Living with a Recurrent Fever

Just a Virus?

I can’t tell you exactly when this started, because it took awhile for us to figure out what was going on, but it was sometime around age 2. For a long time, we just kept thinking Hayley had a bad string of viruses. Our other children never caught any of them, however, and after awhile, we began to realize that all of her viruses were very similar. She never had a stomachache, never threw up, never had diarrhea, never had a cough or a runny nose—most of the common virus symptoms were always absent whenever Hayley got sick. Instead, her fever was always accompanied by a sore throat and a severe headache. It acted a lot like influenza or strep, and as a result, she was given countless flu and strep tests, which almost always came back negative.

I didn’t always take her to the doctor, even though she would run a high fever of 103 or better, because, after awhile, I got tired of being told, “It’s just a virus.” All of those co-pays added up, not to mention her ever growing fear of yet another finger prick or throat swab. We began to believe that the fever was perhaps her way of coping when she didn’t get enough sleep or just got worn down. It seemed that after she had a few days to essentially sleep it off, she was fine.

However, niggling in the backs our minds was the terrifying fear that something more was going on with our child. As a parent, when you start to be able to predict that your child will come down with a fever, you know something isn’t right.

I questioned the doctor several times. Is my child all right? Is her immune system compromised? If these are just viruses, why the regularity? Why don’t my other children ever catch any of them? The doctor continued to insist that Hayley was fine, that some children just have lower immune systems than others, and that she was just one of those children who got sick a lot. She was growing normally, her body was always able to bounce back after being sick, and she never developed any “serious” illnesses, so there was no reason to worry.

We tried to buy those explanations. We really did. Every time Hayley got well after having a fever, she would look and act so healthy, and we would breathe an inner sigh of relief. She’s better. It’s over. Perhaps the doctor is right. Then, a heavy feeling of dread would settle in when, a few weeks later, the fever would start all over again


Missing Out On Life

By this time, I was quite confident that Hayley wasn’t contagious, but I still couldn’t bring her places when she had the fever. For one thing, she didn’t feel well enough to go out, but on top of that, other people would get offended. After all, they didn’t want their kids catching something, which was understandable. Hayley missed dance recitals, birthday parties, church activities, community events, and more. It was so disappointing for her every time she came down with the fever and had to miss yet another event that she had really been looking forward to. It was also terribly inconvenient for the family, because we would all have to stay home as well, if the event was happening while her daddy was at work. If the event happened outside working hours, one parent would bring the other children while the other parent stayed home with her. Thankfully, we homeschool, so we didn’t have to deal with the additional issue of missed school days.


Finally, a Diagnosis

This past summer, everything changed when we met with Dr. Ben Sweeney, a chiropractor, to implement the wellness plan, Maximized Living. When I described Hayley’s symptoms, he said, “This isn’t normal. No healthy child should be coming down with a fever every month.” Finally, we had been heard! Through his encouragement, we began to implement a rigorously healthy diet, as well as exercise and chiropractic adjustments. He also recommended a new doctor to us, who would be willing to treat Hayley in order to prevent illness from happening, rather than simply “fix” her when she got sick.

This new doctor was familiar with symptoms such as we described, but wanted to do more research before examining Hayley. When we did meet with her, she first did extensive bloodwork to rule out any other serious illnesses. When Hayley’s lab work all came back normal, she diagnosed Hayley with PFAPA (Periodic Fever, Aphthous Stomatitis, Pharyngitis, Adenitis Syndrome). It was the longest name of a condition I had ever heard! I had to ask her to repeat it several times, then I finally gave up on being able to pronounce the majority of the words and simply clung to the initials.


What Is PFAPA?

PFAPA is a syndrome that mostly affects children, starting at age 2-4, and going away by the time they turn 10. It is characterized by a regularly occurring fever, which lasts approximately 3-7 days, and can be accompanied by mouth sores, headache, swollen lymph nodes in the neck, and a sore throat. The fevers occur every few weeks, often with such regularity that they can actually be predicted.


What Causes PFAPA?

No one knows. Researchers do know that PFAPA isn’t contagious, it isn’t genetic, and it isn’t an infection. Inflammation is somehow involved, but researchers aren’t sure why. For more information on PFAPA, click here.

A lot of children out there suffer with this, and a lot of parents are frustrated because they can’t get any answers. There is no cure for this condition, but there is a good chance that Hayley will outgrow it. Most children with PFAPA do. Around age 10, the space between fevers will usually lengthen until they completely stop occurring. As far as researchers can tell, there aren’t any long term effects from PFAPA, and it has no effect on growth or overall health. It is very inconvenient and uncomfortable, but it will hopefully go away in the next three years or so.


Our Solutions

In the meantime, although we can’t take PFAPA away from Hayley, we’ve learned through our chiropractor and new doctor some things we can do for her. We can work to lessen the length, as well as the severity, of her symptoms. She takes several dietary supplements, and she is on a very strict, anti-inflammatory diet (Maximized Living). We make sure she gets plenty of sleep, and she sees the chiropractor regularly. Doing these things has resulted in a dramatic reduction of her symptoms. Before we started doing these things, she would run a fever of 103 or better for 3-7 days, which is actually the normal severity and length for children who suffer from this disorder. Since implementing changes like Maximized Living to Hayley’s life, however, we’ve seen a reduction in both the length and the severity of her fevers. They now last between 1-2 days, and her fever hovers right at 100, usually having one short spike up to 102 just before it ends. Managing her PFAPA is possible, but it isn’t always easy. It takes discipline and effort to manage the supplements, chiropractor visits, and strict dietary needs. It is worth it, though, for her to spend less time in bed, and to get to enjoy more of her childhood.

