Mercury poisoning or hydrargyria occurs when the body is exposed to mercury or its compounds. Symptoms that are indicative of mercury poisoning are lack of coordination and visual/speech difficulties. There might be skin shedding, pigmentation and peripheral neuropathy. The intensity of the symptoms varies based on the exposure. Some persons exposed to mercury might notice difficulty in breathing, bad cough and metallic taste. There might be lung damage and brain damage, based on intensity of mercury inhalation. Once mercury exposure is identified, removal of the source is critical. The clothes, skin and eyes must be cleaned. Chelation therapy might be done on a person who has considerable mercury load in the body.
Diabetic Neuropathy is a nerve disorder caused by acute diabetes. Those suffering from diabetes for more than 20 years are more likely to suffer diabetes neuropathy. Abnormal blood fat levels along with long durations of diabetes are the usual cause of diabetic neuropathy. This condition manifests as weakness and numbness in the limbs. It can also affect the heart, digestive tract and genitals. Peripheral neuropathy is the most common manifestation of diabetic neuropathy wherein the limbs of the patient are affected. Autonomic neuropathy affects digestion, bowel and bladder function, sexual response and perspiration. There might be adverse effects on the heart and blood pressure. Focal neuropathy affects a single nerve in the wrist, thigh or foot. It can also affect the nerves controlling the eye muscles. Smoking and excessive consumption of alcohol may further increase the risk of diabetic neuropathy.
Patients suffering from promimal neuropathy experience pain the hips and thighs and weakness in the legs. Symptoms of diabetic neuropathy include numbness and tingling in the feet, legs and arms. There may be dizziness due to drop in postural blood pressure. Diarrhea, constipation and indigestion are common symptoms of diabetic neuropathy. Patients suffering from diabetic neuropathy may have erectile dysfunction or vaginal dryness. Treatment for diabetic neuropahty has to be individualized. Acupuncture or medications can relieve pain in the case of peripheral neuropathy. Persons suffering from diabetes must monitor blood sugar levels. Any foot problems must be attended to promptly.
Cold burn or Frostbite occurs when the skin is in touch with an extremely cold body. Extreme cold can cause damage to the skin and underlying tissues. For example, if there is a prolonged contact of the skin with moderately cold body like snow or very cold bodies like dry ice, liquid helium or liquid nitrogen for a brief period, cold burns or ice burns will occur. Here heat is transferred from the skin and organs to the cold body that is in contact. In other kinds of burns, the body that causes the burn is hotter and heat is transferred to the skin or the organ.
Symptoms of frostbite include pins and needles sensation and then numbness in the area. Initially there may be throbbing or aching. The affected part seems to become insensate. In severe frostbite, when the tissue starts to freeze, the skin at that area may appear white and numb. In areas affected by frost burn, abnormal accumulation of blood takes place. In addition to accumulation of body fluids, a blood clot may form thereby preventing blood circulation around the area resulting in tissue decay. Mottled and violaceous tissue is noticed. Normal functioning of the body is disturbed because of cooling of the internal organs, which will lead to a critical condition called hypothermia. Cooling of the brain or heart is very dangerous.
If hypothermia is noticed, treating it should be the priority. Blisters are noticed when there is very severe frostbite. Blisters are the result of expansion of the surrounding layers of the skin and the release of serous fluid or plasma.
The accumulated plasma in the blister is intended to prevent further damage and also to help in the healing process. To avoid infection from the blister, it is important that it is not punctured as it would expose the raw skin for further infection. The serous fluid will be reabsorbed by the skin usually after 24 hours if there is no infection.
Severe frostbite may also damage tendons, muscles, nerves and bones. Gangrene is inevitable in the case of very severe frostbite. Frostbite may affect any part of the body.
The most vulnerable parts are hands, feet, nose and ears. Recovery may be significant when the skin and underlying body tissues are injured and it may be permanent if there is injury to the blood vessels. If gangrene follows, the affected part may have to be amputated. When warming up of the affected part begins, the patient will experience intense pain. There will be tingling or burning sensation in the affected area also.
People taking beta-blockers that decrease blood flow to the skin and those who suffer Peripheral Vascular Disease are at risk when exposed to cold for a prolonged period. Any person who is exposed to extreme cold for a long period is susceptible to frostbite. Diabetes, peripheral neuropathy or Raynaud's phenomenon are some conditions that may have increased risk of cold burns. Smoking and windy weather when the rate of heat loss from the skin is more will hinder the healing process. Cold burns at the work place are common. People who work in factories where they may come in contact with metal surfaces that are at extremely cold temperatures are prone to cold burns. When the skin is moist, they may receive almost instantaneous cold burns.
Prevention of freeze burns
Extreme cold, wet clothes, high winds and poor circulation are some of the factors that can contribute to freeze burns. Tight boots or clothing and conditions like cramped positions, some medications, smoking or alcohol can cause frostbite. Wearing appropriate clothing in winter when the temperature goes below normal and will help. Winter clothes like mittens, layered clothing that is wind-proof and water resistant gives good protection.
First Aid for cold burns
It is essential that the ice burn treatment is correctly done as soon as possible.
Frostnip is the least severe form of cold injury that occurs after the distal extremities are exposed to prolonged period of cold but non-freezing temperatures. Vasoconstriction is felt. Frostnip is a precursor to frostbite and does not involve the same levels of tissue destruction. The affected area appears pale.
Immersion foot is a condition where there is severe tissue injury due to prolonged and persistent exposure to wet conditions, cold or hot. It results in tissue edema and inflammation. This is often seen in homeless persons who are exposed to the elements. The extremities appear swollen and erythematous (skin turning red often manifested in patches). Bad odor is often noticed as also tissue sloughing.
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Bibliography / Reference
Collection of Pages - Last revised Date: April 5, 2020