I need some medical folks to check the logic on this. If this is true, it could be instructive to many people here.
Helen Branswell’s article today is about a letter in Nature Medicine seen here: http://www.nature.com/nm/journal/vaop/ncurrent/abs/nm1477.html
The gist of the letter is that the cytokine response is responsible for the bad outcomes in H5N1 and that controlling that response is key in boosting survival rates (much as many here have theorized).
After reading that letter, I tracked down the abstract below, which seems to say—if I’m reading it correctly—that at temps of 40C/104F, the cytokine burst is of shorter duration than that produced at 37C/98.6F.
If that is the case, then it would seem that we may want to let fever do the work it was intended to do (kill pathogens) as a means of naturally (i.e., without medical intervention that won’t be available to most of us anyway) moderating the cytokine response.
This is the position of docs in my pediatrician’s office. They believe that fever within a certain range is actually therapeutic and that parents shouldn’t be so quick to medicate their children (unless their is pain with the fever). I have also read this in other publications.
So, anyway…here’s the abstract and source. I would appreciate medical opinions on 1) whether I’m interpreting it correctly, and 2) if you agree or disagree with the therapeutic fever theory (within reason).
“Effects of hypothermia and hyperthermia on cytokine production by cultured human mononuclear phagocytes from adults and newborns
Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 20201, USA. kfairchild@peds.umaryland.edu
We have shown previously that febrile range temperatures modify cytokine production by adult macrophages. In this study, we compared the effects of moderate hyperthermia and hypothermia on the kinetics of lipopolysaccharide (LPS)-induced cytokine expression in monocytes and macrophages of newborns and adults. During culture at 40 degrees C, the initial rates of tumor necrosis factor-alpha (TNF-alpha) and interleukin-1 beta (IL-1 beta) secretion were preserved, but the duration of secretion was shorter than the duration at 37 degrees C. TNF-alpha and IL1-beta concentrations in 24-h 40 degrees C culture supernatants were reduced 18%−50%. IL-6 concentration in 24-h 40 degrees C cultures was reduced 26%−29% in all cells except adult macrophages. At 32 degrees C, changes in early (2 h) and sustained (24 h) cytokine expression were reversed compared with those caused by hyperthermia. Culturing adult macrophages at 32 degrees C blunted early secretion of TNF-alpha and IL-6 by 69% and 65%, respectively, and increased TNF-alpha concentration at 24 h by 48% compared with levels at 37 degrees C. In adult monocytes cultured at 32 degrees C, early IL-6 and IL-1 beta secretion was decreased 64% and 51%, respectively. We speculate that the burst/suppression cytokine profile at febrile temperatures might enhance early activation of host defenses and prevent prolonged exposure to potentially cytotoxic cytokines. Hypothermia, on the other hand, may worsen outcome in infections by delaying and prolonging cytokine production.”
Source: http://tinyurl.com/laccg
I know I’ve always been told that a low grade fever should be left to run its coarse. But, atleast with my kiddos, with a fever usually comes pain, and I’m not willing to let a child suffer the pain for the benefit of the fever.
Great quesion, and that would be great if it works, but who knows the answer, with our limited experiecne with this bug.
Actually the Nature Medicine piece is the important piece. I’ll comment on it later.
The fever one, well, it’s a in vitro study of cultures of human cells. That’s a long way from clinical studies in patients. Your body can have many other responses to temperature changes, so we don’t really know what the combined effects will be in a real person.
Edna Mode – at 15:20 - This is interesting because here there is a growing movement of people who actually say that fever is good. However, I’d like to hear a doctor’s advice as to just how high up one should let fever do the job.
I vividly remember one evening my son aged 6 or thereabouts starting to “loose his mind” telling me he was seeing (non-existent) butterflies and starting to convulse once on a 40.6°Celsius fever. Thankfully I straight away immerged him in a warm bath which I cooled to tepid and he was OK after a few minutes once the fever went down a little.
So at what exact degree/decimal does fever start being dangerous?
How would you hope, at home, to survey your patient all the time to make sure he/she does not exceed this limit, when in all likelihood, for BF, he/she will be very contagious and you’d want to spend as little time as possible exposed to his/her germs?
And also in hospitals, there might not be enough temperature monitors for all patients. Possibly none at all in some locations. So would (fully suited up) nurses watch over them and wait until the patients thrashed about, assuming BF left them with enough strength for moving (or screaming nonsensical words), and assuming also there are enough nurses for this particular job, in addition to all other duties?
