Perceptions

When I was in high school I did this thing called Cadets. Every Friday those students who did Cadets would come to school in their military uniforms and undergo lessons in a variety of training areas, such as orienteering, abseiling, and first aid. In order to progress my knowledge I also took part in an external first aid course run by the local ambulance service. It’s fair to say that by the end of my time in Cadets I had a pretty solid grounding in first aid treatment. So when my wife and I did a first aid course last week it was encouraging to find out that a lot of what I had learnt all those years ago was still valid.
However, there were a few area’s that caused me to stop and question what I thought I knew, and I’m glad that it happened because it reminded me that when it comes to health matters, there are times when perceptions matter. Here’s one example that I found interesting.
GP’s over-prescribe antibiotics. Why do they do this?
They do this for a variety of reasons, but the one that got me was that they do it to make their patient feel like they’ve got value for money for their visit. Going to the doctor is expensive, and if the GP were to turn around and tell you that there’s nothing they can do and that you just need to go home and rest for a few days/week then you might feel annoyed at the money you’ve spent.
The perception is that you go to the doctor and they give you something that will help you get better.
The reality, with a virus, is that there is little we can do to kill them, we have to rely on our bodies immune system to hunt down the virus and kill it. Giving the patient antibiotics is totally useless, especially as antibiotics are for bacteria.
The other topic that challenged our long standing beliefs is that having a high temperate/fever isn’t necessarily a bad thing.
Growing up I was told that we had to get control of a fever, especially high ones, quickly so that we could allow our body to heal. And at the time, when that advice was given out it was probably the predominant thinking based upon the best medical research at the time.
The current thinking says that there’s actually nothing to be gained from trying to lower someones temperature. In fact you may just be prolonging that person’s illness.
Why is this the case? Well, the optimal temperature range for a virus to operate is in the 37° range, which is also the non sick temperature range. When the body detects that a virus has taken hold it raises the bodies temperature. This is a defence mechanism that alters the environment of the virus. By increasing the bodies temperature the virus is out of its comfort zone, so to speak, and it finds it harder to replicate and spread. 
So what happens when we lower the bodies temperature? We allow the virus to replicate and spread, thereby prolonging the time that the person with the virus must suffer from it.
On top of this we learnt that even though someone might have a high temperature it doesn’t mean we have to give them drugs. Drugs like Panadol, or other paracetamols, should only be used if the patient has pain, because that’s the only thing they can effect. Maybe they help you to recover because by easing the pain you are allowing yourself to rest which increases the bodies ability to fight the virus, but that’s more of a coincidence.
But what about seizures or the risk of brain damage due to high temperatures. Well, seizures are the result of the body’s temperature fluctuating rapidly from high to low, and the evidence says that there’s not much we can do about that. All we can do is to provide a safe environment to let the seizures happen in, so that no further harm comes to the patient. As for brain damage, again there is no real evidence that having a high temperature because of a virus will cause this, even when a temperature is above 40°. That’s not to say that brain damage may not occur in someone with a high temperature, it may depending on the illness they’re suffering from, but it’s unlikely that the high temperature will be the sole cause of brain damage.
I can predict how many of you are going to react to this blog, because it’s how I first reacted during my recent first aid course. The notion that a fever was a good thing was totally contradictory to everything I knew or had ever been told. But instead of dismissing it I listened, and I did my own research, some of which I’ve linked to. 
Modern medicine is not static. What doctors and scientists believe constantly changes. It changes because they, doctors and scientists, don’t know everything. They are still discovering a lot about how our bodies work. Just because they thought they know the answer 5 years ago, doesn’t mean that they actually knew the answer. It means that everyone has to be open to the idea of change. We have to be prepared to take our long held beliefs and throw it in the bin when there is evidence that challenge our perceptions.