General Wellness

WHEN TO TREAT A FEVER and TONIC WATER (not related by the way)

Andrew Chuma One comment

WHEN TO TREAT A FEVER and TONIC WATER (not related by the way)

Fevers are a common sign of illness, but they also play a key role in fighting infections. Technically, a fever means you have a temperature of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher in adults. For kids, a fever is when their temperature is higher than 100.4°F (measured rectally); 99.5°F (measured orally); or 99°F (measured under the arm).

I hear patients tell me all the time that they have a “low-grade fever”. Personally, I feel that you either have a fever or you don’t. The whole “low grade” thing to me, is like “a little bit pregnant”. In addition people who tell me that they don’t get fevers are wrong, or they are REALLY, REALLY sick or may have some kind of underlying immune problem, and most don’t.

A fever is a symptom of your immune system trying to fight the virus. The higher temperature does make it more difficult for some microbes, including viruses, to survive.

Fever and the coronavirus

Fever, along with cough and shortness of breath, is among the symptoms of COVID-19. If you have symptoms and think you have been exposed to COVID-19, call your healthcare provider. The CDC’s Self-Checker tool can help you make decisions about seeking medical care. Mayo Clinic also offers a tool that helps you decide on seeking medical care and whether you need a COVID-19 test. See below for the links.

For fever, aches and pains, acetaminophen (Tylenol). If you are taking any combination of cold or flu medicine, keep track of all the ingredients and doses, and make sure not to exceed a total of 3,000 milligrams of acetaminophen per day. It is better to avoid Motrin (ibuprofen) or other non-steroidal anti-inflammatories like Aleve. There is some evidence that NSAIDs can increase the chances of covid-19 taking hold. The mechanisms are not clear. Some think it has to do with their impact on the immune system, decreasing its efficacy or possibly promoting viral binding to cell walls. Regardless of the cause, stick with acetaminophen.

However, keep in mind that a fever is also our body’s response to infection and helps combat it. We are all too soft and comfortable in modern society and can’t deal with the least bit of discomfort. I would say that if your temperature is below 102 and you are not too terribly uncomfortable, ride it out. Drink PLENTY of water since fevers may simply be a result of dehydration. As a general rule of thumb, if you are peeing at least 4 times a day, you are probably hitting the minimum amount of hydration.

If your fever is above 102, or you are really not feeling well, take acetaminophen. Too high a fever is actually a sign that your immune system may become overwhelmed and you should seek medical attention. Too much response from your immune system may also be a problem, resulting in tissue (lung) damage.

QUININE. I was asked about tonic water and covid. The issue is the quinine in the tonic water. Quinine was used to treat malaria back in the day. There is some thought that because hydroxychloroquine may be helpful in some cases, that tonic water might also help? First of all, modern tonic water, uness it’s the expensive kind, does not use real quinine which is naturally derived from the bark of the Cinchona tree. It’s mostly chemical flavoring. Secondly, hydroxychloroquine is only effective in some people who are really sick. It also has some side effects.

I would say to save the tonic water for a nice vodka or gin and tonic with a big huge splash of lime. The vitamin C from the lime is probably more helpful!

Stay safe and Be well.

AC 😎✌️🌱❤🐖🏃🏻🧘🏻‍♂️🌎

https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html

https://www.mayoclinic.org/covid-19-self-assessment-tool

IMPORTANT INFO ABOUT TESTING. False Negatives and proper technique.

Andrew Chuma One comment

IMPORTANT INFO ABOUT TESTING. False Negatives and proper technique.
 
I saw a scene on CNN this morning of a drive-by testing facility. It was not clear where it was but concerned me was that the person doing the swab was swabbing the mouth rather than the nose. I reached out to an Infectious Disease specialist I trust about the accuracy of testing with respect to how it is done and IT IS IMPORTANT.
 
The most accurate way to get a reliable test is actually to get sputum (lung secretions) which a patient coughs up freshly into a sterile container. Obviously, if you are coughing to this degree, you are pretty sick, covid or not.
 
For screening purposes, a nasopharyngeal swab (the back of the nose) is the most accurate since the virus lives in the nose and back of the nose (nasopharynx). This is how the flu screen is properly done. The virus replicates in the nose and is then inhaled into the lungs where is causes lung tissue inflammation.
 
An oropharyngeal (back of the mouth where the palate and tonsils are) swab is great for strep/tonsillitis since the bacteria lives in the tonsils but it is not ideal for covid-19 and has a greater chance of false negative results.
 
A false-positive result (a test which says you have it when you really don’t) is much less likely than a false-negative (test says you don’t when you really do).
 
If you have a false positive result, you will be self quarantining more so you’re better off anyway! however, it can also lead to increased stress which sucks.
 
A false negative is obviously worse since you will have a false sense of security and also put all those around you at greater risk.
 
SO, if you are going to have the test at one of these screening locations, insist it is done properly. Having a cotton swab stuck in your nose all the way back is not fun and a little harder than the mouth, but it is much more accurate.
 
It’s a very momentary discomfort and worth it for more accuracy. Relax. It could be worse. Imagine if this was all a urinary tract infection pandemic in which case drive-by testing could be a whole lot more embarrassing and uncomfortable!! 😉
 
Be safe and stay well.
 
ac

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