How high the fever on Hep"C" can run?

[Skirma]

Hi, I had a fever of 101.5 and felt really bad, so I went to the hospital (it was after hours) and when the hospital called my doctor next day he said that I need to stop my treatment.

I am so upset, because it's been 8 months of hell and I only have 2 months to go.

I am going to see him in 2 days and ask him to let me continue and I want you guys to tell me who had a fever over 101 during a treatment, so I can bring a print out to him and say "look - other people had it higher than me".

My second question is how low your platelets got at the lowest point? My got as low as 30000 and blood count was 1500. I know that it will be my doc's first argument that my platelets are way to low...

Thanks so much.

[BoceprevirGal]

Okay, I'm back, the med that I was refering to was called "Promacta".  I am wondering if any of the Warriors on here, have used this med, to raise their platelets?

[BoceprevirGal]

Ah, I'm glad you are feeling better, maybe it was just that little flu, going around, my two sons had a fever with it, also.
  The massager sounds great, my back is also so achey!
  I had read on here, in an earlier thread, that there was a med, that brought up platelets...but I dont know of anyone, at my Hep Doctors' office, who has taken it. I do know of one guy, who has had platelets as low as yours, but they went up a bit, on their own~ good luck, and good job advocating for yourself
  

[Idyllic]

Yay. I am glad you stood your ground. Your husband is a prince!! My husband would have done the same thing. Lucky one of us is like that! I'm glad you are going to continue treating. Can't you go from 1000 to 800 first? I have been interested in reduced Riba has an effect on remaining UND when we are out of the PI stage and just taking the Peg & Riba.

Grr. Your doctor might be a nice guy but it sounds like you going to the ER freaked him out even though that's what he told you to do if your fever reached a certain amount.

[Skirma]

Golly, I will find the right answers tomorrow, but this is so confusing.

So I went to my GI today to tell him that like it or not I will continue my treatment, cause I will not go with this hellish therapy one more time..haha

First he said there is no way he will agree on the responsibility to continue to treat me, but my husband and I said we were not leaving till he agrees. Finally he did saying that he will reduce my dosage and see how my platelet count goes for 2 weeks, but if it goes down any further than he will discontinue therapy and I will have to find a new doctor.
By the way this guy is very nice and warm guy, but he just doen't want to take any risks...

So check this out - he tells me that I need to cut Riba in half (instead of 1200 go to 600 a day), but stay on the same dosage of Pegasys.

I DO NOT GET IT - didn't you guys tell me that is Pegasys that affects my platelet count, not Riba? Why is he reducing Riba and not Peg?

His main concern wasn't my blood count (which is 1500, low, but still ok)- it was platelet count, which was 30.000.

Is he nuts or me?

I will call Pegasys support nurses tomorrow (they are closed now) and ask the same question, but like I said before several people told me that Riba has nothing to do with plat count..

PS You guys who asked about my fever/pain - I am normal again 98.5 every day, still have some pain in my neck and shoulders, but went to Brookstone yesterday and got me a big, powerful massager and it's on my back constantly and it helps a lot.

Thanks again!

[BoceprevirGal]

Hi, Skirma: how is your fever/pain, now? That is good that the hospital didn't find any infection in you, and you can point this out to your Doctor. Sometimes I find it easier to advocate for myself, with my Doctor, when I have my husband with me....I tend to "wimp out:, around my Doctor, I think alot of us do.
   Make sure you let your Doctor know that you want to finish your treatment, and that plenty of people have had a similar fever, while on treatment!

[JRenquist]

I had a fever of 102 for over a week, that came and went, before I went to the dr.  Thought I had a sinus infection, but it turned out to be pneumonia.  This was about the 3rd week I was on triple therapy with incivek.

I also have hypothyroid (started the last time I treated 10 years ago) As far as I know that wouldn't have anything to do with a fever - I just mention it because you said that you had that as well.  

