Self Diagnosis for the "Umbles" ?

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My approach is to keep my fuel (food) and water up (same tank feeds both the motor and the heater...), keep my insulation dry, and never let myself get to the point of shivering.

There are two kinds of shivering--controllable (mild) and uncontrollable. Controllable shivering (you can will yourself to stop for short periods) is a warning--it is still generally pretty easy to warm up by adding a bit of work or insulation. Untrollable shivering (you cannot will yourself to stop) is much more serious.

So by staying out of shivering, or doing something immediately if I do begin to shiver, I have, so far, been able to stay out of trouble.

Doug
 
umbling along...

The method I use for checking for the umbles, hypothermia, exhaustion, etc. is all pretty much the same .

A compass does the trick for me .

My rule of thumb is... if I'm looking at the compass and haven't got the slightest idea what the readings are trying to tell me...then it's time to stop, regroup, eat food, change/add clothes, make camp, whatever it takes to "unfog the brain".
(I would do the same thing with a GPS but I seldom know what the heck it says anyway).

Snowshoeing ...I have literally re-crossed my own trail late in the day and walked right by them, even though I needed them to lead the way out.
I told my self they were to soon.. or going the wrong way...didn't seem right...and all the other irrational rational that you can come up with when in fact it is the "umbles" that had the upper hand.
 
When I woke up freezing to death in MN (it took approx 60" for this to happen), there was a lot of denial.
I knew I was very cold but did not for one second think hypothermia. I knew all the symptoms but still did not relate them to me.
Both legs were completely numb all the way up. Couldn't get my sorels on or my down jacket on but that still didn't alert me to the problem immediately.
One of my teamates woke up to go to the BR. I was just sitting there on top of my bags. She asked if I was OK. I said "yes". She then asked me if I going to get back into my sleeping bags. I replied "yes". Again, I was in complete denial that I had a problem.
It wasn't until I started blaming both numb legs on a very small toe crest that I wear on my left foot. I can remember thinking...this never happened before. As I sat there pondering this I realized I was totally irrational and thank God I recognized this because I would most likely have laid back down and gone to sleep to be found dead in the morning. I also remember thinking, I just slept wrong and my legs are asleep. Somewhere deep down, it was the knowledge that the toe crest could not have caused this that alerted me to the seriousness of this situation. For a brief time I believed this but then realized I was losing it. At that very moment the thought that once you are getting seriously hypothermic you become irrational struck me.
Even then I was thinking that "this cannot be. I'm going to wake these people up and look like real idiot.Just lay back down, you'll be OK by morning." MORE DENIAL!!!:eek:
I was quite astounded when I realized I could not walk but had to crawl to my leaders. I couldn't even talk to them other than to say repeatedly "help me, help me , I'm so cold. I recall rambling on about Everest (specifically Beck Weathers) and I kept telling one of them over and over again that I wanted her sleeping bag.
DENIAL was such a big factor even though I had the knowledge base and in addition we had just had a whole class on hypothermia that reinforced everthing I already knew and then some.
I cannot emphasize enough how insidious it is and when you are in the middle of it you go down really fast and there is precious little you can do to save yourself.
Darren's story is phenomenal. He got out alive because of his friend and the fact that he yelled "DOWN NOW"!
I got out alive because of my leaders.
Self-diagnosis of hypothermia is very difficult and I fear many time impossible. By the time you appreciate what is happening you are too far gone to help yourself.
Stop at the first shiver and fix the problem, or better still avoid it if you can. I got into my mess because I did something very foolish, I suppose Darren did to.
I do still hike alone with my dogs in the woods,where I am likely to see a few people, on trails I know, and always with enough gear to survive Denali.
Lesson learned and I was allowed to stay with my group.
I have to say that was as important to me as surviving.

:D :D :D
 
Louis said:
Can I asked you what they did to help you... just interested in the ways to help somebody who is showing the same symptoms that you where showing...

thanks


http://community.webshots.com/user/louis2505
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If you can, get them out of any wet clothes. Get more layers on them.

