Day 11 - Back in V-Town

Just arrived home in Vancouver and thanks to Jeff and Jennie for picking me up at the airport. The flight was delayed again because the flight crew was late, again. They called my crippled ass over to the gate to pre-board with the kids and old ladies in wheelchairs. They even told someone to get out of my way so I they could check me in before them. First class! My toes were hurtin' something awful on the plane but it went away and I could almost walk better without the crutches by the time I landed. A couple of New Year's options tonight - one on... what?? East Hastings!!?? It would take me hours to hobble home through the wet streets of the rain city. Sorry Jessica. The other, closer by but I'm feeling like I need to rest... tbd. Wait let me check the mail... woohoo! My Powderwhore DVD* arrived while I was gone! I know what I'm doing tonight! Whoa. Spoke too soon - the hurt is coming back now.

*Shame on you, it's not that kind of DVD. But I supposed it might qualify as porn for tele skiers. http://www.powderwhore.com

Day 11 - December 31 - Cruel Hindsight

Despite being couch-bound for probably the rest of this ski season, I was in MEC yesterday checking out skis and came across these toe warmers. I normally don't use these things so even in hindsight I wouldn't have brought them with me. In the future however, I might just keep a few handy if things turn out to be a bit colder or drawn out in time.

Hindsight is usually 20-20 they say and I've been trying to figure where things went bad for my toes that day in the backcountry.
Being my first time out in a few years and not wanting to slow the group I tried to be well prepared. I replaced my lexan avi shovel with an aluminum one (read http://www.telemarktips.com/TeleNews69.html) and finally bought a real probe since the ski-pole probes that I've been relying on (but have never had to use) are garbage. I had new boot liners custom fitted at the Intuition factory in Vancouver, bought and studied a topo map, carried a compass, headlamp, a transceiver of course, extra batteries, plenty of trail snacks and lunch for energy, some water, and I left a thermos with hot soup in the car for afterwards.

What I didn't anticipate however was the bitterly cold temperature, and time spent in that temperature due to 1. the bushwacking (oh the bushwacking), and worse 2. the long waits due to the (slow) pace of the group.

First the bushwacking. You could hardly call what we did that day skiing. There was very little snow. We bushwacked amost all the way up and bushwacked all the way down. The slopes that were supposed to be our ski out were still fields of densely packed slide alders. Stepping through, around, under and over these fields was both exhausting and horrendously time consuming.

Second, the waiting. I had certainly not anticipated the group dynamics that caused the waits on this trip since it seemed abundantly clear that a prerequisite to join the group was fitness, experience, training, and field tested gear. While all of us were fit enough, and almost all were far more experienced than I, not all of us were. This made for a few long cold waits as the leaders charged ahead (myself among them) and then were forced to wait for the rear to catch up. The pattern went something like this ski, ski, ski (bushwack rather), stop and wait. Ski, ski, ski, stop and wait. Despite the warmth generated while moving there was a net cooling effect on my core, so that by the time we decided to turn back at 1:30pm, I knew that I had to keep moving or I was in trouble. The ski down proved to be much worse for losing heat - in my haste to keep moving, I found myself alone - ahead of the group with no one following - I thought I had taken a wrong turn. Believing I had fallen BEHIND the group, I was alone, in unfamiliar backcountry, getting constantly snagged in slide alder fields with one hour of light and at least two, maybe more hours of bushwacking, the temperature dropping (later confirmed to be -20 to -25C for most of the day) and my core temperature falling fast, I lost all concern for my finger and toes, and instead was dead set on finding my way back to the car. Somewhere on that trip down is when my toes took the worst of the damage. As it turned out, the leaders had sent two skiers to follow my tracks and the rest fared similarly as I did on their own bushwacking adventure. I emerged at the parking lot 30 minutes ahead of the two skiers sent to follow me, and 1-1.5 hours ahead of the rest of the group. Thinking I had become lost, I was convinced that I had fallen behind the group.

