There was a kid who was brought by his mom into the emergency room one night complaining of an earache. When kids or anyone else have earaches, the first thing that most healthcare providers do is look into patients' ears. Makes sense, right? As I sauntered over to this poor young tike and pulled out my otoscope, the kid just looked at me. But the mom leapt off her seat and hit the ceiling. "No medical student is going to examine my child's ears!" she belted out and then proceeded to clap her hands over her son's ears. The poor little fellow shrieked in pain. When I recovered from the pain of listening to this child shriek while his mom freaked out, I saw that the nurse had recorded the kiddo's temperature as normal. "I see that he hasn't been running a fever," I said. Mom responded with, "Of course he has had a fever. I've been giving him Tylenol all day." When I explained to her that fever helped to fight infection and she didn't do her child any favors by reducing the fever and maybe that was why his ears hurt so much, she asked to see the attending physician. Meanwhile, the kid just looked at me and nodded. From that day on, I was determined not to be a pediatrician. But trust me, I loved the kids.

I can't tell you how many mothers have told me that fevers are bad. I guess it's understandable that when your child is sick and miserable, you would like to get rid of all symptoms as soon as possible. But most of our body's response to infection is good - otherwise we wouldn't have such responses. Fever is an excellent example. It turns out that elevated body temperature kills microorganisms. So fever is not only not bad, it's actually very positive. Now, I certainly don't mean to say that all fevers are good in all circumstances. (There are caveats to nearly every statement that I make in this series of writings, which is one reason that it takes seven years of education after college to be a general practitioner.) Fevers above, say, 105, can cause seizures and fevers in some people cause cold sores. Usually, though, the overall effect is beneficial. Thus, taking Tylenol or aspirin solely for the purpose of reducing fever can be detrimental. Parents, take note. If you insist that your doctor tell you that your child's fever should be reduced, then he just might do so, but only because you are a healthcare consumer that might choose a different ER the next time your kid gets sick.

There is some speculation that fevers themselves make you feel lousy. Whether this is true or whether something else (like special proteins called cytokines) makes you feel lousy, there is a reason why we feel lousy during common infections such as colds and flus. The reason? Cool it for a while, so that the body can heal itself. It wouldn't make much sense to be running marathons or pulling all-nighters at the same time your body is working overtime to kill invading microbes, would it?

The body responds to infection in many ways. One way is inflammation. Response to local infection, such as a pimple, is a good example of inflammation. The Romans accurately described the components of inflammation thousands of years ago: calor (heat), rubor (redness), tumor (swelling), and dolor (pain). All four of these symptoms are due to increased blood supply to the infected area. Why blood? Blood carries the soldiers of the body's infection-fighting force - white blood cells. White blood cells kill anything that is not you. So the other day, I was bitten by an insect, I think, on my face. Then came the inflammation. I got a got a big, red, painful bump. The inflammation could have been due to something that the bug squirted into my skin or it could have been due to an infection from bacteria or other pathogens that the bug carried. Did I cover my red facial bump with steroid cream to reduce the inflammation? Nope. Inflammation is my friend, and I want to fight whatever is in there that isn't supposed to be. You?

There are several causes of infection: bacteria (like Strep throat), viruses (like most flus), fungi (like Athlete's Foot), etc. Remember this: antibiotics kill only bacteria. Remember this also: thus, antibiotics don't treat flus. There are no over-the-counter medicines for viruses, and few effective prescription medicines that are effective against viruses. Many coughs are viral. Antibiotics don't treat these either. I have already discussed antibiotics elsewhere, so I won't make too much of an issue of them here. Suffice it to say that just because you have a cold, flu, or cough doesn't by any stretch of the imagination mean that you necessarily need antibiotics. But use your common sense. If you start coughing up blood, for instance, then stop thinking like a doctor and visit one.

YES, THIS IS GOOD

The sores pictured here are examples of inflammation. The bottom aspect is an example of an inflammatory response to infection, whereas the top aspect is an example of an inflammatory response to injury. In both cases, increased blood flow is responsible for the redness and swelling. The inflammatory responses will speed healing and protect from microbial invasion. Click on the picture for a larger view.

