Help: Tylenol and kids danger

Subject: Tylenol and kids danger
From: BlueJay
Date: 27 Aug 01 - 03:50 AM

Sorry to start an un-musical thread, but this may be important. My grown-up daughter, Annie, told me she's seen several "public service announcements" on TV recently, warning parents that Tylenol, (acetominophen), can cause liver damage in children, and that parents should only use ibuprofen for fever and pain with children.

I've been searching all night, and I can't find any references to such a thing. I did find one study which suggested that giving ANY fever-reducing drugs to children is bad, (including ibuprofen), because fever has a way of kicking kid's immune systems into high gear. Therefore, the study states, giving any anti-pyretic weakens children's immune systems.

I'm wondering if any of you can shed a little light on this. Tylenol has been the drug of choice for pain and fever in children since aspirin was declared taboo. As a nurse, (non-practicing), I've known for years of the dangers of high-dose long term acetominophen. And that Tylenol in any dose in conjunction with alcohol is hepato-bad news. But this is the first I've heard that Tylenol could be a serious danger to our children.

I guess what brings this up is that my five year old was found sleeping on the couch yesterday, and feeling her hot skin I found her temp was 103.5 As trained, I gave Tylenol, (and a bath), immediately. I usually alternate Tylenol and ibuprofen every four hours with high fever, but now I'm wondering if any of it is correct, except for the bath

Thanks, BlueJay

Subject: RE: Help: Tylenol and kids danger
From: mooman
Date: 27 Aug 01 - 04:50 AM

I haven't heard any equivalent warnings issued in Europe although the potentially hepatotoxic effects of paracetamol (= acetaminophen, the principal active ingredient of tylenol) overdosing are well documented.

I couldn't find anything of particular concern on a very quick search of the web other than the usual advice on correct dosage and precautions on avoiding overdosage. The following references might be of interet concerning paracetamol/acetaminophen toxicity.

This one

And this one

I hope this reassures you a little.

Best regards,

mooman

Subject: RE: Help: Tylenol and kids danger
From: Mark Cohen
Date: 27 Aug 01 - 05:41 AM

If there were new information about a danger of acetaminophen, someone would be sure to tell us pediatricians. There's nothing on the American Academy of Pediatrics website, nor on the journal-review email list I subscribe to. Yes, acetaminophen can cause liver damage, usually in excessive doses or with excessive alcohol intake. But that's been known for years.

I think it's ironic, and a little annoying, that this current scare includes a recommendation to use "safe" ibuprofen instead of "dangerous" acetaminophen. In fact, ibuprofen, as a nonsteroidal anti-inflammatory drug (NSAID), like aspirin, carries a similar risk of causing Reye's syndrome when used for certain viral illnesses such as influenza or varicella (chickenpox). And the incidence of necrotizing fasciitis -- so-called "flesh-eating bacteria disease" -- which is often seen as a complication of chickenpox, is much higher among those who have been given ibuprofen compared with acetaminophen. So don't go switching teams just yet.

Mooman's links are excellent, especially the first, which is a very well-documented, balanced discussion of the pros and cons of anti-fever treatment and good information about acetaminophen toxicity.

By the way, BlueJay, alternating antipyretics is no longer recommended. And, as Mooman's first link clearly points out, the reflex use of antipyretics for fever is not necessarily good care. I personally think that giving Tylenol when a child is uncomfortable, with either fever or pain, is a kind thing to do. But fever itself isn't dangerous, and is usually there for a reason: to help the body fight infection.

Aloha,
Mark

Subject: RE: Help: Tylenol and kids danger
From: GUEST,Pelrad
Date: 27 Aug 01 - 10:07 AM

Mark, just wondering why the alternating or doubling up of Tylenol and Ibuprofen is no longer recommended? And when did that change come about, because my pediatrician still recommends it if fevers are at or over 103.

We no longer use Motrin in this household, as we suspect it is at the root of a problem my son has. When ill, he consistently runs a fever between 103 and 105. It's gotten to the point where I can tell what his temp is by looking at him. There are times he spends entire weeks getting in and out of a lukewarm bath to bring it down from 105. That's scary enough, but more frightening is what happens when the fever breaks. He screams and thrashes, hits his head with his hand and bangs his head on things for as much as 12 hours at a time for between three and six days. It's been almost a year since his last "episode" (he just turned three), which was the most unnerving; I brought him outside hoping for a distraction and instead he got down and started banging his head on the asphalt driveway. No reaction to the pain while head-banging, by the way.

Last time this happened we asked him about it. He had only just started talking, and he told us he had wax in his head and was banging his head to get the wax out. Not that he has more language I wonder what he would tell us. We're hoping he's outgrown it and we won't have occasion to ask!

Sorry for the tangent. Anyway, operating under the theory that the Motrin is triggering this behavior, we don't give it to him and have no intentions of trying it out on his baby sister. I've always heard that ibuprofen can be bad for little ones, but Tylenol is considered the "safe" one; so thanks for clearing that rumor up!