After 3 weeks or so the fever went to 99.+ and stayed that way throughout therapy a LOT of the time.  Very weird - I've never had a fever in my life before that.  

Anyway, here's info of another person with a similar situation who didn't stop therapy because of the fever.  Maybe it's because they coouldn't find a reason for yours, whereas mine was pretty clearcut?

Let us know how you fare.  

[Idyllic]

There actually is a condition called "Interferon-Induced Hypothyroidism." I developed it myself and it is more than possible eight months of Interferon aggravated your pre-existing thyroid dysfunction and you current dose may not be quite high enough of your thyroid meds may need to be adjusted:
http://www.medscape.com/viewarticle/459923_5

[Skirma]

No, hospital said they need to run all possible tests to see if I didn't have infection or any other conditions and meanwhile they "had to keep an eye" on me while results would come back. And they did. And I had nothing, so... I didn't put all these details in my original post, because I only needed info about fever and platelet counts.

[can-do-man]

Sounds like your just going to have to trust your doctor as it seems there must be more going on... Your original question just said you was feeling bad running a temp of 101.5. Then to jules you said you were in a lot of pain. Since your temp alone wouldn't keep you a day in the hospital let alone 3 days... Good luck

[Skirma]

Oh, and one more thing. I've been on this therapy for 8 months and I NEVER had fever (except after my first shot) and rarely took  pain medication, not even when I had my shots, so for me to take pain pills for 3 days and still feel feel like I was about to die was good enough reason to go to ER... Just so you know:-)

[Skirma]

My GI sent me to endocrinologist because of my elevated thyroid levels - he said he was not sure why my levels were out of whack - I don't know what it has to do with the therapy (if anything), but that's where he sent me (going May 17th)

[Skirma]

Like I said, jules, it wasn't just a fever - I was in so much pain that I didn't know my name and NO pain meds helped me (for about 3 days) and when I called my GI - he was off that day and another doctor told me to go an emergency room that moment.

Also when I started my treatment my doc gave me buch of brochures on the subject and told me himsef - "If you ever go over 100 - call me immediately and if it's after hours you have to go to ER".
He is considered to be the best hep "C" specialist here where I live, so I listened...

I suppose they have a lot of malpractice related issues here, so as soon as you are a bit off they want to cover their , you know....

[jules2551]

I really hate to question your reasoning but why did you go to the hospital with a fever of 101.5?  I just don't get it!  I have always been a person to run high fevers but that one would have never led me to ER.

I hope you are well!
Jules

[HectorSF]

Stopping Copegus will NOT help with your platelet count. As Will pointed out it is the Pegasys that is causing your platelet count to be low, NOT the Copegus. When you can, I would start your Copegus as soon as you can.

As Will said there is no difference between 33,000 and 30,000 just the normal variations of blood levels.

Just curious, but what was your platelet count before you started treatment. Do you know?
Strange that your doctor has scheduled an endoscopy. Endoscopies are for detecting GI and other digestive disorders.

Hand in there.
Good luck with your treatment.

Hector

[Skirma]

Thanks again and I have my thyroid levels a bit high, but I take meds for that and I have an appt for that with endo next month.
I am not even sure if that's due to therapy, but other than that I don't have any other conditions.

[willbb]

I would also add after reading your entire thread that I don't see any reason to stop tx., unless there are some other conditions you doctor is aware of that he may be concerned about.
Plats at 33,000 and a fever of 101(low grade and quite common on HCV treatment) is usually not any reason to discontinue..

Best..
Will

[Skirma]

Thanks so much!!! I appreciate you all guys. This hep C thing *****!!!!!!!!!!!

[willbb]

Hi ..I am not Hector ,however just in case he is not around possibly I can help out some..
  Platelets will jump around  while treating and the Riba would have no bearing on them going up or down.

Often if platelets get "too" low doctors will reduce the Interferon some as this will have an effect on platelet production. However at 33,000 I would doubt very much your doctor would recommend that.

