Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua
Hospital
I hear from the USA about dissatisfaction with medical care
over there. The state of Pennsylvania has no malpractice
reform, and since the average physician in that state is sued
once or twice a year, the insurance companies are pulling out
and the good physicians as well. Patients complain about long
lines to do unnecessary tests which are ordered just so you
won't sue your doctor.
A doctor's job is never easy and neither is what he is given
to work with -- a doctor cannot hope to fully understand or
even adequately treat a person -- so he must merely be a
shaliach.
It was once reported that a rosh yeshiva's wife
expended a lot of money and effort to get the best surgeon
for a procedure. Before surgery she told him, "Just remember
that you are doing nothing, really all is in the hands of
Hashem." In any case, understand the life of your doctor --
he does try as best he can.
While in the U.S., I met a subscriber to my updates, Dr. Josh
Simon, who told me about a fever seizure (we call them
febrile seizures) in his child. Fever seizures are full body
shaking with eyes rolling back, and loss of consciousness.
Seizures are of concern, but in fever in young children
between the age of 6 months and 5 years they are quite
common. They do not mean a person will have future seizures,
nor do they indicate brain damage.
Most of these resolve quickly, although longer ones may need
therapy, such as Valium. We do worry about complex seizures --
they are multiple fever seizures in the same illness,
seizures that last more than 15 minutes, or seizures that
involve only part of the body, and not whole body shaking.
The treatment is to treat the illness. Lowering the
temperature does not prevent them from occurring, but my
experience is that it helps. Giving Valium at the first sign
of illness does not prevent these. Valium can be given the
rectal route if the seizure is persistent. Meningitis
generally presents with other symptoms besides just fever and
seizure.
Seizures in fever are scary and do require a physician's
input, but there is little done in most cases. Expect the
patient to be groggy and perhaps confused for a while. Most
important of all keep a cool head. Do not attempt to put
anything between a seizing patient's teeth or give to drink.
Write me in care of the Yated.
A message from Glaxo, sponsor of this column. There is
an easy way to deal with seizures, but many seizures in
people with a seizure disorder are uncontrolled by standard
medications. Lamictal can be the answer for a seizure-free
existence. Speak to your neurologist.
