The Great Fever Saga (Spring 2012 edition)

My daughter has a cold.

OK, a bad one. She went to see the doctor on Friday to get her sling off (she fell off the couch a few weeks ago and broke her collar bone...aren't four-year-olds fun?), and she had a slight fever. The doc said her ears looked a little red, and if the fever lasted until Monday she should come in and get checked out for an ear infection.

The weekend went by, and by Monday morning she was bright and chipper. So, off she went to daycare like a little trooper with a snotty nose.

Then BAM! The phone call came just before 4:00. She had woken up from nap time with a fever of 102. So, off I went to save her (and subsequently found out that earlier in the day she had face planted and got a bloody nose...unrelated incident, but the broken collar bone had apparently reduced her willingness to use her hands to break her fall. I'm guessing she's learned that using your face is not a viable alternative).

I gave her a shot of Tylenol and kept an eye on her, but by 7:00 she was up to 103.8. That's...kinda high. So, following doctor's orders, we went to the hospital (since the actual doctor's office was now closed), thinking there might be some hidden infection.

By the time we got there the fever was easing slightly from some extra Advil. The nurse was kind enough to keep an eye on her in the waiting room, but by the end of about three hours the only real recommendation seemed to be increasing her doses of both Tylenol and Advil to aggressively keep the fever under control. So, having already committed to $8.00 in parking, I decided to use their Advil before going home and putting her to bed. The instructions: if it comes back up tomorrow, go straight to the walk-in clinic or her doctor's office.

I spent the night up every couple of hours administering medicine. By morning, her fever had clearly broken. Her temperature was down to 94.3, which is pretty typical for a fever break. She was a little dopey for the first part of the day, but I kept her at home just the same.

Good thing. Mid-afternoon, she crashed on the couch and woke up with...you guessed it...a temperature pushing 102 again. This time she was in hysterics, totally unsure what to do with herself. She had no idea what she wanted or didn't want. And it was getting worse. So, since it was pushing 4:00 again, I decided the walk-in would be a more likely bet than the doctor's office.

No dice. The walk-in was also closed. Taking all this into consideration, I elected to go back to the hospital.

The wait time in triage wasn't all that bad, but the nurse wanted a urine sample to see if maybe there was a bladder infection (she apparently neglected to put the coughing and runny nose on the report). Thing is, four-year-olds don't like to pee on command. And they really don't like to do it into a cup. She faked me out once ("Daddy I have to pee..." try...try...try... "I don't have to pee." Gah!), but about two hours into our residency she managed to produce a good sample.

This went into the nurse's urine sample collection box (who knew...there's an interesting niche market design concept, eh?), and we sat back to wait for a doctor. Of course, by this point her fever had all but disappeared from the first round of medicine I gave her, but she entertained herself with some colouring and a dose of Treehouse on the lobby TV.

An hour and a half later I walked by the triage nurse's desk and saw that the sample still had not been picked up. Of course I barked about this. I understand busy, and I get that a kid with no current signs of a dangerous fever will get bumped down the list behind the kid with the broken arm and the two or three helicopters that had come in during our stay. But come on...you can pick up the damn sample and at least get that underway!

Finally we got called in, and we didn't have to wait long to see an actual doctor. Unfortunately, he was clearly overworked and already pissy about having to tend to every snotty nose in the county. When he found out that my daughter had a cough and congestion, he closed his chart and said, "Oh, well that's obvious then. She has a cold. And kids with colds get fevers. We only do urine tests if it's not obviously upper respiratory."

Uh huh. So...the fact that her fever has lasted five days isn't alarming?

"Nope. She doesn't even look sick. They don't worry about infection unless it goes on for two or three weeks."

Uh huh. So...I'm just following her doctor's orders and bringing her in when it doesn't go down.

"Yeah. Parents tend to overreact with fevers. Just take her home, put her to bed, keep giving her medicine to keep it under control. OK, you can go now."

