Fever for a month plus anemia equals what?

[AlienGirl]

Okay, DU medicos...I've been running this dang fever for four weeks now! It's never much higher than 100F, but never lower than 99F. I feel crappy, but can still work and everything. A couple days ago I had a CBC done, and it showed that I'm anemic but nothing is wrong.

What should my next step be? Are there any common virii that just cause a fever for a really long time? I am reluctant to go back to the doctor and keep trying to figure it out, because I'm sick of doctors' offices and without some kind of guess about what they ought to look for, I'll probably just keep bouncing from one round of tests to another without ever finding out.

So, should I just take some iron pills and wit a few more weeks for the fever to go away, or is there anything I should be worried about?

Tucker

[belladonna]

1. Have you been checked for mono? N/T

[AlienGirl]

4. I asked for a mono check twice

Both times, the doc said since I didn't have a really sore throat it wasn't worth checking for.

[nothingshocksmeanymore]

2. They could be totally separate symptoms and unrelated

A CBC would tell you if you have a low grade infection..and it's the cheapest blood test there is.

Could be something as simple as dehydration.

[AlienGirl]

3. The CBC says no infection. n/t

[LeftCoast]

5. Hey AG!

I just finished a Hematology course (study of blood). There are many many different types of anemia and they can be caused by numerous ailments. Your symptoms are worrisome because of the longterm fever, but it's really impossible to say w/out seeing the CBC. What does your Dr say about this?

Also, DO NOT take iron pills unless prescribed. You can do terrible damage to your body if you take too much. You may very well have Iron deficiency anemia, but if not, taking iron would be very bad.

If you want to pm me your CBC scores (MVC, RDW, MCHC, RBC, & WBC) I can at least tell you some basics. I'm not a doctor by any means, but I did ace the class. :)

[AlienGirl]

6. He didn't give me the scores

The doctor suggested starting a multivitamin with iron.

Should I call back and get the actual scores?

What I'm most worried about, of course, is a recurrence of cancer. I had squamous cell carcinoma of the tongue a couple years ago, and went through radiation and chemo for it.

Also, I have a positive ANA titer of 1:160, which has been positive for three years or so.

[LeftCoast]

8. Probably too much bother to get the scores

Is your Dr aware of your history of cancer? Also, have you noticed tenderness of any bones, in particular the breast bone or the arms or legs? I would hope that your Dr would be able to spot all of the things I'm looking for, but :shrug: who knows?

Not familiar with the ANA score you've mentioned, but I do hope you get better soon. A long fever without an elevated white blood cell count seems very strange to me. From the way you've described your doctor, he doesn't seem to be taking this too seriously.

[AlienGirl]

7. I just called back

The front-desk person said my hemoglobin was 11.5, hematocrit 35.6, WBC 6.4, platelets 242, and then got annoyed because "the doctor would have told me if anything else was wrong." :shrug:

[Sapphocrat]

10. Hematocrit 35.6...

That's not too bad. Not optimum, but not terrible. What does the doc want it up to?

[LeftCoast]

11. As a patient, you have every right to see any and all of your scores.

Well, your hemoglobin is fine, WBC is completely w/in normal range and platelets are fine. Your hematocrit is low, but that would be normal for someone with iron anemia. If you have the RBC count I can tell you more about your particular form of anemia, but without it :shrug:

[Sapphocrat]

9. Not a doctor, but...

...having been down this route with someone else, I'd say you've got a virtual smorgasbord of possibilities to choose from -- anything from a low-grade infection to myelodysplastic syndrome to diverticulitis to plain old garden-variety anemia with no known cause... none of which is likely to kill you, but none of which is any fun, symptom-wise.

What did your doctor suggest?

I would definitely be concerned about any fever, low-grade or not, that lasted for more than a few days, let alone a few weeks.

If it were me, and nothing (iron pills and shots included) seemed to help, I would ask about a colonoscopy and a regular endoscopy to see what's going on in both ends, and then (this is getting extreme) a capsule endoscopy -- all to check for diverticulitis or something similar.

If I were desperate (and willing), I might ask about a bone-marrow biopsy to check for myelodysplasia -- although that's pretty rare for most people under 60 (and more common in women).

I'd also get my thyroid checked as a matter of routine, since there's an outside chance it could be hyperthyroidism giving you the fever (those of us with hypothyroidism are chronically low-temp, and in a constant battle to raise our temperatures, and thus metabolism) -- although a thyroid condition wouldn't explain the anemia. (At least, I don't think it would.)

If a doc suggests shots for the anemia, s/he could go with good ol' iron, or possibly Procrit (I forget the generic name), which will boost your CBC in a major way.

Oh, btw, if you go the iron-pill route, do yourself a favor and make sure you get the time-release variety. Otherwise, you may end up terminally constipated.

Again, I'm no doctor -- just the resident advocate for somebody who's been (and continues to go) through all this stuff.

HTH! Good luck, Tucker!

[efhmc]

12. Complete CBC with a differential to see what individual leukocytes

you have should help solve this mystery.