Being without Riba  for three days in all likelihood would not adversely affect the overall success of your treatment ,however there would be no sense in stopping it at this point.

All the best going forward..
Will

[Skirma]

One more question for you - they kept me in the hospital for 3 days (looking for infections), so I didn't have my ribavirin now for 2 days. Pegasys shots I get on Mondays, so that's not due till Monday (all of this hapenned this week - just yesterday I got back from the hospital).

My platelet count went to from 30000 to 33000 in 2 days and I can only imagine was due to me not taking riba, so I was thinking not to take ribavirin till Monday - that's when my appt with my GI is and if he wants to check my platelet count that day it would be even higher, so he might consider continue with the treatment, but do you think being without riba 3  days will affect my treatment?

Thank so much again.

[bbj2856]

I am week 14/24 peg, and rib and i have fever lot time after i take rib pill in afternoon . If it get over 99.9  I take 1 ibuprofen
and it usually drops in about hour it has been 101. 2 few times.
I sure am praying I dont have to go to ER becase I doubt if those in ER would even know what we are on
.
GL an God Bless
bbh

[Skirma]

Thank you

[Skirma]

Thanks for your comment.
Yes, I am on Pegasys and Copegus and also was on Incivek.
I have genotype 1. I do not have cirrhosis.
My virus was undetectable after 3 motnhs of treatment, but I know how important is to finish this therapy...

I  felt so bad (headache, muscle aches, couldn't sleep for 3 days, etc.) that I decided to go to the ER, cause I couldn't take the pain, but before hand I called my GI and he was off that day and I spoke with another doc on duty and he said with this fever I HAD to go to the ER, so that's how I got there.

They tested me for ALL kinds of possible infections, cause that's what was my GI concern when hospital talked to him next day, but they couldn't find any, so only asumption is that that was highly elevated side affects from the therapy.

Thanks again for the info

[HectorSF]

You don't provide mush information to go on so I'll have to assume some basics. If you answer these questions we can be of more help.
What is your genotype?
What treatment are you on? Only Interferon and Ribavirin or did you also take a antiviral drug also?
I assume you are treating for 48 weeks because you have cirrhosis or was there another reason?
At what week did your viral load become undetectable?
Has your interferon already been dose reduced?

Doctor's have their own blood levels of platelets that they are comfortable with. I assume this is a gastroenterologist not a PCP? According to the the drug label for interferon treatment should be stopped if the platelet count drops below 30,000. But many doctors will allow patient's platelet count to go down to about 20,000 before stopping treatment. Of course there are things that can be done to raise your platelet count. 1. Reduce the dose of interferon. 2. You can have a platelet transfusion. 3. You can try the drug Promacta. As far as transfusion and Promacta, these steps are usually only done by hepatologists working at a liver transplant center due to experience with doing this and having the hospital resources available.

Assuming you have cirrhosis you definitively want to complete treatment because your liver disease will only progress in time and it will be more difficult to successfully clear the virus plus you have already treated for so long it would be crazy to have to start all over again, if you can start all over again. It depends on the treatment you are now using.

Going to the ER probably made the doctor nervous about your condition. (What caused your fever? Is it related to your liver condition?) It is always safer for a doctor to err on the side of caution when treating patients. So I would suggest that when you see him you give him a positive picture of your treatment and not go in to all the side effects and problems you have had with treatment. If this doctor won't continue to treat you you could look for another gastro who will but you must continue to talk your drugs consistently or the virus may come back. Of course you could go to the University of Oklahoma in Oklahoma City where they have hepatologist at the transplant center that probably would continue to treat you.

Good luck!

Hector

[AKHepper]

I had fever of 102.3 after my final shot, managed to get it stopped there with tylenol and ibuprofen and a cold shower. Then overnight it was back to normal, the next afternoon back up to 101.7.
I felt pretty bad and thought about going to the ER but I made it thru without.
I'm not sure fever is a bad thing, other than how it makes you feel. High temps kill virus.