CHIN UPS

The lymph node exam can be an important indicator of infection. Lymph nodes, which reside throughout the body and are prominent around the jaw and neck, are the gathering sites for white blood cells and other cells that help fight infection. Typically, infection results in swollen and somewhat painful nodes.

Fevers are good (almost always) since they kill microbes. We feel bad during infections for a reason - to slow us down. Inflammation is good; it allows white blood cells to get to the site of infection. Many different microbes cause infection, but antibiotics treat only bacterial infections. Coughs and flus, for instance, are generally caused by organisms other than bacteria and are not sufficient alone to justify the use of antibiotics.

1. It's best not to get rid of fevers solely for the sake of getting rid of fevers. Tylenol and aspirin should be reserved for non-infectious conditions.

2. Remember that inflammation, because it fights infection, is a good thing.

3. Try to refrain from demanding antibiotics for coughs or flus since these may be caused by infections other than bacterial infections, which are not affected by antibiotics.

4. Over-the-counter cold remedies only eliminate symptoms, at best, or just make you feel groggier.

_____________________

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Here is a good way to think about the concept of the resistance that bacteria develop to antibiotics. Let's pretend that there was a tribe of 1000 people on some remote island somewhere that was responsible for everything bad in the world, and let's pretend that we wanted to get rid of them all. So, we came up with a way to fly a plane over the island every so often and drop pepper spray on them. Pepper spray, in sufficient quantity can be lethal. Now let's pretend there were two scenarios. In the first scenario, we bombarded the island every day for a week with a large amount of pepper spray. After the first day, many of the evil people died, but some survived (perhaps those that ate a lot of Mexican food). The second day, more evil people died, and a few survived, because they were stronger than the rest. By the fifth day, no one could withstand the onslaught of pepper spray and the evil population was eliminated. In the second scenario, we wanted to save money and time so we just dropped the pepper spray once a month or so. After the first month, a lot of the evil people died, but some survived. The same happened the second month. As time went on, those that lived had children, all of which survived due to the pepper-spray survival genes inherited from their parents. By several years, there was a thriving population of evil people on the island, none of which were affected in the least with pepper spray. Frequent and inappropriate use of antibiotics represents the second scenario. And this story explains how frequent use of antibiotics can create a community of multi-drug-resistant bacteria that can eventually kill people.

-- Todd Brady, July 15, 2000

OK, so I have a question as I try to get educated about stuff. When reading various studies, some talk about the RATE of a disease or occurrence and some talk about the RISK. I think I know what rate means; it's pretty tangible. But what is the definition of "risk"?

-- claire, July 27, 2000

I have this cold sore on the right corner of my mouth & i had it last winter for 3 months but then it went away. I know it'z not herpes but please tell me what will make it dissapear! I used camphophenique & pure lip remedy but nothing works. Help me!

-- Anonymous, October 11, 2002

I have a decayed tooth and now on the outside of my mouth on my jaw is what I thought was a pimple well it is now real red and swollen not only to the touch it hurts even when not touched. I had cellulits last year and had to go to the ER and they gave me a shot of Rocepherin (major penicillin)Should I go to the ER again I can not afford a dentist and I am in MAJOR pain, Please email me back asap.

Thanks for your assistance

-- Linda, December 23, 2002

had a facial. the facialist took a pin and popped white heads. i got and infection. the infection is taking a while to clear. I am using a topical gel. the swelling is gone but i have small red spots where the needle entered. Do you have any suggestions?

-- Anonymous, February 19, 2003

Ive had this cold type thing for about a month. It got extremely bad about a week or two ago, then it got better. However, I still have this draining down my throat and I have a stratchy voice. I also cough up greenish-yellow mucus all the time. It never seems to go away and I dont know why.

I went to a doctor and they told me that I just had what was going around campus and that I should just take Nyquill, but I cant go to college and take stuff that makes me groggy ALL the time, I'll soon get addicted adn wind up in soem kind of a rehab. Can someone please tell me what is wrong?

-- Cynthia, March 15, 2003

perphen

-- sean miller, June 25, 2003

This idea of reducing fevor on account that it makes you feel bad seems to be in part r/t to a persons personal decision. For example opportunistic infection viral in nature can manifest, and raise the temperature making the person more suseptical to bacterial infections. A real good hx, pt. conditions, so I think may be things to look at. For the elderly a real bad virus could be the end. What is the difference between this, and the common cold? A person who is immunocompromized? Cancer, Aids..., maybe something we don't even know?