Wow...did I feel like an asshole for wasting that guy's precious time. I suspect the string of professionals before him didn't give any consideration to how much of my precious time I spent sitting around the waiting room at the hospital on their advice.

A lot of people have said I did the right thing, going to the hospital and having her checked out just in case. But from my perspective, I would really like it if doctors and nurses all got together and read the same guide books in terms of what to do in a situation like this. Several layers of conflicting advice does not make for a smooth treatment process for the young patient and the patient's impatient father.

They're right, of course. It's worth going just to be sure. But I probably should have trusted my gut instinct and said to myself, "self, you know this is a fever, and you know it's from the cold. And you know that in a few days if you just keep it down with Tylenol and Advil she'll be fine."

I took her to daycare again today. No fever for the first half of the day, and no phone call yet. We may be past the worst of it; it may come back after nap time. Either way, at least I know what to do with it if they do call.

And I got a nap this morning to catch up.

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How sad is this?

I'm not one to judge people. At least, that's what I like to tell myself. We all like to believe we're non-judgmental because at some point in our lives we were convinced that this was the way to relate to one another fairly.

That said, I don't like to point out faults in other people's appearances because I'm not exactly Mr. Universe myself. Yeah, I have the soft midsection and the crooked nose. I get that, and it's fine, because I have other things going on that give me the confidence to not really care that much about "imperfections" I consider to be pretty minor.

But when a guy comes along who goes to the extremes the guy in this video goes to, I have to wonder. Now, I'm not judging his quality on the weirdly cartoonish way he looks. Clearly he thinks he looks great, and that's fine. It's the motivation behind this much surgery that's cause for concern. I consider plastic surgery reconstructive surgery -- useful for disfiguring accidents, but it can be disfiguring when applied to a healthy body.

In this case, I think it shows a serious issue with self-image to begin with. But it also demonstrates an unusual set of shortcuts that are, frankly, dishonest. Pec implants? Bicep implants? Abdominal etching? These are procedures designed to take the "work" out of "work out," and they're cheats.

One thing I know about shortcuts: they never solve the problem. In the end, it's going to take a lot more work to maintain than a set of crunches, push ups, and dumbbell curls. And because it's done cosmetically, it's only a veneer. With the results, though, he has no incentive to actually exercise. And that may be the most dangerous and tragic result of this whole story.

My opinion: don't do this.

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The Latest on Aspirin and Heart Disease

Disclaimer: The information in this article is provided for informational purposes only, and is not meant to replace the advice of a qualified health practitioner. It is not intended to diagnose or treat any medical condition. If this information is of interest to you, please consult your physician or qualified health care professional before implementing any advice contained herein.


The Canadian Cardiovascular Society has released a report geared toward clearing up some of the confusion surrounding the use of ASA (Aspirin) in the control of heart disease. ASA works as a blood thinner, keeping blood moving freely and preventing clots and clogging that could lead to heart attacks. In cases where people have suffered heart attack or stroke, ASA therapy may reduce the risk of a second occurrence by as much as 25%. However, the CCS also notes that many people make the mistake of taking ASA who really don't need to.

The three key recommendations in the clarification report are:

• A lifetime low dose of ASA is recommended for all people who have suffered a heart attack, stroke or peripheral arterial disease.
• ASA is not recommended as a preventative treatment for people who have not suffered some form of heart disease or other vascular disease, even in the presence of other risk factors such as diabetes.
• Anti-inflamatory drugs, such as Ibuprophen, are not recommended for people using ASA treatment, as the anti-inflamatory character of these pain killers can interfere with the function of ASA.

Not mentioned in this report, but worth mentioning here, is the further recommendation that while Ibuprophen can interfere with the anti-clotting properties of ASA, other treatments, such as Warfarin, krill oil and alcohol consumption can make these properties more dangerous. With anti-coagulant properties multiplied, minor cuts can take much longer to heal, and more significant injuries can become severely problematic.

