Wednesday, April 22, 2009

FEVER!...Not Peggy Lee Style...

Alrighty...what I'm about to write has absolutely nothing to do with Peggy Lee or the YouTube link up above...I just like to hear her sing, "FEVER!", with such flare. click the play on the YouTube window and listen to Peggy Lee make the word "fever" sound incredibly sexy while you read the rest of this dribble.

I really should title this post, "MS 101 - The Pseudo Exacerbation", but I didn't...most of you wouldn't have bothered to read this far if you knew what I was REALLY intending to talk about (and sadly, have now clicked over to an MS web blog far more useful, like MS Strength...yeah, sorry to out you, Jen!). But I've noticed a new and interesting *trend* in the CHEESE blog stats and I'm seeing several new searches for topics that appear to be MS 101 - type issues, so I thought this topic would be good to cover again. And the REAL truth...since it IS all about me...I'm experiencing "FEVER!" (**insert Peggy Lee voice each time you see the word**) and a pseudo exacerbation MYSELF today. It's in my face and it's what I know right're kind of sh!+ outta luck, my friends, if you were expecting anything else.

The previous post would indicate I did NOT awaken as a happy camper this morning...I'm not even certain 4:00AM can be classified as *morning* in most circles (mine, in particular). I instead awakened to the sound of my own lungs attempting to free themselves from my ribcage and a bone-chilling coolness to my body. I'll get back to the lung issue later...but those of you who know me or have read much of my experiences here, recognize I am a perimenopausal/hormonally challenged female who can generate enough HEAT to power a small factory on any given day. I am rarely, if ever, COLD...even when it IS cold or below freezing body just seems to percolate away, radiating enough heat to cause Al Gore to want to shut me down due to concerns about global warming. So, waking up *cold* is a sign.

Usually, the only time I ever feel cold these days is when I am experiencing a "FEVER!"...otherwise known as being febrile...but I'll stick to using "FEVER!" for continuity sake. LOL My bones will ache from the cold sensation when a "FEVER!" is upon bones were experiencing such achiness this morning (or late night...depends on your personal philosophy of time) as my lungs attempted their dramatic escape from my body (little bastids!). Looking back on the past 24 hours, I can now see where I most likely was experiencing a low grade "FEVER!" late yesterday afternoon, sans bone-aching chill...because I was having the *MS Lean* come a knockin'.

So, what does ANY of this have to do with MS Pseudo Exacerbation? Yeah, yeah...put your hand down, Arnold Horshack...I know YOU already know the answer (did I just date myself with that vague, "Welcome Back, Kotter", 1970's TV show reference?!?). But, on the off chance you are someone who has fallen into my evil trap and continued reading thus far without KNOWING this answer, I will tell my own words, from my own experience...because I am NOT a doctor...I just PLAY one on the Innerdnets.

It seems whenever I run a "FEVER!", which I will define for myself as any elevation in my core body temperature above 99.6, I tend to have what, for all intents and purposes, *appears* to be an MS relapse...key operating term in that sentence is *appears*. I am NOT experiencing a body just PRETENDS it is. OK, I probably shouldn't use the word "pretend" here either, because we all know MSer's frequently get accused (or just feel that way for no particular or explainable reason...WTF?!?) of "pretending" their symptoms anyway. Maybe I should say, "when my body reaches a core temperature above 99.6, it EXPERIENCES symptoms not unlike a full-blown MS relapse". Is that better?

Since cave man times, or at least the advent of the mercury thermometer, the standard core body temperature used to delineate "FEVER!" in human beings has been 98.6 (99.6 rectally, but let's not go there, OK?!?)...anything ABOVE 98.6 could be considered "FEVER!" and anything BELOW...well...dead. But that's WAY below 98.6! My core body temperature typically runs around 97.8...sometimes a few 10ths of a point lower, sometimes a few 10ths higher...but standard temp for Moi is 97.8. And, no. I'm not considered *dead*. Most of us do not run the typical 98.6 standard Fahrenheit temperature (sorry to all the Aussie's, Brits, and Europeans...37.0 Celsius is the norm on the metric scale...speaking of *cave men* here in the States).

As you can see, adding MY personal standard core body temperature to the mix makes any "FEVER!" I experience SEEM more like an above 100 degree fever the average person would experience (anyone who typically runs a base temp of 98.6)...thus my narrow margin of cut off - 99.6 - as a magic number which awakens the raging bull of MS inside my body.

"But, why God, WHY?!" MSers shout in exasperation (not to be confused with *exacerbation*, but perhaps we SHOULD confuse the terms for emphasis!). Why can something so benign as a one or two degree increase in our core body temperatures cause the MS to become active, thus experiencing a PSEUDO EXACERBATION? Unfortunately, the science is still out to lunch on this one...sigh. But rest assured MSers, you are most likely NOT in the development stage of new lesions because of your pseudo's just the "FEVER!"..."FEVER!" in the mornin' light...Oops, I digress.

Most neurologists/scientists/VooDoo practitioners agree (or like to think) that, when the core temperature of an MSer is increased (sometimes just ever so slightly, mind you), the nervous system slows in it's ability to CONDUCT it's firing our nerves correctly. If you've ever lived in the South (with or without MS), you already know when the temperature outdoors rises above 100 degrees F and YOU have to be out in the swelter, our bodies as a whole get a little "crabby"...we get "irritable"...OK, some of us get down right mean! We "can't take the heat" as the old saying goes. And this is because, on a molecular level, some cells become *excited* from the heat, while others become sluggish. Some systems have to work overtime to keep us cooled down (thus the purpose of sweat or perspiration...and you thought you just did this to LOOK cool or be a jock?!?).