I have heard people say don't take antibiotics for viral infections. Personally, I have noticed that say, I start out with a real bad cold, and it lasts for a long time. Then a bacterial infection starts. If I quick take antibiotics, even if it doesn't kill the viral infection. Psychologically, I think it makes me shut down, especially with some Codeine cough syrup. Some people of said, don't take antibiotics too much, becasue when you need them they will not work. My mind knows better, so I think. The drug acts on the specific bacteria, and if not taken for specific length to kill it. I could genetically mutate producing a bacteria that has figured out the drug. Certainly, antibiotics could have some effect on end-organs, but that is for a Doctor to know. Probably a reason for anything.

Recently, I went on a 26 day Fast. You know what. I started to run a fevor, and did nothing about it. Made sure it didn't get in the higher than 101, or else start Tylenol. I literally lost pounds a weight, and came out noticebly skinny. Purged myself of all medications. Resperidol, Clonipine, Zoloft, high doses of NSAID's, and Tylenol #3. Yes, against medical advise. Afterward, it felt like the storm was over. During this time, I did alot of reading of Budhism, and the Noble Truth of Stress. Kind of your fast track Tibetan... The closer I came to death, the calmer I felt. Learned dispassion. Even got to the point that maybe Death was O.K. I watched death with so many people, and now started to experience it. Well, I am still here today, so I decided to join this world, and eat. Yet, with new so I beieve spiritual insights of the 8 Fold Path of Truth. Did I change my religion from Christianty, not exactly. In fact, it made my own Christian beliefs stronger. Maybe these Asians knew something about the need for detachment, issolation that was benefical to the the body. To just Stop, and Do nothing, is best. Let Time heal. While in an overseas tour in South Korea, when Aids first became known. I watched some go out in tents, and do this, some died and some for some unknown reason lived. Of course probably with HIV, but you know what. Years latter one person I knew who actually practiced this still lived far beyound what they say the 7 year mark with HIV. Never developed AIDS. The key was that when they first developed it, they detached. Went to the tent to fast to get better, or die. Old Testment said, the same thing about the Leper without the camp. I don't know you can take this sometimes no action, is the best action. So, to immediatly take Tylenol if you have a fevor is probably not or I think sometimes a good idea. It just depends.... Even doctors don't always agree, depends on a host of factors. Past Medical Hx, pt conditions assessments, labs..., maybe even the pt. choice, belief systems... to be considered.

Respond to any comments about what I have written. Didn't do it without a purpose.

-- Kevin McCarty, October 10, 2003

hi my name is julie i am asking this becauses the docktors here in colorado seem to be out of ansewer i have been fighting a bone infection for 4 yrs now we final got the would to heal but the infection is under the skin and deep in the bone the reason im telling you this is beacuses i need advices this is what happing now whe oldinsion site is brown and it now cover half the ankle the other color looks like red strikes are tryingto appear i also have bone tenderness and sever pain i also have swelling the limb turns cold i wake up with night sweats sometimes the chill nausa and if the pain bad enough i have vomited and a couple of time there was blood lots of it my toes looks like there is red strikes in them and it painfull to bare weight i am on pain patches 50 m.g durgices if you can help me scence no one in colorado can seem to treat osteomyelitis and help me rid of the bone infection i would be great full to you .im even willing to travel thank you for your time

-- julie, November 30, 2003

yes!!!!! i had a very bad staph skin infection. and after 3 months (i researched in the internet) i mentioned to my doctor that maybe i had the staph infection, the doctor (my doctor of 7 years is an endrocrinologist) he took a look at my upper chest and scalp and agreed with me. currently i am on my third week of taking keflex and one more to go! now the lymph node (and bone) behind my ear hurts on and off. i am very disapointed with the medical profesion!!!

