GN: help, condolences for Nunavut man facing amputation of his hands

Cambridge Bay’s Kitikmeot Regional Health Centre was built in 2005 for $20 million. (FILE PHOTO)

This is how Romeo Tucci’s frostbitten hands looked after large blisters had formed on the top and bottom of his hands. (PHOTO COURTESY OF C. TUCCI)

The Government of Nunavut will do everything it can to help a Cambridge Bay man who suffered severe frostbite to his hands in early March, a GN health official says.

That assurance came March 31 from Sandy McDonald, Nunavut’s chief of medical staff, who said that overall Nunavut is “very well equipped to deal with frostbite.”

Surgeons at the University of Alberta hospital in Edmonton plan to amputate Romeo Tucci’s hands April 5 due to the extent of the frostbite, which caused the now-blackened bottom portion of his hands to become infected.

“It will change his life forever,” McDonald said of Tucci’s injuries.

On the part of the health department, McDonald sent condolences to Tucci, adding that he hoped Tucci receives “the best care he can.”

Nurses and doctors prefer to see their patients get better, he said.

McDonald said frostbite is “a very common injury” in Nunavut, with its high wind chills.

But most of the frostbite seen among Nunavut residents is of the “first degree,” or minor in nature — such as you can see around every community in Nunavut where hunters often have dark frostbite marks on their cheeks.

The second or third degree types of frostbite are more rare in Nunavut, McDonald said, although he’s seen several people who have lost toes and at least one man whose legs were amputated due to frostbite.

Those more severe kinds of frostbite lead to blisters, much like burns of a similar severity do, he said.

When someone with frostbite comes into any Nunavut health centre, the staff follow a similar protocol designed to minimize further damage, McDonald said.

Tucci suffered frostbite to his hands while he was lost for six hours in a frigid whiteout near Cambridge Bay.

That whiteout, a weather condition in which visibility and contrast are severely reduced by snow, took place during a period in Cambridge Bay when Environment Canada said wind chills ranged between the upper minus 30s C to the low minus 50s C.

When Tucci was finally brought into the community’s Kitikmeot Regional Health Centre, his hands were frozen and grey, photos show.

Frostbite treatment in Nunavut includes warming of the body part for thawing, then offering anti-inflammatories, painkillers, and applying dressings and antibiotics to ward off infection until the state of the damage becomes clear, McDonald said.

“Everyone agrees you [first] have to warm the injured body part,” McDonald said.

In Nunavut, doctors and nurses would also be in touch with specialists in large health centres in the South.

“What we do depends on what the experts say, McDonald said — and if they recommend medevacing a frostbite patient south, that’s what takes place.

Tucci was in Cambridge Bay for nearly three weeks after his hands were frostbitten, before heading March 24 to Edmonton. During that time, his sister started an online fundraising campaign, to raise the money , then an amount of $4,500, that he was looking for to leave Cambridge Bay — this campaign has now changed its focus to raise money for expenses related to Tucci’s rehabilitation.

Often there is a wait-and-see period after frostbite to gauge if the damage is irreversible or not, McDonald noted.

But Nunavut health care centres wouldn’t be able to administer some treatments recommended to ward off amputation of limbs affected by frostbite, he acknowledged.

These include an intravenous dose of a tissue plasminogen activator — which, when administered within 24 hours of thawing, can decrease amputation rates — special whirlpool baths, physical therapy or access and hyperbaric oxygen therapy, which involves breathing pure oxygen in a pressurized room.

In-patient care following frostbite, also recommended for severe frostbite cases, is also only possible in Rankin Inlet and Iqaluit, although Cambridge Bay’s $20 million-health centre opened in 2005, with nine beds, which were designed to be for out-patient care.

Inuit traditional ways point to some other ways of dealing with frostbite.

“Up here in the North, there is no other way to treat frostbites and frozen limbs. You have to fight cold with cold,” said Johnny Uitangak of the Nunavik community of Puvirnituq, who goes into some detail about frostbite in his new book, “Panak, The Snow Book: A Handy Field Guide to the Principles of Snow,” which will be published in September 2016 by the Université de Québec à Montréal in French and Inuktitut.

Treating a frozen limb takes quite a bit of time and effort, said local historian Uitangak in his book, which he shared with Nunatsiaq News, the result of more than 20 years of experience on the land.

Uitangak says when someone has a frostbitten limb, it’s important to dip it in icy water, that is, in water that is extremely cold, with ice or snow, so cold that ice forms on the limb.

“Do not be alarmed if you see ice forming on the exterior of the frozen limb, it is a sure sign that the thawing process has started once you start to see ice forming on it. It can take a bit of time to thaw out all of the frozen limb, but the sure thing is, even the blood that had been frozen solid can start to flow freely again.

“That is the only way one can treat and save a frozen limb,” he states in his book, which has many recommendations for how to survive on the land, in the snow and cold.

When asked about that technique, McDonald said “we keep an open mind to traditional knowledge,” but that in dealing with frostbite “we go with the best evidence available.”

And right now, that starts with rewarming, he said.

But both western and traditional Inuit knowledge are in agreement that the prevention of frostbite remains the best cure.

The clothing worn by Inuit during winter were made in such a way so that no part of the body would get frostbitten, Uitangak says in “Panak.”

Wearing proper protective clothing in the cold is also included in advice from Environment Canada on how to avoid frostbite, which you can find here, which also warns that your body’s extremities, such as the ears, nose, fingers and toes, lose heat the fastest in extremely low temperatures.