The problem is that, especially with children (but even with adults), what may seem safe at 103.5 can quickly escalate to an unsafe 104+, even 105, which can result in seisures, coma or even worse. I also normally let low grade fevers run their course, but higher ones make my children lethargic, feel miserable, don’t want to drink or eat, etc. Keeping someone hydrated is very imporant and hard to do if they are very sleepy and/or uncooperative. While on an intuitive basis it seems that it would be better to let the fever fight the fight against the virus, I haven’t seen enough scientific evidence that with H5N1 this is the way to go. Too risky without more data. Plus it’s really hard to watch your child be miserable.
My ped receommended and I also use how the child is acting as guide as to how sick they are. Not acting themselves, excessive sleeping (eg. if my 10 takes a nap, he is REALLY sick!) is a good rule of thumb.
That is a good article. No definite answer but consider this: I read an old book called Fever Nursing years ago. It was the main book for nursing in 1900. It advised to let the fever run, strict bedrest, give frequent bed baths, frequent enemas (they were hung up on open bowels, but this would seriously dehydrate someone with a high fever who can’t drink or unless you have an IV, but they didn’t use IV’s in 1918). Feed a cold but starve a fever is in this book. You didn’t feed, includes juices, because the body needed to be free from digestion duties while it fought the infection. Foods were introduced back very slowly, gruel, broth, juice. This patience re-introducing food is equally important after fever illness, but nowdays people want to rush the food back. What I just wrote above is what the nurses were doing in 1918 and the reason some got kidnapped by families or maybe I should say not allowed to leave. Nursing care generally meant better odds at recovery.
In 1918 the most common drug available was aspirin. I’m willing to bet it was used for both pain and fever. The flu is extremely painful, so I’m betting folks won’t be able to hold off for long. On the other hand, if you’re nauseauted aspirin, advil, and even Tylenol don’t sit well—so search out buffered if you can.
If you elect to try this—there has to be a temperature cutoff point. Once a fever hits 103 it usually jumps fast higher or hovers. You would have to monitor temps q one hour to keep a handle on this if you let the fever run. Anything over 104 is dangerous to me. I believe fever is the natural response to infection, but it leads rapidly to dehydration which brings on a host of other problems. So, let fever rise to preset point, strict rest, frequent baths, and be sure to sip fluids—at this point if you’re letting the fever go the oral hydration fluids would be better than plain water minus the tang or koolaide except for kids. The key is monitoring the temp and hydration. Young children this is harder to do so consider what’s written above best for adults.
Edna Mode-
Thank you for resurfacing this foundational research.
The importance is contemporary to these present issues because so few parents realise that the fever and the aches and pains are the body’s natural and normal response to viral invasion. Without the invocation of the Heat Shock Proteins, we’d lose much of the beneficial immune defense.
In fact, a human body would fail to recover on schedule and completely from most influenza infections without invocation of certain proteins that are only transcripted above 40 degrees Centigrade.
That range of temperature is traditionally called a fever.
Etsuko HIRAYAMA
Institute of Molecular and Cellular Biology for Pharmaceutical Sciences, Kyoto Pharmaceutical University, 1 Shichono-cho, Misasagi, Yamashina-ku, Kyoto 607–8412, Japan
MG Santoro
Institute of Experimental Medicine, CNR, Rome, Italy.
Basically, everytime the virus assembles the ribonucleoprotein complex in the nucleus, the heat shock protein unbinds (breaks off) the M1 protein from it so that the vRNP complex cannot move back into the cytoplasm for final viral particle production.
High Fever = Viral Inhibition.
Pretty neat, huh!
A fever is your friend and so are the aches and pains that tell you to rest, to stay in bed, to hydrate and to wait.
The key with H5N1 is to get the body to react immediately upon infection so that you don’t have a wave of cytokinic dysregulation two days later when its already too late.
There is one biggie against high fever in H5N1 with respiratory symptoms. The higher temperatures cause a very sharp rise in metabolism and increases oxygen consumption, which could get dangerous in someone one the verge of ARDS. A reduction of temperature towards normal in childhood chest infections is often accompanied by a significant reduction of respiratory rate.
On top of from the regular caveats like convulsions etc.
Keep in mind, that the HSP complex is just one of hundreds of immune responses mediated in part by cytokinic regulators.
Leo7 – at 17:30 — I’d agree with you. However, attitudes differ in other countries. Certainly in my country …feed a cold but starve a fever is in this book. You didn’t feed, includes juices, because the body needed to be free from digestion duties while it fought the infection. Foods were introduced back very slowly, gruel, broth, juice… is still valid, and even in hospitals here they do not force you to eat after any big illness; they will push fluids though.
A22,
I agree fully. We have yet to find a way to make the body respond properly from the start of infection because the residue at position 92 on gene segment NS1 allows H5N1 extra time before detection.
So by the time the lungs are filling, its easy to see that your fever didn’t begin early enough to staunch the infectious spread.
