Fever

I was feeling fine yesterday morning, and then suddenly at 11:30, I wasn't. At first I thought I was just stiff from sitting and working, but then I realized that my entire body hurt. A minute later, it dawned on me that I had a mild fever, just as the chills started.

Sandy had fevers frequently in 2010 and 2011, but she didn't recognize them until they'd already been affecting her for a while. In fact, in early 2011, it was so common for her to have an unidentified fever that whenever she got cranky or irritable, restless or despairing, I'd ask if she had one. Nine times out of ten, the answer was yes. She'd take ibuprofen and pretty soon she'd feel fine.

The fevers and other cancer symptoms had abated in time for
us to attend festivities with the family in July 2010.

The fevers in spring 2010 were mysterious. They mostly occurred late in the evening, and we wondered whether she had some sort of infection. But because they were gone in the morning, we coaxed ourselves into not worrying too much about them. It was those fevers that made me hopeful that the metastases that showed up in scans in May 2010 were actually tuberculosis. I didn't know then that unexplained recurrent fever can be a cancer symptom. The fevers stopped once she was on treatment and the cancer's growth was halted.

So perhaps we should have been more alarmed when fevers became common for her in very early 2011. We were concerned, certainly, and weren't sure whether to treat them or to let them run their course and conquer whatever her immune system was battling. Her naturopath and oncologist both told us the fevers were probably a response to chemo, and she should go ahead and take ibuprofen to feel better.

Now I believe those fevers were actually her body's response to the stealthy spread of the cancer into her spinal column. That realization keeps me from thinking that we might have avoided her death if we'd gone with brain radiation in April instead of June, or if we hadn't stopped the chemo and Avastin at the end of March. The cancer was already spreading by January and February; we just didn't have an MRI of her spine to make that obvious.

So I look at fevers differently now. I used to think of them as friendly indicators of an alert immune system. Many times, I've had an unexplained fever for a few hours, and after a good night's sleep, all is fine. I've hesitated to take anything to reduce the fever because I've trusted my immune system to know when it needs to smoke out an intruder. But now unexplained fevers seem ominous.

I didn't think this meant cancer. Those fevers would be recurrent, and this was, so far, a single event. But not knowing what it was about - and having it arrive so suddenly when I'd been feeling fine - was disturbing. Also, chills and body aches tend to make me a little less rational anyway. So I noted that my sinuses had been problematic (but also that this didn't seem to be a sinus infection, and I'm very familiar with those), and noted some pain in my gut that could mean inflammation or something, and worried about internal wounds that could be killing me. I also knew that it was probably a transient virus that tried to take up residence and was being expelled by my body.

Just in case, I called a close local friend so that someone would know to check on me. I was acutely aware that my own personal nurse is no longer in the house. It occurred to me that I've never called 911 for my own medical emergencies, only for Sandy's, and only when she was incapacitated. I started to dwell on the idea that I could have a seizure or a stroke or something far worse, and no human would be here to get me help. I started feeling pretty darn alone in the world.

And then my friend brought me groceries I'd requested to help me treat my gut tenderly, in case it was the problem. And I did take a regular-strength Tylenol just before bed so that the body aches wouldn't keep me from sleeping. This morning, I woke up with a temperature of 98.6, no body aches, and a remarkably more positive outlook. The worst symptoms I've had today were fatigue and lightheadedness, both resolved with the introduction of calories, especially protein and electrolytes. Whatever this was appears to have passed. I'm still wary, but I'm feeling pretty good.

So this was apparently a benign, potentially beneficial fever. It's still hard not to second-guess such things, when I know that our assumptions were so wrong before.