A doctor must be able to see and feel the affected area. A simple telephone call is probably not sufficient in all but the mildest cases of cold injury to hands and feet. You need to see a doctor for care.
At the time of initial evaluation, it is very difficult to categorize the injury as superficial or deep, and even more difficult to ascertain the amount of tissue damage. Therefore, all people should be seen by a doctor, who will supervise the rewarming process, attempt to classify the injury, and further guide the treatment process. Someone with frostbite will need evaluation for, and possible treatment of, hypothermia and dehydration.
Symptoms follow a predictable pathway. Numbness initially is followed by a throbbing sensation that begins with rewarming and may last weeks to months. This is then typically replaced by a lingering feeling of tingling with occasional electric-shock sensations. Cold sensitivity, sensory loss, chronic pain, and a variety of other symptoms may last for years.
The treatment of frostbite is done over a period of weeks to months. Definitive therapy, possibly in the form of surgery, may not be performed for up to 6 months after the initial injury. Therefore, establish a working relationship between you and your doctor that will continue throughout the healing process.
The first step in preventing frostbite is knowing whether you are at increased risk for the injury.
Although people don't always know or acknowledge these dangers, many of the dangers can be reduced or prevented.
People with diabetes and anyone with vessel disease should take extra precautions, as should the very young, very old, and unconditioned.
Be especially wary of wet and windy conditions. The "feels like" temperature (windchill) is actually much lower than the stated air temperature.
A common saying among surgeons who have treated people with frostbite is "frostbite in January, amputate in July." It often takes months before the final separation between healthy and dead tissue may be determined. If surgery is performed too early, the risks of removing tissue that may eventually recover or leaving behind tissue that may eventually die are great. Some radiographic techniques currently are being investigated that may be able to make this division much sooner, thus permitting earlier definitive treatment.
Beyond this waiting period, 65% of people will suffer long-term symptoms because of their frostbite. Common symptoms include pain or abnormal sensations in the extremity, heat or cold sensitivity, excessive sweating, and arthritis .
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