DEAR DR. DONOHUE: My father emigrated from the Soviet Union after World War II. As a young man, he lost three fingers to frostbite, but he didn’t like to talk about it. I live in a region that has harsh winters and often wonder about frostbite. How do you treat it? – O.S.

ANSWER: Frostbite is an apt term, as ice crystals actually form in the tissues where it happens. The crystals do some of the damage, as does a loss of water from affected cells. However, the greatest amount of damage comes from the disruption of blood supply to the frozen area.

Frostbite can happen anytime the temperature is below 32 F (0 C). It can happen at higher temperatures when the wind is blowing hard. Fingers, toes, hands, feet, chin, nose and ears are the most exposed parts of the body, and they are the ones most likely to be frostbitten.

Frostbitten skin should be warmed in a water bath with a temperature between 99 and 102 F (37 to 39 C). Don’t begin the rewarming process if there’s a chance of refreezing, which causes greater damage than the first freeze.

With first-degree frostbite, the skin turns red and swells, and people complain that it hurts. Rewarming the skin brings about full recovery.

In second-degree frostbite, the skin becomes white, and people feel little pain. In about 12 to 24 hours, blisters appear and even three to 10 days after recovery, the affected area still throbs and aches but should be functional.

In third-degree frostbite, the entire depth of skin is frozen and is black and dry. This degree of frostbite generally indicates loss of the skin and frozen tissues.

If you’re interested in a small book packed with information on cold injuries, take a look at “Hypothermia, Frostbite and Other Cold Injuries” by Gordon Giesbrecht and James Wilkerson, printed by The Mountaineers Books.

DEAR DR. DONOHUE: What makes a runner fast? I’m a good basketball player, but I could be a very good one if I could run faster. I’m an excellent shooter and a good defensive player, but it takes me forever to get down the court. My dad told me to write to you. – J.P.

ANSWER: Your coach is the one to talk to.

Athletes increase running speed by increasing stride frequency (the number of times the feet strike the ground every minute), by increasing stride length (the distance between left and right foot strikes) or by doing both.

Practice is the only way to make a new running form comfortable and natural.

Stride length is the more important ingredient in speed. You have to experiment. If you try to take too long a step, you’ll throw yourself off-balance.

DEAR DR. DONOHUE: I am a 47-year-old female who wishes to improve my overall fitness. I strength-train three times a week, and I perform two sets of 10 repetitions. This causes me to be fatigued, but I don’t reach failure. A book I read states that a person must reach failure or that person is wasting her time. My muscle definition is improving with this program. I am confused. – C.A.

ANSWER: You’re achieving the goals you set for yourself, so stick with your program.

“Failure” means the inability to perform one more lift. If you are striving to win a body-building contest or trying to qualify for Olympic weightlifting, then exercising to failure takes on importance. For you, it’s not such a big deal.

DEAR DR. DONOHUE: I lift weights three days in a row and then run three days in a row. I like doing things this way. What do you think of the program? – M.H.

ANSWER: If you don’t use the same muscles in weightlifting on consecutive days, the program is OK. Unusual, but OK.

DEAR DR. DONOHUE: Trips to the bathroom interrupt my sleep. I am a 79-year-old woman. I have to get up about twice every night. My doctor has examined me a number of times and finds nothing wrong with my kidneys or bladder.

I don’t lose urine during the day, and I don’t have to go to the bathroom frequently. What’s going on at night? – P.V.

ANSWER: In younger years, daytime urine production is greater than nighttime production. In older ages, the reverse occurs. While up and about during the day, fluid escapes from circulation in older people and finds its way into tissue spaces. At night, when people assume a horizontal position, the tissue fluid returns to the circulation. The kidney senses that the circulation has become overloaded with water and promotes urine formation.

Wearing support hose during the day keeps this from happening. Cut way back on your salt intake, and don’t drink much fluid after 5 p.m. – two other preventive steps.

This information doesn’t apply to all older people. Older men have to get up to empty their bladders because of an enlarged prostate gland. Many older women have to do the same because of a fallen bladder or an overactive bladder.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com

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