“Hey papa! We’re walking in a winter wonderland!”

Overheard from a toddler in a stroller talking to his dad.

Photo by Phil Brinkman, Wisconsin State Journal

I skied across the lake to Olbrich Park, home of this seasonal labyrinth, made from donated Christmas trees by artist Lillian Sizemore. That’s where I met the toddler and the dad.

Center of labyrinth

The installation included a “tree museum”, made infamous by Joni Mitchell in the song “Big Yellow Taxi”.
“You take all the trees
Put ’em in a tree museum.
Ya charge the people
A dollar and a half just to see ’em.”

There was no charge for this tree museum, but it included a selection of trees commonly used as Christmas trees in these parts, each with a card explaining where the tree is native, how long it can live, and how tall it will grow. They included Scotch and White Pine; Canaan, Frasier, Balsam, and Douglas Fir; Norway, Colorado Blue, and Red Spruce; and Arborvitae.

Meanwhile, as I got off my bike after work, I heard a commotion in the hydrangeas. It wasn’t Mary Hatch from “It’s a Wonderful Life”. It was a Peregrine falcon with a mouse in its talons, tearing through the dried canes and trying to get airborne again. It was maybe ten feet from me. It did not share the snack.

Mary Hatch in the hydrangeas from “It’s a Wonderful Life”

Lake Geneva Winterfest

The winterfest in Lake Geneva (no, Martha, not that Lake Geneva) is over, but that just means the crowd was smaller to look at the snow sculptures. The snow here has been too cold and fluffy for sculpting, so I have no contributions of my own except the photos. The gallery images sometimes get cropped by your browser, so click to open in fullscreen.

“Babies” – Two babies fighting over a pacifier
“Look at Dat Der Buck, Eh” – Yah, we really talk like dat here, or at least up nort we do.
“Roaring Peace” – little girl and lion
“Time” – detail of face
“When Grief Takes Wing, Love Remains” – lily
“There be Dragons Here”

There were also ice sculptures. On the shady side of the street they were still in pretty good shape.

$2/hour to park, or drive out on the lake and park with the fishers for free.

Frostbite

We’ve hinted about this topic for a while. Let’s get down to brass tacks and talk about frostbite. Remember I’m not a doctor, but I play one on TV. Nothing in this blog should take the place of adequate medical care.

As usual, we’ll start with a story. I was 13. It was a Sunday morning in January, about 5 AM. The temperature was about -15 F (-26 C) with a 20 mph wind (windchill about -40). [While we didn’t know about windchill in those days, and I’ve been known to pooh-pooh it, it is a real factor when it comes to freezing flesh.] I was heavily laden with newspapers and stopping at the first house. The bike was too heavy to make it up the steep driveway, so I parked at the foot of the hill and jogged up with the paper. At the front door I heard a crash. I turned and looked down the hill to see my bike tipped over and newspapers flying about. I ran down and hastened to pick up papers, trying to stuff them back together. With heavy mittens I didn’t have the needed dexterity so I tossed the mittens aside and worked frantically against time and the wind. I’d gotten all 109 remaining papers back together (not all had blown apart) and reloaded on the bike. No more pages were flying around. I noticed my fingers weren’t cold, but they were stiff. I bit one and didn’t feel anything. Under the streetlight they looked white (and I don’t mean Caucasian, I mean really white).

With a couple of hours of outdoor work ahead of me I knew I had to do something or lose my fingers. I found a house with lights on and rang the bell. They knew me as their paperboy, but they also knew my older brothers from when we lived in this neighborhood (as tenants of the person whose house I’d been delivering to when this happened).

They invited me in and let me call my parents for a ride, then I went into the bathroom to thaw my fingers under running water. The pain was excruciating as blood returned to my fingertips – but I kept all my fingers and I delivered all of the papers on time – the next 100 or so from the back of a car. Fast-forward 35 years and I found myself working in a burn unit, treating people with frostbite.

Windchill is definitely a factor with exposed skin. Wednesday it was -12 degrees F (-24 C). It was calm so there was no windchill. I rode to work at 15 mph so, relative to me, there was a 15 mph headwind and therefore a windchill of -35 degrees. If you ride in winter, remember it is always windy.

What do you do for frostbite? The most important step is prevention. When it is really cold, cover all skin. The Cleveland Clinic says 10 minutes at -10 F is long enough to get frostbite. Wear mittens, not gloves. Your fingers help to keep each other warm. If they still get cold, you can make a fist inside of the mitten. A bit of anatomy will help that make sense.

