“Gary, I just got out of the Hospital and they diagnosised me as being sepsis. I had 3 days of IV antibiotics and sent home with on 10 more days of antibiotics. I found that this infection was so slow coming that some of the symptoms I though were just going to be my lot in life. Like running out of breath when I was talking and my sinuses being stuffy all the time. I wound up vomiting and running a temp of 100.3 my GP told me to get right to the emergency room.”
This reminded me how fast things can go from normal to really bad in a short period of time when you have a compromised immune system. This brought back memories of my own bout with septic shock caused by pneumonia, which in my case put me in the hospital near death. This is what I wrote at that time:
“I had been visiting my family up north in Wisconsin, and having a wonderful Christmas. My daughter has a cold and my granddaughter has a cold as well and it seems that everyone in the state is hacking. But I am ready, at the first sign of anything I start on Tamiflu, and then as I start to get a fever the next day (Christmas) I start on my stash of Z-pak. After the first dose my temp goes down from 100.4 to 98.8, but the next day it is back up to 100.4. The last time I spiked a fever and waited to go in until it got to 103, I ended up in the hospital with septic shock. According to the Sepsis Alliance, 40% of patients diagnosed with severe sepsis do not survive. This number is greater for septic shock and a lowered immune system from MM makes it even higher. So this time we went in just as a precaution. At the Janesville, Wisconsin Mercy Medical Center Emergency Room they took tons of tests and determined I had pneumonia. They put me on an antibiotic drip, gave me a shot in the rear, and another antibiotic prescription to take in addition to the Z-pak. The next day my temperature was back to normal.
One of the reasons that we went when my temperature was 100.4 is that at the last IMF support group meeting the group leader, who went through a similar situation to what I describe in this paragraph, recommended that we not wait until 101 as most doctors recommend, but rather to go in at 100.5. I listened to her because she recently lost her husband and my friend from their episode. So her advice to be extra vigilant saved me from a long-term hospital stay at the least, and who knows what at the worst. If there is any take away from my story, it is that you should always, always err on the side of safety!”
The immune system responds to invaders by kicking out antibodies to fight infection, and it increases the body temperature to assist in the fight. If you have a compromised immune system, you can expect that the bacterial load would be much greater to get the same response. In other words, you may be as sick at 100.4 as a normal person at 103. This is not scientific, but in this way I can understand that there is a real reason for, and benefit of, an MM patient going to the doctor with a temperature much lower than that of a person with a normal immune system.
A recent Swedish study reported that multiple myeloma patients were found to be 7.1 times more likely to develop a bacterial or viral infection than the general population. The risk was especially high during the first year after diagnosis where the rate was 11.6 times that of the general population. Without a robust immune system, I would suggest all myeloma patients ask their doctors for a prescription for Tamaflu and an antibiotic so they will be available when needed. Like our support group leader suggested, “Act at 100.5 to stay alive!”