Fever
Fever
26 Coping Tactics
"Man, are you hot!"
In some circles that's quite a compliment. At the moment, however, it's just a cold, hard fact: Your temperature's up, and you are quite uncomfortable. Right now, compared with you, the devil is a real cool dude. But before you take steps to douse the fire, listen to what doctors say.
Make sure you actually have a fever. Although 98.6°F is considered the norm, that number is not etched in stone. "Normal" temperature varies from person to person and fluctuates widely throughout the day. Food, excess clothing, emotional excitement, and vigorous exercise can all elevate temperature, says Donald Vickery, M.D., a corporate-health consultant and assistant clinical professor at Georgetown University School of Medicine. "In fact, vigorous exercise can raise body temperature to as high as 103°F. Furthermore, children tend to have higher temperatures than adults and greater daily variations.
"So here's a general rule: If your temperature is 99° to 100°F, start thinking about the possibility of fever. If it is 100° or above, it is a fever," he says.
Leonard Banco, M.D., an associate professor of pediatrics at the University of Connecticut School of Medicine, adds that often a person's appearance is a better indicator of his condition than hard-and-fast numbers. "A child with a raised temperature who looks ill needs attention sooner than one who looks and acts well."
Don't fight it. If you do have a fever, remember this: Fever itself is not an illness—it's a symptom of one. In fact, it's one of the body's defense mechanisms against infection, says public-health authority Stephen Rosenberg, M.D., an associate professor of clinical public health at Columbia University School of Public Health. And fever may even serve a useful purpose: shortening an illness, increasing the power of antibiotics, and making an infection less contagious. These possibilities should be weighed against the discomfort involved in letting a slight fever run its course, he says.
If you feel the need for extra relief, try the following steps.
MEDICAL ALERT
Know the Danger Signs Donald Vickery, M.D., recommends that you see a doctor for: - Fever in a child less than 4 months old.
- Fever associated with a stiff neck.
- Fever above 105°F if home treatment fails to reduce it at least partly.
- Fever above 106°F under any condition.
- Fever that lasts more than five days.
Stephen Rosenberg, M.D., warns that in children under 6 an oral temperature of 102°F or higher can trigger convulsions. And adults with chronic illnesses, such as heart or respiratory disease, may not be able to tolerate prolonged high fevers. |
|
Liquefy your assets. When you're hot, your body perspires to cool you down. But if you lose too much water—as you might with a high fever—your body turns off its sweat ducts to forestall further water loss. That makes it more difficult for you to cope with your fever. The moral of this story: Drink up, mateys, or your ship will be sunk. In addition to plain water, doctors favor the following.
Fruit and vegetable juices. These are high in vitamins and minerals, says nutrition counselor Eleonore Blaurock-Busch, Ph.D., president and director of Trace Minerals International in Boulder, Colorado. She particularly favors nutrient-dense beet juice and carrot juice. If you're thirsty for tomato juice, notes pharmacology professor Thomas Gossel, Ph.D., R.Ph., chairman of the Department of Pharmacology and Biomedical Sciences at Ohio Northern University, choose one that is low in sodium.
One doctor's botanical tea. Although any tea will provide needed fluid, several are particularly suited for fever, says Dr. Blaurock-Busch. (Look for the following unusual botanicals in health food stores.) One mixture she likes combines equal parts dried thyme, linden flowers, and chamomile flowers. Thyme has antiseptic properties, chamomile reduces inflammation, and linden promotes sweating, she says. Steep 1 teaspoon of the mixture in 1 cup of boiling water for 5 minutes. Strain and drink warm several times a day.
Linden tea. This tea by itself is also good, she says, and can induce sweating to break a fever. Use 1 tablespoon of the flowers in 1 cup of boiling water. Prepare as above and drink hot often.
Willow bark. This bark is rich in salicylates, which are aspirin-related compounds, and is considered "nature's fever medication," says Dr. Blaurock-Busch. Brew into a tea and drink in small doses.