Anon 22:
Severe respiratory symptoms aren’t the norm in the first 24–48 hours is it? Maybe H5N1 is different but I agree with NS1. Let temp rise right at the beginning and hold the antipyretics till it gets to preset point or baths don’t lower temp. Of course if someone’s lips go blue or respiratory distress occurs it won’t make any difference because you can’t abort the ARDS cascade at home—unless you’re right that anticholesterol drugs can do this.
Frenchie,
I’m with you on inputs!
Liquids, liquids and more liquids. No juices or foods.
LauraB,
I’m concerned that suppressing a fever in early stages of H5N1 will deactivate most of the immune response steps necessary for survival.
The real problem is getting the body to have enough NF-kB release initially to begin the immune reponse at the proper time and level.
All, maybe I’m extending myself very far on medical grounds I am not qualified for. Just let me think aloud, and then shoot… So I’ll write up all the bits and you tell me if we can do something with these:
Fever=infection (of whatever type);
Heat (fever), up to a point, helps destroy whatever bad germs are making you sick;
In some illnesses, heat is beneficial, for example:
The BF virus at the moment attacks first the lower parts of the lungs; it is expected that for ease of transmission, it has to adapt to the upper airways.
From the little studies that we have, it is rare to find the BF virus in the blood.\\\ Therefore, would there be a way to deliver sufficient heat to the airways to at least destroy some of the virus (kind of like an inhaled sauna), without damaging the other structures of the body?
Though I don’t know how one could do this, at home (or even in hospital) for pockets of virus inside the intestinal tract.
After all, the old system of herbal/essential oil very hot inhalations do help other types of respiratory complaints (tested and tried for you - in addition to 4 antibiotics, much to the astonishment and annoyance of my hubby’s doctors, but it cleared his pneumonias in 4 days, twice, against their expectations - well there was no hope, so I was left to try anything…). Can we do even better?
Is this too simplistic to think that every little thing might be of help against such a savage illness?
question. My family, we all have lower then the supposedly 98.6 temp.
I am always at 96, when I’m sick the highest it has ever gone is 100 and then I’m really sick.
How will this effect us with H5N1 and what can we do about it if anything?
KimT,
Just food for thought . . . fungal infections and neurotoxins from seafood can have a systemic body temperature lowering function.
Families do tend to harbor the same pathogens due to contagion and the same environmental chemicals due to geographical similarity and lifestyle factors learned in the home.
I’m not aware of any accurate statistics on the percentage of people with normal lowered-temperature. My expectation is that it would put you at a higher risk of most infections.
FrenchieGirl – at 17:10
LauraB – at 17:19 My ped receommended and I also use how the child is acting as guide as to how sick they are.
FrenchieGirl, What Laura says is true on my count as well in terms of letting behavior be the guide. My ped always does a complete “behavior inventory” to decide how to treat. My son can have a relatively high fever and be playing as if nothing’s going on. Meanwhile, my daughter’s normal temp is actually below 98.6F, so for her, what would be a low-grade fever in others is actually higher grade. I always adjust for that.
I have a book that has a range within which it is considered therapeutic to let the fever do it’s thing. I can’t remember what it is, plus it was a book on homeopathy, of which many people here are skeptical, so I hesitate to post it as authoritative.
NS1, Leo7, and anon_22: Thanks for all this great feedback. Keep it coming!
Leo7, your feed a cold, starve a fever info was echoed in two books I read about 1918. It was also noted in these books that aspirin use was almost always a guaranteed death warrant. Homeopaths and nurses did not use the aspirin and supposedly had much better outcomes. Whether this is because of any connection with fever tamping and cytokine I have no idea, but it’s an interesting coincidence if nothing else.
FrenchieGirl at 18:25,
Many times the solution is to use the simplest ideas.
Every little thing is important to your body from your pathogen load now to your environmental toxin body burden now (even parts per trillion).
Please tell us more about your natural intervention on your husband’s part. Did you once post here under another name?
I don’t like seafood or fish so i never eat it, not since a kid anyway. Until recently I have rarely been sick in my life. For some reason its us girls in the family with the lower temp tho my son is the same. Have always wondered why. my doctor doesnt know why either, school nurse would say its only 99 go back to class. I hated that school nurse. : )
Kim T-Why not take everyone’s temp everyday for a week at the same time and before eating to establish everyones baseline? That way you can guage how many degrees from normal the temp is when sick and also combine it with behavioral changes.
Frenchie girl-Your powers of deduction seem to be right on target. I don’t like to breathe scents when I’m sick. See Revere’s article on decreased lung function from things like AirWick. Didn’t surprise me, but some houses have them plugged in as many as three or four and now they’re being advertised for health benefits like lavender etc. When I go in those houses-I start sneezing and get a HA. I won’t be one to try any type of theraputic oils for the flu, but I’m glad they worked for you.
