Oct 272008

It’s the middle of the night and my baby Noah is sick. He’s had a cough and stuffy nose for about a week now, but has been his usual cheerful self and we haven’t been too worried. Then last night he developed a low grade fever, so we spent the day laying low, cuddling and nursing. His color was pretty good, and he was somewhat sleepy and extra cuddly, but not lethargic. He smiled at us like usual, though obviously didn’t feel well. I ran over to my office to get my otoscope while he slept on his Grammie’s chest, and looked in his ears to find the signs of a mild double ear infection. I adjusted his neck, massage the muscles and did some lymphatic drainage. I also used some Nutribiotic ear drops (with grapefruit seed extract and tea tree oil) and continued nursing him on demand. We went to bed early in our “big big [family] bed” and I woke up around midnight to find his fever no longer felt “low grade”. Various temperature measurements were 101-102 (taken with a Braun ear thermometer). That’s when I started to worry.

Being a mama and a doctor at the same time can be tricky. In many ways, I “know too much”– about worse case scenarios and every possible complication. It’s also hard to remember everything I’ve learned and keep my cool when it’s *my baby* that’s sick or hurt. Three years ago when we were visiting friends, my mama radar went off as my then-toddler Mariah got past the baby gate left open by the big kids and I got there just in time to watch her topple down a flight of stairs. I wouldn’t say that I panicked, exactly. I stayed calm and focused, swooped her up immediately and comforted her as she cried. But I was in “mommy mode” and couldn’t think straight enough to remember all the signs of serious head injury or skull fracture. Despite all my training, I was consulting Dr. Google like anyone else would.  

Tonight was a little different, but I had a similar feeling of doubting my clinical judgement in the face of being a mama first. Plus, my philosophy about the body and approach to health is not radical, but it is “alternative” and outside of the mainstream (even by Portland standards). I believe in the body’s innate ability to heal and maintain homeostasis with minimal medical interference– there’s a time a place for medication and surgery, but I’m much less quick to use them than many. I prefer more natural, less invasive ways of supporting the healing process whenever possible. (After multiple ear infections, they wanted to put tubes in my first son’s ears. I chose to treat him with a combination of chiropractic and CST, supplements, and went on an anti-inflammatory diet– no dairy, wheat, or sugar– until they cleared up completely.) While this approach has worked well for our family, there are moments of doubt in times of crisis, like tonight. Am I really doing the best thing for my child?

I know what I tell the parents of my patients when their older infants and toddlers have a fever: Don’t panic. The fever is the body’s way of fighting off the virus or bacteria. Unless the baby is really lethargic or the fever is really high, there’s not a huge cause for concern. Watch them carefully and keep them comfortable. Their behavior is a better indicator of what’s happening than the numbers on the thermometer… But there is an upper limit to this, and at a certain point there comes a time to fight the fever and give them tylenol, perhaps even take them to the ER. When is it time to really worry? 

My comfort zone ends at about 102. Up to that point I let the fever burn and it’s usually gone by morning, along with the worst of the illness. Tonight, Noah’s got up to 103.5 and I had my husband run out for infant tylenol. I stripped off his pants and socks and put a cold washcloth on his head while we waited. And turned to the internet for reassurance.

Dr. Google can be a wonderful thing, *but*… in many ways, it’s a blessing and a curse. It’s similar to the difficulties of being a doctor and a mom. There is such a thing as too much information. So, where do you turn for trusted info in the middle of the night?

I recommend finding sources that you trust, and whose philosophy and approach resonate with you. For me, I am what I consider kind of “middle of the road” with alternative leanings. I tend to use chiropractic, acupuncture, and naturopathic medicine first– but also embrace allopathic medicine when appropriate. I definitely want the western medical take on any given situation, whether or not I choose to follow it. (That’s what I love about my pediatrician, Dr. Joe Sullivan– he gives me the medical information I want, but is always open minded and respects my decision when I choose to handle things my own way. He trusts me to come in when I need to, and I trust him when he says that something is truly medically necessary.) As far as online sources, the best sites I’ve found that blend with my approach are Dr. SearsDr. Greene, and Dr. Gordon.

Tonight I consulted Dr. Greene’s pages about ear infections and fever, and he validated everything I was doing. He validated the idea that fever is a good thing– the body’s natural way of fighting the virus or bacteria– and that the best approach for ear infections is to “watch and wait” in the early stages, that antibiotics are often unnecessary and may do more harm than good. Really the whole point of this post is to recommend these pages when you’re holding a feverish baby in the middle of the night and want some reliable medical information that won’t scare you. 

Now Noah’s temp is back down around 100 and he’s sleeping comfortably on my shoulder. Hopefully we’re through the worst of it.