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Chills, goose bumps, things that go bump in the night

by Dr. Drew Werner Special to the Daily

Welcome to fall! I just liked the sound of my title, but we’ll have to wait until Halloween to hear about things that go bump in the night.

Crisp nights, sleeping with a window open, a bit of frost on the windshield in the morning, aspen leaves turning golden and making that wonderful rustle in the wind, a warm sun heating the day, browns spawning, fall is here, life in Eagle County is good.

Chills and goose bumps are on their way however and several questions have come up regarding them. So, let’s separate the facts from fiction.

Dear Doc:

My body temperature is always low so when my temperature is normal I have a fever, right?

– Always Cold

Dear Always Cold:

Not necessarily true. In fact the “normal” body temperature of 98.6 degrees fahrenheit is only an average. What we wear, the level of our activity, our hydration status and even the time of day affects our temperature. Because of these variations a true fever is an oral body temperature of 100.5 degrees fahrenheit or higher. A temperature of 97.4 or 100.1 can be normal at any given time.

Some people do run a little cooler or hotter than average and that is taken into consideration, but a fever by definition is still 100.5 degrees fahrenheit or higher. Remember, fever is only one sign of illness. Someone who feels terrible with a temperature of 99.9 degrees fahrenheit may actually be sicker than their friend who doesn’t feel too bad, but their thermometer reads 102 degrees fahrenheit. A good rule doctors follow is to treat the patient, not the number!

Dear Doc:

When my husband is sick, he gets the chills, then bundles himself up so much he ends up sweating till the sheets are soaked. Is that good for him?

– Changing the sheets in Edwards

Dear: Changing

A lot of people think that if they “sweat the fever out,” they will get better. Actually the body does all the work for us. Bundling up may only lead to holding your heat in and raising your fever higher. This is especially true for children. If they have fevers, dress them coolly but comfortably. Bundling them up may raise their body temperatures too much, which has even been associated with SIDS (sudden infant death syndrome) in very young children.

So how does our body work? Infections directly or indirectly release pyrogens or heat mediators, which travel through our blood stream to our anterior hypothalamus. This part of our brain is the thermo-regulatory center and raises our body temperature.

As our temperature goes up, the previously comfortable room suddenly feels cooler and we get the chills. They can be pretty miserable too – kind of like sitting naked in a snow bank with our feet in a block of ice. If you try too hard to get warm, all you do is further raise your temperature and make the problem worse.

Finally, your body successfully responds to the fever as it “breaks” and you sweat to cool down. When your temperature lowers, that cool room now suddenly feels hot and the next thing you’re looking to change the sheets!

Dear Doc,

I’ve heard that a high fever will hurt my baby and give him a seizure. What can I do to prevent it?

– A new mom

Dear Mom:

That’s probably the most common question I’m asked about fevers. The fear of fevers dates back hundreds of years, if not longer. Before modern medicine, this frightening symptom signaled the number one cause of death in an infant’s first year of life – infection. Needless to say this worry has persisted through time.

More recently, fevers have been associated with seizures, an equally frightening event to witness in an infant or young child. Thankfully, we’ve come a long way, baby (no pun intended!). Fevers are actually a way to help the body fight infection.

Low-grade fevers of 101 to 102 degrees fahrenheit are not harmful and should be treated only if it is making your child uncomfortable or dehydrated. Fevers of 103 to 104 degrees fahrenheit are generally not harmful for short periods of time – one to several hours.

They may, however, signal a risk for very high fevers of 105-plus degrees fahrenheit, which are rare. Because of this as well as a much greater risk of dehydration, these fevers are best treated with alternating doses of acetaminophen (Tylenol and others) and ibuprofen (Motrin, Advil and others). By giving the recommended dose of each medication every six hours, while alternating the two types your child will receive either acetaminophen or ibuprofen every three hours, which works wonders to keep the fever down.

Dressing them coolly helps, as does encouraging extra water, juice or pedialyte as your doctor recommends to prevent dehydration. Cool baths are rarely needed, but can help if fevers persist over 103 degrees fahrenheit for longer than one or two hours and nothing else is working.

Febrile seizures are very frightening to watch and hard to prevent. They are believed to be due more to how fast the fever goes up than to how high it actually goes. Febrile seizures not uncommonly occur in children who weren’t even known to have a fever.

As scary as they are, however, they are neither serious nor treated. Febrile seizures occur in 3 percent to 5 percent of healthy children between 6 months and 5 years of age. Once children are older, than that they become very rare. If your child has had one, the best treatment is prevention, keeping the fevers down as I’ve mentioned above.

The correct dose of medication is on the label. If your child is under 2, check with your doctor for the correct dose which is based on weight.

Well, enough of chills and fevers. I hope you all stay well – and enjoy our beautiful fall!

Please keep your questions coming in! The only bad question is the unanswered one!

Dr. Drew Werner of the Eagle Valley Medical Center writes a weekly column for the Daily. He encourages health questions. Write him by e-mail to editor@vaildaily.com or c/o Editor, Vail Daily, P.O. Box 81, Vail, 81658.


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