What no one’s mentioned is old time remedies often involved the sweating such as in hot baths for sickness. Native Americans had sweat ceremonies, as did Japanese in hot tubs.
Ednamode: The problem with H5N1 is the related hemorrhaging. Most of US is used to swallowing Advil, Aleve, tylenol etc at any sign of aches, pains and fever. The best thing is to avoid H5N1--if you get unlucky-use baths to cool first and as long as they work-you’re ahead in my opinion.
A properly managed sweat detox opens another route for removing toxins from the body, the skin. Use this as a preparation step for PF51, not as a treatment.
Many have a precisely packed pantry that will be feeding a family carrying maximum body-burdens of toxins.
Preparation isn’t just external.
NS1 – at 22:31 - FrenchieGirl at 18:25 — Is this too simplistic to think that every little thing might be of help against such a savage illness? — Many times the solution is to use the simplest ideas. — Every little thing is important to your body from your pathogen load now to your environmental toxin body burden now (even parts per trillion). — Please tell us more about your natural intervention on your husband’s part. Did you once post here under another name?
To take your last question first. Yes, but not on a health subject, for anonymity for professional reasons.
Natural interventions. I did many with both of my husbands. With respect to pnneumonia with my second husband, this is what happened. He had a mixed primary hepatocellular carcinoma with cholangiocarcinoma which was resected with success two years previously. Unfortunately, the first hospital which did the liver biopsies did not tattoo the trajectory of the needle and at surgery it had not been possible to take out the parts of this trajectory on which cancerous cells had been seeded by the needle (three biopsies attempts took care of seeding them everywhere).
As a result, he suffered a peritoneal extension of his cancer, while the liver remained cancer free and in perfect shape. For all intents and purposes, he was lost, having refused allogeneic stem cell transplants. But he refused to die too quick so as not to inflict his death on his son who was about to take an important exam (for the second time). He pleaded with the doctors to use whatever means to keep him alive until after his son had taken the exams. Unfortunately, he was so far gone, that the doctors gave him no hope, though they tried everything under the sun. He asked me to do whatever I could, so I intervened, mostly against the doctors who thought natural intervention was useless at best, in his full knowledge and support. For the composition of the various mixes, I’d have to look them up at home, I am at work at the moment.
The first pneumonias (both sides) happened in March when he had a peritoneal infection and septicemia, four germs, 2 gram +, 1 gram -, fungus. Huge ascites. Burst colon, burst small intestine, inflammatory shell full of abscesses, infectious areas in brain, low proteins, cancer everywhere. Told us to call the priest before surgery and have family say good-bye. They opened up, cleaned the viscera area; it took them hours, and by virtue of all this plus the surgery positioning, lungs were full of infected fluids.
I used herbs and essential oils this way - I made the mixes myself:
- antiinflammatory/antiinfectious - 3 drops on inside of each ankle and wrist, every two-three hours day and night (I slept in the armchair and got up whenever the nurse came in to check on him).
- eucalyptus mixes in front and back rubs - every 2–3 hours (in between the other treatments).
- eucalyptus mix inside the bubbles water of the oxygen system, added a few drops every half-day or so.
- inhalations of a mix of thyme tea with essential oils, 4 times a day.
- throughout the day, malva silvestris/chamomile/orange flower/hibiscus herbal tea.
- herbal extracts/tinctures and antalgic creams, for all the other various problems
- foot massage at the places where it could help
- all sorts of vitamins/supplements (which I had specially chosen for his illness, not just any OTC stuff)
- all that was in addition to standard treatment provided by the doctors (antibiotics, antifungal, erythropoietic growth factors, albumin, rinsing tubes inside the peritoneal cavity, asthma type of inhalants, sleeping pills, anti-depressants, etc. etc.)
- TLC, speaking to him reminding him of his decision, reassuring, comforting, etc.
After four days of hovering between life and death, he came round, they did CT-scans, the pneumonia was gone, the septicemia also, the brain abcesses were better, the intestines started to semi-work again. The doctors could not believe it. He got better and better, started daily walks in the corridor. I adapted my “prescriptions” to his new state of health. Everybody was furious with me because the oils stank throughout the floor, they had to put deodorizing machines out of the bedroom, visitors could not stand the smell of the herbs and of his colon oozing out through natural fistulas and plastic tubes and two pockets. I was mostly labelled as a desperate stupid excentric in total denial, but I couldn’t care less. The doctors could not blame me for the rubs, etc. but because of the smell they did not realize I’d dumped eucalyptus in the bubbles thing. They realized I must have given him other things, but I hid it well and they never caught me. I will say that I was extremely careful checking every single item on the Potter’s against the Pharmacopeia, checking for any reaction. I checked the doctors mixes as well. I caught the nurse once giving the wrong medicine, and once the wrong dosage. I gave them absolute hell for that, they could have killed him. I checked and rechecked absolutely every single thing, food included, moods of visitors - I interrupted visits of his ex-wife who was asking him to change his will… It was a more than a full-time job. I hardly ever returned home, ending up with a suitcase in the room where I hid my “medicines” with my clothes, sometimes washing my clothing in the sink.
