Fevers? Upset & Exhausted

[cherichair19]

Good Afternoon All,

I have noticed more fatigue this week and have had a low grade fever of 99.0 mostly. No other s/s. I'm thinking that the low grade fever is a sign of exhaustion? I have had them for years on and off and usually lasts for a couple of days to a week or so. I wasn't diagnosed with everything until a year and a half a go.

I have had to switch my job from a floor nurse to a school nurse this year and have found I am quite frustrated, sad, pissed off and so much more. I am loving the school nurse gig, the different pace is much better for me, especially with the lessening in the hours a day, less stress and the minimization of position changes.  But, I find any time that I talk to a friend or spend time with friends from my old job I leave the time the together or end a conversation so sad and mad. I am not usually a crier, but boy oh boy have I been lately.  

I know that this is a transition period, with alot of new things going on, but anyone else have some of these frustrations before? 

Sometimes I feel like I don't even know myself anymore, so much has changed in such a short period of time...I miss my old self.

Thanks,

Charity

[StayAtHomeMom]

Out of curiosity, have you been checked for autoimmune? Sometimes that can cause low grade fevers for no apparent reason. Also depending on your age you may be beginning menopause (I am assuming you are female by your name). 

I do know after leaving a job it is hard to relate to your old coworkers. Try to not talk about work when you get together. Maybe that will help with the frustrations. It sounds like your new job is ideal though. I have an uncle who is a nurse and I know it can be very stressful. 

[DizzyGirls]

Like StayAtHomeMom said, autoimmune.  I would have your PCP run an ANA test to see if it comes back positive.  If so, the titer should be checked as well.  My daughter was having fevers like that for quite a few years.  Her ANA came back high enough for the Rheumy to say it was a "true positive".  He gave her the option to try Plaquenil.  It has gotten rid of those fevers.   They can really make a person feel bad.  She has suspected RA.

[kafie]

Autoimmune was the first thing that came to mind for me as well. I have arthritis (we thought RA, pretty sure now that it's PsA). I run a fever anywhere from 99*f-100*f (via forehead) quite often with flares. AID can have a lot of non-specific symptoms that are easy to pass off till like gets bad enough to point towards a diagnosis. Fatigue is also very common of pretty much every AI condition every.

[p8d]

Up, autoimmune should be checked.  I get low grade fevers during flares of my undifferentiated connective tissue disease along with increased fatigue and joint pain.

[cherichair19]

Morning all. I was tested for autoimmune stuff in the past, but not for awhile. I see my drs next week so def will talks to them about it. Thanks for responses and suggestions. I’ve been tracking temps and seem to be temp spike in afternoons, and I’ve been normal in am. Perhaps exhaustion idk. This is all a lot of info and crazy! 

[StayAtHomeMom]

3 hours ago, cherichair19 said:

Morning all. I was tested for autoimmune stuff in the past, but not for awhile. I see my drs next week so def will talks to them about it. Thanks for responses and suggestions. I’ve been tracking temps and seem to be temp spike in afternoons, and I’ve been normal in am. Perhaps exhaustion idk. This is all a lot of info and crazy! 

Make sure you have a thyroid panel done as well. At the minimum TSH, T3, and T4. And make sure the doctor sees your data. The more data you have the better chance of finding out what it could be. 

[p8d]

I was tested every five or so years for thirty years before my ANA came up positive, including three times in eighteen months.  Keep pushing for the test and maybe see a rheumatologist.  A good rheumatologist will treat based on symptoms not tests.  There’s a lot of recent literature showing that Dysautonomia and autoimmune disease is possibly linked.  

[Pistol]

I have had low-grade temps and joint pains coinciding with my hyperPOTS flares. Several auto-immune studies have all come back negative, except for slightly elevated ESR ( Sedrate ). Even now that my POTS seems to be controlled I still have joint pains and swelling - no longer run temps, tough. I am not sure if this is related but I wanted to let you know.   

[kafie]

On 12/16/2018 at 2:33 PM, Pistol said:

I have had low-grade temps and joint pains coinciding with my hyperPOTS flares. Several auto-immune studies have all come back negative, except for slightly elevated ESR ( Sedrate ). Even now that my POTS seems to be controlled I still have joint pains and swelling - no longer run temps, tough. I am not sure if this is related but I wanted to let you know.   

Have they looked into a seronegative arthropathy (Irritable Bowel Disease or Psoriatic Arthritis)? Both will cause joint pain and an elevated ESR - for PsA elevated ESR is actually more common than elevated CRP... psoriasis can show up after the arthritis (though this isn't terribly common) and the skin condition may be minor (like a single plaque behind an ear or a single messed up nail (thick, flaking, crumbling)) or confused for other conditions (eczema, fungal infection, ect).

Also, as mentioned by someone else... you can have the disease and be "seronegative" - this can happen with a lot of AI stuff... sometimes it takes awhile for the antibodies to rise to levels that would cause a positive result/diagnosis... But symptoms can start long before the inflammation is detectable on tests.

[StayAtHomeMom]

1 hour ago, kafie said:

single messed up nail (thick, flaking, crumbling)) or confused for other conditions (eczema, fungal infection, ect).

Crumbling? Like you barely touch the nail and it just crumbles off? My mom has that issue and the doctor said it was fungal and there was nothing they could do because her liver number are too high from her RA meds. I always thought it was a weird thing for her toenails to do. Her old PCP told her to put nail Polish on it. 