The Multiple Sclerosis body, being the fine-tuned, yet FLAWED machine that it is, functions in the same manner. Nerve conduction becomes somewhat random as some nerve cells get too excited from the heat, while others just decide to take a break from it and sit in the shade to do nothing...plaques that already exist in the brain or spinal cord make the conduction system work harder or sometimes not at all,acting as *reactivated* road blocks on the nerve conduction road. Basically, nerve conduction/nerve fibers act just like I do on a hot day...if I can, I find somewhere cool to lie down and I take a nap...and if I can't? Well, let's just say it ain't *purdy* and I tend to misfire my irritability all OVER the place!

When the MS body is forced to contend with increases (or drastic decreases also...but we're not talking about that here) in it's core body temperature, it responds in kind by creating a sequela of symptoms MIMICKING an MS relapse. And believe me, "FEVER!" in my body can recreate a host of MS symptoms long forgotten in previous MS relapse periods! Once the "FEVER!" subsides, the MS symptoms eventually go away also...sometimes in a matter of minutes to several hours.

When I have a "FEVER!", I will typically experience painful nerve firing, often in my left leg, hip, or arm...pain was one of my primary diagnostic symptoms, which occurred in my left side. My vision will often become distorted, giving shapes a fuzzy or blurred appearance, especially in my left eye. My ability to demonstrate higher cognitive functions generally decreases (often consisting of a vocabulary simplified by swear words) and I can experience what is best described as confusion or *slowing* of my thinking. On rare occasions, my speech will be affected (not this time, thank you Baby Jesus!). I tend to get lower limb, bilateral weakness...feeling as though standing is too much effort or that my legs will collapse out from under me. I develop the *MS Lean* and occasionally experience the MS (not) Hug in my chest (again, something I don't have today). I once developed a fine to coarse upper trunk tremor when I experienced a "FEVER!". So, as you can see...anything is possible when "FEVER!" strikes the MS body...AND, the MS body STILL has to deal with whatever the SOURCE of the fever is as well. Like urinary tract infections or, in my case, upper respiratory/viral illness.

I've been home from work today resting my aching bones and eating Ibuprofen candy...since it is obvious I have managed to contract yet ANOTHER germified virus of some sort, my only options are to rest and try to eliminate my "FEVER!" with antipyretics (stuff that makes a "FEVER!" go away, like Ibuprofen, Aspirin, Acetaminophen, Jack Daniels, and a twist of lime). This, too, shall pass...or kill me...I'm good either way.

But, I sure do like Peggy Lee's rendition of "FEVER!" better than my own...


Living Day to Day with Multiple Sclerosis said...

You crack me up!!!! I love Peggy Lee's "FEVER" song too. I actually did read your whole definition of "MS 101". It was perfect and so true. I too run very low temperature on a normal day and the slightest increase in body temp will start my symptoms acting up... However, oddly enough the very cold in the dead of Winter will also cause me to have symptoms too. Does that happen to you too? Or is it just a "ME" thing????


Hey, for my honest-to-goodness pseudoexacerbation due to a UTI, I measured an entire 97.0 degrees at the doctor's office. Yes, I typed that correctly, on the way to hypothermia. LOL.

OK, also, just so you know (cause of course, I don't want ANYBODY thinking that I would, like, copy their ideas or anything)...btw, brilliant minds still think alike....I had tried to twist the arm of my (other site) producer to approve the authoring of a post on this very topic. Phew, that was a long, windy sentence.

And, guess what? She FINALLY agreed and it goes up next week, almost two months after the idea had been pitched.

So, almighty CHEESEHEAD, I hope that the Tylenol candy works a little magic and leaves you minus one invasive fever. Then the germs will get all bored and go 'bug' somebody else.

Thank you for adding to our collective knowledge of MS101 topics. It helps us all and the heat of summer is just around the corner. Yikes, not my friend.

Webster said...

I'm sorry you are still under the weather, a fitting metaphor given what a crappy Spring we've had so far (minus 2 1/2 days. I hope it spares you soon.

When you said you experienced a "trunk tremor," a symptom I hadn't yet heard of, all I could think of was tassels. Do with that (them?) what you will. Lol.

PedestrianCrossing-Colleen said...

I also am in the 97 degree range. After my dx and hospitalization (I also was having back surgery), I wrote down my vitals every time they took them. Nice low BP and that crazy 97 ish temp every time!

The one time I ran a high fever (102) as a side effect of Avonex, I was MISERABLE! Being new to the MS dx and mostly symptomfree, that was an awful experience. Incredibly stiff/spastic muscles. Made walking to the bathroom almost impossible which was a real problem since I was having what can only be described as bladder spasms (is that an MS thing?). And vision was splotchy. Actually it was like looking though a screen door. Awful, awful, awful.

Is there a correlation between what one experiences during a fever and what one can/will experience during an exacerbation/episode?! (shudder)

Kelli said...

I am new to your blog and you have certainly made me smile. I too have RRMS and understand so well. My temp runs 97.2 - 97.6 most days. So Ms Braincheese I look forward to reading more of your blogs.
Take care,

Jooolie said...

Wow this is the best explanation I have seen on what happens when a person with MS gets a "low grade fever". A low grade fever elevates the body temp to the point where I walk like I am drunk, double vision the whole 9 yards...yet I am fine an hour after I pop a couple of advil because the fever goes down... I look like I am making it up. I am going to print this out an show it to my co- workers so they stop thinking I am crazy ;)