If they are conscious, hot, sweet liquids to refire their furnace and motivate them. NASAR suggests sweetened jello. I carry strawberry :D all the time. It must not be the unsweetened variety. Heat the jello and water and have them drink it. Simple sugars to restart the furnace which are absorbed in the stomach so should have pretty fast effect.

If they are unconscious or incoherent then put them in a hypothermia wrap and get them down to help. There is little that you can actually do for them at that point except keep them from losing more body heat and to get them help.

Keith
 
I will be happy to share this with you.
I know a lot of the more senior members have read this account previously. Please bear with me.
The students were sleeping under tarps and our two leaders were in a megamid approx 10-20 feet away from us. All Outward Bound leaders are wilderness first responders.
Abby immediately place my feet on her abdomen, slowly and gently massaged them. Megan went to find my missing clothes, boots, hat, jacket. They got me into all my clothing except the boots. They literally poured hot chocolate down my throat and fed me lots of pieces of chocolate. I didn't realize that they kept a thermos of hot chocolate in their sleeping bags for just such an event. Megan went to the cook tent and made a fire in the stove. I started to warm up some and as soon as I could stand, they put my boots on,and they brought me to the cook tent. I'm sure that once the fire was going,if I could not have walked with their support, they would have brought me over in the dog sled which was right close to us. They made hot lime jello and they had me keep drinking it....lots of it. I would say that within one hour I was complete recovered. It could have been even longer. It seemed like forever.
We then went back out to the "mid". Megan got my two sleeping bags and they made certain that I was in them properly. This is what I had done wrong the first time. Before we went to sleep, our leaders explained to us that we had to be all the way in our bags, zipped up tight, hoods on. If we needed to get up for any reason, we should be certain to run around, jump up and down before we got back into our bags. You should never get back in your bag without warming up first because it's very difficult to warm up if you are cold by just getting into a sleeping bag. This was my big mistake. Being the very knowledgeable and experienced person that I was, :eek: when I arose to relieve myself the first time, I opted to eliminate the running and jumping and just got into my sleeping bag. When I tried to get into the second bag I had no patience for fiddling with the zipper to get it all the way up. I said screw it...placed bag #2 over me like a big blanket and went fast asleep.In the minus 40 temps, I must have started to freeze up immediately. For the remainder of our "expedition", I slept between the two leaders in the megamid.
You see, my arrogance got in my way. I had winter experience, I had slept out before, all those instructions were for the newbies. I could handle myself and a fine job I did at that. :eek:
Had I had the wisdom to listen and learn from my experienced and very knowledgeable leaders I would never have gotten myself into this very life threatening mess.
As Abbey so wisely said to me:
"It's not what happens to you in life, but what you do with it that matters".
Many lessons learned in MN, this one being the most dramatic. :cool:
 
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Two methods for generating heat while in a sleeping bag:
* Isometric exercises--just tense your muscles.
* Eat something. It is ok to bring some food into the bag or tent with you when the bears are hibernating...

Example: I ate some hard candy once when cold. I warmed up before the candy was gone. I had to stay awake sucking on it because I didn't want to go to sleep with it in my mouth. (A chewable candy bar might be better--warm it in your mouth to soften it, chew, and swallow. Then you can go to sleep when you warm up...)

Doug
 
DougPaul said:
Example: I ate some hard candy once when cold. I warmed up before the candy was gone. I had to stay awake sucking on it because I didn't want to go to sleep with it in my mouth. (A chewable candy bar might be better--warm it in your mouth to soften it, chew, and swallow. Then you can go to sleep when you warm up...
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Yes, but think of the tooth decay! :eek:

Seriously, this and the other hypothermia threads are always interesting. Question-does anyone know if it is possible for a victim to bypass the shivering stage? Or does this happen in more or less every case?

Matt
 
I think Maddy's story illustrates a point that most people overlook: It is very difficult to self assess for hypothermia.

With all due respect, though it sounds good to pose logical tests for yourself (like the earlier example of going over the multiplication tables) to test whether you CAN do it, the hypothermia may affect your thinking enough that you don't realize that you CANNOT do it.

