Keeping warm is vital to staying fit and healthy in the cold (Eli Duke)
Article Words : Dr Jane Wilson-Howarth | 18 October

Out in the cold

Winter travel can be great for morale – but seriously bad for the health of the poorly equipped. Follow our expert advice to help you stay safe and warm

At first I’d jiggled and flapped my arms in an attempt to keep warm, but now I’d been standing around shivering and apathetic for a long time. I wasn’t wearing enough layers and was wet from an earlier soaking. I was uncomfortable but unconcerned. Then, as the hours dragged, I felt almost acclimatised. I shivered less, felt better. What I didn’t realise was that I was suffering from exposure or – more correctly – hypothermia.

It is a dangerous condition striking the ill equipped, exhausted, hungry and wet, especially at altitude. It creeps on insidiously so that a victim’s central or core temperature can drop significantly before they’re aware that much is wrong. And there are plenty of situations in which hypothermia can strike.

Feeling the chill

 

Less serious than hypothermia, but more common, is a circulation problem some people experience as they chill. The process starts from the tips of the fingers, which are increasingly starved of blood, causing the digits to become white, numb and clumsy. Re-warming provokes painful tingling and the affected skin becomes patchily discoloured red, white and blue; the fingers remain red and throbbing for a while. This is Raynaud’s syndrome. It is most common in women; smokers are more likely to suffer than non-smokers. The best treatment is protection from the cold but prescription medicines including nifedipine can help.

Frostbite – deep-freezing of live tissue – is nastier and can strike if the weather closes in unexpectedly. Try to listen to your body and don’t ignore tingling fingers and other signs of chilling. Any protuberant body part may suffer. The flesh becomes white, hard and looks like frozen chicken. Once this happens, evacuation to a warm place is crucial; meanwhile, it is important to protect that frozen part, since it will be numb yet highly susceptible to damage. It is best to delay thawing until you are somewhere safe. Just as with hypothermia, the re-warming needs to be slow and gentle. Someone else’s body heat is ideal.

Hypothermia is more risky. Lower temperatures make enzyme systems slow, the blood thickens and ultimately the heart stops. Serious symptoms of profound cold get progressively worse and the chances of survival diminish as the core body temperature drops from around 36.5°C to below 35°C.

Once the core temperature is so low that shivering stops, the victim no longer feels cold, but becomes relaxed, apathetic and careless. In my case I was confused enough to not recognise friends and I lost my usual healthy fear of sheer drops. What was really weird was that I started shivering again once I was home and in a hot bath, and the shivering continued long after I was tucked up in bed that night.

Catching those rays

The perfect pick-me-up after our unsettled summer might be to leave the drizzle behind and head to where the precipitation is more attractive – on the ski slopes. Fine frosted scenery entices us to spend more time outdoors, which is good for stimulating melatonin levels, improving mood and shaking off seasonal affective disorder (SAD). Perhaps as many as one in 50 people suffer from SAD – which is a form of clinical depression – but many more (perhaps one in eight) experience ‘winter blues’ or a lowering of mood as days shorten. Women are four times more likely to suffer than men; a common age of onset is in the 20s. It is less common in residents of countries nearer to the equator.

Anything that gets you out of doors for one or two hours in daylight is more effective in dispelling symptoms than anything a lightbox can deliver. On a recent trip to Iceland I was impressed at how much easier it is to get outside there, despite the climate being far more hostile than ours. Most communities have outdoor public pools, geothermally heated to about 28°C, plus a range of hot tubs (up to temperatures of about 38°C) to allow you to wallow outside even when it is wet, cold and windy.

In addition to catching any rays, increasing your activity levels stimulates the body’s endorphins – the feel-good hormones, our home-brewed heroin. Winter travel, especially if it includes outdoor activity, is good for you – a tonic – but make sure you’re prepared for lower temperatures and have some respect for what the climate can do. If that’s too daunting, then heading for some winter sun is also mood-lifting, and a better mood seems to enhance the body’s defences generally. There’s also often a better range of fresh fruit and vegetables than are available in winter destinations so you can feast on those antioxidants.

Tips for cold weather

Wear layers, which you can add or take off according to the conditions and your activity levels

Carry spare gloves and socks if you are taking a remote trip

Be ready for a change in the weather, even on a bright day; carry waterproofs and also a little compact high-energy emergency food

Protect against nosebleeds, which are common in high and dry climates: anoint the inside of the nose with a greasy, non-perfumed cream or grease

Protect the inside of your nose: sunburn there (from sun reflected up off snow) is painful so cover up

If you're taking a long drive in the wilderness, keep extra clothes, waterproofs, a shovel and even extra food and blankets in the car

Pack aciclovir cream if you’re prone to cold sores – cold conditions may provoke them

Don’t re-warm with alcohol if you’ve become seriously cold – St Bernard got it wrong

Carry a mobile and know the local emergency services number: it’s 112 in the EU and 911 in North America

…and some dont's

Don’t rub snow into a cold limb: it doesn’t aid re-warming

Don’t rub frostbitten parts or chilblains: it’s bad for them

Don’t re-warm in hot water: it can cause scalding and permanent damage

Don’t reheat in a hot bath if there’s serious hypothermia: re-warming should be slow

Core body temperature changes - the dangers

38°C - High temperature: sign of significant infection – feels awful

36.5-37°C - Normal temperature, at which human body functions best

35°C - Hypothermia (exposure) starts: victim feels cold, looks cold and shivers; ability to make key decisions deteriorates

34°C - Victim starts to switch off, doesn’t care and may do daft things such as shed clothing

33°C - Stumbling and balance difficulties experienced; victim appears not with it and incoherent; shivering stops

32°C - Serious risk of heart attack; body can’t replenish heat without help; limbs stiffen

31°C - Unconsciousness

30°C - Pulse and breathing undetectable

24°C - Few victims recover

18°C - Lowest recorded temperature anyone has survived