Image from the Journal of Personalized Medicine.

The main takeaways from the picture are: 1) the blood supply to your hand (like your brain) is redundant. Notice that the radial and ulnar arteries join to form an arch and the blood supply to your fingers comes off of that arch. Thus, even if one artery is injured, your fingers get blood; 2) there are two arches – a superficial and deep arch. (Okay, three in this image, including the unlabeled one – I’ve never seen that third arch depicted and I haven’t dissected a palm lately to look for it. If I do, I’ll post an update.) This gives further redundancy; 3) the arteries to your fingers run up the sides. If your fingers are separated in gloves, more surface area is exposed to allow more heat to escape. Conversely, if your fingers are touching, they keep each other warm. Also, the pads at the tip are the last place to get blood – the vessels are pretty small by that point; 4) due to the multiple vessels running through your palm, if you tuck your fingers into a fist, the tips are warmed by the palmar blood.

As an experiment this week, I wore my big mitten from Empire Wool and Canvas Co on one hand. On the other I wore various liners under the mitten: 1) a thin polyester biking liner glove; 2) a full-fingered insulated biking glove [a spring and fall glove]; 3) a nitrile exam glove. While a glove was handy when I had to work locks and keys and mount a pannier, the mitten alone was warmer while riding. When my fingers got cold I had enough space inside to make a fist and warm them up. They warmed quickly due to direct skin-to-skin contact.

[An aside here: Clearly, the brain and the hand are important structures in humans. With the Circle of Willis in the brain and the palmar arches in the hand providing redundant blood supplies, our bodies have gone to great lengths to protect these structures. Think about that. Discuss among yourselves.]

Toes are also subject to frostbite. I could argue that they are easier to live without, but instead I’ll argue that you should protect them. Wool socks, liner socks if it’s really cold (I use silk for less bulk), and warm boots are essential. The longer you are out, the greater your chances of losing parts. Consider hand and foot warmers (battery-powered, or chemical pads that release heat when exposed to air).

You’re out in the cold. You notice your fingertips are getting cold. DO something! Get inside if possible. Move (your body in general, your hands and feet in particular). Get your hands out of the wind. Make fists. Stick your hands in your pockets (with mittens on if possible) or in your armpits (without mittens). (Zip your jacket back up to preserve core heat.)

Did you fail to do any of those and your fingers stopped feeling cold? Did they stop feeling anything? If you squeeze your fingertip, is it hard and you don’t feel it? Are your fingers stiff? Warm them up!

Do NOT rub snow on them. Do NOT run hot or cold water on them. You are trying to rewarm them to body temperature. Use water about that temperature. Feel it with an unfrozen body part (like an elbow or another person’s hand), because your frozen fingers can’t tell how warm it is and you don’t want to burn them on top of the frostbite.

When the skin has turned white and the tissue has frozen, there is no blood supply. The tissue will die if not rewarmed. As it rewarms, it will hurt. Deep frostbite can cause lasting damage. If in doubt, get to a doctor, preferably a regional burn center.

Deep frostbite will blister. The skin will turn purple. It will look like a bad bruise. That is essentially what you have – damaged and leaky capillaries that allow blood to flow into the interstitial spaces and cause the skin to look purple; clots that prevent flow into and out of small vessels. From there, one of two things happens: either it slowly returns to normal color, or it turns black, mummifies, and eventually falls off (which is known as auto-amputation). I am not going to include pictures of any of this. If you really want to see that, Dr Google will show you pictures of what happens when you get deep frostbite. Suffice to say that I have worked with people with fingers that were amputated at the first joint, leaving nubs (which can be surprisingly functional, but I don’t recommend you try it), and with people who lost their fingers (and legs, for that matter) entirely. I’ve seen it so you don’t have to.

Deep frostbite requires a doctor’s care – in a hospital. For the first 72 hours we encourage the patient to move their fingers actively but, unlike burns, we don’t move them passively – that could cause further damage to deep tissues. After initial warming, the fingers will have to rewarm from the inside out. Medications can improve circulation and re-establish blood supply before tissue dies (like the treatment to cerebral arteries after a stroke, or in the lungs after a pulmonary embolism). The body will scavenge dead tissue. That process can cause further complications that you can’t manage by yourself.

Your fingers may stay purple for a while. The doctor will wait for them to “declare themselves”. It is not always clear what tissue will survive and what is dead.

