Gareth is sick. He came down with a fever on Thursday and had a horrible barking cough during the night. I took him to see the doctor on Friday and her diagnosis was bronchitis. Now he’s on antibiotics, mucosil, zyrtec, probiotics, and paracetamol. Probiotics is to replace the good bacteria that is affected by the antibiotics. It doesn’t appear to be enough because Gareth has had two incidences of purging. It was so bad his diaper overflowed!
Despite being sick, Gareth has been a real trooper. Although he is clearly more cranky, fussy and clingy lately, I would have to say that his reaction to being sick is very mild compared to his older brother. The worst part of being sick for Gareth has got to be being “home bound” given that he is normally such an active child. Unfortunately, Gareth being sick has also been rough on Gavin because I cannot give him as much attention as I normally would. It has also spoilt what remains of his holidays before school starts because we haven’t been able to go out and complete our list of activities. Thankfully, Ah Mah, Ah Kong and Daddy have made it up to him somewhat by taking him out.
“-itis” means inflammation and the bronchus (or bronchi for plural) are the main airway passages of the lungs, so bronchitis just means the main airway passages of the lungs are inflammed. Bronchitis can be chronic (long lasting and recurring) or acute (occurs as a single episode that usually resolves itself as long as there are no complications).
Gareth has acute bronchitis which is normally the result of a viral respiratory infection that affects the nose, sinuses, throat and eventually leading to the lungs. If it is viral, why would he need antibiotics? Well, some cases of acute bronchitis can also be due to a bacterial infection. Sometimes, a secondary bacterial infection can occur on top of the original viral infection so the antibiotics can be used to treat the primary infection (if it is bacterial), a secondary bacterial infection, or serve as prophylaxis (preventative measure) against a secondary bacterial infection.
Whether the cause is bacterial or viral is usually inferred unless a sample of phlegm is examined for the presence of bacteria. The presence of green phlegm is suggestive of a bacterial infection but apparently not a conclusive sign. It just means the neutrophils (white blood cells) have engulfed foreign bodies and the body is in a purulent state.
Bronchitis can also be due to the inhalation of irritating fumes or dust, like chemical solvents, smoke (particularly cigarette smoke) but in Gareth’s case, it’s clearly due to an infection. That said, it is still best to avoid air pollution, things that trigger allergies, and other infections because these things can make an existing case of bronchitis worse.
So it’s day four and Gareth is still running a fever on and off. We’ve been treating it with paracetamol suppositories because I didn’t want to give him yet another oral medication since he has been so resistant to taking his “strawberry” flavoured antibiotics. What’s up with that anyway? It’s strawberry flavour but it doesn’t fool the kids. They still hate it. I’ve been trying to mix it with orange flavours (because Gareth loves orange juice) but we end up having to force-feed it to him which I am loathed to do but I see no other way out (feel free to share your secret tips for feeding medicine to a 20 month old toddler in the comments section).
When the kids are sick, the grandparents will always be extremely anxious. Even though we’ve been to see the doctor, I keep getting asked every other day if I should take him back to the doctor because he “doesn’t appear to be getting better”. Considering we aren’t even half way through his course of antibiotics, I felt it was a tad premature to be calling the doctor again but just to be sure, I thought I’d check the general recommendations for medical care for bronchitis and this is what was recommended on eMedicineHealt.net:
- for relieve of symptoms such as coughing that interferes with rest or sleep, and wheezing.
- if the fever persists beyond 4 to 5 days, it might be necessary for a doctor to rule out pneumonia.
- if the patient is coughing up blood, rust-coloured sputum, or if there is an increased quantity of green phlegm.
Well, he already has medication to address his symptoms so now we just have to check if the fever persists tomorrow…
Addressing the Old Wives Tales Surrounding Fever
The most common belief is that if you have fever, you can’t take a bath. In the past, this advice was sound because the water source was not always clean and the last thing you want is to get infected with something else when your immunity is down. These days, we don’t have a problem with our water supply so this belief no longer applies. In fact, a tepid water bath is a means for reducing the fever so rather than being contra-indicated, a bath is recommended.
Secondly, the fever does not need to be treated unless it is causing discomfort or if it is very high. Normally, the hypothalamus acts as the body’s thermostat and regulates the body’s temperature. In the presence of an infection, the hypothalamus increases the body’s temperature and induces a fever. A fever is actually one of the body’s defences because the bacteria and virus cannot function at these higher temperatures. Sometimes the thermostat malfunctions and the temperature keeps rising – that is when you need to treat the fever so that the body’s normal functions are not unduly affected. The general recommendation is to leave any fever below 38.5 degrees celcius so that the body can fight the infection; and any fever above 40 degrees celcius requires immediate attention.
Thirdly, it is not necessary to wake a child to treat a fever (unless instructed by the doctor or if the above applies). Rest and sleep allows the body to devote more resources towards healing itself.