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Fever in Children: When to see a doctor

Fever is one of the most common childhood encounters. Yet, despite its frequency, the very thought of a child having a fever can fill even normally composed parents with worry and anxiety.

Parents often have questions like:  “When should I worry?”  “How high is too high?”  “Will my child have a seizure?” “Does my child need antibiotics?” “If I use ibuprofen or acetaminophen will that mask a serious illness?”

First of all, let me reassure you, it’s a great time to be a child. Modern vaccine advances have led to staggering protection from previously deadly and debilitating illnesses. For a healthy, vaccinated child the chances that a fever represents a life-threatening illness are much, much lower than years ago.

How a fever works

Fever is a healthy child’s normal response to an infection. By raising the body’s temperature, fever helps activate certain enzymes needed to fight infection and may also have some direct effect in killing the causative virus or bacteria.

However, a healthy child’s temperature will not just continue to rise unabated. The body has a very sophisticated thermostat, much like that in your house.  The upper limit of the body’s thermostat is around 106.  So even if your child’s temperature seems to be climbing (101… 102…103…104) it will not continue at that pace until your child spontaneously combusts.  The healthy brain will tell the body not to take the temperature over 106 and no brain damage will occur at temperatures of 106 and below.

Likewise, seizures are not a direct result of a high fever.  There is a phenomenon in children called a “febrile seizure.”  However, these seizures result from a rapid rise in fever that typically occurs even before the parents know the child is ill.  These seizures are usually benign and never cause any long -term problems.

When to see a doctor

Although I always advocate that parents should trust their parental instincts and seek care when they are concerned, below is some additional guidance.

See a doctor when:

  1. The fever associated is with other symptoms such as: trouble breathing, abdominal pains, persistent vomiting, sore throat, severe headache, neck pains, extreme body aches, or rash.
  2. A fever lasts for more than two days since hard- to-detect infections such as urinary tract infections can be the cause of fever particularly in children less than 2 years old.
  3. Any fever (defined as more than 100.4 on rectal temp) occurs in a child less than 3 months old.
  4. A fever occurs in children with other serious medical problems or immune deficiencies.

Dr. Courtney Mann is an emergency physician at WakeMed Health & Hospitals.


Garner Gives Go-ahead for WakeMed Healthplex

WakeMed is on track to open a health care complex on U.S. 70 in Garner, scheduled to open in April 2013.

The Garner Town Council approved this week a special use permit for the facility and agreed to rezone the 20-acre site across from the Agri-Supply store, according to the Raleigh News & Observer.

The 50,000-square-foot facility will feature a 14-bed emergency department and lab services, and include physicians’ offices. It will also serve as the base for medical helicopter operations and create about 150 jobs.

An estimated 12,000 to 15,000 people could be treated in the emergency department in the first year. That number could jump to 27,000 by the end of the facility’s first decade in operations.

Learn more.


Furniture Accidents – A Hidden Home Hazard

For many toddlers and young children, home is a place of discovery.

The adventure of learning to stand, walk, and reach that shiny object way on the top shelf can prove irresistible. But these adventures can be dangerous and even downright deadly if the proper precautions are not taken.

The U.S. Consumer Product Safety Commission (CPSC) estimates that between 2000 and 2010 there were at least 245 deaths related to tip-overs of furniture, televisions or appliances among children ages 8 years and under. Most of these deaths, 90 percent of them, involved children younger than age 6. In 2011, the CPSC identified this issue as one of the top hidden home hazards.

Kids can be seriously injured or killed as a result of climbing onto, falling against or pulling themselves up on shelves, bookcases, dressers, TV tables, and other furniture.

Here are some tips for keeping your home safe:

  • Fasten top-heavy or unstable furniture to a wall using brackets, screws or wall straps.
  • Keep heavier items on lower shelves or in lower drawers.
  • Don’t keep remote controls, candy or other tempting items on unstable stands or tables.
  • Teach children not to climb or jump on furniture.
  • Push the television as far back as possible from the front of its stand.

Kids are also in danger of suffocation if they become accidentally trapped in a cabinet, toy chest or laundry machine. In 2007 alone, there were 3,270 injuries to children ages 2 to 14 involving toy chests. Always supervise children around any confined space and keep the doors closed and locked.