-- Anonymous, February 27, 2004

MY SCALP WAS USED AS A DONOR SITE FOR SKIN GRAPHS TO MY LEGS WHEN I RECIEVED 60 PERCENT BURNS TO THEM. SINCE THEN I CAN NOT SEEM TO GET RIG OF INFECTION AND SOARS IN MY SCALP . ANYONE KNOWS OF SHAMPOO, A PHYSICIAN, A CREAM, A REMEDY , ANYTHING.PLEASE HELP.

-- LEROY SIMON, June 10, 2004

Preventing Colds - 365 days a year

My mom had this weird hang up - always telling me not to rub my eyes because I would "make wrinkles". Who knows if she was right, but I'll tell ya this... I almost never get sick.

Nice warm mucus membranes are a favorite way for germs to get us. Between not rubbing my eyes, and washing my hands regularly, I don't seem to pick up whatever is going around, even when I fly on airplanes a lot.

At my current job, the people sitting around me have had colds go around 3 times in the 9 months I've been there... and I haven't been sick once.

Then again, maybe I'm the only schmo not smart enough to use my 6 sick days a year!

-- Shel, July 5, 2004

ok i could not sleep my throat is so swollen i got up in the middle of the night and made tea and tryed to eat a cracker. I hardly got the tea down but when i tryed to eat the cracker i started to cry it hurt so bad. I have allergys but they are never this bad and i think i am alergic to something to make my throat swell up it hurts so bad what can i do?

-- kortney, November 28, 2004

As for the cold sores, I too get them once or twice a year and they are not herpes. But, they are caused by a virus in the herpes family, hence, the herpes affiliation. The only thing that works for me is Zilactin-L. Regular Zilactin does not work.

It clears it up in just over a week. But, if you can get it right when it starts, it will stop it all together.

-- Jeremy, January 14, 2005

My father is a perfusionist (heart/lung machine operator) at a major heart hospital. He says that when the body blood is heated to high temperatures(104-105) for extended periods of time, the heat will kill off major immune system diseases(cancer, aids). This process is called Hyperthermia, and it has shown great promise in early testing. It has been also known to kill disease when people catch fevers that last for awhile. I myself am battling late stage colon cancer and will be going to Texas to have this procedure done. Nothing else has worked (chemo, radiation, alternative medicine)so I hope to report the results soon.

-- Matthew, February 4, 2005

for over twe years now .i have been having skill infection on my nose and I have tough somedrugs and cream for 'it yet.the skill disesea is still their ,i dont know what to do,plz i need help

-- dan, March 11, 2005

i think i have a throat infection how do i know i have had pain everwhere around my body.

-- Anonymous, March 15, 2005

Hi,

My name is pebbles two days ago i had bitten my lip in two places inside and outside on the bottom lip. My lip has gotton REALLY big on only half of my bottom lip! i went to the doctor office and they said i have a bad infection. they gave me Cephalexin...i am taking it but my lip is in Pain so what can i do to reduce swelling because im taking the medicine but i feel like its doing nothing? so anybody can help by telling me remedies! thankyou

-- Pebbles, September 16, 2005

I TOTALLY agree with you that fever is our body's way of fighting infection.

Too many meds given too soon actually may pro-long a flu or virus.(and what about colds with cough....everyone wants to "supress" that cough....how foolish..your body wants to "rid" this stuff, and you want to "keep" it supressed(ok, the only time i give a cough supressent is at night, to get some sleep, but during the day, its healthy and necessary to encourage that cough.

Our bodies were made to LIVE. They basically know what to do to keep us alive and for the most part...HEALTHY.

Our bodies cant "speak" so they "symptom" to us.

I have always taken a"wait and see" approach with a fever.

If you are not too uncomfortable then forget about it, rest, and let the body do its work.

Our bodies are constantly producing and directing....dont disrupt that beautiful symphony!

-- arlene, September 23, 2005

I have sores in my nose. They started last year in Oct and went away after I kept putting cordizone cream up inside of my nose for them. Well they are back this year and I have had them for 2 months. They hurt really bad but do not seem to be in a hurry to go away. Please tell me what to do. This is very aggrevating and it is very unpleasant.

-- Anonymous, November 8, 2005

Hi, in the above it says that fevers are good and one reason for this is that they help kill the bacteria etc. It seems hard to beleive that these bacteria are so feeble that a change from 98.6 to 100 degrees F would have this effect. I would like to hear a scientist/doctor's response.