If you have a child whom you suspect might have PFAPA, I recommend finding a doctor, preferably a pediatric rheumatologist, who will listen to you and help you make this condition more manageable for your child and your family. I also recommend checking out Maximized Living. Implementing this wellness program has made a world of difference, for Hayley, and for our entire family.

How To Tell if your Child Has a Fever

All children pick up bugs and ailments.
No matter how much we try to protect them, kids get sick.
Most bugs are shaken off within a day or two by a healthy immune system, but are still a great worry to parents at the time.
Most bugs just make kids feel off-color and miserable, but infections sometimes need treated with medical assistance.
One of the signs parents need to look out for are high temperatures.
This is often a sign that the immune system is not coping well, and your child can become really ill.
How can you tell when your child has a fever? What are the bench-marks of a high temperature?
Certainly, you can feel your child's forehead with the flat of your palm.
The brows of children with fevers feel hot, with almost a burning heat compared to normal. However, it takes a lot of practice to be able to definitively diagnose a fever this way.
Do not be afraid to practise this, because children derive comfort from your hand being gently placed across their forehead.
To tell the exact temperature, it is much better to use a thermometer.

What are normal body temperatures?

The normal body temperature is 35.5ºC/95.9ºF to 37.2ºC/98.9ºF
Temperatures below 35.5C/95.9F are indicative of hypothermia, and are not discussed here.
Temperatures above 37.2C/98.9F are considered to be high, or feverish.
Temperatures of 38C/95.9F, 39/102.2F or even 40C/104F are not uncommon in sick children, whose immature immune systems tend to cope less well, and send temperatures higher than adults would be expected to contend with.
To prevent fever fits, it is best to try and reduce high fevers in children where possible.
It will also help your child to feel a little better.

Thermometers

The most accurate thermometers are those filled with mercury.
Mercury is highly poisonous, and because of the risk of accident, there are many digital thermometers on the market now.
As I haven't used them and so cannot vouch for their accuracy, it is seldom of great importance to know the exact reading anyway.
A child has a fever, or not.
Any thermometer will tell you that.
If a child has a high fever, or a very high fever, then home thermometers will tell you, even if they are a fraction of a degree off.
It actually makes no difference for you, or your doctor, to know.
The only thing I would caution against is using one of the ear thermometers on a sick child.
A high percentage of all childhood fevers are caused be ear infections. The insertion of a thermometer to even the outer ear would cause intense pain, and so is best avoided.

How to Reduce Fever in Children

There are various ways you can reduce your child's fever.

1. Paracetamol is excellent. Buy a proprietary liquid brand suitable for children, and give your child the minimum recommended dose for their age group.

2. Cool compress. A damp facecloth held against a feverish child's forehead will help lower temperature as well as make the child feel better. Never use freezing cold water. Rinse in hand-hot water and refresh as often as necessary.

3. Remove clothing. An over-heated body needs cooling quickly, and this can be achieved by removing warm clothing. If your child is in bed, remove outer blankets and covers, leaving only a thin sheet. If your child may start shivering, replace covers or clothing, but as this is also a sign of a high and fluctuating temperature, be prepared to remove them again at a moment's notice.

4. Tepid sponging. If your child's fever has reached 40 or beyond, then you must quickly reduce that temperature to help prevent fitting. This can be done by tepid sponging.

Take a cloth and a basin of warm water, and gently dab the skin all over your child's body. At such a high temperature, their skin will be burning hot to touch, and the warm water you add will cool their skin.

Do not be tempted to use cold water. This is too big a shock to the system.

Check your child's temperature again, and if it is still high, and you are unhappy about your child's condition, call for medical assistance.

Reduce fever for children

Fever in a Child

A fever is defined as a core body temperature above 100.4°F (38°C).In some cases, the temperature will become extremely high and should be reduced as soon as possible (in cases where the body temperature is in excess of 105°F, take the child to the emergency room immediately).

Reduce fever 

Medication (including acetaminophen and ibuprofen) may be used to keep a fever under control. Never use fever reducing medication on a child younger than three months: a fever in a very young infant is an extremely serious event and the child should be evaluated by a medical professional immediately.

Fever Control Medications

The only medications that may be used for controlling fevers in children are ibuprofen and acetaminophen. The appropriate dosing information is located on the medication bottle - follow the instructions carefully and do not give the child more medication than is indicated. Infant formulations of these medications are more concentrated than the "child" formulations - it is important to follow the label directions exactly. If your child's weight or age are not listed on the label, contact your child's doctor to ask about the proper dose.

In general, acetaminophen may be given every four hours and ibuprofen may be given every 6-8 hours. To control a difficult fever, the medications may be alternated. Ibuprofen will control a fever longer than acetaminophen.

Aspirin should never be used in children under the age of 18 years. A condition called Reye's Syndrome may attack a child's liver and brain - this condition is linked to the use of aspirin during a viral illness.