So what would have saved my toes?
Basically it comes down to experience. It's been some time since I've been in the backcountry and I've never been in a situation where it was so important to conserve body temperature. On this day, when it was so important to conserve it, I wasted mine:
My down puffy, waiting for me in the car, would have kept my core warmer; I watched with envy as the leaders pulled theirs out of their packs to keep warm during the long waits. Strike one.
I wasn't the only one without a puffy though. Others without puffys, obviously more experienced than I, were certainly capable of keeping up with the leaders but chose to move at the pace at the rear, so that they would not have to wait (and while waiting, lose core temperature). Smart. Strike two for me.
I should have avoided drinking water. I wasn't dehydrated, only a bit thirsty. My water was ice cold and cooled my core each time I took a drink. I took two. Strike three.
All of the above might have helped to keep me just warm enough to avoid the frostbite. Maybe not. But chalk this up to experience. The next time I hit the backcountry I'll know the importance of staying warm. It's a tough lesson.

Day 10 - December 30 - foot fetish?

The blisters on my toes a couple of days ago were a good sign. It's supposed to mean that the blood is flowing there, that they're repairing themselves. But if your toes are dying, I imagine it feels something a little like this: take a rubber band and wrap it tightly around your finger (or toe). Leave it there for ten minutes and watch your finger (or toe) turn purple. You'll feel some tingling, some burning and then nothing. Now take off the rubber band cause you don't really want to kill it. That's what my toes feel like except I can't take the rubber band off, and I can't see my toes because my toes are covered in bandages.

The last couple of days I thought that the pain I was feeling was good, and I still hope it is. But tonight at dinner I realized that I couldn't really feel right#2 and left2,3,&4. I thought the dressings were too tight on the left but I don't think that now. Maybe my mind is playing tricks on me.

I've also imagined that maybe they're infected now. Been trying sniff them out a bit, but they seem to still be smelling clean. Yesterday it felt like my toes were swimming in fluid. But they're not. Maybe new blisters have formed completely around the toes and I'm feeling that fluid. Gross but maybe this is good. Maybe they've formed new skin underneath (like my thumb and fingers (yes I frost bit my right hand a bit too) and the old skin is just shedding off. I imagined this the day before I had the dressings changed too and when I actually saw them, they were far far from this rosy scenario.

I've imagined what it would be like to be toeless. Can I still run? Beach volleyball might freak some people out. Yoga in socks? I think I could probably still ski. This might make getting a new girlfriend even harder! At what stage do I reveal this? "Uh I just have this thing, with my toes - I don't have any" or maybe she'll say "Honey, why do you always wear your socks to bed?". Kyle tells me I have to make sure she doesn't have a foot fetish... how many girls have foot fetishes? Wes says toelessness is cool... maybe chicks will dig me more without toes. I do have to admit it will be fun to give the grandkids nightmares: I can tell the story about how grandpa froze then cut off his toes and then, to their horror, I'll whip off my socks to reveal my freaky toe-nubs. There's always a bright side.

PS. I'm caught up now. I started this blog today and the posts up to this point have been written from memory. New posts shouldn't be any older than a day or two old... will try to keep it as real time as possible.

Day 9 - December 29 - don't drink beer

The sensation has been coming back slowly to my feet. Some tingling, some burning, some freezing. Any feeling is good news but man oh man. I've been drinking a few beers in the evening pretty much all trip, but I went for a couple of suds today with Kyle and my feet bloated up and started screaming at me. No, SCREAMING at me.

Sometimes I need to keep them elevated to keep the pain bearable. I had some T3s yesterday morning - never again - I'd rather take the pain than feel as loopy as I did on those drugs. Okay well maybe I'll keep them just in case. I've been taking ibuprofen three times a day - theoretically, says the doctor, it should help. I dunno if it does though - even the placebo effect is enough for me. One good thing: I've been able to sleep just fine.

