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,