Black elder. Another old-time fever treatment, black elder is preferable to willow bark if you can't tolerate aspirin, she says. Again, brew into a tea and drink as desired.
Ice. If you're too nauseated to drink, you can suck on ice. For variety, freeze fruit juice in an ice-cube tray. To entice a feverish child, embed a grape or strawberry in each cube.
Get compressed relief. Wet compresses help reduce the body's temperature output, says Dr. Blaurock-Busch. Ironically, she says, hot, moist compresses can do the job. When the patient starts to feel uncomfortably hot, remove those compresses and apply cool ones to his forehead, wrists, and calves. Keep the rest of the body covered.
But if the fever rises above 103°F, she says, do not use hot compresses at all. Instead, apply cool ones to prevent the fever from getting any higher. Change them as they warm to body temperature and continue until the fever drops.
Sponge off. Evaporation also has a cooling effect on body temperature. Philadelphia, Pennsylvania, nurse clinician Mary Ann Pane, R.N., recommends cool tap water to help the skin dissipate excess heat. Although you can sponge the whole body, she says, pay particular attention to spots where heat is generally greatest, such as the armpits and groin area. Wring out a sponge and wipe one section at a time, keeping the rest of the body covered. Body heat will evaporate the moisture, so you don't need to towel off.
Doctors warn that although alcohol evaporates more rapidly than water, it can be uncomfortable for someone with a fever. What's more, there's the danger of inhaling the vapors or even absorbing them through the skin.
Thermometer Ins and Outs Your mother could gauge your temperature just by feeling your forehead. If you didn't inherit the knack—or if you don't have much confidence in this hands-on approach—you'll need to rely on thermometer readings. Here's how to get the most accurate results: - Before using a glass and mercury thermometer, hold it by the top end (not the bulb) and shake it with a quick snap of the wrist until the mercury is below 96°F. If you're concerned about dropping and breaking the thermometer, do this over a bed, says Stephen Rosenberg, M.D.
- Wait at least 30 minutes after eating, drinking, or smoking before taking an oral reading, he says. These activities alter mouth temperature and will cause inaccurate readings.
- Place the thermometer under your tongue in one of the "pockets" located on either side of your mouth rather than right up front. These pockets are closer to blood vessels that reflect the body's core temperature.
- Hold the thermometer in place with your lips, not your teeth. Breathe through your nose rather than your mouth, so the room temperature doesn't affect the reading. Leave the thermometer in place for at least 3 minutes (some experts favor 5 to 7 minutes).
- In children under 5, take rectal readings rather than oral ones. Rectal temperature is generally 1 degree warmer than oral. Recognize rectal thermometers by their shorter, rounder bulb.
- To use a rectal thermometer, place your child, stomach down, on your lap and hold one hand on his buttocks to prevent movement, says Donald Vickery, M.D. Lubricate the end of the thermometer with petroleum jelly. Carefully insert it about 1 inch, but never use force. The mercury will start rising within seconds. Remove it when the mercury is no longer rising, after 1 or 2 minutes.
- If a thermometer breaks in the mouth or rectum, don't panic. The mercury is not poisonous, and usually the only harm done is a superficial scratch of the mouth or lining of the rectum. But do call a doctor if you can't find all the pieces of glass.
- After use, wash a glass thermometer in cool, soapy water. Never use hot water. And never store it near heat.
- Use a digital thermometer according to the directions that accompany it. Afterward, wash the tip with soap and lukewarm water or with rubbing alcohol. Do not immerse the instrument completely or splash water on the readout; you risk ruining the thermometer. Be prepared to change the battery every two years.
|
|
Take a dip. "Often when I have a fever, I really start to shiver," says Dr. Gossel. "At that point I'm most comfortable getting into a tub of warm water."
Dr. Banco advises room-temperature baths for babies. An alternative treatment, he says, is to sandwich the child between wet towels and change them every 15 minutes.
