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Prevention is the key to avoiding frostbite. Here are some important reminders:

  • Stay well hydrated and well fed to enable your body to generate heat!
  • Avoid alcohol, which can impair your sensation (and judgment!)
  • Avoid smoking, which will constrict your blood flow
  • Don’t climb/trek under extreme weather conditions (wind, very cold)
  • Avoid tight fitted clothing, no wrinkles in the socks
  • If your clothing/socks/gloves get wet from snow/rain or perspiration, DRY them quickly – including boot insoles
  • Wear mittens rather than gloves in extreme cold and a liner glove underneath if you need quick temporary access to fingers (e.g. photography)
  • Never ignore numbness – as an old professor once told me – “if you feel your fingers and toes getting numb and you ignore it, that numbness might be the last thing you ever feel!” Numbness is a sign that you may be getting into trouble. If it doesn’t resolve by increasing activity, you need to get somewhere to take off your gloves/boots and rewarm yourself.
  • Avoid rubbing frostbitten areas – beating on them only increases the chance of injury and doesn’t help them rewarm faster.
  • IF you or your buddy has frostbite, get somewhere warm, but only rewarm the injured area if there is no chance it will refreeze
  • Keep the area padded and protected against further heat loss. The quickest way to rewarm is to submerge in warm water (~104F, or the warmth of a hot tub, test the water first with a thermometer or an uninjured body part – a frozen hand can’t determine if the water is too hot!)

Hypothermia can kill in mere minutes. Cold temperature, but also strong wind causes the body to rapidly lose heat. You start to shiver in order to maintain body heat from the rapid muscular shaking. If your body temperature drops to 35C/95F, you may get dizzy and disoriented, then the shivering stops. The body now maintains temperature only around the important organs; heart, brain and lungs and shuts down blood circulation to the arms and legs. Your pulse becomes weak and slow. Your blood vessels widen. Now, you feel hot and want to remove your clothes, finally slipping into unconsciousness. Eventually, your heartbeat stops.

Full blown Hypothermia will not be improved by additional clothing since clothing doesn’t generate heat. In difficult climbing situations, you need to put hot water bottles in your armpits, to your crotch and/or stomach – or you can strip and get into a sleeping bag - together with another undressed person, to warm up by the others body heat (yeah, yeah - keep your dirty imagination to yourself!).

Otherwise - keep moving until at safety. In 1998, a climber died of hypothermia on the North Side. All that was found left of him was his clothing neatly folded below the summit. This is quite typical of the condition. Confused, the brain tries to bring some order in the situation, thus folding the clothes.

Again, prevention is key! Here are some tips:

  • Stay well nourished to help your body produce heat and shiver effectively when needed.
  • Stay well hydrated and well rested.
  • Change wet inner garments promptly
  • INSULATE! (head and neck are key!) – great materials include Gore-Tex, Thinsulate, Flectalon

Follow the C-O-L-D clothing principle

  • Clean
  • Open – when exercising to reduce sweating/wetness
  • Loose/Layers – to retain heat
  • Dry – to limit conductive heat loss
When you're sliding into second and you feel something beckon

Some people take prophylactic (preventative) medication to prevent diarrhea, but this may be a very risky practice. The potential side effects from some of these medications range from slightly annoying to deadly, not to mention the alteration of your natural bacterial flora and potential development of antibiotic resistance. You should make the decision to take prophylactic medications with your personal physician. I don’t advise it in most situations.

When you're sliding into third and you and you feel a little. . .

FFor climbers with diarrhea on Everest, higher camps provide even more hostile situations; stripping in the icefall or while roped at the Lhotse wall is inevitable at times, and memorable always. In 1997, a climber fell and was killed while doing his thing at C3. Always be carefully roped when leaving tent at C3, even for very short distances!

Diarrhea causes dehydration and disturbance of the mineral balance in your body. Drink plenty and add electrolyte supplement (ORS packets are widely available in Nepal.)

When you're sliding into home and you feel a burst of . . .

Since diarrhea is such a pain on Everest, sometimes you will have to take aids like Imodium to halt it. You should be careful with these aids though. If you have a bacterial infection, diarrhea is your body’s way of getting rid of the bad bacteria. Use Imodium or the equivalent only when you really have to.

Again, prevention is key:
  • WASH YOUR HANDS after using the toilet and before eating.
  • Treat your water with a good filter or by boiling or by using iodine – and don’t slip up!
  • Avoid raw food. Boil first or wash and peel before eating.
  • Avoid unpasteurized dairy products.
  • drinking products with ice that is made from untreated water.