Toy chests that meet voluntary standards set by the CPSC are equipped with lid supports that hold the lid open in any position. The standards also call for ventilation holes to prevent suffocation. If you have a toy chest with a lid that doesn’t stay open, the CPSC recommends you remove the lid or install a spring-loaded lid support.

Safe Kids Wake County works to prevent unintentional childhood injury, the leading cause of death and disability to children ages 1 to 14. Safe Kids Wake County is a member of Safe Kids Worldwide, a global network of organizations dedicated to preventing unintentional injury. Safe Kids Wake County was founded in 1996 and is led by WakeMed Health & Hospitals.

For more information about home safety, call 919-350-8364 or visit

Siobhan Davis is the WakeMed Injury Prevention Representative and Safe Kids Wake County Coordinator.


Human Milk for Human Babies: WakeMed’s Mother’s Milk Bank Featured in News

WakeMed’s Mother’s Milk Bank was recently featured in a news story by Fox Wilmington about the increasing demand for “human milk for human babies”. The milk bank is one of the most established on the East Coast and one of only 10 in the country. Thousands of babies have benefited from the program. WakeMed collects nearly 24,000 ounces a month and ships out about 20,000 ounces. While the demand for milk is high, WakeMed’s priority is helping babies with special needs.

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Whooping Cough Vaccine Recommended for Adults

Both WRAL and NBC 17 did stories this week featuring WakeMed Physician Dr. Michele Casey about the importance of getting the whooping cough vaccine.

Eighty-two cases of the contagious disease were recently confirmed in Alamance County.

Whooping cough, also known as pertussis, is a bacterial disease which leads to severe coughing that can cause people to make a whooping sound as they gasp for breath.

The Tdap vaccine, which protects against tetanus, diphtheria, and whooping cough, lasts for about 10 years and is recommended for all adults, but especially for those who are around vulnerable populations such as young children and the elderly.


Healthy Snack Ideas for Kids: Help fuel their play

As they grab their uniforms, cleats, rackets, helmets, sneakers, etc… make sure your kids grab healthy snacks to keep their energy high and their minds nourished.

And, if you’re the parent in charge of snacks, it’s important to bring something that will keep all the kids moving!

Here’s a list of go-to snacks that will surely be team-pleasers. Be sure to offer at least two options – a carb and a protein.

  • Low-fat cheese, string cheese
  • Greek yogurt
  • Apples, bananas, pears, oranges (fresh or dried)
  • Carrots, sugar snap peas, cucumbers
  • Hummus and pita
  • Trail mix (be aware of nut allergies)
  • Plain popcorn, pretzels, baked chips
  • Granola bars (watch the sugar and fat)
  • Almond butter or peanut butter mini-sandwiches (again, be allergy aware)

With all of the on-the-go packaging available these days, providing these healthy options is not only good for them – it’s easy to keep stocked! If you’re feeding the team, going to membership stores (Costco, Sam’s, BJs) is a great place to find favorite snacks in bulk at great prices.

Julie Paul is a program coordinator with WakeMed Children’s Diabetes and Endocrinology.


WakeMed Cardiologist: CPR is Best Chance of Surviving Cardiac Arrest

CPR Anytime kitThirty-two people die every day in North Carolina of cardiac arrest, but that could change if more people were trained to do CPR.

WakeMed Cardiologist Dr. George Hamrick, spoke with NBC 17 this week about the importance of learning CPR during a “Feel the Beat: CPR Anytime” event in Garner.

The program includes a presentation on the warning signs and symptoms of heart attack, followed by a 30-minute CPR Anytime training. Participants will receive a free training kit per household.

The next CPR Anytime training session will be held from 10:30 a.m. to noon on Wednesday, February 29 at WakeMed Brier Creek Healthplex, 8001 T.W. Alexancer Drive & ACC Boulevard.


Probiotics Used to Treat Norovirus

WakeMed pediatrician Dr. Travis Honeycutt spoke with WRAL this week about the use of probiotics in recovering from the contagious norovirus. Symptoms of norovirus include nausea, vomiting, diarrhea, and stomach cramps. Probiotics is a healthy bacteria that normally lives in the intestine and can be found as dietary supplements. They combat the virus by putting in more normal bacteria in the intestine to help compete with the virus and sometimes even attack the virus directly.