Don't suffer. If you're very uncomfortable, take a pain reliever. For adults Dr. Vickery recommends either two aspirin or two acetaminophen tablets every 4 hours. The advantage of acetaminophen, he says, is that fewer people are allergic to it.
Since aspirin and acetaminophen exert their effects in slightly different manners, he notes, you might want to pair them up if one alone is not effective in controlling the fever. Take two aspirin plus two acetaminophen (a total of four tablets) every 6 hours. Or stagger the medications so you take two aspirin at one time and two acetaminophen 3 hours later. Make sure this therapy gets your doctor's approval.
Give children acetaminophen. Where those under 21 are concerned, avoid aspirin. That's because aspirin can trigger Reye's syndrome, a potentially fatal neurological illness, in feverish children. Instead, says New Orleans pediatrician George Sterne, M.D., a clinical professor of pediatrics at Tulane University School of Medicine, use 5 to 7 milligrams of acetaminophen per pound of body weight. Repeat every 4 hours. "There is no reason to give it more frequently," he says. "And excessive doses over a period of days are dangerous."
Dress the part. Use common sense as far as clothing and blankets go, says Pane. If you're very hot, take off extra covers and clothes so body heat can evaporate into the air. But if you have a chill, bundle up until you're just comfortable.
Be especially careful to monitor infants, who cannot undress themselves if they become overheated, cautions Dr. Sterne. In fact, he says, overdressing a child or leaving him in a hot place (such as a car) can actually cause a fever.
Create a healing atmosphere. Do your best to make the sickroom conducive to healing, says Dr. Blaurock-Busch. Don't overheat it—German doctors generally recommend that the temperature not exceed 65°F, she says. Allow just enough fresh air to promote recuperation but not to create a draft. And keep the lighting subdued so it's properly relaxing.
Eat—if you want to. Don't fret over whether you should feed a fever or starve one. Some doctors, like Dr. Blaurock-Busch, prefer juice fasting until the fever is reduced nearly to normal. Others feel that you should eat during a fever because the body's increased heat uses up calories. Ultimately, of course, the choice is yours and hinges on your appetite. Just remember to keep up your fluid intake.
PANEL OF ADVISERS
Leonard Banco, M.D., is an associate professor of pediatrics at the University of Connecticut School of Medicine in Farmington. He is also director of pediatric ambulatory services and assistant director of the Department of Pediatrics at Hartford Hospital in Connecticut.
Eleonore Blaurock-Busch, Ph.D., is president and director of Trace Minerals International, Inc., a clinical chemistry laboratory in Boulder, Colorado. She is also a nutrition counselor specializing in the treatment of allergy and chronic diseases at the Alpine Chiropractic Center there, and is the author of The No-Drugs Guide to Better Health.
Thomas Gossel, Ph.D., R.Ph., is a professor of pharmacology and toxicology at Ohio Northern University in Ada and chairman of the university's Department of Pharmacology and Biomedical Sciences. He is an expert on over-the-counter products.
Mary Ann Pane, R.N., is a nurse clinician in Philadelphia, Pennsylvania. She is affiliated with Community Home Health Services, an agency catering to people who require skilled health care in their homes.
Stephen Rosenberg, M.D., is associate professor of clinical public health at Columbia University School of Public Health in New York City. He is author of The Johnson & Johnson First Aid Book.
George Sterne, M.D., is a pediatrician in private practice in New Orleans, Louisiana. He is also clinical professor of pediatrics at Tulane University School of Medicine there.
Donald Vickery, M.D., is president of the Center for Corporate Health Promotion in Reston, Virginia. He is also assistant clinical professor of family medicine and community medicine at Georgetown University School of Medicine in Washington, D.C., and associate clinical professor of family medicine at the Medical College of Virginia in Richmond. He is the author of Life Plan for Your Health and coauthor of Take Care of Yourself.
