Self Diagnosis for the "Umbles" ?

[Chip]

When I was younger and drank more I would juggle to field-test my sobriety (or lack there-of).
Last March, by myself in a freezing fog bank near the summit of Algonquin, I was aware that I didn't want hypothermia to get ahead of me, so I was practicing multiplication tables while attempting to relocate the trail. I figured I'd recognize an inability to multiply as a sign I needed to hydrate, eat and add layers.

Are there any good pre-cursors that could act as red flags before someone has gone too far to help themselves ?

 

[NH_Mtn_Hiker]

When I was younger and drank more I would juggle to field-test my sobriety (or lack there-of).
Last March, by myself in a freezing fog bank near the summit of Algonquin, I was aware that I didn't want hypothermia to get ahead of me, so I was practicing multiplication tables while attempting to relocate the trail. I figured I'd recognize an inability to multiply as a sign I needed to hydrate, eat and add layers.

Are there any good pre-cursors that could act as red flags before someone has gone too far to help themselves ?

Yes, you know you've gone too far when you start doing math problems while hiking.


Sorry, couldn't resist.

 

[TomD]

Chip, In Hypothermia, Death byExposure, by Dr. Wm. Fogery, there is a symptoms chart. Shivering and the inability to do what Fogery calls complex tasks with your hands (not sure exactly what those would be) are early signs;one fairly reliable test is walking a straight line for 30 ft. If you can't do that, you may be hypothermic. I would want to get all my gear on immediately, get some food and get some warm liquid if possible.

 

[Roxi]

Shivering and the inability to do what Fogery calls complex tasks with your hands (not sure exactly what those would be) are early signs

For me, I knew I had early signs of hypothermia when I was shivering and had trouble unlacing and relacing my boots. I'm guessing that would fall under Fogery's "complex tasks with your hands."

 

[--M.]

Unfortunately, you'll also be fighting the loss of judgment that tells you that you don't need no stinking tests. Bit of a catch-22, that. I'd cram in a third movie allusion, but I can't make my fingers werk.

 

[Tom Rankin]

Unfortunately, you'll also be fighting the loss of judgment that tells you that you don't need no stinking tests. Bit of a catch-22, that. I'd cram in a third movie allusion, but I can't make my fingers werk.

Reminds me of a failed ad campaign for a certain beer:

Think when you drink!

 

[Kevin Rooney]

For me, I use stumbling as the signal. When the large muscles in the thighs get tired, you're more apt to stumble - time to quickly drink, eat, and then get down. If you use mental exercises as a guide you may put yourself at great risk as it's tough to come up with an objective measure to quickly determine whether you're crossing over that line.

Most of us don't realize how close we were to that line until well after we're in a safe place and have fully recovered. As is often pointed out - self-diagnosis of hypothermia is difficult to determine. Don't attempt to play games with yourself over it.

 

[SAR-EMT40]

Chip, In Hypothermia, Death byExposure, by Dr. Wm. Fogery, there is a symptoms chart. Shivering and the inability to do what Fogery calls complex tasks with your hands (not sure exactly what those would be) are early signs;one fairly reliable test is walking a straight line for 30 ft. If you can't do that, you may be hypothermic. I would want to get all my gear on immediately, get some food and get some warm liquid if possible.

If you can't tie your shoe that is fine motor skill that is a strong indicator that you are hypothermic. The next stage would be gross motor control which would be difficulty in walking such as stumbling usually with severe shaking as well.

You are already in deep trouble in the earlier stage when you have a loss of fine motor control. Think of it. You cannot tie your shoes, zip your coat, put on another layer of clothes etc. without serious difficulty if at all.

I would say this in the strongest terms possible that when you shiver, that is your sign that you are hypothermic and need to correct it now. All the signs that you are talking about like the fine motor control problems are latter signs. The gross motor controls problems such as stumbling are even later. This is an indication of someone who is seriously impaired. Why are people waiting to see these late signs? You are in a very dangerous place when you are getting these signs.

Keith

 

[Kevin Rooney]

Thanks for your post, Keith.

Just to clarify my post - I'm using stumbling a bit differently I think. One a typical winter hike I may catch a toe/stumble perhaps once an hour or so. If I catch myself doing that more frequently, especially on a cold day, then my alarms start to go off, and I instinctively massage my legs, just above the knees. If they feel a 'certain' way - then I know they're cold. It's hard to describe that 'certain' way - perhaps a slight loss of sensation? Hard to describe, but when I feel it - I'm outa there.

I've never gotten to the point where I've lost fine motor control and hope never to be in that position.

 

[darren]

SAR raises very good points. I used to have an article on hypothermia on the site a long time ago. I'll see if I can find it and see if it is worth posting it again.

