By Judy Foreman
Pain relievers are in the news again — and the news isn’t great.
Acetaminophen, the active ingredient in Tylenol, is the focus of a series of scary investigative articles by ProPublica, the online new organization. The bottom line of the series: about 150 people per year die from accidentally taking too much acetaminophen, and even though the line between a therapeutic dose and a dangerous dose is slim, the FDA (and the drug companies that sell the products) have done little to warn consumers.
To be sure, treating pain with any medication is an intrinsically dicey, though often necessary, business. Opioids can reduce pain, though not entirely, and carry the risk of dependence, immune and hormonal changes and, in some cases, abuse and overdose.
In some ways, acetaminophen is the slipperiest of all the pain medications to understand because it’s not just in over-the-counter medications such as Tylenol, but in a whopping 600 prescription and OTC products, including cough syrup and in combination pain-relievers such as Vicodin, a mix of acetaminophen and hydrocodone. Continue reading
The journal “Pediatrics” has just put out a report pointing out to parents that fever itself is nothing to fear — it’s just the body’s germ–fighting mechanism — and arguing that if a child has a low-grade fever and is in no discomfort, there’s no need to try to bring the fever all the way down to normal.
The study also discusses the common fever-fighting practice of alternating doses of Motrin and Tylenol, and warns that while it appears to work, it could lead to dosing mistakes. The Associated Press sums up some fever guidelines from the study’s authors — including the different rules for infants — here.
My personal takeaway: It’s useful to know that there’s no reason to try to bring a low fever down to normal, and that alternating Tylenol and Motrin can be tricky. But overcome my fever phobia? Would that I could! Fever calls for vigilance, and for the life of me I can’t figure out how to be vigilant without being a touch terrified. I even wrote this Boston Globe story back in 2009 so I could seek advice about my phobia. This helped most:
Dr. William Coleman, chair of the American Academy of Pediatrics’ committee on psychosocial aspects of child and family health, said that “feverphobic” parents should keep in mind that “it is the natural state of the child to be ill with minor acute illnesses.” They should know, too, that experienced pediatricians pay more attention to “the general state of the child” than the number on the thermometer: Is the child inconsolable? Unresponsive? Unable to drink? Those are the biggest warning signs of something possibly more serious. A fever, up to a certain extent, is just a “normal and healthy response” to infection, he says.
But really, what I came away with was the conviction that it’s possible to be vigilant without fear only if the patient is not your own child…
Anyway, the Pediatrics study is worth reading in this flu-laden season, and here’s the abstract: Continue reading