Subject: RE: Help: Tylenol and kids danger
From: Peg
Date: 27 Aug 01 - 11:57 AM

I agree, the information on paracetemol has been around for a long time. Adults are also in danger if they rely on these sorts of drugs for extended periods of time. I knwo peope who take Advil every day practically...

I think the big picture take is this: too much reliance on ANY sort of OTC remedy (pain killers, nasal spray, degongestants, antacids, laxatives) is harmful. Especially dangerous to get children used to taking them for every little ache, pain or sniffle. There is a veritable epidemic of probelms in yoiung children whose frequent ear infectsion, treated with antibiotics, are recurring with alarming frequency because treatment with antibiotics makes kids MORE susceptible to infection! Imagine that.

There are a great many holistic or herbal based treatments for kids' frequent ailments, for anything from diarrhea to fever to earaches. I believ there are a couple of books on this sort of thing, too(I got one for my sister when her little boy was plagued with earaches). Aromatherapy is particularly effective with kids and a great many essential oils are perfectly safe for them. One drawback is that not too many oils have an analgesic effect...although peppermint, rosemary and lavender are all excellent for headaches (use peppermint sparingly with kids; it can overstimulate them at bedtime!) Cool baths with lemon essential oil are meant to work well for mild fever. These substances do not build up in the body like chemicals we ingest and have little or no side effects...tea tree, naiouli and eucalyptus oils can eliminate the need for antibiotics in the cold and flu season (when antibiotics should not be used anyway but doctors still prescribe them for some reason...)

We get sick for a reason; the body needs time to heal, and often must go through a crisis to do so. Using "instant" remedies meant to mask pain or "kill germs" or dry up phlegm or artificially move the bowels, etc. do not really help the healing process; and often make the iummune system more susceptible to illness in the long run...

Meanwhile, use Tylenol sparingly if it is worriesome to you. Certainly no more than once every month. If it is needed more there should be some attention paid to underlying health problems that can more effectively be addressed with changes in lifestyle (nutrition, sleep, exercise,environment, etc.) This takes time. Be patient. Best of luck!

Subject: RE: Help: Tylenol and kids danger
From: M.Ted
Date: 27 Aug 01 - 12:27 PM

Pelrad, have you taken your child to a pediatric neurologist for an evaluation? When symptoms like that present themselves, it can be a reflection of a neurological problem--My daughter, who has cerebral palsy, goes into very similar seizure-like episodes when she gets a fever, and, so we use Tylenol or Children's Motrin to control the fever--

Also, rather than warm baths, try relieving the heat hy wetting a wash cloth, wringing it out, then gently swabbing the child's skin with it--the tiny amount of remaining moisture will evaporate from the skin very quickly, and produce a cooling sensation that is wonderfully comforting--it is much more effective than the baths, much, much less trouble, and can be done quickly, whenever it is needed--

Subject: RE: Help: Tylenol and kids danger
From: M.Ted
Date: 27 Aug 01 - 12:55 PM

As to Peg's comments--generally, I am very inclined to use of alternative therapies, especially for the regular, every day variety of ailments--HOWEVER--they are only therapeutic options, and when there are serious health problems, the critical thing is to get good diagnostic work done, by qualified medical professionals--once you have determined what the problem is, then you can review all of the therapy options, and if you decide to go with alternative therapies, fine--

There are many, many problems, shortcomings,with our medical system, but it offers better diagnostic tools than you are going to find anywhere else--use them--Don't try to diagnose and treat yourself with a book from a health food store, and don't entrust your child's health to the part-time clerk behind the aromatherapy counter--

Subject: RE: Help: Tylenol and kids danger
From: Jim Dixon
Date: 27 Aug 01 - 01:32 PM

I'm not a doctor or nurse, but please let me put my 2 cents in -

Pelrad, what do you mean by "lukewarm"? Have you ever measured the temperature of the bath water? Over here, "lukewarm" means "somewhat warm" and any water that people would call "warm" would probably be warmer than body temperature and therefore useless for bringing down a fever. It seems to me the bath should be "cool" to relieve anything.

Subject: RE: Help: Tylenol and kids danger
From: GUEST,Doc
Date: 27 Aug 01 - 02:00 PM

This will be more like thread leap than creep.

Well, Peg, the reason that there are warnings about medications and that the warnings change from time to time is because those particular "natural" substances are studied in a formal, scientific way. Their effects, both wanted and unwanted, are measured, tested and reported by the scientific community. And when their costs outweigh their benefits in a given application they are withheld.

Whereas the natural substances you recommend are a total crapshoot. Their qualities are known only through anecdote and custom. Your statement that they "do not build up in the body" and "have little or no side effects" necessarily comes out of thin air, since no credible scientific studies have ever been done to substantiate or support such unlikely assumptions.

I would be interested in seeing ANY reference you might cite to support your sweeping assertion that, "treatment with antibiotics makes kids MORE susceptible to infection".

Of course, being essentially anti-scientific in orientation relieves the herbal, and other "alternative" therapeutic belief systems from having to adhere to that which is objectively demonstrable.