An important thing to realize is the position you are in when the symptoms occur. When I went hypothermic, I was using my ice ax and crampons to hold on to an ice face that was directly above a lip that dropped hundreds of feet into a ravine. I was focusing on getting up the icy face, so I missed the early signs. The first thing I really remember was shivering a bit. We have all been cold before and shivered. Heck you can get the shivers just sitting by the pool at home. I just had to go a little ways more and I could get to some shelter behind some boulder so I didn't think much of it. Very quickly the shivering became uncontrollable. Then, pretty quickly after that, the shivering stopped and my large motor skills went down the tubes. It wasn't until that point that I realized I was going hypothermic (at that point I was already in bad shape). I turned around to tell my partner Dave that we had to head down and I had problems talking. I'm not talking slurred speech, I mean I had serious problems getting words to come out of my mouth at all.

It was shocking how fast hypothermia set in and how fast my condition got worse. In all the reading I had done I had never known that your condition could get that bad that fast. I went from some mild chills to severely impaired in no time. Minutes, not hours. I had no idea that you could go from ok to a mumbling stumbling fool in 10 minutes.

As SAR said, by the time you realize that you are having some problems you are already in big trouble. You will have problems zipping up your coat or putting on gloves or anything simple.

Your mental capacity goes right down the drain too. I couldn't add 2+2, nevermind multiplication tables.

Just to verify, it is common for people to feel burning hot in the last stages of hypothermia. You will usually find people who are solo that die of hypothermia with their clothes removed. Or they get into their sleeping bag to get warm and then get out of it because they got "too hot".

- darren

 

[expat]

Re: self diagnosis

I sometimes hike/backpack with a friend who is diabetic. Low blood sugar can have symptoms like hypothermia, too.

He keeps a close eye on his blood sugar level, but just as a backup check, I'll ask him math questions from time to time. One I like to use is to count backward from 100 by 3's, or 8's, or something like that. I was once asked a question like that by an MD after I had hit my head while sledding.

I'm not sure whether this would work as self-diagnosis, as you might be hypothermic enough to think that the wrong answers are right.

 

[KayakDan]

If you can't tie your shoe that is fine motor skill that is a strong indicator that you are hypothermic. The next stage would be gross motor control which would be difficulty in walking such as stumbling usually with severe shaking as well.

You are already in deep trouble in the earlier stage when you have a loss of fine motor control. Think of it. You cannot tie your shoes, zip your coat, put on another layer of clothes etc. without serious difficulty if at all.


Keith

Having been in this situation in the most bizarre of circumstances(in the Bahamas!),it occured to me after the fact that if I had to make a phone call for help,I was shaking so violently I couldn't have done it!
And the fact that it happened in warm(upper 60's)condition was also an eye opener. Hypothermia can happen in a wide range of temperatures.

 

[SAR-EMT40]

Having been in this situation in the most bizarre of circumstances(in the Bahamas!),it occured to me after the fact that if I had to make a phone call for help,I was shaking so violently I couldn't have done it!
And the fact that it happened in warm(upper 60's)condition was also an eye opener. Hypothermia can happen in a wide range of temperatures.

If I remember correctly most cases of hypothermia occur at temps between 30F and 50F with rain. That is an excellent recipe for hypothermia.

People that go out in zero and sub zero weather usually know what they are getting into and have the clothing and equipment to keep from getting hypothermic, usually. Its the day hikers (not bashing day hikers) who head out on a gorgeous 65 degree day that turns to 45 degrees with rain.

Keith

 

[SAR-EMT40]

I'm not sure whether this would work as self-diagnosis, as you might be hypothermic enough to think that the wrong answers are right.

Altered mental status is a late sign. About the time you are stumbling, your thought processes are probably out the window as well. That the reason for the removing clothing and other things often seen of late stage hypothemics.


You diabetic friend also has to be extremly careful for frostbite with his fingers and toes. That is going to be a major concern for him. Most diabetics (especially if he has had it for over 10 year) have poor to extermely poor circulation in their extermities. If he keeps real close watch on his sugar levels he of course reduces his risk.

Keith

 

[darren]

Ok, I posted my hypothermia story here.

- darren

 

[SAR-EMT40]

It was shocking how fast hypothermia set in and how fast my condition got worse. In all the reading I had done I had never known that your condition could get that bad that fast. I went from some mild chills to severely impaired in no time. Minutes, not hours. I had no idea that you could go from ok to a mumbling stumbling fool in 10 minutes.

Thanks for relaying this story to everyone Darren. This is really why I try to stress to not look for the later symptoms. Fix this the minute you identify what is going on. If you start any type of prolonged shiver (i.e. longer than 30 seconds) you are hypothermic. Granted, its at the easily fixable stages but your body is telling you that you are hypothermic. Fix it now. It will be more difficult to fix later on by just putting more clothes or dry clothes on and may be impossible to fix if it gets much farther.

