which most if not all will likely return. Surprisingly I havn't lost any skin a week later! I can move and feel all my feet, there is just a hair of numbness at the skin level. Very similar to simply having 'cold feet' for a few minutes or a foot that is just starting to fall asleep. Its all at the very surface. My feet don't seem to get cold very easily, thankfully. Its been a bit chilly for May here in PA and I have been wearing crocs to keep my feet dry and without pressure.

I think we'll have a happy ending here!