Having studied the processes of healing, curing, harming and dying for a lifetime I am convinced that from a spiritual point of view it is the "healing relationship" between a practitioner and the person who is ill that is the key factor in the restoration of wellness, and that the particular metaphor adopted by the healer is of secondary importance. When things are just not right with a person, homeopathy, spritual healing, classical acupuncture or Bock flowers may be as effective as allopathic medicine, perhaps more. The usual methods of practice of allopathy, in fact, may often not provide what the spirit requires to feel better, or even make it feel much worse. But to give the devil its due, allopathic medicine is clearly superior for determining the true causes and devising specific cures for specific illnesses or conditions. Moreover, it is precisely because these cures are so powerful that their unwanted effects may also be severe, and precisely because herbal remedies are only marginally if at all effective, that their side effects may go unnoticed or not appear to be conected with their cause.

Despite the imperfections of medicine and science, to suggest that we abandon medications in favor of a return to the natural foods and herbal cures of an earlier time -- when the average lifespan was 45 years, seems to me at the same time simplistic and extreme.

Yet I have no objection if any should themselves want to do that, and have never been offended when patients declined my medical recommendations. I view the refusal of medical treatment as an interesting natural experiment: natural selection at work, as it were.

I have always recommended trying physical methods to relieve symptoms rather than medications, such as cool baths for fever that is going towards the level that causes seizures or permanent brain damage. I reassured parents with the confident assertion that they would be able to remove heat from their baby's body faster than he or she could produce heat, resulting in a net cooling. But for a middle ear infection I never hesitated to use appropriate decongestants and antibiotics, having in 1943 when I was a kid, before antibiotics were available to civilians, survived a week of extreme vertigo and delerium before being held down so the doc could lance my eardrum and let the pus out.

As a young physician I used to see a few older adults with large depressions over the mastoid bone behind the ear, where the bone had been scooped out after becoming abcessed secondary to a middle ear infection. The procedure was done to prevent the next step in the natural process, which was the development of a fatal brain abcess as the bone eroded through on the inside of the skull.

But in more than 35 years of practice I never saw mastoiditis (a term that used to strike terror into the heart of any parent who heard it) or a brain abcess in a patient, thanks largely to antibiotics.

I've heard it said that about 80% of people who are ill will get better so long as whatever you do doesn't make them worse. And is it 40% who will feel better when given a placebo? So with a sugar pill, a bear's gallbladder, an herbal remedy or dancing widdershins in a clearing in the moonlight most ill people will recover and could have done without ANY of that, much less allopathic medications or surgery. But for the seriously ill it may be another matter entirely.

My own strategy has been to avoid unnecessary medications, use currently recommended medications without hesitation, expect that for any medication new side effects may be discovered as time goes along, and stop using the medication if and when that happens.

From what Mark Cohen says, and he is more current than I, it does not appear that that time has come for acetominophen.

Doc

Subject: RE: Help: Tylenol and kids danger
From: GUEST
Date: 27 Aug 01 - 05:47 PM

Jim, I was always told that the water should be lukewarm, or room temperature, because cold water can cause shock or chills due to the sudden change in temperature.

Subject: RE: Help: Tylenol and kids danger
From: Jeri
Date: 27 Aug 01 - 06:53 PM

Just one comment to Doc - please be sure no studies have been done on herbal medicines before you state no studies have been done. (It sounded like you were lumping all herbal treatments together, but you may have just been talking about the ones Peg mentioned.)

I'm taking Feverfew for migraines, and my neurologist refuses to talk about it, since he didn't prescribe it. (Wonder what he'd say if I told him I was trying Absinthe.) There have been several studies to show this herb is effective. It's very frustrating to have to deal with a doctor who's main focus is the pharmaceuticals and not the ailment.

I don't know about the ones Peg posted - it was hard enough to find information on what I DO take. One thing I've noticed in some people is that they mistrust any prescribed medication but will swallow all sorts of herbs without doing any research. Some of them can be quite toxic, and others can be ineffective but expensive. Rosemary oil is one which I believe can be toxic if taken in high enough doses. Most of them may or may not be effective, but if a patient's not at risk from taking herbs instead of something else, what does it matter? If there haven't been studies, the herbs may or may not be effective, but if they work for a particular person, who cares?

Subject: RE: Help: Tylenol and kids danger
From: Mark Cohen
Date: 27 Aug 01 - 07:05 PM

It won't cause shock, but it may cause the child to shiver, which would tend to make the temperature go up instead of down.

Maybe it will help to have a little understanding of how fever works. Normally, we adjust our body temperature by increasing muscle activity and/or directing more blood flow to the interior of the body and away from the skin (either of which will raise the temperature) or by increasing perspiration and directing more blood flow toward the skin (which will lower it.) The "setpoint" for normal temperature is maintained by a part of the brain called the hypothalamus, that works much like a thermostat.

There are a number of chemical substances that can temporarily reset this "thermostat". Many of these chemicals are produced as part of the response to infection, while some are produced by the invading organisms themselves. When the setpoint is pushed higher, your body "thinks" that its normal temperature is too cold, and it responds by increasing involuntary muscle activity. You may shiver, or, if the change is large and sudden, you may have shaking chills. It's the shaking that causes the fever, not the other way around. At the same time, you "feel cold", even though your body's temperature is perfectly normal, so you crawl under the covers...and that also helps to raise your temperature.
When the signal fades, and the thermostat is reset towards normal, that's when you feel hot and start to sweat, as your body tries to lower its temperature. So saying that you want to "sweat out the fever" is really backwards: you start sweating when whatever was causing the fever has stopped.