I remember seeing something on PBS years ago that assessed the thinking ability of mountaineers without oxygen at extreme altitude - perhaps on Everest? Their answers to simple questions quickly grew increasingly erratic the longer they went without oxygen. Further, it was clear they did not realize their thought processes had deteriorated. Granted, this is oxygen deprivation and not hypothermia, but I think a similarity can be drawn in the way both can negatively affect one's thought processes. In other words, if you're not thinking well, how can you expect to recognize that you're not thinking well?
 
This may be slightly off topic, but can someone explain what happens from a physiologic standpoint to your body to cause the outward signs of hypothermia. I know you core temp is decreasing, but what does this do to bp,hr,etc.Is your brain getting less oxygen?
thanks
 
Hypoglycemia and Hypothermia ?

Any Doctors or Holiday Inn Express residents care to explain the relationship with Hypoglycemia and Hypothermia ? Is this a chicken or the egg relationship ? I've seen it stated that Hypoglycemia can cause Hypothermia and visa versa. Both stand to reason, I guess. Is it common knowledge that people with low blood sugar are more susceptible to Hypothermia ?
 
Chip said:
Is it common knowledge that people with low blood sugar are more susceptible to Hypothermia ?
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People with diabetes almost always have circulation problems, some very serious circulation problems. I don't know about hypothermia but certainly frostbite is a major concern. Anyone who has had diabetes over 10 years we are told to assume that they will have circulatory and/or heart problems as well. Doesn't mean that they will but it is a pretty good assumption.

And of course low blood sugar does mean that their cellular furnace probably doesn't work as well as people with normal blood sugar which I would think could complicate the hypothermia problem. This is speculation on my part though. Maybe a doc or someone with more experience could speak directly to that point.

Keith
 
Jason Berard said:
This may be slightly off topic, but can someone explain what happens from a physiologic standpoint to your body to cause the outward signs of hypothermia. I know you core temp is decreasing, but what does this do to bp,hr,etc.Is your brain getting less oxygen?
thanks
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OK, I'll admit being lazy. I copied this from something I wrote here earlier. Hope it is what you are looking for. As far as your brain getting less oxygen the answer is yes. You are starting to see that in stage II with the mumbling and incoherent rambling. Stage III is actual unconciousness or serious mental impairment. These are all signs of an altered mental status. If I remember correctly there aren't significant changes in BP and HR until stage III but that is off the top of my head. I really should look that up. At that point HR and BP are both very, very low and slow. it would be difficult to impossible to detect either one from radial pulses. Even in stage I you may have trouble picking up radial pulses if enough vasoconstriction and shunting is occuring.


SAR-EMT40 said:
By definition hypothermia is a lowering of your core body temperature from what is normal. The thing to keep in mind is that all your bodies reactions with respect to hypothermia is core driven. By that I mean, you cannot put your hand on a piece of ice and that alone will cause you to shiver. You might give yourself frostbite but the only way you start shivering is if your core temperature has dropped sufficiently. Shivering is one of the first signs of hypothermia. I have been taught that actually the first is a mental degradation. I know this will sound corny but follow this through. A group of people standing around. One guy standing there shivering and the other says “you look cold?” The guy says “Yeah, its freaking cold out man”. The other says “why don’t you put your hat on?” The shivering guy says “NO I’M OK”. Anyone seen this happen? I know I have. Hell, I’ve done it. Fact is. He is not OK. He is already got a core temperature low enough that his body is responding. It is responding by shivering. This shivering is your bodies way of making your muscles generate heat. This is how the body responds to hypothermia in its first stages. This is when to treat it but his mental degradation is telling him, “NO I’M OK”. He doesn’t recognize how much trouble he is in. This is more than just a warning sign. It is actual hypothermia. It’s just that we see it and ignore it so often many of us don’t recognize it as such. Are you going to die in minutes, hours? This obviously depends on the conditions, but make no mistake you are hypothermic and headed in that direction unless you take corrective action. Put a hat on, change out of wet clothes. Put on extra layers.