The second time happened the day he was transferred to another clinic for convalescence! They had decided to wean him off the antibiotics for a week and then I organized the transfer. On arrival, he started with fever tremors (don’t know the English name for this, it’s not convulsions). Bam! Septicemia again. So I did the same again as above. Added to the teas some Viola Tricolor which I found in the clinic garden. We called the priest and the family again. There they weren’t willing to do the inside cleaning job again straight away (the anesthesist refused on the risk). So I intensified but it was more difficult because there were many more rounds of doctors and nurses. So I did most of all this at night. There I slept on a camp bed, the bathroom was transformed into a “chemical” lab, the doctors were more easy going. After a week, the pneumonias subsided. They did another surgery cleaning job, though at that stage, it was not possible to do it as thoroughly as before. He kept breathing difficulties because the intestinal passage was blocked just below the stomach and he refused a naso-gastric tube to empty the stomach, preferring to vomit naturally 3 or 4 times a day, and some gastric secretions always got into the airways and irritated them. The doctors were more sympathetic to me there and asked me some of my (lighter) recipes. Some staff asked also. Though I was more considered as a “wise woman”, they were nevertheless not for such natural therapies, but they tolerated me and the “can’t hurt stuff” I gave him (they never saw some of the things I gave him and it was probably a good thing for us that they had little idea of the power of plants). That time, I never returned home for 7 weeks. The only times I went out was to get more supplies.
I did many other things too, after, to improve every single little bit I could. At one point, after another clinic change, he was so tired (just after his son’s exams), he asked the doctors to stop anything not essential. Then three days later, changed his mind because he wanted to know the results of his son’s exams and found the will to live again. He asked the doctors to reintroduce the medicines. But it was too late. So, again, I took over. The doctors could not understand why he wasn’t dying…
Days before dying, he got a nasty tooth abcess. We were unable to either take him to a dentist or have one come in. The doctors simply wanted to push more morphia but my husband refused. A friend of ours, a young dental prosthesist, came with her instruments, disinfectants, etc. and she anesthesized with WinterGreen and Clover essential oils. It stank, irritated him a little, gave him a bad taste, but after 1/2 hour, the abcess was cleaned up and gone, the tooth ache did not come back. The doctor who came just as she was finishing the job was mad as hell - but my husband was smiling.
With completely busted innards, four surgeries, 2 pneumonias, 2 septicemias, etc. etc. he managed to live from February to early July. I’ve got all the CT-scans to prove what I say.
He fulfilled his mission, he was alive for his son’s exams and alive also the day of the results (passed with success), he died the next day, happy. Me too, I had done what I was meant to do.
I will not pretend that this achievement was due only to natural methods, this would be untrue, he got the very best care and goodwill and energy from the doctors, even though I could not agree to everything. However I’ll definitely say that the 1% I contributed tipped the balance towards the success of his mission.
Back on the fever subject.
If we decide that fever may be beneficial, up to a point, then that means that beyond that point, one has to use some means of lowering it.
Natural alternatives:
Baths
Bed baths
Towel envelopes
Frozen peas
Short of these methods, there remaines natural or medicinal remedies to lower the fever with a lasting result.
Finally, if you read what I wrote above, albeit for a different illness than bird flu, I ask myself just how practical, or what is the expected ratio risk/benefit, to using natural means or ‘medicinal’ means of lowering the fever.
One has to realize that with H5N1 you’d be dealing with a very contagious illness. Baths and the like would put you, regardless of the quality of your PPE, at much more risk of contracting the illness, therefore becoming sick yourself while trying to save your loved one.
In such a quest, despite my penchant for natural methods, I think I’d rather, if necessary, lower the fever with the pharmaceuticals at hand than with bed baths/towels, etc.
It’s not just that, but if you’re going to try to treat the pneumonia, on your own at home, with the methods I used for my husband, you’ll be working with your patient 24 hours a day, for weeks. I had the logistic support of the doctors and nurses for the allopathic interventions, but if you’re on your own, with less than adequate facilities or remedies, how will you cope, giving baths or bed baths or towel baths? Plus cleaning the bed, washing, ironing the sheets/towels, feeding your patient, etc. etc.
