104 to sometimes 107 sudden fevers and harsh shaking chills

[Sedigheh]

Hi everyone,

My mom is 60 years old. She was diagnosed with ulcerative colitis about 30 years ago and was on Asacol until 2008 when the doctor felt a mass in his examinations in the left side of the colon. Colonoscopy showed polyps with dysplasia so they decided to remove the large intestine. During the surgery, the surgeon realised that the small intestines is involved too and that there is fat wrapping in the small intestine. Diagnosing Crohn's disease during the surgery (!) he did not touch anything... I can't understand their decisions ... First they say the polyps are as dangerous as hell and then they don't touch them ...

They just changed her medication to Pentasa since then ... She refused to pursue any more treatments or visiting doctors as she was traumatised through this procedure. Daily, she experiences many flares (pains, chills and fevers and extreme diarrhea (over her regular diarrhea)).

Recently, she is having sudden episodes with very high fevers up to 107 (!) that leads her to ER and antibiotics injections. Last time the temperature went up so fast that there was not enough time to get her to ER before it reaches the critical levels...

Did anyone have similar episodes? Could it be due to Gallstones? Some doctors say that this can be due to a 1 cm gallstone she has and they want to do another surgery but I read about the complications of a such a surgery for Crohn's patients due to the adhesions... I am worried sick for her but I can't do much I am thankful for any sharing of info and experience you have. It will be great help...

 

[shamrock15]

Those temperatures should have her heading immediately to the hospital regardless of any other symptoms. They are signs of infections and at that temperature they can cause damage in short order. I can't speak to decisions made about discontinuing surgery or future procedures. I do wish the best for your mother though, and don't envy trying to get help. I can't see however how she would be discharged from hospital with such a potentially serious condition.

 

[Jennifer]

I agree that it sounds like there's an infection happening somewhere (whether it's a gallstone, abscess, bowel perforation etc) but I'm honestly not sure where exactly and her doctors won't know either without testing. What tests did they run on her when she would go to the ER (CT scan for example)? When was her surgery? Knowing what it is will decide what treatment she actually needs rather than treating with random antibiotics each time things get really bad, otherwise this is going to happen over and over again or worse.

I really hope she changes her mind about seeing a doctor and trying to figure out what's going on. Please keep us posted on how she and you are doing. My heart goes out to you both.

 

[2thFairy]

I second (third or fourth, whatever!) the others that it is a sign of infection somewhere. Gallbladder surgery can still be done even with massive adhesions..I had this done myself. The difference is with adhesions, the surgery is done as an open surgery (one large incision) versus laparoscopic surgery (three small incisions).

 

[Sedigheh]

Hello everyone,

Thanks very much for your replies.

Each time she goes to ER, they run an ultrasound. The most recent result is:
multiple gallstones (largest 12 mm) but the size of gallbladder is normal, minimal free fluid in pelvic. The rest are reported normal. This is the only time they said the infection might be from the gallstone. The previous times they did not give us any reason for the problem.

As Jennifer said they just treat her with random antibiotics until they stop the fever ... Her last surgery was in 2008 when she was supposed to go under colectomy but the surgeon cancelled the procedure.


I am trying to convince her to see a specialist again but she says they are the same people who opened me up and closed without doing anything... they can't help but make me suffer more...

 

[shamrock15]

They need to test to determine what the organism causing the infection is. Far too many different ones out there. Far too many that are developing resistances for them to haphazardly treat with random antibiotics. They should be able to figure out what the bug is and treat it appropriately. It may require admission and IV antibiotics. They won't know until they actually test.

 

[Jennifer]

They didn't continue with the surgery because removing the colon would have gotten rid of the Ulcerative Colitis but since they saw involvement in the small intestine they couldn't justify what they were about to do because it was Crohn's instead. I'm not sure if they felt everything was salvageable and preferred to try medication for Crohn's instead of removing pieces of the bowel but they did make the right decision I think in closing her back up so her and her doctor could make a more informed decision based on the new diagnosis. Did she see her doctor again after the surgery to discuss medication?

I know a lot of people aren't able to see a different doctor for many reasons but I think it's worth going back and discussing your options. Instead of an ultrasound is she able to have a CT scan done on her entire abdomen to find out exactly what the cause is be it Crohn's, gall stones or something else?

 

[Sedigheh]

I am trying to get appointments with some new doctors and convince her to see them.

It's not acceptable for doctors in Iran to be asked for a specific test or procedure but I will try to ask for an abdomen CT scan in a nice way!

Is there any non-surgical treatment of gall stones assuming they are the infection source?

 

[Sedigheh]

After the surgery, the hospital GI prescribed her Pentasa instead of Asacol and explained that Pentasa is more effective in case of Crohn. She met her GI after hospital release and he also confirmed it. She keeps filling the same prescription ever since...

 

[Jennifer]

Asacol and Pentasa and other Mesalamine medications are mainly meant for Ulcerative Colitis as they are topical and do not penetrate deeper in the intestinal lining which Crohn's can effect. It's also time release mainly for the colon but if you have inflammation further up into the small bowel then the medication won't work as well. With her symptoms this bad Mesalamine medications aren't enough. http://www.crohnsforum.com/showthread.php?t=50253

With symptoms like she had in my area it's pretty standard for an ER to order a CT scan. We've had many members with similar problems in the Middle East trying to have certain tests done and certain medications given but it can be difficult. Some have even come to the United States for treatment and surgery and then went back but I know that not everyone is able to do this. I hope that you'll be able to convince a doctor in your area to do more for her and I'm glad that she has you for help and support. :hug:

If she cannot undergo surgery then there are medications for gallstones.
http://www.mayoclinic.org/diseases-conditions/gallstones/basics/treatment/con-20020461
http://www.webmd.com/drugs/condition-2208-Gallstones.aspx?diseaseid=2208&diseasename=Gallstones