From there of course it will get worse if no corrections are made. You experience a loss of fine motor control, if you haven't already, so you find it harder to tie your shoes, change your wet jacket and other simple tasks. This is directly attributable to your extremities being vasoconstricted and shunted, again, core driven. Your hand muscles are receiving less blood so they cannot perform the way they normally do and the way you think they should be performing. Everything takes longer to do and is more of a challenge. Yes you can stop your shivering at this stage (first stage) by force of will.

You are in stage two when you have a loss of gross muscle coordination and at this point you cannot stop shivering. You also suffer from the ‘umbles. They are still conscious but will stumble when they walk, mumble when they talk, and fumble when they attempt to do simple things. You are getting near the point of no return.

End stage consists of unconsciousness and shivering has stopped. The body cannot re-warm itself at this point. It is almost impossible to help someone in the field to and bring them back to consciousness. The best you can do is to try to keep them from losing more body heat. Change them out of wet clothes, put them in dry clothes and put them in a hypothermia wrap and evacuate them rapidly and treat them very gently.

One other statistic I will leave you with is that any person, who has a core temperature change (up or down) of seven degrees, has a 50/50 chance of surviving.
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Keith
 
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thanks. I guess the outward signs are WAY more important in a practical sense, its not like one would have any good way to measure vital signs in the woods anyway. :D I guess like most people, I never really thought about controlable shivering as BEING hypothermia, as opposed to some kind of precursor. I definately will take this to heart!
 
The vast majority of people hiking are already dehydrated to some degree, in winter even more so. While they are hiking the heat they put out is sufficient to mask a lot problems, but when they stop walking the cold can come on quickly. As with all heat/cold related problems preventing them from starting is of primary importance.

So, eat and drink often, keep an eye on each other for signs, and don't be afraid to ask for help. Carry the right gear, food, and clothing and use them. Take a WFA course and keep it current.

-dave-
 
Dave is absolutely correct about this. One of the docs that taught one of the hypothermia classes that I attended stated "I never treated anyone for hypothermia who wasn't also dehydrated."

Keith
 
SAR-EMT40 said:
One of the docs that taught one of the hypothermia classes that I attended stated "I never treated anyone for hypothermia who wasn't also dehydrated."
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While true, this is, IMO, a bit of a red herring.

Assuming that you start with adequate water in your system:
When you are chilled, you vasoconstrict peripherially, and with more blood than circulatory system volume, the kidneys kick in and remove the excess water. (This is why you have to urinate when you get chilled--the body isn't "smart" enough to store the excess liquid for later.) When you warm up again, the system volume increases, and unless you add water (ie drink) you become dehydrated. So anytime you are chilled and warm up again, you are likely to become at least somewhat dehydrated whether you were cold enough to be classed as hypothermic or not.

Note that in the above sequence, when you were chilled, you had an appropriate amount of water in your system. It is only upon warming up without adequate fluid intake that you become dehydrated.

Note however that dehydration before becoming chilled can be a contributing factor to developing hypothermia because it reduces the capacity of the muscles to work and produce heat.

Doug
 
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Jason, If you can find a book like the Fogery book I mentioned in my post above that gives detailed medical info on hypothermia, that will answer your questions, but the short answer is yes, your brain gets less oxygen because your core is cooling down and your heart rates slows as well. Fogery says it goes down 10 beats per minute for every degree below normal and you may also get an irregular heartbeat.
 
wondering...

I have often wonderered if the possible "irregular heartbeat" symptom can become a permanant condition as a result.
I have talked it over with a doctor or two, but not subject specific to hypothermia .
 
TomD said:
Jason, If you can find a book like the Fogery book I mentioned in my post above that gives detailed medical info on hypothermia, that will answer your questions, but the short answer is yes, your brain gets less oxygen because your core is cooling down and your heart rates slows as well. Fogery says it goes down 10 beats per minute for every degree below normal and you may also get an irregular heartbeat.
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Your oxygen requirements also go down as the body temp drops. (Hypothermia is sometimes used in surgery for this purpose.) I have seen/heard authoritative comments to the effect that the body shuts/slows down effectively as it cools down. The problem is that it doesn't warm back up very well...

The drop in temp affects many chemical reaction rates (generally slows them) which is also likely to be a factor in the body's response to a drop in temp.

Doug
 
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