What the antipyretic medications do is to block the transmission of the signal to the hypothalamus, and thus prevent the thermostat from being "bumped up". Now, we know that the growth and activity of many viruses and bacteria is slower and weaker at high temperatures. So, by agressively "treating" a fever, you're actually preventing the body's defenses from doing their job.

I think that both Peg and Guest Doc make good points. One thing that is often not appreciated is that the reason some herbal treatments (tea tree oil, garlic) work "as well as" antibiotics is that they ARE antibiotics! And as such, they can have the same "bad" effects of toxicity, development of resistance, etc., as the more familiar "drugs".

Remember also that the body is lots smarter than any doctor OR herbalist. When I prescribe an antibiotic for a child, all I'm really trying to do is to slow down the spread of the "bad" bacteria enough to give the child's natural defenses a chance to catch up and do the real "curing".

Aloha,
Mark

Subject: RE: Help: Tylenol and kids danger
From: catspaw49
Date: 27 Aug 01 - 10:46 PM

Hey....Antibiotics.......yeah, there can be some problems, but I love them little beggars! A few weeks ago, I found that you can skip over damn near everybody in a crowded, jam packed, ER by saying, "I have a St. Jude's mitral valve, I'm running a fever of 103, and I think I'm developing cellulitis." Worked like a champ, which was good because my BP was below 70/30 when I passed out! A couple of days of pushed IV antibiotics and by golly I felt a lot better and never once did I get a whiff of eucalyptus or a lemon oil bath.

Spaw

Subject: RE: Help: Tylenol and kids danger
From: Mark Cohen
Date: 27 Aug 01 - 10:56 PM

Thanks for reminding me about that one exception. If I were prescribing antibiotics for 'Spaw, all I would be trying to do would be to get him to shut up long enough for his natural piss-in-your-face personality to send the bacteria packing!

Aloha,
Mark (glad you're better, Pat)

Subject: RE: Help: Tylenol and kids danger
From: Peg
Date: 28 Aug 01 - 01:16 AM

My knowledge of the effectiveness of herbs and essential oils does not come out of thin air; it comes from actually using them! And my knowledge of the antibiotic response in children, again, comes from my own observation and anecdotal evidence. Not good enough for ya, Doc? Too bad. I think anecdote and custom are perfectly acceptable ways of learning about a potential cure for a mild condition, or even a serious one. Are you going to now tell us all that allopathic medical practitioners never make mistakes in diagnosis and treatment? 'Cause I will laugh at you.

And until you have seen an upper respiratory infection utterly eliminated through the use of tea tree oil, don't tell me such cures are only "anecdotal" at best. This substance was given to soldiers in Australia in the last century as a poetnt antimicrobial. It has been used in the bush by aboriginal Australians for centuries before that. And we can use it for a myriad purposes today. I myself have seen it cure athlete's foot, strep throat, yeast infection, sinus infection, chancre sores, and other conditions. Imagine that.

By the way, it is "Bach" flower remedies, and no, they are NOT the same thing as essential oils.

One reason that herbal substances are not subjected to the same rigorous studies as newly invented phramaceuticals is that there is far less profit potential in them. Also it is difficult to test them rigorously because, being plants, the chemical constituents in herbs varies widely according to climate, location, season, etc. Such lack of testing did not stop our ancestors from using these cures successfully. Why do you think they are in vogue again? Because our ever-so-sophisticated medical system is inadequate. It is my understanding that most medical degree programs in the United States, do not even require physicians to study the basics of nutrition, for God's sake. In China or Japan or Germany, this would be seen as perplexing and ludicrous. I am sure there are a great many American doctors who think this is a problem, too; but not most of 'em

Gee, is it not enough that some of these substances have been used for thousands of years with great success? They haven't been tested, you say? They have been used for centuries!!! Just because it is not the best idea to isolate their constituents and put 'em in a pill that can be manufactured and sold for big bucks, doesn't mean they aren;t any good. Yes, of course they are capable of causing bad reactions if someone takes too much of them; any anyone who takes "handfuls" of herbs or whatever without thinking much of it probably deserves what they get. A qualified herbalist knows that these substances must often be introduced gradualy into the body. If someone tries to treat themselves by reading a a few pages from a book at the health food store, well, maybe they will get better and maybe they won't. But I WAS talking about treating UNDERLYING causes of disease with nutritional and herbal options; NOT treating cancerous tumors or hepatitis or diabetes or myocardial infarction or some other acute condition with them. Sheesh. Don't put meanings into my words that are not there.

Antibiotics are a wondrous invention. No question about that. But they are VERY MUCH OVERUSED in this country. Spaw, in your case, I am glad you got them!

