Thursday, February 10, 2011

We've had quite a bit of sickness in our home the past few weeks.  Everyone has had at least one virus, and we've had one child end up on antibiotics.  As I watched my feverish 4 yo resting on the couch yesterday, I thought of how much I'd learned over the years.  I used to give tylenol to my children every time they ran a fever.  I wanted to bring the temperature down to normal.   It's rare for me to treat a fever anymore.

Fevers have a job to do.  They are part of God's design --  the body's way of killing the virus that is making it sick.  When we reduce the fever, we make it harder for the body to kill the virus.  Fevers also cause us to rest.  When we give our children fever-reducing medications, they start to play and be more active instead of resting.  Rest is an important part of the healing process for the body.  In my experience, if I give tylenol or ibuprofen to lower a fever, then my children may feel better temporarily, but they take longer to recover from the virus.

I do treat fevers sometimes.  I will give tylenol to lower a fever if I feel it's getting too high.  This varies with the age of the child, but when my 7 year old was running a fever last week, I started giving tylenol as it neared 103.  (I treat sooner with younger children, especially babies.)  I did this for more than one reason, though.   Not just to lower the temperature, but also to provide pain relief for his throat so he'd eat and drink more.  Fluids are very important when dealing with a fever, so I will treat the fever (and pain) if the child isn't drinking enough.  Since rest is also important when sick, I will also give pain relievers if the child is unable to rest because of pain or coughing.

By choosing to spare the medication and let the body work on healing itself, I do take on a different responsibility.   I have to monitor the child's temperature more closely.  I have to pay attention to how much water they're drinking.  I have to talk with them about their pain level or find appealing foods that are gentle and healthy.  We try to support the body in its healing rather than just cover up the symptoms of the illness.

We don't usually rush into the doctor at the first sign of a fever.  Usually we wait and see what happens.  If the fever lasts more than 3 days, we take them to the doctor.  If we think we've been exposed to strep, or the symptoms match strep, we do take them in sooner.

Some of the other reasons we'd take a child to the doctor include:

  • fever lasting more than 3 days

  • the child is dehydrated by the fever or vomiting, though I have never needed to take one in for this

  • the child is having difficulty breathing

  • the child is incoherent or not waking up, though I've never had this happen either

  • there are signs of an infection (ear, nose, lungs or throat)

  • the fever will not come down with medication (also never has happened)

  • a newborn has a fever

  • we just feel something is wrong


When Friday arrives and our child is borderline between waiting it out (by our standards) or seeing the Doctor, we have to make a decision.   We look at how long they've been sick, how this sickness has played out in other family members thus far, and the child's personal medical history.  Sometimes we choose to see the Doctor before the weekend, just in case.   Other times we decide to wait until Monday.  When we choose to wait, we know that there is always the option of going to urgent care if the child grows suddenly worse.   Usually they don't need urgent care, and they are improving by Monday.

A Recent Example

Two weeks ago, my active 7 year old son was sleeping his days away on the couch, running a fever between 102 and 103.  He'd wake up to get a drink, snack a bit, or talk to me.  He was definitely sick, but the greatest danger was dehydration.  When his fever topped 103, and I knew he'd been drinking very little, I gave him some tylenol.  His fever soon fell to 99 and he was up playing.  He played until the tylenol wore off four hours later.  I tried to get him to lay back down and rest, but he wouldn't.  I was reminded of why I like to leave fevers alone.  The fever has work to do, and it can do it better if the child is resting.  (Thankfully he did drink quite a bit during those four hours.)

When his fever was still going strong after 3.5 days, I took him to the Doctor  Friday afternoon.  He'd already had a negative strep test earlier in the week, since he is prone to strep.  But it was Friday, and it had been more than 3 days, so we went just in case.  The doctor still felt it was a virus, which just needed to run its course.  She did wonder about mono, but didn't want to test for it yet because it requires a blood draw.  She saw no signs of infection, but did give an antibiotic, just in case.  We started the antibiotics Friday night.  Saturday morning, his fever was gone.  I suppose it's possible that one dose of antibiotics broke his fever because he had some underlying infection we couldn't spot ... but I suspect it was really just the end of the virus.  If only we'd waited  until Saturday morning to fill his prescription.  We could have called the pharmacy and told them we didn't need it.  Instead, he's finishing the course of antibiotics he probably didn't need.

Education and Experience

We saw the doctor last month for a baby checkup on Baby V.  The nurse thanked me for not running in with every sniffly nose or fever our children get.  I guess even when I was a younger mom, it never occurred to me to rush in for every sniffle or cough, because I'd watched my Mom treat plenty of colds at home.  However, there were times I took in a child whose cold or cough seemed especially bad, only to have a family doctor tell me it was viral and keep doing what I was doing.