With this in mind, however, let's take a quick note of some of the other therapies and what they do, just for the sake of interest:

Warfarin: This is a commonly-prescribed anti-coagulant, particularly for people with clotting issues already. Warfarin is a major blood thinner, and should not be taken without close medical supervision. To give you a sense of this, it's important to bear in mind that this stuff is used as rat and mouse poison. It acts by causing massive internal bleeding in the rodent, so they literally bleed to death as their organs disintegrate. That doesn't happen with people, but you shouldn't opt for this one for any sort of self-treatment.

Alcohol: I don't know anyone who treats alcohol as a treatment for anything, although significant research into the "shot-a-day" home remedy, as well as the antioxidant effects of red wine, is an ongoing field of study. Alcohol thins the blood, but you know all the other stuff it does that might not be considered medically useful, so approach this one carefully as well. Excess alcohol consumption (which literally means two beers a day) can interfere with fat transport, cause damage to the liver, and kill brain cells. When you note that eating red grapes (with seeds), or even just some blueberries, provides the same anti-oxidant protection as that glass of red wine, the benefits dwindle sharply.

Krill Oil: This is the new kid on the EFA block. Krill oil is being sold as a healthy alternative to fish oils for Omega-3 supplementation for three key reasons. First, its ORAC values (measuring antioxidant activity) are off the charts; way beyond any of the standard antioxidant treatments. At the same time, it has shown significantly more impact on pain and stiffness in arthritis studies, greatly improved cholesterol and blood glucose levels compared with standard fish oil, and is a powerful blood thinner that also prevents clotting. Second, it is farmed only for this purpose, so while fish oil supplements are usually "leftovers" from other processes (which can produce a lack of freshness, or even rancid products), the krill that is caught is really only applied to this and a few select purposes. The other advantage of this is that the source is so far down the food chain that it hasn't accumulated the toxins that predator fish (like cod and halibut, the main fish oil sources) accumulate through levels of feeding. Third, it's a highly sustainable source. Krill is only really consumed by large mammals like whales. It has little other commercial value, and so is not in danger of being wiped out by over-fishing. Human activity and catch limits have barely even dented this population. That's not to say they won't some day, but with careful management this is one of the most plentiful nutrient sources on the planet, and a far more ecologically sound option than fish oils. (See a more comprehensive outline of these benefits HERE.)

Ginkgo Biloba: This isn't a blood thinner. Ginkgo's popularity as a supplement for "brain function" may be a little misplaced...there's not as much clinical evidence to support its memory-enhancing properties as was once thought. However, where that assumption is derived from is worth noting. Ginkgo is a vascular dilator. This means it relaxes your veins and arteries, allowing a more relaxed flow of blood throughout the body. This in turn aids in oxygen uptake; and therein lies the theory behind its power to enhance mental function. In low doses, it can cause a slight headache (increase bloodflow will do that), but only for the first few days.

Ginkgo's property of enhancing blood flow does have other advantages, however. As a part of workout supplementation, this increased flow also enhances oxygen uptake to improve VO2 max levels for increased cardiovascular endurance and conditioning. It also creates a more open flow of blood to the muscles, which in strength training can have a beneficial impact on the transport of nutrients and oxygen to recovering muscles. And, for those who are concerned about sexual function (in both men and women), it functions in exactly the same way as prescription Viagra (note the side effect of the headache is the same), unless combined with a blood thinner. There are properties of fluid dynamics that may make thinner blood and relaxed vessels less effective for maintaining erection (thus the infamous "whiskey dick" when one consumes too much alcohol). It can also make cuts flow more freely, which is a bit of a risk as well. However, under normal healthy conditions ginkgo can make a beneficial addition to a natural supplementation program.

Remember, if you're looking at increasing blood flow any of these options should be discussed with your physician or cardiologist (or even urologist) under all circumstances. This is especially true if you plan on combining any of these. Know the benefits, but stay wary of the risks, and keep your doctor involved.

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