And for the record, I do not work part time behind the aromatherapy counter...but an article I wrote on treating cold and flu symptoms with essential oils WAS referenced in an article in a professional nursing journal...

peg

Subject: RE: Help: Tylenol and kids danger
From: ponytrax
Date: 28 Aug 01 - 02:42 AM

I wish the anti-Western-medicine bunch had the voices of old aunties and uncles whispering in their ears.

My uncle Hart was born in 1910. His older brother died in 1929, of gangrene. It took him 7 months to die, in agony and delerium. We were all together in 1980, and there was some rotting hamburger in the cooler. Uncle Hart was weeping and I asked why. He said, "the smell made me think of my brother William. I didn't want to be with him even though he was lonely. That is what his room smelled of, that summer. The docter kept cutting and cutting on his leg, and still he died." With modern antibiotics, he would not have suffered or died.

My great-aunts Helene, Lavinia, and Eva all died in about 1910, of diptheria. I am not sure of their birthdates, but my grandmother, who was the oldest (1885) thought they were born about a year apart, in 1890, 91, and 92.

Subject: RE: Help: Tylenol and kids danger
From: BlueJay
Date: 28 Aug 01 - 03:48 AM

Sorry to drift away from herbal remedies, but my basic question is still unanswered. I referred in my initial post to TV warnings about Tylenol hepatotoxicity in children giving average doses. Has anyone else seen these ads? This is reported to me by my daughter, who is probaly more reliable than the stations the ads were run on.

Mark Cohen, I agree with your remarks regarding fever. I have never taken a knee-jerk approach to reduce any and all fevers. Fever is beneficial, to a point, is my understanding of our current knowledge. But given the state of flux of our medical knowledge, research and hasty FDA approvals, I'm not willing to gamble my kid's health on the belief that a sustained temperature of 104 F is beneficial. I'm going to try and get it down. Plus, I've never seen a kid, (or adult for that matter), who was comfortable with such a body temperature.

I am comforted, but only slightly, by the fact that the American Academy of Pediatrics knows nothing of this. Drugs are constantly being pulled for side effects not uncovered during initial testing. (E.g. Propulsid, and various blood pressure medications). In reality, I've seen a lag time between early warnings and when physicians actually stop prescribing the drug, or it's pulled from the market. In the past, FDA approval for good pharmaceuticals has been long and laborious, but I wonder if the pendulum hasn't swung too far to the right, and I'm not at all comfortable with how drugs are prescribed and advertised today. Even Tylenol, which not long ago appeared to be fairly innocuous, is now suspect. Hence this thread.

I appreciate all of you folks' comments. Thanks, BlueJay

Subject: RE: Help: Tylenol and kids danger
From: Peg
Date: 28 Aug 01 - 10:41 AM

sorry to hear about your loved ones, ponytrax.

I am not anti-Western medicine thoguh. I did say I think antibiotics are a wondrous invention. Particularly for things like gangrene. However, that, too, can be cured with herbs. An herbalist named Juliet de Bairicli-Levy did so more than once. But antibiotics sure are faster.

Subject: RE: Help: Tylenol and kids danger
From: M.Ted
Date: 28 Aug 01 - 03:12 PM

Peg,

My point is not to disparage anybody--as I said, I am a great believer in alternative medical treatments--However, many people who buy aromatherapy products, herbal medicines, and alternative medicines, do buy them from *part time* people who have no formal qualifications to recommend treatments or remedies, but often ask for therapeutic advice from these people, they usually give it, and, at least if customers use what they buy, they follow that advice--this is not a good thing, no matter what kind of medicine one believes in--

The real problem is that medical knowledge is still pretty much a blank area for most people--Dr. Mark has shared a bit of information on body temperature that most lay people have never learned--and yet most people, most of the time, are their own doctors, diagnosing and treating fevers and whatever other health problems that they have, by choosing from the stock at the drugstore or supermarket--

And, on the occasion that they do visit a trained physician, most people don't understand enough of what they are told to make good choices about the treatments that are offered--This is the biggest problem of all--

Subject: RE: Help: Tylenol and kids danger
From: Peg
Date: 28 Aug 01 - 09:15 PM

I agree with you M. Ted--you are making some very valid points. Especially about the way that doctors and laypeople cannot communicate very effectively; the system seems to have set it up this way. People do have a responsibility to educate themselves about their own health, I think.

My gripe tends to be more with people who deny there are any benefits to using alternative methods when they have not been "properly" researched and tested, etc.

As for getting advice from part-time store clerks: When I worked in a shop years ago where we sold herbs, people often asked us about medicinal uses. We did not offer such advice; we did refer them to books, or to herbalists. We also would tell them about things we had personally used ourselves, thus giving them anecdotal advice. But we always let people know we were not medical professionals or even trained naturopaths, and as such we could not legally offer such advice.If someone had a seriosu condition we urged them to see a professional about it.

Subject: RE: Help: Tylenol and kids danger
From: GUEST
Date: 28 Aug 01 - 10:20 PM

M Ted: Yes, we insisted upon a ped neurologist. The first one we saw diagnosed him as the youngest bipolar case he'd ever seen. Good grief, he was barely two at the time. I was already taking that diagnosis skeptically, because I've yet to meet a bipolar person whose mood swings were only set off by high fevers. When he mentioned later in the same conversation that he has seen MANY very young bipolar children lately, the warning bells went off and we started looking for someone to give a second opinion.

