Medical Advice: Burning down the house - Ahwatukee Foothills News: Health

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Medical Advice: Burning down the house

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Posted: Monday, April 30, 2007 11:00 pm

Valley Fever, Hay Fever, Rocky Mountain Spotted Fever, Scarlet Fever, Yellow Fever, Rheumatic Fever, Cat Scratch Fever. Fevers are here, there and everywhere. Elvis Presley said it best: "Lord almighty I feel my temperature rising." The presence of a fever is one of the first things we try to ascertain when someone is ill. The patient's temperature is one of the four basic "vital signs" with pulse, respirations and blood pressure following close behind. The thing that makes a person's temperature vital is that the body's homeostasis, or ability to maintain all functions optimally, depends upon a certain range of heat. Most everyone can recite that the average body core temperature is 98.6 degrees Fahrenheit with a healthy range being anywhere from 97 to 99 degrees. Temperatures that vary below or above this average create an internal atmosphere that is not conducive to the various systems' functioning. The term "fever" generally refers to anything over 99 degrees. In order to maintain the healthful range, the body has a regulating system that kicks in much like any thermostat. If the core temperature starts to rise, we begin a cooling mechanism through sweating. If the core temperature starts to decrease, shivering will initiate warming through muscle contractions. All fevers, however, are not bad. Many conditions will have a mild accompanying fever that does not need to be of concern, nor need to be treated. Oftentimes, a fever is a positive indication that the immune system is mounting a defense against infections (in other words, deliberately making an inhospitable environment for the invading microorganisms). Just think how uncomfortable you are when outside on a hot Arizona summer day. Some germs don't enjoy a very hot environment either. Granted, fevers greater than 104 degrees will grab a health professional's attention quicker than a fever of 102 degrees, but too often patients are afraid to admit that there has not been a fever or that the fever was only for a day or two. When we ask a patient if there is a fever we are not using that piece of information to determine the severity of the illness. What we are really trying to ascertain is if the fever occurred at the onset of the illness or later after a few days of illness, if the fever oscillates, waxes and wanes or spikes repeatedly. The cause of any fever and the timing of the fever are more important sometimes than the height of the fever. When we recommend acetaminophen or ibuprofen for adults or children the goal is simply to reduce the discomfort of fever. Remember: no child under the age of 15-16 should be given aspirin for a fever - a topic for a whole other article. Cool compresses, light clothing and bedding will also be comforting and, of course, drinking plenty of fluids. When to seek medical help? Certainly if there is accompanying delirium, major stiff neck or headache or persistent vomiting or diarrhea. Other situations that warrant medical help include fevers in infants, and in otherwise compromised adults or fevers lasting more than three days. As with any situation involving your health and well being, if you're not sure, just call and ask. --Agnes Oblas is a nurse practitioner with a private practice and residence in Ahwatukee Foothills. For questions, or if there is a topic you would like her to address, call her at (602) 405-6320 or e-mail her at agirnnp@cox.net. Her Web site is www.newpathshealth.com.

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