Keith

 

[Dugan]

Yes, shivering is the guide I use - if it happens for very long, or if it doesn't go away as I move.

Only once have I been hypothermic enough that I stopped shivering. My destination was close enough that I just wanted to get there, dry off, and warm up. In retrospect, I probably should have stopped, but luckily I made it.

 

[John H Swanson]

From a person that like to keep cool to minimize overperspiring.... I have learned something quite interesting.

In winter I hike with an altimeter watch that has a temperature sensor. The sensor is largely influenced by my body temperature. I wear the watch over my polypro and under my shell. The wrist of the shell is loosely open; just hanging over the watch. When It is very cold out the temperature reading is influenced.

I have found a corrolation between this temperature and my (core?) body temperature. Of course this is pseudo-science and perhaps I prefer to think that it works more that it actually does. That said, when the sensor says 45 or colder I'm in bad shape. Over 50 - no problem. Despite whether it is always true or not, having a number to drive my actions overcomes the internal rationaization that I'm not too cold to stop and add layers...as opposed to hiking a little faster to generate more heat.

 

[Pete_Hickey]

Not always easy to self diagnose. Here's my story from several years ago.

The other day, I performed an interesting experiment on myself with cold & hypothermia. In preparation for the Canadian Ski Marathon, I went for a 65Km ski trip in temperatures starting at -30, warming up to -24, then getting colder again.

I started to have "problems" on my way home when it was dark, and I was tired, hungry, and thirsty.

I had 3 liters of water with me, and finished the first two by 30Km. I had no more water for the next 35Km (3 hours). The bottle froze solid. In my last hour, I knew I was somewhat dehydrated. As far as food, I had a couple of sandwiches mid-way, but skiing that kind of distance burned those calories up fast. I was hungry towards the end.

In the last hour, I found my performance somewhat interesting. Although it *appeared* to me that I was moving at a good speed, I knew from experience on that trail, that I was going significantly slower (I count steps, time myself in various segments, etc.) I could attribute that all to the dark, however. Moving at night always seems like you travel faster. Normal nite confusion, or were my senses distorted?

My balance wasn't too good. I fell on some extremely easy descents. But that could have been from being tired, night's illusions in the snow, my iced up glasses making it hard to see, etc.

I was cold. The cold felt like it went all through my body. I had some extra clothes in my pack, but I didn't feel like stopping to put them on. I wanted to keep on moving. (clouded judgement?) No matter how hard I pushed on the climbs, I could not warm up my fingertips, nor could I work up a sweat. Earlier in the trip, I would pace myself to prevent overheating on the climbs.

When I got to the end of the ski trail, I took off my skis, and ran the last 150 yards to my house. I was somewhat uncoordinated. But of course, after skiing 65Km, nobody should be able to take off their skis and run normally, right?

When I got home, my speech was somewhat slurred. But that could probably be explained by the layer of ice on my beard which prevented me from moving my mouth the way I should.

In the last half hour or so of the trip, I suspected that I was suffering from mild hypothermia. I knew that I had only to push a bit more and I would be home, had I been in the backcountry, I would *not* have continued pushing myself. Also, I wanted to 'experiment' on myself with hypothermia.

Soon after I got home, I took my temperature. Nothing registered. 15 minutes later, I took it again, and it was up to 94. After half an hour, it was up to 97. I probably should have used a rectal thermometer to get a more accurate reading, you after skiing 65Km,
I just didn't feel like sticking something up my butt. I think you can understand.

What I found interesting about this 'experiment', was that

1) I could identify (or at least suspect) hypothermia in myself.

2) All of the symptoms could easily be explained as being caused by something else. If I was not aware of what hypothermia was, I would have suspected nothing serious.

All in all, an interesting experience.

 

[Kevin]

Been There, Done That, Got the Bills...

As I already posted on an earlier hypothermia thread a few weeks back, I was laid out by my own experience with hypothermia... And yes, the weather was not the classical notion of freezing cold weather but 40-50's and lots of humidity...

I am going to be living with the philosphy that if I start to get the 'Umbles' I will be stopping to get my butt squared away before things go from bad to worse... And believe me, that happens quicker then you would think.

Also one of the best things, I think, is how some folks have mentioned keeping an eye on each other... Denial is not just a river in Egypt. If your partner starts to exhibit the classic 'Umbles' signs, do them and yourself a favor and STOP! Get everyone squared away then continue... Know if the idiots that I had been hiking with done that, I may have completed that hike... But that is another story.

Catch you on the trail...
Kevin