Kids and dogs. These feet are magnets for them - bouncing around, roughhousing, banging into them, stepping on them. Two nights in a row now I've had to retire to my bedroom to avoid my feet being banged up by the kids and dogs.

Day 7 continued - T3's and Crutches

While the dressings were being changed today I started to feel my toes again, and then some. Got a prescription for some Tylenol 3's and went to every drug store and medical supply house in town looking for crutches - none to be found in my size. Later learned that my uncle had some that he barely used. So I got me some crutches!

Hmmm... Plan A for this trip had me skiing with Kyle at Marmot for three days, starting today. Dang it.

Day 7 - December 27 - Dressing Change #1

It's been a week since the incident. Anxious to see some progress so I went to the walk-in clinic to have the dressings changed today. As suspected, the doctor did not appear to really know what to do, so I pulled out the materials and instructions from the cute-resident-in-purple-scrubs in Vancouver and tried to walk him through it.

Removing the bandages was a bit of a chore as the gauze had hardened around my toes and the silver dressings had stuck to the wounds. He also seemed to be in a bit of a rush as he was the only doctor in the office, a walk-in clinic on a Saturday over the Christmas holidays, and the queue was growing as he worked on me.


The left big toe appears to have become one massive blister. Underneath the toe, the toenail, everything around the tip looks almost separated from whatever might be underneath. We didn't cut this "blister" off.


The bandages on the right foot were even crustier than the left. It was tough to get them off and we had to pull a bit, taking off some of the skin in the process. It hurt a little.

Having a look with the bandages off the right foot doesn't seem to be as bad as the left. The big toe is not as blistered but toe #2 is still almost black, even after the blister was cut off.


Overall:

The good news:
Three new large blisters had formed on three of the toes-at-risk. Right#2, Left#2&3.
No infection!

The bad news:
The nerves are growing back and it's starting to hurt like a bugger. I can handle the hurt if it means I get to keep my toes. So really, this is good news!

It's hard to imagine from these pictures that this is a good news story. Time will tell. It's only been one of many weeks.

Day 6 - December 26 - Can't wait to change my dressings

I'm getting a little anxious to change the dressings on my feet. It's been a week and I'm wondering what's going on under there. The gauze has long since soaked through with fluid from my feet and hardened so the bandages feel solid now. Kinda want to do it myself because I saw my doc do it and I don't trust a walk-in clinic to do the job right. I wasn't going to go until the 29th but I think I'll go tomorrow.

I've been feeling a little bit in my toes. Some tingling. Some warmth.

Sidenote - Bathing has been interesting. Can you say sponge bath (with your feet sticking out of the tub. And no, not from a hot nurse.)? On a positive note I am using a fraction of the water I would normally use to shower. Who knew this would make me a greenie?

Day 3 - December 23 - Tips for traveling at Christmas

With the airports backed up, flights canceled, and line ups stretching into the international terminal, here are a few tips for getting to the front of the line.

1. First, freeze your toes so they're nearly falling off... then,
2. Make sure you have only carry-on baggage (important so you can get your boarding pass at an automatic kiosk and avoid check-in). People in line at check in: hundreds. People in line at auto kiosk: zero. Also note that Christmas gifts must be small and un-weaponlike to be carried on.
   
3. Limp your way to the customer service desk and ask for a wheelchair. Here they will deny you the wheelchair but one-up you by offering a golf-cart ride to the fast track security check in
4. Enjoy the ride!
5. Go through security. people in front of me at security: zero. Here they will take away your half-empty shampoo because the bottle says 125ml which is 25ml over the 100ml limit.
6. Get on another golf cart where they will deliver you to your gate and push together two chairs so you can elevate your feet per doctor's orders. Sweet!

Total Elapsed time: 20 minutes. Way to go ...Air Canada? Yep, Air Canada (and the Vancouver airport).

Now, wait 6 hours because you arrived four hours early for line-up contingencies plus a 2.5 hour flight delay (not for lack of a plane - for lack of a flight crew) - that sounds more like the Air Canada I know.

