foot infections on the Grand

My trip in fall 2007 one guy ended up with a serious infection that started in his feet. Poor guy got sunburned really bad on his feet in Marble Canyon. I guess there's something to be said for putting on the sunscreen before deciding to make it a ten beer morning...

Anyhow he got this weird heat rash, which he said was typical. He had to keep his feet in the water or they itched like mad. It was a big group and like most trips there's some folks you just don't talk to or pay much attention too... Sure I noticed that he would haul a bucket up and sit in his chair with his feet in it it every night, in November, but he didn't complain once that I heard. Tough son of a gun. He made it out without evac but I guess he was bed ridden and on serious antibiotics for a long time. Wish I had more details for you but I never heard from him again.

Cold Urticaria is an interesting thing, but it is not Grand Canyon "Tolio". Tolio is an infection:

What about Tolio?
According to Dr. Tom Myers, "Tolio" is a condition that impacts river runners causing skin lesions typical of chilblains, also termed pernio or immersion foot. Dr. Myers notes cold and wetness cause this painful condition.
According to Myers, biopsies have shown Tolio is not a primary bacterial, fungal, or viral disease, although there can be secondary bacterial infections. The condition is not contagious person to person. The textbooks describe chilblains as itchy, burning, painful blisters of violet color taking up to three weeks to clear.
Interestingly, Myers notes some people are obviously more susceptible than others and repeat cases are common. Dr. Myers and Dr. Walt Taylor did a study of Tolio, and these doctors feel that the cold water temperatures and relatively long time frame of Grand Canyon river trips make the condition more common than on other rivers. The roles that sun, sand, minor dings, prolonged sitting and water quality factors all play a role in this condition.
What can one do to avoid or minimize this problem? Myers notes first and foremost, take good care of your feet! Try to avoid sunburn especially on the first trip each season.
Use a potent waterproof sunscreen frequently before getting red or sore. One could wear kayak boots or river socks or the like.
Wiggle your toes and move your feet a lot so they are not just stationary in the water on the floor of your boat.
Keep your feet clean and the skin well hydrated by using Super Salve, Bag Balm, Lubriderm, Vaseline Intensive Care Lotion or some similar goop in camp daily.
Do not soak your feet in the river. It may numb the pain, but it makes the condition worse.
Anti-inflammatory agents may help the pain.
Steroids may help the symptoms, but of course, have numerous problem side effects when taken orally.
Antibiotics help only if there’s a secondary bacterial infection.
Our Thanks to Dr. Tom Myers for letting us use this information!

Thanks to RRFW web page where I copied this from. Hope you don't mind Tom Martin!

Montana Cat 65 said:

I did a little research on this a couple of years ago after a friend had a bad case of Tolio. There's a lot of speculation and possible misinformation on the internet (who knew?). This link seemed to have the best-researched information: BQR - winter 1999-2000 - "Tolio" Revisited

Click to expand...

Have they followed up in the intervening 15-ish years? It seems like people are experiencing several different issues in the Grand. If its this "folio" then its not a bacterial infection and should benefit from cortisone creams, etc. But it seems like some folks are benefiting from topical antibiotic that hints at an altogether different issue, unless the Grand just seems conducive to the secondary infections the pdf author mentioned.

I always thought what I experienced, which was worse than home but mild in my book, was athlete's foot. The pocking, redness and other symptoms happen on most rivers in the desert when my feet are consistently wet. It never lasted more than a week and has never been all of that painful for me. But I can't imagine having constant pain in my feet in the Grand, ouch.

Phillip