Hot stuff

 Fever is such a strange phenomenon. You feel like your body's on fire, then can't get warm. Chills can wrack the body for hours but overcompensating can put you back into the fever zone. 

Usually fever is the body's  response to infection, the body's soldiers sent to do battle with invaders.

 But chemo pretty much wipes out those defenses, leaving one vulnerable to, well, everything. So doctors step in to help the process by identifying the invader and sending targeted medicines to wage war. Thus, the 5- or 10-day course of antibiotics most of us have taken at times throughout our lives.

The problem is determining which flavor of bad guy is attacking. There must be hundreds, and each responds a little differently to specific drugs. Though I'm sure it's much more scientific, it feels a bit like looking for a needle in a haystack, or spinning a roulette wheel.

Or maybe there is no bad guy. Neutropenic fever occurs approximately 60% of the time when chemo has wiped out the immune system. So what fights the fever when there are no "soldiers?" Fresh recruits, of course.

But before the white blood cells  and neutrophils can regroup, frequent and high fevers make life pretty miserable. I'd been told 24 hours without fever would be a landmark, but time after time, I'd get only 12, 18, or then 20. So discouraging!

About this point, I got frustrated with the "telephone tag" between St. Anthony's Hospital and my oncologist from Swedish Medical Center, Dr. Chris Benton. A little hissy fit got me the transfer I wanted.

Talented at breaking down the complexity of medicine, Benton put a lot in perspective with this illustration on my room whiteboard last weekend. Early on, there is only fever, but as the body's defenses build enough to fight, the intensity and frequency of fevers slowly dwindle.

 For the first time in two weeks, I have hope there might be an end to this carousel of discomfort. Though the infectious-disease docs still want to be absolutely sure there is no infection. I'm pretty sure I've reached the final bump in the road.

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