Fever

Posted 26 January 2016

It’s been a rocky few days, but today I am on the mend.

I woke up feeling pretty well on Sunday, and went for a couple of walks during the day.

In the afternoon, I started feeling tired, and noticed my temperature was a little high.

By 8 pm my fever was up to 101, and I was feeling pretty lousy, in a vague flu-like way.

I am under strict instructions to call the oncology office day or night, any time my temperature exceeds 100.4. It had beem above that for a couple hours now.

I was still inclined to ride it out until the morning, but Irene insisted we call the doctor. We did, which of course was the right thing to do.

He said I really should go into the emergency room now. For patients with biliary stents, his experience has been that fevers are usually an infection in the bile duct.

Going into the ER was so much not what I wanted to do, but that was that.

So off to the Sutter ER Irene drove me once again. Irene has now taken me there twice, but this is the first time I have gone there while entirely conscious. When I was there a month ago with what turned out to be sepsis, I was nominally awake, they tell me, but I have no recollection of it, and it didn’t seem at all familiar being there on Sunday.

This time, fortunately, I was entirely conscious — enough to take this picture — and didn’t feel any worse than having the flu. The ER was empty, and I was taken to a room right away. They recorded my temperature as 102.6.

For the next hour, they drew blood, took a chest x-ray, did an EKG, monitored all the usual vital signs, and gave me Tylenol.

My blood tests were remarkably normal — no elevation in white blood cells, as you’d normally expect with an infection, and normal levels on everything associated with the bile ducts (bilirubin, alkaline phosphatase). Nothing on the chest x-ray or EKG.

However, apparently the white blood cell test is unreliable after chemo, and my oncologist remained convinced that I had a biliary infection.

So I got IV antibiotics in the ER, and a prescription for a week of oral antibiotics. By a little after midnight we were on our way home.

I was so grateful that they didn’t find any reason to keep me overnight.

I still thought I just had the flu or something, and that the antibiotics probably weren’t needed. But on Monday I felt steadily better over the course of the day, and today I feel 80% better. So it seems likely that it was an infection, and whether it was biliary or what else I’ll never know.

These ups and downs — well, the downs — are tough on my spirit, while they last. It is hard to suddenly feel lousy again after days of feeling good. I have been able to bounce back pretty quickly, however, once I start feeling better.