Doctors do not want to amputate fingers that are only “mostly dead”. They don’t want to amputate dead fingers but leave some dead parts behind. They also don’t want to amputate too far and take parts that will heal. Once the fingers have “declared themselves” they will take the dead part and cut back to healthy, bleeding tissue so the residual limb will heal. Then the therapist will work with you to help regain function with partial fingers, help you learn to compensate for what is lost, and help reshape the residual fingers.

Obviously, you don’t want to have first-hand knowledge of most of this. That’s what I’m here for – to convince you to care for your body and keep all the parts.

Some call it “cross training”

I call it “fun”. My complaining about the snow ruining my skating lasted for less time than it took to shovel it.

I realized that 5 inches of fresh power called for getting out the skis, not complaining about not skating. That same giant park that works for ice skates works for skis as well.

I retrieved the skis from the garage, brought them onto the porch to warm up, scraped off the old wax, added a coat of Special Green (for 14 to -4 degrees F or -10 to -20 degrees C), and walked down to the lake. My old wooden touring skis are perfect for cruising through fresh snow.

I soon found I was over-dressed, as the temperature was almost in double digits (-13 C). I started across the lake on roughly the same route I skated last week, then decided on a change and turned west to ski the length of the lake instead of across. I needed to zip up my jacket to head into the wind.

My ski tips were submarine periscopes poking up through the powder. I was in a pristine wilderness on untrammeled snow.
Pristine wilderness, or downtown? State Capitol at right edge of photo.

I skied downtown with a stop at the convention center, a Frank Lloyd Wright design that only took 50 years of discussion to build.

Monona Terrace, the FL Wright-designed convention center

There were several other skiers, a few snowshoers, a handful of fat bikers (not bikers who are fat, but people riding fat bikes), and a fisher or two. I stopped and asked one, and he told me the ice was 8-12 inches thick – almost enough to drive a car on, plenty thick for skis.

Water expands when it freezes. It has to go somewhere. This is where the extra goes — up.

Another few inches are on the way tonight. With the temperature holding steady at 8 degrees (-13 C) it will be powder again, possibly enough to obliterate today’s tracks and make the park pristine, ready for fresh tracks.

Monday, 24 January

Three inches of new powder overnight heralded the leading edge of an Alberta Clipper. The temperature is up to 18 (-8 C) but the windchill down to -1 (-18 C). The warmer temperature meant adding some blue wax (23 to 31 F, or -5 to -1 C) for traction – blue because I couldn’t find or am out of green for the 14 to 23 range. The snow doesn’t care about windchill, but my windward cheek does. The temperature will be below zero by the time I go to work tomorrow.

I skied to the library. It being Monday I had the lake to myself. The only sounds were the schussing of my skis through the snow and the scratching of my pole tips across the ice. The light was flat and grey. The lack of contrast made the wind-driven waves hard to see and harder to photograph, but the snow had the contours of water on a windy day at the right angle.

Another shoreline ice heave

I skied from our neighborhood park to the beach, then walked to the library.

[Aside to MAK: I can’t disagree with you but, working in healthcare, I have to work the way your source works. When I walk into a patient’s room much of their backstory becomes irrelevant. One of my favorite patients (worked hard to rehab, was appreciative and polite, seemed like an all-around nice person) was charged with manslaughter. I have treated murderers. I have treated people who were shot in drug deals. I have treated people who drove drunk and killed their best friend or their child in the passenger seat. Like their vaccination status, that can’t matter while I’m in the room with them. My brain compartmentalizes that for me. It doesn’t seem to be a conscious process. You, on the other hand, don’t have that responsibility, and I applaud your rant from my position at home in front of my computer. I know that rant is no longer accessible but, to those of us who subscribe via e-mail, it arrived in our inbox. Thank you for speaking honestly. And if you like rants, check out this one: https://www.dailykos.com/stories/2022/1/21/2076138/-Is-Clarence-Thomas-the-most-corrupt-Supreme-Court-Justice-in-your-lifetime?detail=emaildkre ]

Snow

If you’ve looked at this blog more than once, you probably know I like sculpting in snow; one of the profile images is of a guy in my backyard.

And there’s this couple in my front yard

I went to a winter carnival last year to see the work of the pros.

I just read about a Finnish architect and his work sculpting on a frozen lake. These images are from the Twitter page of Pasi Widgren:

He does his work on a frozen lake, with a shovel.

No snow sculpting around here this week. I have my front door open, providing passive solar heat from the sunny, enclosed, south-facing front porch.