Is there any truth to this?

cmthmpsn · Apr 17, 2013

I know for me, personally, when I'm sick, the thermometer almost never actually registers above 98.6 (unless I'm really, really sick), but I feel feverish symptoms: achy joints, burning eyes, every breath I exhale feels hot in the back of my throat, and general body malaise. I haven't monitored my healthy temp, but if I feel those symptoms and the thermometer doesn't register a fever, I can only assume my "normal" temp is somewhat below that.

sunflrz321 · Apr 18, 2013

Like others on here, I run a low baseline temp- around 96.4-96.8. By the time my temp hits 99, I usually have chills, body aches, burning sensation behind my eyes (I don't know why, but every time I have a fever I feel that) - but I have all of the other symptoms of fever, even if my temp never actually goes over 100.

I take this with a grain of salt in myself and my patients. Does a higher-than-normal-for-the-patient temp mean they are probably fighting an infection- quite possibly. Does this mean the patient is septic? Usually not, unless they have other clinical signs indicating sepsis. Many patients who have experienced hypoxic brain injuries (especially those patients who are trach/vent, like the one mentioned on the first page of comments) will have lower core body temps, because they hypoxic brain injury affected their hypothalamus which regulates the body temperature. It is important to adjust your expectations for these patients as well.

The most important thing is to know your patient, and what is normal for them, and also to look at fever as one piece of your thorough clinical exam. Once when I worked PICU I was caring for a stable vented patient with a stable temp in the 97's, she spiked to 99.5, but when I touched her she was just burning up, even though she only had a light sheet on her. Her cap refill was delayed, and she looked a little mottled- this was a drastic change from my last assessment just an hour earlier. I called the doc in, got an order for blood cx even though her temp hadn't reached 100. I wasn't going to wait until it got to 100 to treat her, I could see where this was going. The patient crashed that night, almost didn't make it, but she pulled through. Perhaps she pulled through because we caught her just in time, or perhaps God was just really looking out for her that night. Either way, you have to consider the temperature in relation to the rest of your clinical exam, rather than focusing too much on the numbers/ vitals.

hiddencatRN, BSN, RN · Apr 18, 2013

So someone who normally runs a heart rate of 45 and is now 90 resting, you aren't going to worry? After all, pulses fluctuate throughout the day.

If I get a patient who trends their vitals throughout the day over a few days, then I'd have a meaningful baseline to work from. I think it's more likely to run into someone who has actually done that with heart rate than temperature. Even women charting for fertility purposes are only looking at basal temperature.

If a patient is complaining of *feelings* of fever while a febrile, that's quite different from someone who feels fine but thinks they have a fever because "they never run that high."

OCNRN63, RN · Apr 18, 2013

FWIW, I happen to be one of those annoying people who normally runs a low temp. I'm healthy as a horse, rarely get sick, certainly don't complain about it if I am, and would rather stay at home and quietly bleed to death than ever be admitted to a hospital, so I'm not some whiny hypochondriac. However, my temp v. rarely fluctuates unless/until I'm really sick, and a temp of 99.1 actually does represent a significant elevation for me (a fever). Feel free to roll your eyes ...

Same here, and I get symptomatic: aches, flushed, eyes burn, skin hurts. I've learned not to say anything because of people giving me the "inward eye roll."

typoagain · Apr 28, 2013

The other day I had a 19 yr old mother of 3 come to the ER with her youngest (8 month old). she brought the baby to the ER at 7:00pm on a Wednesday night because he had "been running a fever and burning up all day." I asked her if she had taken the babies temperature she replied that she had taken a rectal temp that was ". . . way high, . . .like . . .98-somthing!"

(Guess who covered the ER bill?)

MomRN0913 · Apr 28, 2013

The other day I had a 19 yr old mother of 3 come to the ER with her youngest (8 month old). she brought the baby to the ER at 7:00pm on a Wednesday night because he had "been running a fever and burning up all day." I asked her if she had taken the babies temperature she replied that she had taken a rectal temp that was ". . . way high, . . .like . . .98-somthing!"
(Guess who covered the ER bill?)

A 19 year old. Other of 3????? Oh this is a whole other topic......... How sad.

SandraCVRN · Apr 28, 2013

I got up to take my temp because I'm one of "those" people. It's 97.4 when my temp is 99 I feel like I have been hit by a truck....believe what you will but I know that 99 for me is a fever.

