Fevers of Unknown Origin
No, FUO is not a mixed up acronym for unknown flying objects with bug eyed space aliens. FUO stands for fevers that patients get, especially when they are neutropenic, and no one can quite figure out why.
Harvey has had a fever since yesterday evening. It is only 99 degrees plus change at its highest and Fairview Hospital does not consider it an official fever until the temperature goes up beyond 100.5. I tried telling the nurse that Harvey (like most CLL patients I know) tends run cold, his normal body temperature is around 97 degrees and therefore 99 degrees is a real fever for him. No dice.
But they did the usual urine and stool cultures anyway and once again he got compliments on the purity and clarity of his urine. Ditto for stool sample. No obvious reason for the small spike in temperature and as far as I am concerned, that classifies it as a FUO. That is my story and I am sticking to it.
He is a little more tired today because of the FUO, but it has not kept him from exercising. He put in his usual half hour on the treadmill, gradually picking up speed and incline with each passing day. I am a terrific exercise coach if I say so myself – too bad I am much better at dishing out advice than I am at taking my own medicine.
At home most of us are quick to pop a Tylenol or some other NSAID to reduce fever. Not so at the transplant ward. They do not want to mask any lurking fever by medicating the patient with Tylenol. Fever is a good indicator of something happening and therefore of diagnostic value. Harvey is on intravenous antibiotics, antivirals and anti-fungals. You might say he is well protected. So for now, there is nothing to do about the FUO, just hope it does not recur again this evening. There is a definite diurnal rhythm to body temperature, a pattern of regular rising and falling of temperature over the day. In Harvey’s case his evening temperature is always the highest. Back in Sedona when I was monitoring his daily temperature through the Revlimid therapy, I made sure I took his temperature at the same time each day.
All in all, a quiet and boring day. Just what we want, steady as it goes and no excitement until he is discharged.
Be well,
Chaya
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6 comments on "FUO"
Follow-up comment rss or Leave a TrackbackChaya,
There is some variability in the definition of FUO in neutropenic patients. The criteria are less rigid in some institutes. The rise in neutrophils so soon is certainly welcome news
Your advise about fitness is well heeded. I myself am trying to bulk up (not easy when you are vegan), but with a personal trainer and home weights I have gone from 155 to 170 pounds in 3 months. I also use a Nordic track which is easier on my arthritic knees. From accounts I have read of the harsher mylo-ablative transplants, huge weight losses and deconditioning are common. It is great that Harvey is being spared much of that particular trial.
Thanks for your thoughtful notes. Waiting is the hardest part, and your blog is so helpful.
Brian
Quiet and boring is a good thing. I hope that Harvey’s temp is back in normal range today.
Is it possible to consider a fever that is CONTROLLED a bodily defense function in Harvey’s situation?
Has the procedures and fever affected Harv’s sense of taste?
How did “Serena” ever get her name?? Keep crackin’ that whip!
Wayne and Fay
I used to have a rock steady temp of 98.6 and if I was running a fever I could tell by the way my legs felt (confirmed of course by a thermometer). After my “pre-diagnosis event” I started running a very unsteady 97-98. And I can no longer tell when I have a fever with out actually taking it.
Could a rise in temperature signify the body returning to a more “normal” state?
chaya…i was in the hospital three times for FUO, twice in seattle after the tp, and once here at home in philadelphia. my temp is usually 74 something but they respond only to that magic 100.5. cultures grew nothing and they were monitoring my CMV but had no real reason for the spike. i think i remember IvIG infusions too…
Hi, Chaya — we haven’t been in touch in quite a while, but Lincoln and I wanted to say “hello” and we’re following events for you and “Harvey.” Best wishes to you both and good healing to “Harvey.” Steady as she goes and boring, may it be ever thus. Good things to help you both endure.