Celebrity accidental overdoses show dangers of prescription drugs

WakeMed medication safety officer and pharmacist Alex Jenkins discussed prescription drug safety with WRAL. Pain medications, sleep aids, and anti-anxiety medications can be of concern, especially when a patient is taking a combination of all three. They work on the same brain receptors and can cause drowsiness, dizziness, unconsciousness, and difficulty breathing.  It’s important to inform your pharmacist of all medications you’re taking – even if those medications are being filled at a different pharmacy.


Bariatric Surgery – How to become a winner at losing

Bariatric surgery is a surgical procedure to help patients lose weight, reduce the risk of life threatening conditions like diabetes and high blood pressure, and improve the overall quality of life.

Weight loss surgery is not a cure for obesity.  It is, however, a powerful tool to help you jump-start your weight loss and begin your journey to improved health and fitness.  It involves commitment, support, and the determination to succeed.

Here are eight tips to help you become successful at losing weight with bariatric surgery and keeping it off, courtesy of some of our most successful patients at Wake Specialty Physicians – General Surgery Bariatric Surgery Program.

1.      Family support is key to keeping the weight off. Be clear about your weight loss goals and desire for better health and talk to your family about it. Help them help you by requesting that dinners out have several, tasty healthy options on the menu or inviting your kids to join you as you walk for exercise.

2.      Motivation is more than willpower. It’s the engine that drives you toward success. Find something that motivates you to reconnect to the purpose of your weight loss journey. It could be as simple as carrying a photo of your children in your wallet or listening to an empowering song.

3.      Start eating healthy foods before surgery. It’s tempting to wait until after surgery to incorporate healthy foods in your diet. But adding a small salad to a meal or discovering whether you like yogurt vs. cottage cheese now will help you make better food choices later.

4.      Meal planning helps you avoid the temptations that come during the day like the tray of doughnuts that magically appear in the break room or the four o’clock snack attacks. Plan ahead for small meals during the day and stick to your grocery list when shopping.

5.      Lose as much weight as possible before surgery. Some programs will require you lose weight before the surgery to demonstrate your commitment. But more importantly there is a medical reason for the pre-operative diet.  Pre-surgical weight loss reduces the amount of fat stored in the liver making surgery easier for your surgeon and safer for you.

6.      Join a support group. While the help of family and friends is essential in maintaining your weight loss, nothing beats getting together on a regular basis with people who share your experiences. Support groups offer educational information, peer support, and nutritional, fitness and medical advice.  In this comfortable forum, members have an opportunity to ask questions as well as share experiences, tips, and advice.

7.      Continue with eating habits and exercise. Remember, it’s not about the surgery. It’s about developing a healthy lifestyle that includes eating right and exercising. Doing both will ensure your success on your weight loss journey.

8.      Count the cost. If bariatric surgery is covered by your health insurance, you may only need to pay the required co-payment or deductible.  If you are paying out-of-pocket, the surgery can cost between $17,000 and $35,000 depending on the type of surgery (lap band vs. gastric bypass), geographic location of the treatment center, the bariatric surgeon’s experience, and level of post-op treatment. Make sure you have a clear picture of all of the costs and what your insurance covers before deciding to have surgery.

For more tips and information, attend the “Bariatric Challenge Breakthrough” this Saturday from 9 a.m. to 4 p.m. at the Embassy Suites at Crabtree, 4700 Creedmoor Road in Raleigh.  Interested participants can register online.  The registration fee is $59 and includes lunch and your take-home challenge kit.  This event is sponsored by Wake Specialty Physicians – General Surgery Bariatric Surgery program.

Erin Akey and the Bariatric Guru Team will motivate and educate you in addition to making you laugh and think. Working closely with others who have similar goals, you will spend a motivational day addressing important topics such as nutrition, cooking, commitment to success, and emotional considerations.

Carol F. Kunkel, BA, BSN, RN is the Bariatric Program Coordinator at Wake Specialty Physicians Bariatric Surgery.