Treating fever-phobia

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By 2017-12-17

Written By Aney Darling

Dear Dorothy,
My daughter caught my husband's flu (which he was suffering through for about a week) and it has been yet another taxing few days for me; both physically and mentally. But it also made me do a lot of research on a topic that has been on my mind for quite some time now and that is our rather warped perspective on 'fever.'

My mother comes from a generation of what I refer to as 'fever phobes' or those with fever-phobia. Her immediate response to a heightened temperature is to bring it down, no matter what. So, even though I protested, she insisted that an ice water and eau de cologne forehead wrap be placed on the baby, as soon as she heard the word 'fever.' I understand that this is purely out of concern and the baby's fever did subside, but I was absolutely not okay with it. Let me explain.

The modern attitude toward fevers has been socially and culturally mediated through generations of misinformation and misdiagnosis (that often resulted in prolonged suffering). Any Sri Lankan knows the extent to which we have been warned against a heightened temperature. This phenomenon, known as 'fever-phobia,' is an exaggerated, distorted fear of fever that first came to be in the 1980s. Then, a prominent paediatrician named Barton Schmitt coined the term to describe the desire of many parents to bring down fevers in their children as quickly as possible. And although almost four decades have a passed since then, fever-phobia is still alive and well today.

In fact, a recent study in the Paediatrics journal showed that 91% of parents surveyed thought that a fever can cause harmful effects, with 56% of caregivers very worried about the potential harm of fevers for their children. And 89% of parents reached for fever reducing medication and home remedies even before temperatures reached 102 degrees (parents.com).

Also many healthcare professionals today believe that this mentality stems from decades - perhaps centuries - of misinformed medical advice. 'But what is so wrong in being afraid of fever and how can its treatment be unnecessary,' you might wonder. Let me elaborate.
A fever generally indicates that your body is fighting off some kind of infection (most times the common cold, flu, or an ear infection). The fever in itself is not an illness but a positive and effective response by the human body to combat one. In fact, a study published in the February 2004 Journal of Allergy and Clinical Immunology found that children who ran a fever during their first year were less likely to develop allergies later in childhood than children who did not. More importantly, according to the American Association of Pediatrics, a fever can help your child's body fight off infection.

Many illness-causing microbes do their best at the body's average temperature. A fever raises this temperature beyond which they are able to reproduce and kicks your immune system into high gear, spurring the rapid production of white blood cells. So the idea that you need to cool your body down with iced water, by removing clothing or by treating it with medication may become counterproductive to this process, as it will stop the body's efforts of trying to get warmer (that is why you feel chills when running a fever - because we will then proceed to cover under a blanket, wrap ourselves up in a shawl or seek warmth to further heighten the body's temperature).

As for the concerns among those who state that fevers can have harmful long term effects, it is important to understand that these instances are very, very rare. The brain has an internal regulatory mechanism that prevents fevers caused by infections from getting over 105 or 106 degrees (body temperature must go above 108 degrees to cause damage). Temperatures that run higher are caused only by exceptional circumstances, such as central nervous system disorders or heatstroke.

Treating a fever usually doesn't bring the body temperature back to normal (just down 2 or 3 degrees). Also only very rare instances of heightened body temperature will lead an adult or child to experience fever seizures marked by momentary loss of consciousness, eyes rolling back, shaking, twitching or stiffening. And even when they do occur, they cause no permanent harm. More important is how you feel and look - than the exact reading on the thermometer (whether it is moderate or high in numbers).
If it is the discomfort caused by a fever that is making you feel very ill, it can be reduced with treatment and medication such as Paracetamol that remedies aches and pains (usually a fever has to be above approximately 103 degrees before it becomes uncomfortable). But medicating yourself is not advisable unless under the supervision of a medical professional (refrain from administering any fever-related drug to yourself or others without speaking to a doctor first).

There are times when a fever, in combination with other symptoms, warrants an immediate call to your doctor or a drive to the ETU (Emergency Treatment Unit). These include a temperature above 103 degrees; a fever that lasts for longer than five days; if the symptoms accompanying the fever appear to worsen, a high temperature caused by heat stroke, confusion, lethargy or excessive drowsiness and fever; Meningitis (a life-threatening and highly contagious disease with fever accompanied by severe headache and a stiff neck); difficulty breathing or chest pain with a high temperature; blood in the stools, urine or mucus while running a fever; anyone with compromised immunity and an unusual temperature or signs of Dengue such as severe headaches, pain behind the eyes, severe joint and muscle pain, fatigue, nausea, vomitting, a skin rash which appears two to five days after the onset of fever, mild bleeding through the nose or gums and/or easy bruising.

So, Dorothy, I can safely say that I am definitely not one of those parents who are going to drag their child or themselves to a doctor or hospital whenever the thermometer reads a higher number. This doesn't mean that I endorse taking a high fever lightly. I think you should monitor it and watch out for any signs of concern, but you must also give it enough time to subside on its own before panicking and reaching for some drug or medication. Having said all that though, it is important to remember that this week's column should only be considered an opinion and not medical advice. Always seek the direct advice of your own doctor in connection with fever and ask a professional about any questions or issues you may have regarding information published here before acting on it.
Write to us at [email protected] and share your thoughts and comments on fever-phobia in Sri Lanka.

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