Germy McGerm calling
January 20, 2008 7:22 PM   Subscribe

At what point is an adult fever too high?

Is there some sort of time frame or temperature cutoff where it's time to pack it in and head to the ER? I know the whole 'if you can't put your chin to your chest thing' is a major sign to get there pronto. But what if it's just an evil, evil fever that breaks with acetaminophen/ibuprofen only to return when the meds wear off?

If it matters, I've had a fever for the past 24-ish hours ranging from 101-105.3F. I can get it to go down to about 99.7 with the aforementioned meds. I've got a killer headache that comes and goes. Thankfully, it's been gone for the past few hours.

I think I'm possibly on the mend, because the chills have finally gone, and I'm no longer freezing. Just the opposite, in fact - I'm hot and keep lowering the thermostat.

BTW, I know you're not my doctor, etc. etc. And I do plan on going to the doctor tomorrow morning if it's not better. (and if it gets any worse tonight, I suppose I will have to go to the ER...)
posted by dancinglamb to Health & Fitness (23 answers total)
IANAD, but on two occasions, doctors have told me that being above 103 is bad and recommended cold bath/showers to bring the fever down quickly. Once for my pregnant wife and once for my daughter when she was ~2.
posted by Argyle at 7:26 PM on January 20, 2008

I'm not going to attempt a diagnosis or anything, but here's some general ER-related advice.

Given that your symptoms don't really seem to describe an emergency, it's quite possible that you wouldn't be seen at the ER until tomorrow anyway. For non emergent cases, wait times in excess of 12 hours are not uncommon, especially on the weekends. In the meanwhile, you would be surrounded by sick, unhappy people and unable to access the comforts of home. To top it all off, the whole thing would probably be very expensive.

Were I in your shoes, I would wait until tomorrow, assuming I could continue to control my symptoms with over the counter medications. The ER is really not a fun place.
posted by jedicus at 7:28 PM on January 20, 2008

If you start to get hot, DO NOT TURN DOWN THE TEMPERATURE. The getting hot is the feeling of your fever breaking. The chills are when the fever is coming back up again. When the medicine is going into effect you feel better, but if you strain yourself at all i.e. going outside, getting out of bed, lowering the temperature because you are hot will not get you better. Medicine is great because it makes you feel better while you heal, but remember even if you feel well, you are not better and are still contagious.
posted by ooklala at 7:57 PM on January 20, 2008

Get to the ER immediately
posted by arimathea at 7:58 PM on January 20, 2008

What else is wrong with you? What other symptoms?
posted by gjc at 7:59 PM on January 20, 2008

Go to the ER.

had a fever of 102 for a whole day 6 months ago, and finally went to the ER after feeling like crap for 12 hours. I was seen faster than I've ever been seen in the ER and ended up in the hospital for two days - I had pneumonia.
posted by pombe at 8:03 PM on January 20, 2008

Over 103, you at least speak to a doctor. If I remember correctly (I'm sure one of the MeFi doctors will be along to correct me shortly), prolonged 106 or higher can result in brain damage.
posted by Ryvar at 8:04 PM on January 20, 2008

Also make sure you are measuring your temperature correctly, and what your base temperature normally is. 98.6 is only an average.

I had pneumonia a few years (ack! 10!) ago, and I never had more than a 102 fever, and I was under three blankets, huddled around a heating vent sweating and freezing at the same time. I went from "hey, I have a cold coming on" to "almost dead" in like 6 hours. Luckily, a cold shower was enough to clear me up enough to call the doctor and pick up a script for Cipro.

Which is to say that bad things can sneak up quickly. Jim Henson adopted a wait-and-see attitude, and now we have wrong-sounding muppets. Be careful. If you live alone, probably ought to go to the hospital so IF you pass out, you won't die. If you have parents/roomate/SO who will check on you occasionally, you should be ok to wait and see.
posted by gjc at 8:18 PM on January 20, 2008 [3 favorites]

Response by poster: gjc: Some nasal congestion and somewhat productive cough. The cough isn't consistent, wheezy or hacking, though I did cough up something particularly nasty before (sorry for the TMI). I started out with a whole bunch of sneezing and runny nose, but that's stopped for the most part (I took some Benadryl to help with that yesterday).

The last time I had a major fever like this, I did have pneumonia, but I also couldn't breathe. So I'm not so worried about that this time around.

I definitely feel out of it and kind of woozy. My husband was asking me instructions on how to make soup and I seriously had to think hard to give him an answer. It's a boxed soup. Definitely not rocket science.

The headache still hasn't come back (but I've noticed a definite correlation between the headache and lying flat - must be a pressure-related thing?) for now.

My 3yo had a fever for 48-ish hours last weekend and then was fine (negative strep test). I'm hoping that whatever she had is what I'm dealing with now. Nothing like a little renewed sympathy - it's been a long while since I've had a fever. Pretty easy to forget just how much it sucks.

The thermometer is upstairs, but I don't think I'm running anything seriously high at the moment - I'm also still within the range of where the ibuprofen/aceto. are still working. I've been swilling water and had some soup for dinner. Mr. Dancinglamb is off tomorrow, so I have one more day to get it together before I have to be a responsible grownup again. Until then, back to bed...
posted by dancinglamb at 8:34 PM on January 20, 2008

jedicus: For non emergent cases, wait times in excess of 12 hours are not uncommon, especially on the weekends.