[ddschool]

On 12/13/2018 at 3:40 PM, cherichair19 said:

Good Afternoon All,

I have noticed more fatigue this week and have had a low grade fever of 99.0 mostly. No other s/s. I'm thinking that the low grade fever is a sign of exhaustion? I have had them for years on and off and usually lasts for a couple of days to a week or so. I wasn't diagnosed with everything until a year and a half a go.

I have had to switch my job from a floor nurse to a school nurse this year and have found I am quite frustrated, sad, pissed off and so much more. I am loving the school nurse gig, the different pace is much better for me, especially with the lessening in the hours a day, less stress and the minimization of position changes.  But, I find any time that I talk to a friend or spend time with friends from my old job I leave the time the together or end a conversation so sad and mad. I am not usually a crier, but boy oh boy have I been lately.  

I know that this is a transition period, with alot of new things going on, but anyone else have some of these frustrations before? 

Sometimes I feel like I don't even know myself anymore, so much has changed in such a short period of time...I miss my old self.

Thanks,

Charity

 

[ddschool]

Yes, I too have low grade fevers & no one can find out why. I just figure it’s because my nervous system is failing more in addition to the other dysautonomia symptoms.

I used to work as a hospital nurse,  but haven’t been able to work since getting my pacemaker 8 yrs ago.

[kafie]

On 12/18/2018 at 12:02 PM, StayAtHomeMom said:

Crumbling? Like you barely touch the nail and it just crumbles off? My mom has that issue and the doctor said it was fungal and there was nothing they could do because her liver number are too high from her RA meds. I always thought it was a weird thing for her toenails to do. Her old PCP told her to put nail Polish on it. 

Not necessarily quite to that extent but it can make the nails pretty brittle and prone to breaking. Some people's nails do just fall apart though, or come completely off (the body overproduces collagen and this builds up between the nail and skin and separates the nail from the bed - this also creates gunk under the nail that does just crumble).

The only way to really be certain is either

1. Try a treatment for either fungal or inflammatory, if it works you've probably got the right one (note: steroids will make fungal infections worse)

2. Get it biopsied (note: the two things can co-occure... You're actually more likely to get a fungal or bacterial infection where the psoriasis is flaring)

[StayAtHomeMom]

2 hours ago, kafie said:

Not necessarily quite to that extent but it can make the nails pretty brittle and prone to breaking. Some people's nails do just fall apart though, or come completely off (the body overproduces collagen and this builds up between the nail and skin and separates the nail from the bed - this also creates gunk under the nail that does just crumble).

The only way to really be certain is either

1. Try a treatment for either fungal or inflammatory, if it works you've probably got the right one (note: steroids will make fungal infections worse)

2. Get it biopsied (note: the two things can co-occure... You're actually more likely to get a fungal or bacterial infection where the psoriasis is flaring)

She is treating her RA with infusions (like remicaid but it is a different one). They won't give her oral anti-fungals because of her liver numbers, and the over the counter stuff doesn't work. She refuses to go to a podiatrist. She "has enough doctors already". It would be interesting to see though. 

It almost seems like a lot of the autoimmunes are interconnected. I have heard once you get one you usually get at least one more. And her and 2 of her sisters have autoimmune but different ones. Between the 3 of them they have Lupus, Sjogren's, hashi's, and RA. And the are between 50-60. All recently diagnosised. 

[kafie]

They do have some vitamin a treatments that she could ask her doctor about (I imagine this would be easier on her liver). Some people see improvements in psoriasis (including the nail) in as little as three months... but toenails grow really slowly and it's likely that she may not see results for at least six months.

Part of medicine, unfortunately, is weighing risks and benefits. Even long courses of topical steroids can have significant negative effects (namely thinning the skin and dampening the immune system in the area so that infections can get in easier).

If she's ever been on Prednisone, Methotrexate, or Sulfasalazine and saw improvement in her nails during that time I would consider that pretty definitive that the nail changes are psoriasis (though no change doesn't really mean anything). If Prednisone made the nail worse this would suggest that it was an infection and not inflammatory. If she's ever been on Plaquenil and the nail got worse, this may also suggest psoriasis as Plaquenil has a reputation for worsening psoriasis (though, again, no change doesn't mean anything - and the reactions of psoriasis to worsen with medication is pretty personalized - for example, some people have problems with Sulfasalazine worsening psoriasis, but studies have also found it to help).

[StayAtHomeMom]

30 minutes ago, kafie said:

They do have some vitamin a treatments that she could ask her doctor about (I imagine this would be easier on her liver). Some people see improvements in psoriasis (including the nail) in as little as three months... but toenails grow really slowly and it's likely that she may not see results for at least six months.

Part of medicine, unfortunately, is weighing risks and benefits. Even long courses of topical steroids can have significant negative effects (namely thinning the skin and dampening the immune system in the area so that infections can get in easier).

If she's ever been on Prednisone, Methotrexate, or Sulfasalazine and saw improvement in her nails during that time I would consider that pretty definitive that the nail changes are psoriasis (though no change doesn't really mean anything). If Prednisone made the nail worse this would suggest that it was an infection and not inflammatory. If she's ever been on Plaquenil and the nail got worse, this may also suggest psoriasis as Plaquenil has a reputation for worsening psoriasis (though, again, no change doesn't mean anything - and the reactions of psoriasis to worsen with medication is pretty personalized - for example, some people have problems with Sulfasalazine worsening psoriasis, but studies have also found it to help).

She was on a handful of autoimmune meds before it started. She has been on low dose steroids for about 7 years or so now. I don't remember when it exactly started but it has been about 3 years. I will have to mention it to her again and see if she will finally go see a podiatrist and maybe get her an answer. She doesn't seem to care much because it is so low down on her medical issues.