-- Bill, November 30, 2005

Be aware that sometimes you can have a serious infection without fever. I recently went to the doctor and requested a strep swab. I told her that I had had tonsillitis for six days and my neck was sore, but no sore throat and no fever. She looked at my throat and said that she thought I was fine. I insisted, so she swabbed for both Strep A & B. Turned out that I had Beta Hemolytic Strep.

-- Anonymous, January 19, 2006

I have a problem that no one can seem to figure out. Every so often I will get bumps under my skin, anywhere on my body, these bumps a itchy and hot to the touch. Not only this, but sometimes my fingers start to swell, maybe sometimes just my finger tips. Every so often I will have half of my bottom lip swell? Please help me figure out what is going on with me!!!!!

Oh, this started happening after I had a breast reduction sugery 10 years ago, and one other thing none of these things happened while I was pregnant with both of my girls?

-- laura, January 21, 2006

As a follow up to my last post, I think it amazing that I once had mononucleosis and an idiot doctor in NJ never diagnosed it. I am not even sure when I had the mono, all I know is I went a stretch of time, like 3 weeks when I did nothing but lay on the couch and feel horrible. Two years ago I was hospitalized with CMV (cytomegalovirus) and after the bloodwork finally came back with the diagnosis, the infectious disease doctor said from my bloodwork I had mono once. I said to him "no way!" but he said "here it is, right here on your bloodwork" - I was ANGRY that I went through so much misery under the care of a doctor who spent alot of time telling me once how I had an acute sinus infection--now I wonder what I really had. Where are the GREAT diagnosticians of the old days? THESE GUYS ARE AWFUL and don't seem to give a fig about a patient-I HATE HMOs.

-- Lorraine, February 19, 2006

I have huge tonsils when I am not ill (thanks for passing that gene on, Dad), and I have had tonsillitis countless times. I'm not a doctor, I don't claim to be a doctor, and I sure as hell don't want to be a doctor.

I started feeling ill last week around Thursday--my ears started getting stuffy, and I started getting headaches. Then Monday rolls around and my throat starts hurting, and my tonsils swell, along with the other symptoms, plus strong pain around my ears. On Wednesday/Thursday of that week, I started getting some nice thick abscess on my tonsils, and the rest of the symptoms had gotten much worse. I never had a fever all the times I took my temperature, but I did take ibuprofen a lot and a dose of Tylenol on Thursday because swallowing was incredibly painful. HOWEVER, don't reach for the pain medication so quickly. Try some warm liquid like hot cocoa or some tea. That helped MUCH more than the pain medicine. I was trying Halls Max throat lozenges and cold foods, but the former provided absolutely no relief, and the latter provided minimal relief. Friday makes it, I'm dead tired, I skip my one and only class for the day, and go to the doctor. His diagnosis was tonsillitis and perscribes me Azithromycin. My father, an optometrist, had given me the same over Christmas break 2005 when I had tonsillitis previously, and I cleared up after 7 days. My Dad also gave me Azithromycin about four years ago when I had tonsillitis. I think it works well, but it takes a while. You take 6 pills over five days, but they don't really take effect till the third day or so. However, Azithromycin really gives me awful stomach cramps. The first time I took it four years ago, I thought I was going to die. The second time I took it over Christmas break, it was painful, but I wasn't on the brink of "death." This time around, however, the cramps had been less, but it caused me to throw up once, I think. It could be the deliciously delightful abscess causing that because the pus made me very nauseous Friday morning; I threw up at the doctor's office. The second time I threw up, I had cramping but no nausea. I really recommend taking Azithromycin with food because it seems to lessen the cramping. I've not had any ill effects from the antibiotic so far this morning. But, the morning is still young, and I only took it an hour and a half ago.

So, here's my uneducated, yet much experienced in having tonsillitis advice and the gist of this extensive post:

1. Skip the pain medicine or lozenges; try warm fluids like tea or cocoa. Also try cold things like popsicles or ice cream if the warm liquids provide no relief. Drink a lot of these fluids.

