By Andy Sully
BBC News
Wellies packed? Glastonbury starts this weekend and prayers are being said for good weather. Because last year's mud bath resulted in trench foot for some.
Every year I can, I go to the Glastonbury Festival and pick up a T-shirt or two as a memento. But last year's souvenir was unexpected and certainly unwelcome. I came home with trench foot.
Muddy festivals are no surprise, but 2007 Glastonbury was something else. The rain barely ceased for a moment and site conditions resembled the Battle of the Somme - with added music.
And it's all this water and cold mud that cause the condition, which gained its common name from the trench warfare of World War I.
Trench foot - or Immersion Foot as it is more properly known - occurs when blood vessels restrict their flow to extremities to conserve heat for the body.
"There is a lack of oxygen and nutrients to the feet, and tissue and nerve damage can occur within 24-48 hours," says podiatric surgeon Kaser Nazir.
"The amount of damage can vary. In the first stage the feet are red and numb, then you get a swelling and tingling, itchy pain and finally blisters, which can become infected, and break out in ulcers."
Left untreated, it can lead to amputation - and even death.
Plastic bags
The condition has bedevilled soldiers since it was first noted during the Napoleonic Wars - and at one point in WWI it affected 20,000 British soldiers on the front, seriously hampering the winter 1914 offensive.
FESTIVAL FOOT CAREMore recently, doctors tend to see the condition in builders, security guards, hikers, extreme sports enthusiasts and festival goers.
Podiatrist Amber Kibby is a trustee director of Festival Medical Services, a charity which provides medical services at Glastonbury. Its 13 festival podiatrists are familiar with the symptoms of trench foot.
"The team started its work in 1998, which was the worst year for trench foot. We were seeing approximately 90 cases a day. Over the years, we have seen less and less of the condition. On the whole people are better prepared and they bring socks and wellies, they understand that there will most likely be mud."
Most cases involve someone who came in trainers or walking boots, who got their feet wet and continued to wear their soggy footwear.
"Sometimes people put plastic bags over their wet socks, which traps the moisture and encourages trench foot," she says.
In my case, problems began when my sensible wellington boots split. At night, I removed my ruined wellies and soaked socks, but a badly leaking tent meant I woke up in a small lake.
And it was not until a fortnight later that the swelling and the discomfort forced me to seek medical aid. Despite this delay, I avoided the secondary infections that can result when maceration - white, wrinkled waterlogged skin - is severe.
Trench foot feels much like repeatedly stubbing your toes. My feet reddened. And one nail came off, but grew back after a few months.
Air the feet
WWI soldiers were given whale fat to rub on their feet to try to stave off the condition, but treatment has advanced a little since then.
At the festival, the team of podiatrists treat the condition with a potassium permanganate footbath, which draws fluid out of the affected area. Then they apply an anti-bacterial and anti-fungal dressing.
Antibiotics and anti-inflammatories also help alleviate the symptoms, and sufferers must avoid tight footwear and allow their feet to "air" as often as possible.
I also found that alternating between cold and hot footbaths brought the feeling back to the soft tissue.
Avoidance is by far the best course of action, says Mr Nazir, as trench foot typically takes three to six months to heal.
His advice to festival-goers? "Avoid too tight or too loose footwear, don't sleep in wet shoes or socks, use talcum powder - but avoid 'clumps' of powder forming - and gently rewarm cold feet, rubbing to stimulate the circulation."
He also recommends polypropylene sock liners - these draw moisture away from the skin - or coating dry feet with Vaseline to repel water.
And don't forget those wellies. Even if the forecast is for sunny weather.
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