I’d started a thread some months earlier thinking I might turn some of us intellectuals to practical considerations, but the thread never really took off so I left it. Are we now more ready, as H5N1 marches ahead, to speak about the caring of the sick? Despite our fears, despite our ignorance, despite --- (add whatever concerns you)
Smile!
What about cycling some times of fever reduction with some times of suppression (for rest)? Would that be the best or worst of both worlds?
Forgive me. I meant some times of allowing the fever with some rest periods of fever reduction.
FrenchieGirl:
It goes without saying if H5N1 gets in your house the s@#t has hit the fan! It will be a total life and death struggle going on and yes you must make the decision about your exposure times. For a child I guess the moms will never leave their side, and will do the frequent sips and wiping down of the body while the child coughs in their face. The parent is putting their life at risk. What about aunt Nelly? It goes without saying if its in the house—all—have been exposed. The only thing to do is to do what’s required for survival. I’m sure in 1918 there were people who nursed family to health and then turned around and died. How much anyone does at the bedside is a reflection of how much they care—just as you demonstrated with your husband. He was a lucky man.
kc_quiet – at 11:39 - Yes I suppose that could be a strategy, but unless somebody can tell me the fors and againsts, I’d be in a big dilemma.
Leo7 — at 12:18 - On a thread some weeks ago, there was some heated debate on the exposure one would have caring for loved ones, which would be better, cuddles/care or protection/ppe. The opinions were varied. A moral dilemma would be: is it a better demonstration of love/care to put knowingly your life at risk to save your child, if you have other children too (even if you don’t have other children, husbands, wives, etc). If you die, you make orphans/widows/widowers. If you take precautions, you deny them love. So this question is a tough one, striking a good balance very difficult, and some may think as you do, but others not.
Fever. NS1, Anon_22. More suggestions?
The other day, on the Indo news on another site, there was a link to this photograph of a little 6 or 7 year old boy surrounded by doctors in silver space suits. Poor little kiddie. I was shocked. He must have been terrified.
I could be more precise:
If you die, you make orphans/widows/widowers, love lost permanently. If you take precautions, you deny them love, love lost temporarily.
Which is the most difficult to cope with, short and long-term? Which is the worst for the one left alone?
Fever, and using such natural means as described to reduce it, actually puts you much more in a difficult position to decide than just administering tablets. (Of course it would be somewhat true also of the cleaning of body fluids and matters)
Sorry staircase mind tonight
Read: Which is the most difficult to cope with, short and long-term? Which is the worst: the one left alone because of your death, or the one left with you whom you deprived of some love/care?
Too difficult to sort my ideas this evening. I need some BBRWFW!
Posted this comment earlier on Effect Measure: De Jong’s Vietnam Paper
I am convinced that these strains of H5N1 with the residue 92 polymorph on the NS1 gene segment are rapid replicants due to the Interferon pathway interference. The in vivo interference, likely a stultification of NF-kappaB, allows the early viral particles a headstart on the immune system, a temporary invisibility.
I surmise that the Cytokinic Dysregulation is closely mediated by the late start of the immune response due to this early stage failure to detect and respond. By the time the H5N1 infection is fully detected, numerous polymerase activities are already completed. The CD is a fail-safe, even a limited self-destruct, because the virus evaded the early sentinals.
I’ve additionally conjectured early this year that this particular glutamic acid polymorphism on the NS1 gene segment may also mediate higher mortality rates in pregnant women and the young due to the involvement again with NF-kappaB, which is also required in a number of phases of cell differentiation.
I can’t seem to get to the bottom of the actual mechanism as yet.
Perhaps the bulk of a particular cell’s NF-kappaB population is consistently engaged for cell differentiation in the pregnant and the young leaving the H5N1-infected cell short of resources when NF-kappaB is needed to unbind and translocate to spur the Interferon pathways?
Perhaps we are all short of supply from the start of an important mediative factor?
FrenchieGirl – at 06:13
Well done. Know that your gift to your husband is deeply admired on my side of the ocean.
Please, if you are able, let others here on the FluWiki know of your abiding interest and deep experience with the natural aspects of living. Your gift will continue to bear fruit for everyone who sees your devotion and the discipline required to create such a beautiful modality.
FrenchieGirl, tears in my eyes for what you did for your husband.
FrenchieGirl – at 15:13 On a thread some weeks ago, there was some heated debate on the exposure one would have caring for loved ones, which would be better, cuddles/care or protection/ppe. The opinions were varied. A moral dilemma would be: is it a better demonstration of love/care to put knowingly your life at risk to save your child, if you have other children too (even if you don’t have other children, husbands, wives, etc). If you die, you make orphans/widows/widowers. If you take precautions, you deny them love. So this question is a tough one, striking a good balance very difficult, and some may think as you do, but others not.