2. Get some rest!

3. If your symptoms persist for several days, go to a competent doctor.

4. If you end up on the antibiotic, Azithromycin, take your pills with food to avoid stomach cramping!

5. Try to stay away from people so you don't spread your sickness.

6. Don't freak out if you have vomiting; it's more than likely caused by that delightfully delicious abscess.

7. As much as it may hurt like hell to eat food, you have to eat something. Try some crackers, especially if your stomach needs to be soothed. Just chew until they are very soft and mushy, then try swallowing with some liquid.

There you go. Hope my tonsillitis experiences help someone out there. :)

-- LK, March 11, 2006

Yes I was just wondering about this, ok my boyfriend has a staph infection but it was not an open wound, it was just a bump, and I touched it. I was wondering of I could get it now?

-- Anonymous, March 20, 2006

It was strange, the night before last I had some shrimp from a well known resteraunt and later on had a few beers and a couple hours later my throat started to get scratchy.I figured it was from smoking and went to bed.When I woke up the next morning I couldnt even speak and it hurt to breathe.This lasted all through the day and kept me up until 4 in the morning.Then when I woke up this morning My voice was mostly back and my nose was runny, but throughout this whole thing I have still had energy.I have never heard of anyone having anything like this.It was strange.

Fort Myers, Fl.

C. Kapatos

-- Anonymous, May 1, 2006

I have had a sore throat comming on for close to a year now, although it didn't start to become sore untill about a month ago. I first noticed redness and no pain at all but thought maybe it's supposed to be that shade of red but it seemed to get redder over a course of a few months. I would gargle with salt water and no change except now after about 8 months of first noticing the redness I have yellow pus like rashes developing on either side of the far back of my throat. The doc says I have strep (he didn't do a swab or really listen when I told him this has been comming on for months, I don't think it's strep) so he gave me the Z-pak and after 4 days there is absolutely no change at all, as a matter of fact I think it's getting worse. I figured the symptoms are from smoking so I quit but they still seem to continue to get worse. Doc did a simple poluminary stress test and saw that my lungs are not operating at peak (o2 level read 98 and after doing the step test went down to 95.) Any ideas???

-- Anonymous, July 13, 2006

I was in Europe for vacation for 8 weeks and spent 7 weeks sick and taking medication. I didn't feel as though I had a fever or head ache or any of the common cold symptoms. I had gotten a aore throat one morning and thought it would pass, but in 3 days it progressed to me not being able to swallow anything. after a week I went to the doctor and was prescribed 500 mg amoxicillin pills that helped but after I finished them, I got sick 2 days later and the same symptoms started to come back. I went to another doctor a week later who said that I had a very bad infection and gave me 1500 mg silapen to take 3 times a day for 2 weeks and finally the symptoms were gone. I had a minor alelrgic reaction to the Silapen and my skin from head to toe was covered in itchy hives so I had to go back and get allergy medicaiton. After everything finaly went away, I'm still left with swollen tonsils in my throat, 5 weeks after taking medication and my doctor can't tell me why it's still swollen. A strep throat test was done but it came out negative and there is no more infection. I don't know why it won't go away but hopefully those symptoms won't return, ever. Especially during sumemrtime when the weather is hot, not being able to breathe becuse your airway is cut off from a swollen throat is not good.

-- Ivana, September 24, 2006

how can i make my stretch marks disssapear?

-- Maria, October 21, 2006

I took my 6 yr. old to a dr. today, and he informs me that her cough is pneumonia as well as some bacterial infection. All he did was listen to her chest and back.

He gave me a prescription for amoxil as well as an inhaler for asthma.

He tells me if there is no improvement in 2 days either bring her back to him or go to the emergency room and they will probably give her a mask for breathing.

When she breathes it seems to take an effort on her part, and yes she has a crackly sound in her chest. Oh. the dr. also mentioned that he would put her on prednisone. She seems to be fine otherwise, except for that blasted cough. She does have a mild allergy to the cat that we have, so I was wondering if this could be part of the problem. Dr. thinks no.

She has had these particular coughs before and I have given her vit. c, garlic, lots of herb tea, as well as vicks and the steamer. They seem to go away on their own.

I just don't know what to do regarding this medication. should i fill the prescription and give her the inhaler or what???

-- Bev, November 11, 2006

Experiences, Comments, or Tips of your Own?