A pediatric behaviorist said it sounded like a form of seizure to him, and referred us to a friend of his. It took us a while to track down which hospital he worked at that would accept our insurance; going out of state is tricky. Now we have his name and our clearance, but Little Son has not had a high fever or an episode in nearly a year and we have decided to see if it happens again. We are hoping since he now has a huge vocabulary he can tell us a little better what is happening to him.

I'll try that cloth trick next time. It sure is tough on him to be in and out of the tub every time that fever spikes.

How similar are your daughter's seizures?

Jim Dixon: By lukewarm I meant warm on the skin. Not a hot bath, but not too cold for comfort as it starts him shivering - which raises his temp. 105 is scary enough, don't need it any higher!

Subject: RE: Help: Tylenol and kids danger
From: toadfrog
Date: 28 Aug 01 - 10:48 PM

M. Ted: Pardon this comment from an non-medical type, but why is it that the "natural" remedies don't get studied? I am told, e.g. that Saint John's wort is used in Europe, and works approximately the same as some of the expensive anti-depressants we use here. I would never dream of buying Saint John's wort in the U.S., because it is not regulated and you can't tell what it is that you are buying. What I can't understand is why these things are not regulated here, and speculation leads to slightly sinister explanations.

I had two good friends who taught medical school, who told me vitamin supplements had no merit, you could get your MDR from eating a balanced diet. And I responded, for animals they calculate optimal vitamin intake and that is higher than the MDR necessary to prevent scurvy or beri-beri; is it not probable that this is also true for humans (who are, after all, very like animals, and who are sometimes said to be a species of animals). And they replied, no, vitamin supplements cannot do you any good, because research has not established that this is so, and because "we scientists" do not deem such research worth performing.

This same couple were fond of deploring the gap between the "two cultures," and the ignorance we laypeople display of science. They were extremely intelligent. And they made me very angry.

Subject: RE: Help: Tylenol and kids danger
From: catspaw49
Date: 28 Aug 01 - 11:52 PM

If you're interested, you might contact Dr. Harrison Tweed at Ohio State University who can report to you the details of experiments run with a series of different lab animals iver the past ten years, First, a balanced, nutritional diet is developed for the species, and then they are divided into three groups:

GROUP ONE---Gets the basic nutrtional diet and they are free to control their own intake, food is always available.

GROUP TWO---Gets a "supercharged diet" which includes vitamin and mineral supplements, antioxidents, etc. for the species along with the basic nutritional diet. This "health nut" group also can have food upon "request" although they are not just "trough fed."

GROUP THREE-Gets the basic nutritional diet and their intake is strictly controlled to provide only the calories needed to perform normal activities.

All groups get the same amount of exercise and sleep (as well as can be monitored). The health standards previously established are measured on a regular basis over a period of years............Which group always is the healthiest....in every species, every time?

If you said GROUP 3, give yourself a seegar!!!

Spaw

Subject: RE: Help: Tylenol and kids danger
From: Mark Cohen
Date: 29 Aug 01 - 12:10 AM

One of the many myths that circulate in this controversial area is that natural remedies are not studied by reputable scientists. Take a look at this book, The Holistic Pediatrician, by Kathi Kemper, M.D. There are well over a hundred (I stopped counting) references to scientific studies of "nonstandard" treatments, in established medical journals such as the Journal of Pediatrics, Lancet, and the New England Journal of Medicine. Toadfrog, your friends need to update their information.

Pelrad, your child's symptoms could have a number of causes, and I won't presume to make a diagnosis here. Children with high fevers commonly hallucinate, but you said this happened after the fever went down. Seizures would not be high on my list, but it's difficult to tell based on the limited information. I'd be more suspicious of some kind of para-infectious encephalitis. There is a growing awareness of a number of neurologic syndromes that are either "post-infectious" (after an infection) or "para-infectious" (associated with an infection, but not directly caused by the infectious agent), that probably result when the natural immune response to an infection is either "overactive" or "misdirected". One of the oldest and best known (among doctors, that is) is something called Sydenham's chorea, which is seen in acute rheumatic fever -- antibodies against streptococci (from a strep throat, for example) attack the body's own tissues, notably in the heart and brain. A good pediatric neurologist, preferably at an academic medical center, would certainly be your best bet if the symptoms recur--but let's hope they don't!

BlueJay, I completely agree with treating fever when the child is uncomfortable...I just don't think it's necessary when the only person uncomfortable is the parent. But I've done it enough with my own kids, so I understand completely!

As far as the "dangers" of Tylenol, I do understand your suspicion of the "safety net" -- that's one reason I tend to be the last one in town to start prescribing any new medicine. But my experience of TV medical "news" stories is that the great majority of them make a lot of noise about old news, or about questionably significant results. Somebody publishes a paper that confirms established information, or demonstrates a real but insignificant effect of something on something else, and the media jump on it like it's a message from Sirius--especially if the information is in any way scary or sensational. I would very much like to see just what was in these news stories you're talking about. I understand your concern, but I'd be very surprised if there's anything to this one. If you can give me specific information, I'd be happy to evaluate it, or send it to an expert. And if I'm wrong, I'll be the first to admit it.

