When to Call the Doctor: Fever, Diarrhea, and More (cont.)

The physician may have a mistaken impression as to why the patient is seeking medical care. In the scheme of things, the most valuable part of a doctor's visit is the time spent listening to the patient, and offering guidance and education. Unfortunately, the physician may feel that the patient has to leave with a parting gift of some sort, and many times it is a prescription for a medication based on the presumption that the patient will be unsatisfied if they are not given sample medications or a prescription.

Education takes time, and a wise physician takes the time to listen to the patient, and answer questions that aren't even asked. Some situations are universal.

  • If a child's symptom is abdominal pain, the parent or caregiver wants to be reassured that the child does not have appendicitis.

  • If headache is the symptom, the answer the patient or caregiver wants to hear is that it is not serious such as  bleeding in the brain or a tumor.

  • Sometimes the visit is precipitated because of what's reported in the news. At the height of the H1N1 (swine) influenza epidemic in 2009/2010, news stories reported the serious complications of the infection, and many parents brought their children to a health care facility to be seen because they feared their child might die.

For many illnesses time is the ally, and watchful waiting is the key to diagnosis, treatment, and recovery. The following are common conditions that often resolve on their own without medical intervention.

Fever

Fever is a routine symptom in infants and children. It is a normal immune response to an infection to generate an elevated body temperature and make the body inhospitable. That doesn't mean that the fever should be ignored, but if the child is otherwise doing well, treating the fever with over-the-counter (OTC) medicines such as acetaminophen or ibuprofen may be all that is needed.

Fever in an adult is a different situation, because the patient is old enough to identify associated complaints and symptoms, and can provide a past medical history. Fever is a systemic response to inflammation. Patients with compromised immune systems and a fever are a completely different scenario. Those with immune system conditions or disease do not function as well as those who are not immunocompromised, and their body may not be able to fight off infection adequately. For example

  • people receiving chemotherapy for cancer,

  • those who take drugs to treat chronic inflammation such as rheumatoid arthritis or systemic lupus erythematosus,

  • individuals with HIV/AIDS may be so immunocompromised that their body may not be able to respond appropriately to an infection, and

  • older people may be very ill, but do not have a high fever (lower than 100 F [37 C]).