If I hit 100 I need to go to the Dr for sure, had the flu last year and never got over 99.9. I had to insist they do the test, they just knew it wasn't the flu since I didn't have a fever in their opinion.

KelRN215, BSN, RN · Nov 13, 2013

This is an old thread but I'll add this. I usually run a low temp (in the 96-97 range). I am sick with something right now- I'm not sure what, I think it's the flu because I have almost all the other symptoms (headache, sore throat, chills, malaise, whole body hurts). Yesterday I did have a significant temp (102.2 at 8am). Last night I thought my fever broke because I woke up soaked in sweat despite the fact that I was sleeping in shorts and a t shirt with no covers (and it's winter up here, it snowed this morning) and the heat turned WAY down (been going back and forth since Sunday between being very cold and being very hot). This morning my temp was 96.2- a full SIX degrees less than it had been the day before. It's been steadily climbing all day (started to feel like crap again somewhere around 99) and, now, I'm sitting at 100.6- so my temperature has risen 4.4 degrees over the course of the day. That's a little different than someone with a baseline temp of 98.6 who with the same temp would have risen 2 degrees. I have a doctor's appointment tomorrow that was previously scheduled- I'll be interested to see what- if anything- they say if my temp is still hanging out in the high 99-100 range. (It's an oncology appointment so my guess is they'll either say "it's not a fever unless it's 101.3" or they'll freak out that I didn't call or go to the ER when I was at 102- I'm not on chemo and don't have a line so I don't see any need for that, the ER is the last place I want to go when I feel like crap.)

Penelope_Pitstop, BSN, RN · Nov 13, 2013

This is an old thread but I'll add this. I usually run a low temp (in the 96-97 range). I am sick with something right now- I'm not sure what, I think it's the flu because I have almost all the other symptoms (headache, sore throat, chills, malaise, whole body hurts). Yesterday I did have a significant temp (102.2 at 8am). Last night I thought my fever broke because I woke up soaked in sweat despite the fact that I was sleeping in shorts and a t shirt with no covers (and it's winter up here, it snowed this morning) and the heat turned WAY down (been going back and forth since Sunday between being very cold and being very hot). This morning my temp was 96.2- a full SIX degrees less than it had been the day before. It's been steadily climbing all day (started to feel like crap again somewhere around 99) and, now, I'm sitting at 100.6- so my temperature has risen 4.4 degrees over the course of the day. That's a little different than someone with a baseline temp of 98.6 who with the same temp would have risen 2 degrees. I have a doctor's appointment tomorrow that was previously scheduled- I'll be interested to see what- if anything- they say if my temp is still hanging out in the high 99-100 range. (It's an oncology appointment so my guess is they'll either say "it's not a fever unless it's 101.3" or they'll freak out that I didn't call or go to the ER when I was at 102- I'm not on chemo and don't have a line so I don't see any need for that, the ER is the last place I want to go when I feel like crap.)

Eek...feel better, Kel! I can't even imagine 102.2. I'll be thinking about you!

ilmbg · Nov 13, 2013

Some of you need more education.....

What were you taught about hypothyroidism? ? If your memory is shot I will remind you...one ss of hypo is low baseline temp. 96 is common. When that person rises to 98.5 that is like a normal baseline of 98.6 going up to100.6! VERY uncomfortable for that person These people do not tolerate warmer climates either.

Research your endo!

I can confirm....as I am one of them. Even though I take a total replacement (200mcg), I still run low baseline like the majority of other ↓thyroid patients.

Low Wy and Montana.....HATE Florida/Texas!

Don't think a patient is whining next time....

theantichick · Nov 13, 2013

I have many s/sx of hypo thyroid but because my labs are normal my doc tells me it's just depression. Grrr.

tcvnurse, BSN, RN · Nov 13, 2013

Some thoughts: When I did home health nursing I often dealt with the little old lady with a low baseline temps. I quickly learned to take her seriously when she told me 'I don't feel good and this is why." However-I was not focused on the particular temperature. Patients are more than a number. This lady, besides having a temp elevated two degrees above what was NORMAL FOR HER, also had new onset crackles and dyspnea. The doc was called, not for the 'fever' but for the clinical picture of the patient. Some lasix and she was right as rain the next day.

Moral of the story: 95% of the time when the patient feels fine, they're fine. IF they say they feel like crap there is usually an underlying reason especially if it is a new change from THEIR baseline.