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]


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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

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I welcome email from any being clever enough to fix my address. It's open
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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
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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.