In December 2009 I finished the arduous Hellgate 100k for the third time, and for the first time since 2005. Hellgate is the most difficult race I have completed. This year I received a special souvenir from the race: severe frostbite on the tip of my right big toe, along with three other less severely frostbitten toes.
I think it would be useful for others to read about my experience with frostbite. I have been surprised by the pain and difficulty of recovery and as you will see my case is pretty minor.
The Race Experience
Hellgate starts at 12:01 AM the second Saturday in December. This year we knew that conditions would be cold. Temperatures at the race start were in the mid-teens and we expected a drop of as much as ten degrees F as the hours stretched onward and as we climbed the mountains.
Just a couple of miles into Hellgate, all the runners wade through Hellgate creek. This is the first of many times during the nighttime hours that we get our feet wet. Yet frostbite rarely occurs to runners. We are smart enough to wear wicking socks and running shoes that drain water.
This year, however, there was a lot of water on the course. Every little creek and spring that we crossed was flowing. It was impossible to keep our feet dry. Sometime around 3am my toes and feet really started to hurt with a stinging coldness. The temperatures were in the very low teens. Melinda recorded temperatures of 11 degrees while driving between aid stations.
By the time I reached Headforemost mountain, around 27 miles, my feet felt comfortably numb. I didn’t worry about them after that. When I reached Bearwallow Gap, 47 miles, mid-morning on Saturday I decided to change my socks. As soon as I removed my socks I knew I had frostbite. The tips of my toes were covered in blisters, and I never get blisters on the tips of my toes. Moreover, the skin was pale blue. I had pale blue blisters on the tops of some of my toes. I quickly put dry socks on and finished the race.
Immediately After the Race
Back at Camp Bethel after finishing, I removed my shoes.
At Camp Bethel, the race Medical Director Dr. George Wortley cleaned up my feet and dressed the worst blisters. At the hotel in Roanoke I took a warm bath and put some neosporin on my toes. As my feet warmed the blisters started weeping and then bleeding. The bleeding became so bad that I had to use duct tape to secure a small towel around my right foot so that I didn’t get blood all over the bed sheets.
The next morning I noticed that the tip of my right big toe was turning dark and the skin was hardening.
It was Sunday morning when I realized that the frostbit on my right toe was severe. At that point it didn’t hurt so much as it was uncomfortable. It continually felt as though someone was standing on my right big toe.
Wednesday I went to my podiatrist and he put me on a routine of soaking the toe in warm water with epsom salts and rubbing alcohol, then dressing the toe with an antibiotic cream. He said it would take up to a month to know how much tissue would die.
By now my toe was consistently hurting. The only relief was from soaking the toe in warm water. I was soaking the toe several times each day and night.
As I finally realized how horrible frostbite is, my thoughts turned to people in some books I read recently. One book about Mormon handcart pioneers who suffered death and frostbite, and another about Soldiers in the Korean war who fought the Chinese army in sub-zero temperatures. These people lost limbs from frostbite, if they lived. The short version is that my little frozen toe really expanded my mind to the suffering of others with real frostbite.
After One Month
After a month I went to a surgeon and he sliced the dead tissue off the end of my toe right there in the exam room. The two middle toes on my left foot had scabbed over and healed on their own. The surgeon said that I was in the clear and will have a full recovery. He said that a skin graft was more trouble than it was worth because it would probably fall off, being at the end of my toe, and that the area was pretty small to start with. He said it would take another couple of months for all the skin to grow back.
As the weeks have passed the pain slowly diminishes. As I write this on January 30, seven weeks after suffering frostbite, I have a constant discomfort in my right big toe. I no longer have to soak my foot, and I can wear shoes. I’ve cut the toe out of my running shoes and I’ve been running regularly. It feels about the same as a bad blister. I’ll be really glad when it is all better.
What Have I Learned?
I’ve already committed to running Hellgate again this year, so maybe you think I haven’t learned anything. I’m definitely going to pay more attention to my feet next year. I wore NB MT 100s for the 2009 Hellgate. They are like wearing slippers, only weighing 7 oz. This year I’ll wear more substantial shoes and socks. I’m also going to coat my toes in vaseline before and during the race.
I’ve definitely learned that frostbite is very painful. I haven’t been comfortable for a couple of months now, and the pain was very disconcerting for around three weeks. It’s improving slowly but steadily. It seems kind of silly to complain about pain resulting from such a small wound.
I haven’t learned to tell the difference between cold toes and frostbitten toes in the moment. My cold feet during the race this year didn’t feel any different from other times I’ve been running in low temperatures and had cold feet and hands. It’s still something of a mystery to me why things ended up the way they did.
These days my frostbitten toe REALLY hurts when I go running in “cold” temperatures. I hope that is a temporary condition. Holiday Lake is coming up in two weeks!
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