Still can't feel my toes.

Day 2 - December 22 - Innovations in bandage technology

Waiting for Christmas. So what does one wear on ones feet when they're bandaged up big well beyond recognition and normal size? Hut booties. Hut Hut. To keep those finicky tensor bandages from always sliding out of place? Your roomate's old nylons, cut into very masculine "socks". P.S. the snow is 2 feet deep outside (in Vancouver!) and still falling. And I'm not skiing. Wonder if my flight will be canceled tomorrow.

Day 1 - December 21 - 9:30am

I called a cab to the hospital and arrived at 9am, a full hour ahead of schedule. The doctor from the night before had given me a "fasttrack" letter to get into emergency for my appointment. Plastics would come to emergency to have a look. It didn't take long for two doctors in purple scrubs to show up and begin questioning what had happened.
We relocated to a treatment room and unwrapped my feet. The bandages slid off easily and the blisters from the night before, along with a few jumbo-sized friends and some residual burn cream greeted us.

The resident doctor made some observations and the other made notes. The resident doctor cut off the blisters and cleaned my feet with gauze and sterile water. Doc applied a special clear gel and cut strips of silver anti-microbial dressing (with real silver, not the fake stuff). Gauze was draped over my toes and then my whole foot was wrapped in more gauze. Finally a tensor was wrapped around my feet and I was ready to go. Throughout the entire ordeal I didn't feel a thing, but I have to admit I became somewhat enamoured with my doctor and hardly noticed my feet while she worked her magic. Yes, she.

With the holidays around the corner I would hit a bt of a snag. I was traveling to Edmonton for Christmas and the burn unit there would be closed - so I would either have to cancel Christmas to go to the Vancouver burn center or go to a walk-in clinic at home to get the dressings changed. I chose the latter, or rather the latter chose me - despite Vancouver being snowed-in, my flight made it out with only a 2.5 hour delay. Most walk-ins don't see frostbite this serious, let alone carry the expensive gel and silver dressings, so doc gave me some materials to take home with me along with some written instructions on how to apply them.

Still no feeling in my toes at this point.

Day 0/1 - December 20/21 - 2am

As it has now been almost two weeks since the day, we have some catching up to do. We'll do this in the next couple of posts.

On Saturday December 20th, I went out on a backcountry ski trip with a very experienced BCMC group. I am also adequately experienced for the trip that was planned but a few things gone wrong, some in my power and some not, conspired on that day to give my feet a good shellacking (look it up, it's a word). I hadn't even realize the seriousness with my feet until I was at home attempting to thaw them in a warm tub and feeling in my toes... nothing.

My roommate Ange walked in the door at that moment and I asked her to drive me to the hospital. All of my toes were hard, HARD, to the touch. I could feel nothing. The doctor had a look, noted toes 2 on the right and 2, 3, and 4 on the left as highest risk (hmmm, not good) and made an appointment for me to return the next day at 10am to see the plastics department (hmmm again). One blister had begun to appear on my right big toe. The nurse drained the blister and applied copious amounts of refrigerated burn cream to the tops of my toes - I could feel the coolness on the tops of my pinky toes only. She wrapped them in gauze and sent me on my way. It was 2am. Ange had remained to drive me home.



Sidenote - both the doctor and nurse took an interest in my trip as they are both backcountry skiers themselves.

First Post

It's almost two weeks now since the day I got frostbit... since I'm now laid up, with my feet up, watching lots of TV, and not skiing, running, hiking, tobogganing with the nephews, or doing any of the things I like to do, and since quite a few people have taken an interest in the progress of my toes, I thought I would create this blog. I give one disclaimer: I will not be censoring this blog in any way - the photos are you are about to see are not for the weak of stomach. The fate of my toes is still unknown as of today - my recovery will be long and, as I'm learning as my nerves begin to grow back, quite painful.