Fever! Starve it? Feed it? Treat it? What to do?

Ok, what is a fever and why do we get them?  More importantly, what to do?  As with many health issues, the answer to the second question revolves around, “It depends.” Of course, there’s the old saw: Feed a cold, starve a fever.  Is that advice we can trust?

Let’s start with the “executive summary:”

  • Fever is NOT an indicator of illness severity
  • Treating with aspirin, or other salicylates, may be life-threatening  for children and teens
  • High fevers, between 103 F (39.4 C) and 106 F (41.1 C), can be life-threatening and require immediate treatment

What is a fever?

One section of the brain, specifically, the hypothalamus, is the body’s thermostat.  It manages its task via a complex mix of neurotransmitters which control metabolic rate, as well as, blood flow to muscles, skin and mucous membranes.  Infections cause the release of chemicals which the hypothalamus detects and responds to.  Interestingly, the response is not limited to raising temperature; in fact, one indicator for sepsis (a potentially life-threatening condition) is a sub-normal temperature.

Why do we get fevers?

What is the purpose of a fever?   Good question, and the answer is not completely understood.  Current thinking leans towards fever as a positive evolutionary response, and includes the thought that we might be better off letting a fever run its course.  The rationale is that the immune system is kicking-in to “high gear’ and is more effective at higher body temperature.  (Any competent chemist will tell you that reactions are often driven, and more efficient at higher temperatures, and virtually all of the body’s system are chemical in nature.)  There is also the thought that many pathogens are adapted to fairly narrow temperature ranges, and raising the temperature inhibits their growth and spread.  On balance, there are some pathogens that prefer higher temperatures, and themselves release the same temperature regulating chemicals in an attempt to drive the body to supply the conditions more favorable to them…

What should we do for a fever?

Well, if you’ve gotten this far, you’ve probably already come to your own version of “it depends.”  Definately, high fevers require treatment, and possible medical intervention.  But what about those garden variety fevers? My personal opinion is to let them run their course.  I come down on the side of the last million years of physiological evolution, and believing that Mother Nature often knows best.  Of course, if you’ve got a cranky, whining child, due in part to some of the other associated symptoms, such as aches and pains, then for the comfort of all involved, consulting with your medical provider and treating may be a rational and appropriate choice.

Feed or Starve?

According to an entry on the Duke Medicine site, John Withals wrote back in 1574, “Fasting is a great remedie of feuer.”  I’d suggest letting your own judgement take precedence: If you’re hungry (or your child is hungry), eat!  If not, don’t eat.  Basically, I believe our body sends appropriate signals in most cases.

NurseBobStay Well

References:

Disclaimer: This information is not intended to replace the advice of a doctor. NurseBob  disclaims any liability for the decisions you make based on this information.
Previously posted on www.crassparenting.com

 

NurseBob’s Back!!!

Ok, “later this week” stretched out a bit – to three weeks! My apologies!!!
I’ve been trying to manage both my home office “reorg” along with a work schedule that has impacted my blogging availability. I’ve discovered, and had to accept, that I am no longer the “twenty-something” who could get by on only four hours sleep day-in and day-out. Rather, I’m a “sixty-something” who needs to accept that I need at least six hours sleep, and also to recognize that a 150 mile daily commute on a motorcycle leaves me with little energy to do more than sit down and lie-back in a recliner at the end of the day, fianlly stumbling off to bed after my brain has slowed enough to drop-off to sleep.
So, what’s up? I’m starting a multi-segment episode on an aspect of end-of-life care for a loved-one. Namely, Total Parenteral Nutrition (TPN) – providing “food” for someone we love who has no chance of recovery. This is a challenging subject, and one that can not be addressed in a single segment. Starting today I will try to look at all the aspects of keeping someone alive as long as is medically possible. For the video version check out www.nursebob.org.

NurseBob