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FEVER / CHILLS

FEVER
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WHEN TO SEE YOUR DOCTOR
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# You have a fever higher than 39.5oC or more.
# Your fever persists for more than 72 hours.
# You also have a severe headache or stiff neck, you are coughing up discoloured phlegm or you have pain while urinating.
# You have a history of heart disease, diabetes or other chronic illness.
# Seek immediate medical care for any infant less than three months old who has fever.

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What Your Symtom Is Telling You

Believe it or not, fever is your friend.
And like any close friend, fever tells you a couple of things that you may not like but that you need to know.
First, fever is an early warning sign that a viral or bacterial infection has invaded your body. Second, it lets you know your body's defenses are vigorously resisting that invation.
But more important, fever itself is part of that defensive struggle. When a virus or bacterial infection sneaks into your body, your white blood cells release substances called endogenous pyrogens. These pyrogens stimulate a part of the brain called the hypothalamus, which raises your body's internal temperature, causing a fever. That fever may speed your recovery.
"By heating itself up, the body slows down the growth of invading organisms," "That makes it easier for the immune system to track down and kill these invaders."
In most cases, fever is caused by minor ailments such as cold or flu. But any infection and an armada of other conditions and diseases can induce a fever.

Symptom Relief

High fevers of 39.5oC or more should be evaluated by a doctor. But if you have a fever of less than 39.5oC and you don't feel too uncomfortable, let the fever break naturally without treatment.
"Most fevers are less than 39.5oC and aren't going to harm you. We probably would not even consider treating a person unless their fever was 38oC or higher. Even then, it would only do it to make him more comfortable."
Here are a few ideas for coping with fever on your own:

Keep those drinks coming. Get plenty of water, but also make sure you drink teas, juices, sports drinks and chicken and beef broth. "You can get dehydrated when you have a fever, so it is important to drink lots of fluids, particularly something like a sports drink, which will restore your body's supply of vital minerals".
Eat only if you want to. "That saying about feeding a fever is just a myth," "If you feel hungry, eat. Otherwise, don't force yourself to eat, because all of us have adequate stores of fat to go a day or two without food. It is more important to drink an adequate amount of fluids."

Cool off."Soak in tepid water- water that is neither hot nor cold to the touch- and sponge the skin," "As the water evaporates off your body, it cools the skin and the blood vessels underneath it, which in turn may reduce your fever." Repeat the bath every two hours, if necessary.
Take aspirin, but don't give it to the kids. Two aspirin tablets every four hours may help adults keep a fever in check. But never give aspirin to children under 2 years. Aspirin can cause feverish children to develop Reye's syndrome - a potentialy fatal illness that affects the brain and liver. Instead, give your children acetaminophen in the dosage recommended by the manufacturer.

Know your medications. Drug allergies can cause fevers. Some of the prime suspects include antibiotics such as penicillin and high blood pressure drugs like methyldopa. Even ibuprofen and aspirin can cause fevers in a few people."There isn't a rip-roaring epidemic of drug-induced fever, but people can be allergic to almost anything." If you suspect a drug reaction is causing your fever, ask your physician to prescribe another medication.

Find your normal. Determining whether you have a fever, or when it's over, is not all that cut and dried. To be prepared for dealing with fever, it helps to know your normal temperature.

Just because you have a temperature other than 37oC doesn't mean you have an abnormal temperature. In a study of 148 healthy men and women ages 18 to 40, reserches at the University of Maryland found that normal temperatures for the group ranged from 36 to 37.6 oC. "Based on another study they consider fever as anything greater than 37.6oC."

But an individual might be able to refine that considerably if he knew his own normal temperature. To determine your normal temperature, record your temperature every four hours while you are awake for three days. This should give you a reasonable indication of your particular range of normal temperatures.

CHILLS
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WHEN TO SEE YOU DOCTOR
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# A child who has chills and is also irritable or lethargic should see a doctor immediately - this could be a medical emergency.
# Your chills are so severe that your teeth are chattering.
# You have severe chills for more than an hour or the chills are recurring.
# You also have pain or discomfort anywhere.
# You have a heart valve abnormality and recently had eithre dental work done or an infection.
# Yuou have a condition that compromises your immune system, such as diabetes.
# You have been taking oral steroids or are being treated for cancer.
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What Your Symtom Is Telling You
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When you dash out into a frosty morning in your pyjamas to fetch the news paper, a quick shiver is your body's natural response. A home thermostat set too low might produce the same reaction: Brrrr,I am cold!
Other than when you're simply chilly, a chill is most likely to be your body's signal that a fever is on the way.
When viruses or bacteria invade, your trusty white blood cells release proteins that send message to your brain's tempereture control center. To fight off the infection, this control center begins to raise your temperature by constricting your blood vessels and making you shiver. As you shiver, the iccreased muscle actvity produces heat, and the blood vessels in your skin contract to prevent heat loss.
When you have a chill, your skin may feel colder, but as blood is diverted from the skin to deeper inside your body, the temperature at the core of your body is actually on the rise. Most chills last for no more than 15 minutes before the fever becomes truly obvious, doctors say.
The flu bug or some other virus most often cause your chills, but any infection is a possibility - from pelvic or urinary tract infections to pneumonia. If your chills are bad enough that you feel like you are shaking all over, suspect an infection that has spread throughout your blood stream. And if you have recently traveled in the tropics, it could be malaria.

Symptom Relief
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When you shake, rattle and roll and there's no music playing, here's comfort and cure.

Treat the fever. The over-the cuounter medicines you normaly use for fever will also blunt the chill response, Acetaminophen and ibuprofen are both effective.

Hydrate and rest. The basics of virus care are the same for chills. Be sure to increase your intake of liquids and get plenty of rest.
Use comfort strategies. Try these steps when a chill hits, " During the chill, pile on the blankets. In a while, you will get a fever," "Then take your Tylenol and sit in a tub of body-temperature water. Use a washcloth to rub your skin, which will dilate blood vessels, and as the water slowly evaporates you'll cool off."

Avoid alcohol rubdown. Don't use alcohol as a body rub. Rubbing alcohol on your skin will evaporate quickly but add to your discomfort. "You don't need to bring your temperature down that quickly and if you're having chills, your skin will feel even colder."

Dismiss Alcohol. "Alcohol will affect your mental abilities and may mask more dangerous symptoms you need to be alert for." "When the fever comes, alcohol may also cause fainting and a fall in the tub."

See the doctor. When chills and fever are persistent, your doctor will need to evaluate any symptoms you may have, such as pain or a cough. If you have respiratory symptoms, he may want a sample of your sputum to test for bacteria that may be responsible. If a treatable infection is diagnosed, your doctor will prescribe antibiotics. In the unlikely event that you have malaria, a variety of anti-malarial drugs are available.


Indebted to Medical Bulletin/Das