Dear Friends and Family,
It was a welcome sight to see a friendly familiar face when I arrived on the fifth floor at the University of Utah Hospital today.
“Good to see you again, Winnie.” Lisa, like the other nurses and personnel on the floor, still remembers us. Though it seemed like a long time ago, it’s only been two weeks since our last hospital stay.
“Does she still have a fever, Lisa?”
Lisa looked at the floor and said somewhat hesitantly, “39.7, Winnie. Bless her heart.”
“Guess you’re still providing the heat in here, sweetheart,” I told Nancy as I entered her room and kissed my favorite, now somewhat disarrayed and fuzzy head.
Even without a fever, Nancy warms any room. But 39.7 degrees Centigrade? I quickly did the math in my head. 103.5 degrees Fahrenheit. In an infant, that is a very high temperature. And when I discuss a 103.5-degree fever with the mother of one of my pediatric patients, I usually say, “It feels like I could fry an egg on your daughter’s stomach.”
But Nancy?
My wife, as you well know, is not in the pediatric age range—103.5 degrees is very high. During my medical training, a fellow resident contracted measles and had a temperature similar to Nancy’s. His fever caused a seizure and he hallucinated.
So Nancy’s fever, in and of itself, is scary—but even scarier are the three critical questions such a temperature raises:
1. Where is the infection?
2. Is the infection viral or bacterial?
3. And most important, will it respond to treatment?
Jayna has learned more medicine in a few months than many students do in their first year of medical school. She was quick to report that the required tests had been completed. She also assured me that Nancy’s IV contained “big gun” antibiotics.
With luck, Nancy’s fever is merely the signature of an everyday virus.
With luck, Nancy’s fever will leave her as quickly and mysteriously as it arrived.
With luck, Nancy’s fever will depart, leaving Nancy unscathed.
Immediately, I thanked Jayna for the information and gave her a hug. I also did the best I could under the circumstances to pretend that I was not having “bad” thoughts, because I was (once again) in the distasteful position of knowing that I know too much.
So why would I be so concerned?
Nancy’s immunity is barely forty-five days old. If you imagine her immune system as a brick wall, the bricks are there, but the mortar is still lacking. There is a specific part of her immunity, the T-cells, that not only needs to grow and mature, it will need to not be suppressed by her medicines as it is now. The balance between infection and graft-versus-host disease is a daily tightrope that now may be unbalanced.
Currently, Nancy remains in good spirits, continuing to make me laugh during the brief periods she stays awake. Though very weak, she is quick to reassure me that she has no new or significant pain. A few moments ago, she laughed ever so lightly and said, “I can’t wait to get back on that treadmill.”
Summary: Though we are back in the hospital, Nancy’s spirit is strong and she is not in pain. We are anxiously trying to determine the cause of her fever while hoping that it will respond to treatment.
Love,
Winnie