I'm so thankful for those doctors who didn't throw a bunch of prescriptions at me and gave me confidence to reognize a virus and let it run its course.   I've learned over the years to tell the difference between a virus and an infection (most of the time) and I've also learned to recognize when a secondary infection has settled in after a virus.   Some of that came with educating myself more on the nature of viruses, and some of that came with experience.

I'm not a nurse or a doctor ... just a Mom trying to share some wisdom gained from 15.5 years of experience with 8 children.  You have to know your own child.   If your child never runs a fever, or is prone to seizures or serious dehydration, you'll need to respond differently to fevers than we do.  My children tend to run fevers with viruses, and sometimes those fevers can be high.  We've learned that it won't hurt them to let them run a fever.  They sleep, and they get better.

I hope your family stays well this winter and you don't face any high fevers, but if you do ... consider letting the fever run its course and do its work.  Trust the body to heal itself, the way God designed it to.  And if your child has a fever, please keep them home.  Don't give them cold medicine and tylenol to cover the symptoms up and take them out in public to spread their germs (and where they also can't rest.)

Stay well,
April E.

4 comments:

  1. Thanks so much for your wisdom on this topic! We are very similar to you in our treatment of sickness...and I really try to stay out of the doctor's office unless it is truly neccesary {lest they pick up something worse while we're there :)}

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  2. We're the same as well. A mom mentioned once to me that she always takes her children in to the doctor for a fever, because it must mean that the child has an infection, right? I didn't really know how to answer her at the time, but our pediatrician has always told us to let illnesses run their course, unless we felt that something else was going on and was wrong. So, if the girls have a cold that continues beyond two weeks, or symptoms of chest/sinus infection, then we'll take them in. I probably give more Tylenol than you do, but even when my girls are on Tylenol, they stay put on the couch and don't run around and play. They've always been like that, for some reason.

    In fact, we go to the dr. so infrequently that it usually has been over 3 years and the child needs a "new patient exam" - ha! That can work against us, though, because it's a 30-minute time slot they need to give us, and it can be three months away, which won't help us if a child is ill with something. For our family, it's better if I take them every 2-1/2 years or so, just so we won't have to deal with a "new patient" exam and can't get a regular appointment when we truly need it.

    Great article, April!

    Julieanne
    http://www.JoyInOurJourney.com

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  3. Some of our kids usually make it in before 3 years goes by. I'm not sure what the policy is in our new doctor's office, but I also do try to get a general check-up or physical every other year anyway. That would satisfy the need to see the doctor often enough to stay current. I think that's a silly policy, btw. Punish you for being healthy and not needing the doctor? Phooey!

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  4. It's so nice to read about others who feel the same way I do about treating a fever. When my oldest was a baby, she would run 103.5 fevers when she teethed. I nursed her frequently and she never once became dehydrated. There was one night when the fever creeped higher and I was on the phone with a nurse in the middle of the night and the recommended course was still just to nurse frequently and leave her be. I was told to bring it down gradually, just a bit more into a comfortable level, by using warm washcloths. Bascially, the rule of thumb is that if they otherwise seem OK, they are OK.

    There were 2 exceptions we had, both of which I made a phone call to the doctor rather than rush in to the office or the ER. One was when my middle daughter was unresponsive. She was 3 at the time. She had vomitted earlier, but had no fever. She promply fell asleep and I could not wake her 2 hours later. The doctor walked me through all the typical ways to rouse a sick child and when none were effective, he told me to locate my husband (who was in a conference with his phone off) and take her to the ER. The paramedics came and also could not wake her, but when they took her blood pressure, it was unique enough that she became conscious and was lucid. That was all she needed to be, so she was fine at that point.

    The other incident was when my youngest was 2 and she started coughing at night. After each cough, she stopped breathing for 8-12 seconds, started breathing again and then would cough and repeat. Once again, I made a phone call to the doctor who listened to her over the phone and gave me information about croup - even though it wasn't a croup-y cough. If the suggestions she made weren't effective, we were to take her to the ER. After 10 minutes outisde in the cool air, the cough went away and she slept through the night just fine.

    I would never put my children in danger and had I been concerned for their lives, I wouldn't even have madea phone call other than to 911. However, in these circumstances, I was confident that we had time to discuss the situations with a physician. Having worked in the ER, I reserve it for life threatening emergencies and the doctor's office for when we need medicine or medical testing. Yes, all the scenarios I described could have become life-threatening had we not taken the steps recommended by the doctor over the phone, but it saved all of us time and money and possibly unnecessary medicine and tests by making a phone call first.

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