From: ((Steven B. Harris)) Newsgroups: sci.med Date: 10 Nov 2002 17:47:45 GMT Subject: Re: Lower Your Fever and Stay Sick Message-ID: <20021110124745.20315.00000073@mb-da.aol.com> ><< Subject: Re: Lower Your Fever and Stay Sick >From: "Wyle E. Coyote, M.D." kidsdoc2000@hotmail.com >Date: Sat, Nov 9, 2002 7:59 AM >Message-id: <1CA34637DEA943B9.31B9BD41F6BC8167.E91AAB985A69EAAE@lp.airnews.net> > > >"aussiefi" <aussiefi@hotmail.com> wrote in message >news:B9F355B8.32E56%aussiefi@hotmail.com... >> I have a daughter who has suffered febrile convulsions. As a parent these >> are not nice to watch. A blanket statement saying that fever is a defence >> mechanism is fine, but in young children fever can so easily lead to >> convulsions. Get to know your child's normal temp and if it is only mildly >> up then perhaps consider leaving it, but if the child is seriously febrile, >> at least get a dr to check on him/her.\ > >Actually, if the fever is already up, chances are that the child will not >have febrile seizures. These seizures (which, as far as doctors can tell are >basically harmless -- despite how scarey they are) appear to occur mostly as >the fever is increasing, not once the fever is there. I would not recommend >giving any child any drug just because the child has a fever. If the child >is runnign just fine with a temp over 101, but feeling ok, I wouldn't do >anything. > >But, as always, talk to your doctor. COMMENT: Correct. Febrile convulsions seem to be more connected to the shivering (motor tetany and tremor) response that raises body temp to cause the fever, than they are to true epilespy. Thus the lack of brain damage. We badly need prospective placebo controlled studies of febrifuges. It's a terrible shame they haven't been done yet, and amunition for the critics of the present "all drug research done by drug companies" system. We know from studies in reptiles that fever is essential for immune activation, but in mammals all we have is retrospective epidemiology, which isn't very convincing. Plus some interesting old time fever therapy treatments for things like tertiary syphilis, from the era before penicillin. They were tested scientifically and they did work. And there is no question that fever activates the immune system, so mechanistically it does seem dumb to suppress it during an illness. I've always discouraged it as a routine measure. Not only are you perhaps messing with host defenses, but you also rob yourself of important clinical information you need in deciding how long to extend antibiotic treatment in bacterial illness, or close monitoring and care in viral ones. That said, the idea that the "drug free" anternative scum get any credit for coming to the same conclusion, is laughable. Even a stopped clock is right twice a day, as Lincoln used to say. These are the same people who are against morphine and other painkillers, anasthetics, antiseptics, antibiotics, and vaccines. In other words, they are completely clueless. Steve Harris From: "Steve Harris" <sbharris@ix.RETICULATEDOBJECTcom.com> Newsgroups: alt.parenting.solutions,misc.kids.health,sci.med,sci.med.pharmacy Subject: Re: Lower Your Fever and Stay Sick Message-ID: <SSfA9.1499$Bh1.127654@newsread1.prod.itd.earthlink.net> Date: Tue, 12 Nov 2002 23:09:38 GMT CBI <00doc@mindspring.com> wrote in message ... >I'm not sure I see that it [fever] makes any difference. A lot of the >"lousy" that the Tylenol is treating is the myalgias and arthraligias >more than the temp. I think it is useful to have some idea initially that >the kid is having temps and roughly how high they are but don't see much >use in repeatedly measuring it - especially when it leads to the >temptation to medicate the fever rather than the symptoms. COMMENT: And to make things complicated, some of the classic symptoms of febrile illness, myalgias in particular, may be caused by simple muscle soreness from excentric exercise, to wit: shivering. People with flu don't come down with severe muscle/body aches at the same time they first come down with the malaise and headache, in my own experience, but rather they come down with them after at least a day or so of shivering with fever. I think they are mostly due to the shivering, and if that's prevented by letting the patient warm himself in the bath, the body aches are far more mild, or do not occur at all. ARTHralgias, which are pains in the joints, are a much rarer phenomenon, and are not a classic manifestation of endogenous pyrogen, or febrile illnesses in general. MYalgias are. I find that suspicious. Now, it is known that endogenous pyrogens cause muscle protein catabolism and the rise of inflammatory factors like pgE2 in muscles, even without shivering. And it's been suggested that this causes the muscle pain. But it hasn't been proven, and I personally think this story is either wrong, or else more complicated. After all, even DRUG reactions that cause drug-fever, also cause myalgia. Not arthralgia. No infectious organism is even needed. SBH Chest 1989 Sep;96(3):688-9 Related Articles, Links Previously unreported adverse reaction to encainide. Goli-Bijanki R, Nair CK, Nair N, Sketch MH Sr. Division of Cardiology and Allergy-Immunology, Creighton University School of Medicine, Omaha, NE. We describe a patient with recurrent atrial fibrillation who suffered a previously unreported adverse reaction to encainide therapy manifested by fever, chills, diaphoresis and myalgia. The patient had a similar response upon rechallenging with encainide, which resolved on discontinuation of therapy. PMID: 2504544 [PubMed - indexed for MEDLINE] -- I welcome email from any