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Monday, June 18, 2012

Don't fear the fever

*Cue the Blue Oyster Cult soundtrack...*

A few days ago my daughter went to bed with a stomachache (nothing highly unusual for her, since without her bran flakes, she gets kind of constipated). Anyway, by Saturday afternoon we were running a high fever (103.5) and a mystery rash appeared that night. Panic! No, wait, don't panic. I love Dr. Sears - not only because he's a dad of a small army - but because that's the first thing he says: "Don't panic!"

Due to an earlier outbreak of something mysterious when my oldest was about her age, I knew a little bit about fevers - enough to know, in my copious reading, that fever is not always a bad thing. After all, it's the body's natural defense mechanism against invading germs, and therefore I only give fever reducers sparingly now - like only if they're horribly miserable. Even then, fluids and an early bedtime usually does wonders.

Anyway, I was beginning to freak out, because yes, that does seem high. She started throwing up Sunday, and while it wasn't every 20 minutes or anything, it was concerning. And there was that rash. I wondered: she had strep throat last fall, could it be scarlet fever? Hand-Foot-And-Mouth Disease? Chicken pox? I jumped with glee a little inside at the thought of that, because she's only had one shot - and after all, chicken pox is a "normal childhood illness." (Depending on who you ask, anyway... more on that later.)

Of course, being the dummy that I am, I posted a message on Facebook: something about misery, a high fever and prayers (perhaps not so much for her, but for my sanity, as I had concurrently had a three-year-old regressing in toilet habits all day long thanks to one too many bran muffins. Never again.) Anyway, it wasn't long before my mom called. All in a tizzy, of course.

I reassured her we were fine, we were dealing with it, keeping an eye on her, and that was it. We exchanged mutters and disgust over the chicken pox vaccine and how really, it's better to just get the actual illness, stuff like that. Then we hung up.

I had done my research, was confident that yes, I was doing the right thing. My husband encouraged me to stop worrying and get out of the house. I took a nap. I went swimming. I even enjoyed it.

Later, she called me back. In an even bigger tizzy. This time she'd talked to my well-meaning but totally drinking the KoolAid nurse relatives who thought, along with the bombastic, condescending, interrupting fill-in on-call pediatrician, that she should be taken in. I started to feel the panic rise up again, the second-guessing: Was I doing the right thing? Was I being stupid? She had done her share of Google searches, as I had, and came up with even stranger results: all I remember was something about typhoid fever. Seriously? I pictured in my mind a quick visual of Typhoid Mary cooking over a hot stove, shedding her virus into everyone's food, then snapped back to reality. "Mom, it's not typhoid."

"Well, it's 104. What about those bugs you have?"

"Mom, it is not 104. And those bugs are Mayflies. They're dead now - they go away at the end of May. And don't you remember when Oldest Kid had a fever of 104 for a few days? Afterwards I talked to the pediatrician and he thought maybe it was swine flu - and I didn't even know to be freaked out and panic, we just treated it!"

We've had conversations before, interestingly, about how my close relative who happens to be a nurse thinks medicating for everything is necessary and always a good idea; sort of "if it's there, you might as well use it" approach. I don't disagree that sometimes it is a good idea, but when people are overdosing their children on Tylenol, you come to realize that our medical culture definitely has a "more is better" approach, which is probably more dangerous in the long run than just monitoring and caring for the child in the first place.

I still remember some movie - not even sure what it was - where a mom is worriedly hovering over her young child, who is running a very high fever. Fast forward to the hospital - she's in an ice bath (the last thing you want to do, apparently), there's an angel coming to take her away kind of deal, and that's all I remember. I don't think I was even a mom yet, but of course it freaked me out - kids are sick, no one knows what's wrong, kids are dying, I can't watch this anymore. Of course, that scene is the first thing I think of when my child's fever gets high. Wonderful.

When you think about it, what is a fever, exactly? The medical community thinks that it's the body's response to get rid of an invading bacteria or virus. In some ways, fevers are kind of misunderstood and much maligned, which causes us to run around and panic more than anything else. So if it's the body natural response to fighting illness, which is just built right in (in most people, that is, unless your immune system is compromised), what does constantly throwing a fever reducer do to it? It lowers the body's natural defenses, letting more invaders in!

Doubling up on Motrin and Tylenol? Even worse. If a fever doesn't respond to either, then perhaps it's some cause for a call to the doctor - but when you douse it with both at one time, those "stubborn fevers" are just going to get even more stubborn - in fact, they may actually prolong the illness. Just what you always wanted, right?

Now we're seeing more variant strains of chicken pox (yes, even with vaccination!), scarlet fever and Coxsackie virus - that produce unusual symptoms. Could this be from gradual overuse of fever reducers? Who knows. But every time your child runs a fever, you could be thwarting the body's own natural defenses by not giving them half a chance to do their job, which leaves a child perhaps even more vulnerable to these new strains that keep showing up.

And with regards to Coxsackie virus, look for signs, be vigilant about watching temps and all that stuff - but please! Do yourself a favor and do not go all crazy with media reports - because they are going to make you psychotic with worry. There have been deaths from things like chicken pox, coxsackie virus, H1N1, etc. - and I wonder: were they using fever reducers? In the case of Swine Flu, it can actually increase the risk of death if you use it, which sounds contrary to what our government and health professionals tell us.

Even the American Academy of Pediatrics (FTW this time!) says "fever is good for you" and that the media (and just about everyone, it seems) has a "fever phobia." You'll probably notice this quickly - that stupid movie I watched didn't even treat it correctly. An ice bath is not recommended, because it can cause shivering, which actually raises the body's core temperature. And as far as brain damage is concerned, that generally happens around 107.6 degrees. What a difference a few degrees makes, huh?

More reading:
Scarlet fever on the rise
H1N1 and Fever Reducers: A Deadly Combination
Atypical strain of coxsackievirus caused outbreak of HFMD in four states
Pediatric Parenting Myths: Fever is Bad for You
Fighting Fever Phobia: The AAP


tanc(z) said...

so what happened to the fever and the rash after all?

Anonymous said...

I have kids that get crazy high fevers. 104-105 is not at all usual around here. I count my blessings that they have good reactive immune systems unlike their mother who has managed fevers over 100 a handful of times in my life despite dozens of raging ear infections and tonsils and lymph nodes so enlaraged the ENT was concerned I had cancer.
I am MUCH more concerned about how a child is acting than by what the thermometer says. A child with a 100.5 who is listless, not drinking, not eating, crying a lot etc....bothers me a WHOLE lot more than a kiddo with a 104 who is complaining of being hot and maybe has a headache but is otherwise acting normally. The only time a fever had me upset was when it was in my 4 day old baby. I knew what it meant and cried all the way to the ER. Thankfully the ER doc was a mom too and didn't make me feel bad for sitting there all teary while I watched them stick my perfect little boy with needles and catheters and bend him in half for a lumbar puncture.He had viral meningitis. I medicate my febrile kids so they can sleep comfortably and stay hydrated. I don't medicate very much during the day.

The Deranged Housewife said...

Tanc(z), I'll have to write up a separate post about that adventure. *sigh* But we survived it and are doing well. More later.