Dealing with the chills |

Dealing with the chills

Dr. Drew Werner

EAGLE COUNTY – Crisp nights, sleeping with a window open, aspen leaves turning golden and making that wonderful rustle in the wind signal the arrival of Fall. A warm sun heating the day, a homecoming football game, snow on the peaks with a promise more will come foreshadow winter is just around the corner. More than Jack Frost and a change of season have arrived, however.In the dark of the night, has a cold sweat moistened your brow? Has a chill crept up your spine? No, not from things that go bump in the night, but from the fever brought by a cold or the flu. Many myths surround fevers, so let’s separate fact from fiction. Here are some myths I often hear:My body temperature is always low, so when my temperature is normal I have a fever, right?While that seems to make sense, it is 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 effects 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!When I get sick and the chills, I just bundle myself up to sweat out the cold and then I feel better.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. As your body successfully responds to the fever, 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 do is change the sheets!”I’ve heard that a high fever will hurt my baby and might give him a seizure.”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 No. 1 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 four to six hours, while alternating the two types, your child will receive either acetaminophen or ibuprofen every two to 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 old. Once children are older, 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.On a side note, elections are coming and several key items are on the ballot. I agree with the the Colorado Medical Society and many other health care organizations in supporting Referenda C and D. These two important referenda will direct money to health care, education and transportation. If this money is not targeted toward health care, more than $400,000,000 will be cut from the budget, drastically limiting care for the uninsured and underinsured. 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 or c/o Editor, Vail Daily, P.O. Box 81, Vail, 81658.Vail, Colorado

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