Aloha,
Mark

Subject: RE: Help: Tylenol and kids danger
From: M.Ted
Date: 29 Aug 01 - 01:11 AM

Pelrad,

The circumstances are a bit different with us, her muscles lock up, and she experiences tremors and convulsive movements--

Children and adults who have suffered brain trauma can experience headbanging episodes, tremors, and a variety of other problems, including vertigo, dizziness, and memory lapses and sensory input distortions, when they are stressed,physically or emotionally fatigued, or ill. Problems can be particularly exacerbated when they have become dehydrated(This from my own experience, and that of my daughter, as well as from years of contact and converstion with other TBI survivors)

Depression, mood swings, and attention fluctuations, are also typical problems that appear in children who have suffered some sort of insult to the Central Nervous System-It isn't out of line to consider the possibility that, when these problems appear, that there might have been some kind of traumatic cause(the post infectious syndromes that Dr. Mark mentions could be considered to be results of something akin to trauma, as well, in the sense that they may have inflicted some types of damage)--

I am not trying to alarm you, but you have said that someone has already given you a diagnosis of possible bipolar disorder, so you already know that there are some rather dramatic irregularities that your son is experiencing--

If you want to talk more about this, send me Mudcat PM's(my e-mail is hopelessly choked with streams of spam right now, and PM's are actually the only reliable way of getting to me) since those of us who have to deal with this do it in "baby steps", there is a lot to talk about--good luck!

Subject: RE: Help: Tylenol and kids danger
From: GUEST,Doc
Date: 29 Aug 01 - 02:36 AM

Yes, Peg, I learned the wrong spelling for Edward Bach's name and have wrongly always thought it was spelled differently from the family of composers.

Redarding some of your other points I fear we are just going to have to agree to disagree. I do realize, as Mark has pointed out, that there has been some relatively small amount of credible scientific research on "herbal" cures in recent years, mostly, as you mentioned, in Europe. I am aware of some work done in Germany on St Johns' Wort which indicated it may have efficacy as an antidepressant. However I have often been offered references to self-serving, incompetent,anecdotal or apocryphal "research", usually appearing in Prevention Magazine or in advertizing for some herbal product. This I do not count as credible.

I hasten to add that I am also quite skeptical of much of pharmacologic research paid for by drug companies or done by drug company hacks, or university physicians so arrogant they believe they will be impervious to corruption by even an enormous conflict of interest. The fact that such research is often reported in big-name, "refereed" medical journals doesn't impress me much if the paper is, upon careful scrutiny, clearly bad science, which it often is. Hence, again I agree with Mark, in that I don't rush out and try every new medication. My rule of thumb is to wait between one and two years to see how they shake out.

But I believe the reason little "herbal" research is done in the US is not as sinister as some might choose to see it. In the US the FDA assumes a protective role which the public of most other countries does not enjoy. In order for a product (and many, many pharmaceuticals are herbal, you know), to be marketed and sold for a particular purpose, a carefully controlled formal series of clinical tests and trials must demonstrate, to a degree that is found to be statistically significant and not due to chance, that the product is efficacious and that it's undesired effects are well defined. Both the efficacy and the "side-efects" are usually well quantified by the time the product is on the market, so that prescribing physicians can include estimates that the medication will work and estimates of the risk of harmful side effects into the complex and artful process of diagnosing and treating illness.

In addition to the fact that there is little incentive for a pharmaceutical company to underwrite such an expensive undertaking (because the herbs are not patentable) it is also true that even if they were willing to pay for the research on crude herbal products containing thousands of known and unknown ingredients, it is often impossible to demonstrate efficacy once the placebo effect is ruled out; or safety when the witches' brew of organic compounds in the raw herb is considered.

I am, by the way, not seeking here to convince or convert you or anyone who shares your point of view. More I think I am speaking to all the other folks out there who don't really understand much about medicine (as someone put it) and to whom your approach might otherwise sound quite plausible. I spent my first 17 years as a Family Physician, mostly explaining to my patients in plain English what those other doctors were talking about: being sure that they DID have enough information upon which to base the decisions they needed to make. I guess it's a hard habit to break.

Wisdom, I suppose, might be defined partly by knowing when to accept and when to decline any particular form of treatment, whether herbalist or allopathic, or any of the other several hundred theories and methods of treatment of which the planet boasts.

Denis

Subject: RE: Help: Tylenol and kids danger
From: BlueJay
Date: 29 Aug 01 - 03:42 AM

Mark- Unfortunately, I don't have any details regarding the advertisement. I started this thread in hopes that somebody else had more solid info. All I know is that my daughter, (adult), has seen this warning several times. She doesn't recall which channel. As I said earlier, Annie is a more reliable historian than most TV channels, so I am sure she's seen something, but I wish I had more details as well. I was hoping somebody else would shed some light. I really doubt that this falls into the "hoax" category. More likely is the "media frenzy" which you suggest. But Annie is now reluctant to give acetominophen to my grandson, due to the ad. I am as well.