FrenchieGirl, You really have your thinking together on the love lost permanently, love lost temporarily conundrum. Since the death of my beloved brother nearly 20 years ago, I have always contended that death (not to be confused with the dying) is far worse for the survivors than for the deceased.
I certainly don’t want to leave my children motherless. On the other hand, what Leo7 says is correct in my experience. By the time someone in your household is symptomatic, chances are everyone has already been exposed. We practice excellent hygiene in our house, but almost inevitably colds and flus run through our family with a predictable domino effect.
The only solution is to basically start using social distancing practices with my own husband and children, and if I am going to get sick from H5N1 and die, that’s not how I want to spend what may be my final days on earth with the people I love.
All that said, I think there is a way to balance PPE with compassionate care. I did it for more than a year caring for my brother at a time when his disease was poorly understood and there were many misconceptions about transmission vectors. We will use common sense approaches to caring for the ill in our home: separate (but not 100% isolate) from well members, gloves, masks (not that I think they’ll do much good, but just in case), bleaching surfaces and bedding, using disposable items whenever possible, integrated (allopathic and homeopathic) remedies, etc.
Regarding treating fever that rises above the therapeutic range, we will use a combination of OTC and non-medicinal measures, including many of those you listed above. OTC not so much to reduce the caregiver’s risk of infection as to conserve energy expended in providing care to ensure enough reserves for the marathon that caregiving will no doubt be.
There does come a point, however, when we must face the fact that we cannot control all outcomes. We can only do our best and hope for the best for ourselves and our loved ones.
I couldn’t decide where to put this article but since this is such a good thread it will give it a bump up. For those people taking a daily aspirin for heart health, taking Ibuprofin or Advil for fever will cancel the aspirins effects out. You might want to discuss with your doctor but I think this will only leave tylenol as an alternative treatment for fever. Please read cbs news article: http://tinyurl.com/hnt3v
Actually this is a better resource than above. http://tinyurl.com/qau5x
I have a question for those knowledgeable about fever. Perhaps a silly question?
Frenchie,
Good questions! Even though the hospitals may have all the right antipyretics or other measures, bottom line is fever is symptomatic of a disease process, so antipyretics are only useful for temporary relief. If the underlying infection or immune process is still raging, the fever will spike right back up again. In that sense, lowering the temperature by any other means such as tepid (lukewarm) sponging or baths, are also useful for supportive purposes only. Doesn’t mean that you shouldn’t use them, in fact I think you should, since any reduction in stress to the whole system would be beneficial. But in the context of a very dangerous disease, the extent of the benefit for survival would probably be marginal. Also, remember that lowering the temperature is not the primary objective, overcoming the disease process is.
I don’t know about weeping willow bark, perhaps someone else can address that one. :-)
So the 2 things that might overcome the disease process would be that which kills the viruses, aka antivirals, and that which reduces any abnormal host response, aka immune modulators such as statins.
anon_22, thank you. I do understand that fever is symptomatic of a disease process, and that as long as the underlying infection is still there, the fever comes back. But could the (constant) lowering of the fever provide for a less hospitable environment for BF? Would it slow the raging process just a little so that this may give a window of greater efficacy for other medicines such as antivirals (or the prednisolone advocated by Tom DVM)?
FrenchieGirl – at 18:59
But could the (constant) lowering of the fever provide for a less hospitable environment for BF? Would it slow the raging process just a little so that this may give a window of greater efficacy for other medicines such as antivirals (or the prednisolone advocated by Tom DVM)?
I can only revert to the very unfortunate line “there is no data to support that notion”. LOL
We can’t say. I suspect not, simply because the severity of the disease is such that these marginal changes would probably not make any difference. Plus I’m sure tons of antipyretics have been tried on all these patients, and they still die. Sorry.
Sigh. Then at the very least, it would not harm the patient if it relieves some of the stress. OK, next time I have a cold, I’ll see if my disease is shortened… I don’t think I could try with (ordinary) flu, it seems I’m not susceptible, I’ve never had it… Sometimes I think it’s thanks to my GP Dad who used to have us play in the patients’ waiting room every flu season so that we were supposed to become hardened! Now, any result of this experiment will have to be regarded as “anecdotal” :-). Well, if we have, say, 300 FluWikians who try natural fever lowering during a cold … it might be the beginning of a worldwide clinical trial. Anyone willing to write up the rules of the trial?
Are there anti-viral herbs? Garlic, echinacea, Chinese medicine, lemon balm? There seems to be an endless list in Google’s response to the subject.