You don't appear (based on your respective profiles) to live anywhere near each other so this may not actually be a true or useful tidbit.
posted by loiseau at 8:39 PM on January 20, 2008

I had a 105 degree fever for a day and a half once, went to the ER, and my jerkface HMO doctor wouldn't let them even treat me, much less admit me, even though every doctor and nurse who saw my temp wanted to immediately dip me in whatever cold materials they could find. I ended up at the urgent care, where I was diagnosed with severe bronchitis. At the time, I had no symptoms other than the fever. I was told by the urgent care doc that prolonged fevers of 105 and over can cause brain damage (I have not verified this, but hey, he seemed really concerned). A couple of weeks of antibiotics and a lot of bedrest and I was ok, but I was in really rough shape for a few days.

So... go to the doctor. Just to make sure.
posted by bedhead at 8:40 PM on January 20, 2008

Response by poster: loiseau- it's not that far off the mark. Mr. dancinglamb spent 4+ hrs in the ER last weekend for an allergic reaction. And that was somewhat early on a Sunday morning.
posted by dancinglamb at 8:54 PM on January 20, 2008

Drink a *lot* of water and broth to keep the yuckiness flowing and keep the fever under control. If your kid survived it, you most likely will too.

I am a fake doctor, but I'm not your fake doctor.
posted by gjc at 9:41 PM on January 20, 2008 [1 favorite]

I had strep about 15 years ago and my fever got to above 103. I could barely give my mom directions to my house i was so delirious. I mean, maybe that's something you can deal with but I was plenty ready to see a doctor by that time.
posted by rhizome at 10:10 PM on January 20, 2008

105 worries me, especially with a headache. I worry about meningitis, which can be fatal or lead to permanent brain damage.
posted by ikkyu2 at 11:18 PM on January 20, 2008

Oh, and if it wasn't obvious, there are treatments for meningitis, which can be prescribed in the E/R. So the poster should probably go there.
posted by ikkyu2 at 11:18 PM on January 20, 2008

My rule of thumb for myself is if it hits 103, start paying close attention. If it hits 104, it's seek immediate medical attention time. Under 103 I don't worry too much.

If you live alone you probably want to be cautious as you don't have anyone to get you to the hospital if your fever spikes and you become delirious or whatever.
posted by Justinian at 12:16 AM on January 21, 2008

Take two aspirins and call us if you're still alive in the morning.

Jesus christ.

I am staggered at just how bad the US medical system looks from here. If I went to my local hospital with a fever of 103, I would definitely be seen and treated, no question about it, and even though this is an understaffed, underfunded regional hospital there is no way I'd be kept waiting for anything like 12 hours, and I would not pay a cent.

You people really need to push for socialized medicine.
posted by flabdablet at 5:31 AM on January 21, 2008 [7 favorites]

IANAD, but the rule in my house for adults has always been that anything over 101 you get your ass to the ER, especially if accompanied by confusion, back pains, headache, weakness.
posted by desuetude at 6:22 AM on January 21, 2008

Response by poster: Well, I'm not dead yet. The fever broke last night around 10ish, but I'm still pretty congested and the cough has gotten worse. I have an appt to see my GP this afternoon. I'll report back if he has anything interesting to say.
posted by dancinglamb at 8:44 AM on January 21, 2008

flabdablet- How the medical care is funded is a separate issue from the care that is given. It has far more to do with the management of the hospital and whether they care enough to do a good job.
posted by gjc at 9:08 AM on January 21, 2008

gjc, my point is that advice like this,

Given that your symptoms don't really seem to describe an emergency, it's quite possible that you wouldn't be seen at the ER until tomorrow anyway. For non emergent cases, wait times in excess of 12 hours are not uncommon, especially on the weekends. In the meanwhile, you would be surrounded by sick, unhappy people and unable to access the comforts of home. To top it all off, the whole thing would probably be very expensive.

if it accurately describes the common wisdom about US hospitals, means there's a strong incentive to avoid even seeking such care as is available. It strikes me as completely strange that anybody would even be wondering whether a trip to Emergency to check out a high fever is worthwhile. Where I live, you'd just go.

In Australia, the general consensus for many, many years has been that public health is a common good, and ought to be publicly funded. Sure, that is indeed a separate issue from the management of hospitals and whether the care they offer is actually any good; but it's one of the very few political issues that the vast majority of Australians agree on. Even the right is forced to pay lip service to maintaining socialized medicine here: admit to wanting to water down Medicare and you will get voted out.

And although the funding and management issues are indeed separable, there is a huge amount of cultural leakage from one to the other. Australians expect our public hospitals to be well run, because we're paying for them with our taxes, and when we find out they're not well run, tremendous amounts of political pressure get applied to fixing that.

In fact, in general, Australian public hospitals are fairly uniformly excellent. As I said before, I would have absolutely no second thoughts about getting myself to one if I were in the OP's situation.
posted by flabdablet at 4:07 PM on January 21, 2008

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