Given acetominophen's proven hepatotoxic effects in adults, it doesn't seem to me to be an unrealistic concern in pediatric patients as well. Indeed, it seems logical to me that the children may be even more susceptible to the side effects or adverse reactions.

Thanks for your insight, Doc. If I learn any more, I will pass it on to you. If you learn more, please post it.

It's all probably good. Even if the TV ad was a total hoax, I have re-evaluated my casual usage of Tylenol. Thanks, BlueJay

Subject: RE: Help: Tylenol and kids danger
From: Brigie
Date: 29 Aug 01 - 07:48 AM

In terms of giving Children Tylonel.........my solution is to only give it when every other method (non drug) of reducing fever has failed. The one method that I can always rely on is the following: Put some lukewarm water in a basin, add a couple of spoonfuls of ordinary vinegar. Then soak two good sized faceclothes in it. Wrap them ( not wrung out too much ) around the lower leg (between the ankle and the knee).Then to secure them gently put a big pair of socks on the child. You will notice the difference in a shorts space of time. Normally you would have to replace the facecloths every couple of hours. This mehtod never fails for me. Of course if the temperature goes over 40°C then I would immediately call the doc.

Subject: RE: Help: Tylenol and kids danger
From: Peg
Date: 29 Aug 01 - 10:18 AM

I have heard a couple more radio news blurbs on the Tylenol issue; any sort of potential public health scare which has a noteable corporate attached is usually big news; Tylenol bounced back before! But for whatever reason the scare is being attached to a brand name and not the actual drug (acetaminophen); why is that?

Doc: I agree with your assessment of where "wisdom" lies; but it does seem like such wisdom is impossible even for the most finely trained doctor, naturopath, herbalist or wise woman...I think the worst thing is that most people do not care to educate themselves about their own bodies, do not bother to make lifestyle changes to aid their own well-being (the nationwide addiction to antacids and laxatives is testament to this) and people are willing to take any pill if promised it will cure their ills (no matter what that ill is: depression, obesity, fatigue, stress, etc.)

As for testing of herbal cures: plants will simply never be subject to he same sorts of measureability as lab-produced drugs, for the reasons already mentioned. I still think it would be wise for anyone planning to spend any time away from civilization to learn basic plant identification in the wild and how to utilize plants for everything from anti-septic wound treatment to food poisoning and beyond...when pills in a bottle are not available or desirable, Mother Nature offers a veritable pharmacy. As you say, many pharmaceuticals are herbally derived. Using the plants themselves as opposed to a pill is similar to eating an actual tomato, as opposed to taking supplements which purport to supply vitamins A, C, and those other nutrients the tomato gives.

Interesting study you cite, Spaw (but, Harrison Tweed???) One could not live on supplements alone; a great many otherwise intelligent people seem to think eating a few Power Bars every day provides them with nutritional surfeit. But it's not FOOD.

Subject: RE: Help: Tylenol and kids danger
From: catspaw49
Date: 29 Aug 01 - 10:46 AM

Great name huh? Funny thing, but when you meet the guy, the name matches!!! I had occasion to talk with him when I was going through several days of pre-surgery testing at OSU University Hospital and he really is a fascinating character. How I came to be talking to him is a long story, but the 2 hours was interesting to say the least. He is very knowledgeable about drugs in general and had a piece of information about a drug I'm taking that I was completely unaware of....and so was the cardiologist who prescribed it. I take more that an average interest in the drug/medicine thing because over the past few years, we've had some problems that mandated it.

This drug, Pravachol, is prescribed to lower cholesterol. I told my cardiologist that I had never had a cholesterol problem, which is true. Prior to taking Pravachol, the highest my cholesterol had ever been was 148 with corresponding great levels in LDL and Triglycerides so I couldn't see the point. He felt that it was just a good idea because of the aneurysm, which may be true, but I still didn't see how it could be all that beneficial. Tweed told me something I had never read....that testing has shown a benefit with this particular cholesterol reducer that even the manufacturer had been unaware of. Namely that with Pravachol, you are twenty times less likely to have a second heart attack.....changed my mind a bit.

Spaw

Subject: RE: Help: Tylenol and kids danger
From: BlueJay
Date: 30 Aug 01 - 02:23 AM

Peg- I chose the title of this thread because more people,(Americans, anyway), are familiar with "Tylenol" than "acetaminophen". Most news organizations probably share my view. Relate to the largest numbers of people. I am not singling out the makers of Tylenol. That would be stupid, since acetaminophen is generic and is present in hundreds of over the counter products. But I'd bet that only 25%, at best, of American consumers know what acetaminophen is. I'd bet even fewer know that acetylsalicylic acid is aspirin. A headline of "Acetylsalicylic Acid Reduces Platelet aggregation" would generate less interest than "Aspirin can make you bleed to death".

For good or ill, Tylenol is equated with acetaminophen in the United States. I don't recall which company produces Tylenol, but I bet they are delighted that the generic name "acetaminophen" is so strongly linked to their company. And since they managed to trademark the drug, they will just have to live with any bad news associated with the drug. BlueJay