I just got a call from a patient. She is less than one day out, and said “I have a fever.” Her temperature is 99. With her, I do not consider this a fever. And the likely reason for her temperature is because of her pain, she is taking shallow breaths. The treatment is to take deep breaths, hold them in, and then exhale. But when do you worry about a temperature?
So, I thought I would write a blog.
What qualifies as a fever?
Normally, your temperature should be 98.6. If it is above that, we don’t consider it a fever until you are 101.5. There are natural variations in your body temperature. When taking your temperature, an oral thermometer or one you put in your bottom are more accurate than ear or forehead temperature probes.
What causes fever after surgery?
People always worry “OH NO! I have an infection.” This is typically not the case. The most likely cause of your temperature varies with how far out you are from surgery. These are GENERAL points. Every person is different
- DAY 0-2: NOT TAKING DEEP BREATHS. The fancy doctor term for this is atelectasis. What it means is you aren’t taking deep breaths, so the little alveoli balloons in your lungs don’t open up fully. If this continues to progress, it could eventually lead to a pneumonia, but that is rare.
- To prevent this TAKE DEEP BREATHS. Hold it in. Use an incentive spirometer.
- Also HAVE GOOD PAIN CONTROL. The most common reason people get this is they feel pain when they take a deep breath (particularly seen with breast surgery or abdominal surgery), so they take short little shallow breaths.
- DAY 4-5: URINARY INFECTION. Again, this blog is about the common causes. This would likely only be seen in those with longer surgeries who got a catheter during surgery. Signs of a UTI are urinary frequency, having tiny amounts of urine come out, and pain with urination.
- To prevent this, stay hydrated, so you pee a lot.
- This is uncommon.
- DAY 7-10: SKIN INFECTION/CELLULITIS. This is when your skin turns pink or red. It can be tender. Frequently you would see this near the incision sites.
- The treatment for this is usually an oral antibiotic.
- I like you to mark the red area with a Sharpie pen (yup. just draw on your skin). You should see the area of redness get LESS red over time and RECEDE from the markings. If it is getting beefier red or spreading, you need to let your doctor know. It means the antibiotic you are on is not working or something else is underlying.
- How to prevent? KEEP CLEAN. Even if you are not allowed to shower, you can still clean the area. I give my patients a special surgical soap before surgery. You can use it after as well. (Or get an over the counter antibacterial soap). Wash your hands before and after touching your incisions.
- Wash you clothes. If your garment (abdominal binder, bra, ACE wrap) is stained, smelly, and yucky, that is not good- wash those.
- If gauze has discharge or blood on it, change the gauze
- If the area is moist, mucky, or smelly, then clean and pad the area.
- Sponge bathe to keep clean
- You do not need “sterile gloves” to clean yourself. Simple soap and water is good.
- If you have redness, alert your doctor.
So bottom line?
Have good pain control. Take deep breaths. Hydrate. And keep clean.
And if you have a temperature over 101.5, alert your doctor.