Wednesday, June 20, 2007
Fever all through the night
Chemo had just been getting normal. I'd fallen into a pattern which worked. Have chemo, feel a bit shit for several days, don't sleep, have trouble 'going', and end up starting to feel normal again by the following week.
Except this time round my energy levels had picked up a little earlier and by Saturday I was feeling alright. Woohoo. I'll have the next three treatments licked, I thought.
But then on Sunday I felt exhausted again. Couldn't move. Monday felt like I had lead weights around my ankles and after a rubbish night's sleep, I took the easy option and called work to say I'd be in late and grabbed a few more hours sleep.
It felt like skiving. There have been a million Mondays where I just haven't felt like getting out of bed, it's only now I have a legitimate excuse. I eventually got in a little after 12 on Monday and worked til 6, then joined R at a friends house for a casual dinner.
Halfway through dinner I tasted something funny in the back of my throat. Nope, it wasn't the tuna. I had that horrid sore throat 'You're about to get sick' taste. I said nothing and we went home about 10.30pm. By 11.30, I was in bed wearing pyjamas, a big woolly jumper and a knitted beanie hat. I was freezing. The night before I had slept with nothing on, the covers off, and the fan on low all night long. It wasn't cold. I lay there, trying to get warm enough to sleep.
Then at 2.24am I woke up with a start. I was now boiling hot and threw off my layers. A few more hours of sleep and I was up again at 6am, listening to my upstairs neighbour crash around and wondering what was wrong with me.
I took my temperature with my cheap digital thermometer.
I check the chemo book. If it's more than 38 degrees they admit you to hospital. If it's more than 37.5 on two readings less than an hour apart you have to call into the chemo ward. Chemotherapy means no immunity, so if you get an infection, your body cannot fight it. Great.
Half an hour later the thermometer still reads 37.5 degrees. I start wondering if it's under-reading me as I feel so hot. It only cost me £7.99 and all the other digital thermometers on the shelf were over £40. And when I first took my temperature at the start of this process I'd sometimes come up really low - around 35.4. Maybe it's not calibrated right. Either way, I'm more than a whole degree hotter than I normally am.
R appears from having spent the night in the spare room and encourages me to phone the ward. I call and start telling my story four times before being interrupted halfway through and handed on to the next person. This happens four times until I end up with the doctor who is patient and listens to my whole tale.
He wants me in for blood tests and to check my other symptoms. If my sore throat is an infection and I do have a temperature, then treatment will depend on my blood cell count. If my white blood cells have recovered sufficiently from last week's chemo then they simply send me home with some antibiotics. If not, and my blood count is deemed too low, then I will be admitted to hospital.
Part of me thinks this is crazy. I've spent nights tossing and turning in pools of sweat in my bedsheets countless times before. Bouts of flue, tonsilitis, bad colds. This feels just like every other cold I've ever had, so why all the fuss.
But there's a bit of me that's genuinely scared of my lack of immunity and what's going to happen next. The idea that I have no natural way of fighting infection, that my body's defences have been removed by the chemotherapy treatment, is terrifying. It may just feel like a fever and sore throat this morning but what happens in the next 24 hours? How do things like this progress when your body is helpless?
This side of me might just be grateful if someone doctorly chose to take control and admit me.
Later that morning I'm back in Chemo Day Care. I can see the nurses brows creasing slightly. Wasn't she only in last week? I'm back too early, the cycle is broken, I'm out of sync.
The doctor arrives and takes my blood. He's not portocath experienced so he takes it from the vein in my elbow, although as he's prodding and pushing at my veins to come up he does joke about how we may need to resort to the port after all, my veins are so hidden. Once again, I feel grateful for having chosen to have a port fitted. I'm also relieved that before I left the house I rubbed a little Emla cream in the crook of my elbow as well as over my port - just in case they went this route to take the bloods.
As I had my Neulasta injection on schedule last week he is confident that my blood cells should be okay. He is relaxed and seems happy that I will be fine. My sore throat is feeling a little better and I feel less feverish. Maybe I made this up, or maybe it has passed? Who knows. But I need to wait and find out.
In the meantime a nurse takes my temperature. She huddles with the doctor. He comes back over and is more hurried, more concerned than before. He talks quietly but quickly to me. Do I have any other symptoms? Does my back ache? Does it burn when I pee? Do I have diarrhea? His manner worries me. I feel like he's about to retract his earlier prognosis and start to worry that I may be facing hospital admission again.
Turns out my temperature was 38 on the nose. I've shared my concerns over whether my cheap digital thermometer works with the doctor so at least this proves it's reading things in the right direction, if maybe a little conservatively. So the doctor is concerned but admission still hangs on the results of my blood test. Which, when it finally comes 45 minutes later is good. My white blood cells are relatively normal so I can go home with a prescription of antibiotics instead. More drugs, but I am relieved to be in a position where I know the medical profession are not so concerned about me that they want to tie me to a hospital bed.
A day later and my temperature has dropped. It's still high but not worryingly so. The drugs are clearly kicking in. The drama has passed and I am left with too many home improvement and property programmes on daytime telly. Maybe tomorrow I'll brave the office again.
at 1:31 pm