I believe that the body is it’s own best defensive system. And that if the body has the nutrients that it needs it can heal and fight whatever aliment. I personally seldom give fever reducers, the fever is part of the healing process. If your child has a fever that is trying to irradicate an infection and you lower the temp then you have actually hindered the healing process, and while making the patient feel better temporarly you have increased the duration of the illness. I honestly believe that it is the overuse of fever reducers that has led to stronger more virulent viruses and bacterium. Most of these pathogins cannot live at a higher temp. I have planned on trying to avoid using fever reducers, however I will closly moniter the fever. But I plan on letting it run it’s course like I always do, I do however plan on using benadryl. Remember the old addage feed a fever? Keep in mind that a fever is burning up a lot of energy and patient may need some easy on the tummy energy boosters. To them feel better I like to give the kids apple juice slushies. Try Jell-O, not the time for sugar free, chicken soup or ramen, candy, suckers, remember peppermint helps soothe an upset tummy, so peppermint candy is good to have around that and ginger ale, ginger ale is actually made with ginger and ginger is an anti-nausient and vitamins before and during any illness.
I went back and read some more of te posts and saw someone wanted to stop a fever so a patient could rest. When I have been very ill it was at night when I spiked a fever, at night when the body goes into heal and repair mode. I think it waould be better to just moniter it at night and try to comfort the patient. I like to place a cold wash cloth on the forhead. Sometimes I keep a basin of cold water near the bed to refresh the cloth it seams to ease the headach, the rest of the fever is usually bearable. Note that a headach is often a sign of dehydration and a feverish or sweaty patient may be in need of rehydration. Also FYI you can absorb up to a cup of water by osmosis, so a shower or bath may be one alternative.
Tepid water is better than cold water, as the cold causes vasoconstrition which reduces the effectiveness in lowering the temperature.
Cold water can also start shivering, which will increase the temp. Stick with tepid.
FrenchieGirl,
Your questions are the ones that researchers around the world are trying to solve at the moment, and not very well from the looks of the CFRs.
After all you’ve written, I know that you realise that results that an individual gets from seasonal influenza treatments may not be at all predictive of results against H5N1.
We are definately premature in making a general decision on raising or lowering temperature to treat HPAI H5N1.
Ok, Here is another suggestion. I have read on another thread here about the ability of this virus to shrink and swell depending on the humidity available to it. If you have low humidity the virus shrinks and will travel lower in the lungs and tend to increase the odds of an infection. So the advice of the article was to keep the rooms with a high humidity. This was a study with clinical conditions and methodology. No time to find the link but it was within the last few days. In the days of treating my daughter for a very bad lung infection, I bought a personal steamer. The kind you place your face over and inhale the vapor. This was in my opinion one reason she got better. I worked in a chest clinic with a very experienced TB doctor. We talked a lot about the workings of the lungs…though I was/am not a doctor. I have an intuitive grasp of their workings. I think that the shrinkage and expansion process of a virus may in fact have something to do with it’s ability to bind to the surface. It could use the ability to hold tight to a surface not only by the shape of the “H” but also by a mechanism like a climber going up a chimney. you expand you legs and place your back and use that pressure to get a grip. So, my thought is this. At the early stages of an infection, use a inhaler of steam. Take tamiflu as prescribed. BUT also put a tablet of tamiflu in the water that is heated and inhale that into your lungs. You get the medicine to the surface where it can do the most good the fastest. It will be absorbed in the lung tissue and be at the site of the infection. The higher humidity also makes the virus expand before it is ready and may no longer fit what it wants to…”H”…
When I am sick, at the first signs of illness, I go to bed early, cover up with lots of blankets, get very warm - and sleep in total darkness to stimulate the immune system. I sweat the colds out of me and they don’t take hold. Ok, shoot me down. Grin.
Dude - great ideas.
I will keep the house well humidified this year.
I do not yet have any Tamiflu, but I would consider putting it in a nebulizer, will it emulsify? I am taking note that it may be much more concentrated this way and wonder about taking it both ways. Perhaps it would be better to alternate methods as the effectiveness of it being inhaled has not yet been proven.
By the way I do usually only use cool or tepid water, but I only administer to the forhead as I am not trying to reduce temp but comfort patient. I do think cold applied to the body, neck, or arms would indeed bring on shock.
frenchie - one thing you posted got me thinking - about the patients receiving the “best” care possible in Indonesia. Most of the patients coming in have already been sick for a few days and either weren’t getting better/got worse (usually with breathing problems). By then the disease has invaded/entrenched iteself into so many cells and systems the doctors are fighting an uphill battle. I wonder how many of the patients had fever reducers available to them and/or actually used them prior to coming to the hospital? If they have been running a high temp (+40c) perhaps that is allowing the virus to replicate more easily. If that’s the case, my inclination, based on how litte we know to date, is to treat with fever reducers, especially if the illness is causing the patient not to drink or rest.
Closed to maintain Forum speed.