being clever enough to fix my address. It's open book. A prize to the first spambot that passes my Turing test. From: "Steve Harris" <sbharris@ix.RETICULATEDOBJECTcom.com> Newsgroups: alt.parenting.solutions,misc.kids.health,sci.med Subject: Re: Lower Your Fever and Stay Sick Message-ID: <2sTz9.6901$Aq5.731710@newsread2.prod.itd.earthlink.net> Date: Mon, 11 Nov 2002 19:22:38 GMT D. C. Sessions wrote in message <0ahnqa.hht.ln@news.lumbercartel.com>... >You're more aggressive than I (or others) are. >Feeling lousy -- including direct fever-induced lousy -- is >OK as long as it doesn't get into other, recovery-impairing, >modes such as sleep loss. I'd consider a temp where the >pt. starts having chills to be well up into the "requires >management" range, though. ------------- Comment: And the management of viral chills and rigor is a warm shower or bath till your temp goes up, and the chills go away. "Chills" don't mean you have a fever, they mean you're *trying* to run one (or raise your body temp). You're only uncomfortable while they occur, and the faster you help your body do what it's attempting to do, the faster the chills, rigors (shivering), and feelings of cold go away. Once you warm up to your hypothalamous reset point, you usually are no more uncomfortable than you'd be in a warm bath, hot beach, or Florida vacation. Which is not so uncomfortable you need a pill which may interfere with your ability to fight your virus. Geez, it's becoming clear from this discussion that there are lots of people who don't understand the basic physiology. Fever is a RESULT of chills and rigor/shivering. These can be unpleasant, but they aren't necessary if you know what you're doing and use your warm water. Fever itself is really not that unpleasant. SBH -- I welcome email from any being clever enough to fix my address. It's open book. A prize to the first spambot that passes my Turing test. From: "Steve Harris" <sbharris@ix.RETICULATEDOBJECTcom.com> Newsgroups: alt.parenting.solutions,misc.kids.health,sci.med Subject: Re: Lower Your Fever and Stay Sick Message-ID: <q7fA9.1389$Ta6.138213@newsread2.prod.itd.earthlink.net> Date: Tue, 12 Nov 2002 22:19:02 GMT CBI <00doc@mindspring.com> wrote in message ... > > > >"Steve Harris" <sbharris@ix.RETICULATEDOBJECTcom.com> wrote in message >news:2sTz9.6901$Aq5.731710@newsread2.prod.itd.earthlink.net... >> >> Geez, it's becoming clear from this discussion that there are lots of >> people who don't understand the basic physiology. Fever is a RESULT of >> chills and rigor/shivering. These can be unpleasant, but they aren't >> necessary if you know what you're doing and use your warm water. Fever >> itself is really not that unpleasant. >> > >I think it is a lot easier to wrap yourself up in a warm blanket than to >take 4 or 5 showers a day - especially the part where you get out dripping >wet in a drafty bathroom. > >-- >CBI It's easier to keep yourself warm with a blanket AFTER you get the temp up. But it's a long and time-consuming process to heat a body from the outside in, as you may know from studies on warming hypothermia victims. All a blanket really does is cut down on heat loss while continued shivering does the real job of raising your temp, and that can take half an hour. You can stop all that in about 2 minutes in a warm bath. If you get yourself a degree or two over you set point, you don't cool enough while toweling and dripping (60 sec) to make any difference. Any more than you get a chill from toweling yourself after a dip in a hot tub. SBH -- I welcome email from any being clever enough to fix my address. It's open book. A prize to the first spambot that passes my Turing test. From: "Steve Harris" <sbharris@ix.RETICULATEDOBJECTcom.com> Newsgroups: alt.parenting.solutions,misc.kids.health,sci.med Subject: Re: Lower Your Fever and Stay Sick Message-ID: <ixgA9.1505$Ta6.152513@newsread2.prod.itd.earthlink.net> Date: Tue, 12 Nov 2002 23:54:54 GMT D. C. Sessions wrote in message ... >No argument about chills being the body attempting to raise temperature. OTOH, when someone has reached steady state with plenty of insulation and is *still* having chills,<< That shouldn't happen unless somebody is trying to run a fever over 104 F (40C), which is the limit of the temp you want your bath or hot tub at. And of course, there are very different rules about applying this to a child too young to say they are cold or chilled or too hot (not a good idea), and children of (say) school age on up. Plenty of school age kids hot-tub with their parents, and despite some grumbling from the authorities, I know of no good evidence that so long as the water temp is under 104 F, that this is unsafe. If you have your head/scalp out of the water, you'll never make it up to water temp in any reasonable time, anyway. For babies and toddlers, I'm not recommending hot bath therapy for chills at all. >>you can either lay on artificial heat (dangerous in itself) Only if your water is over 104 F (you can measure the temp with the same thermometer you use for yourself). >>or lower the body's thermostat because sustained chills are will pretty fast fatigue anyone, and *that* isn't good for recovery either.<< Agreed. But if you are otherwise in good health and you are mobile and not mentally impaired, and your body wants to run a temp of up to 104 F because you have some virus like the flu, then let it. Indeed, you'll be more comfortable is you ASSIST it. SBH -- I welcome email from any being clever enough to fix my address. It's open book. A prize to the first spambot that passes my Turing test. |
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