fms

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A little over a year ago I began treatment for B12 anemia, aka pernicious or megaloblastic anemia. At beginning I saw many substantial improvements, especially with fatigue. At the time I even stated that it had stopped my crashes, but that wasn’t true. The seemingly random crashes went from regular to rare. If I don’t push myself too hard I may not see an anemia attack for weeks, but with the return of the summer heat combined with my morning power walks, I’ve had a few more attacks than I’m used to. The most recent attack happened yesterday, triggering a full flareup.

During my lunch break I climbed up on the roof to work on patching it before the rainy season. The weather was nice with a good breeze, so I didn’t experience overheating like I did last time I was up there. I was able to get my work accomplished in about 30 minutes and came down feeling decent. A couple of hours later I was at a doctor appointment and informed her of my morning power walk and the roof work that day. She commented on how energetic and perky I seemed, to which I responded that while I was feeling good at that time, I could feel my body starting to get weak. A couple of hours later, at dinner, I took all my supplements, including extra B12 to help fight the attack, but before I knew it, I was chilled and passing out.

I’m not exactly sure how to describe the feeling of the anemia attack. My body starts to feel off, motor controls may be okay, but everything feels heavy and tired, but usually not painful. As the attack worsens muscles get weaker and I start to feel a chill, not long after this my eyes get heavy and hard to keep open. Bad attacks, like yesterday evening’s, are rare, but they can trigger painful fibro flareups. When the flare began I could still get around the house and was planning on cooking an easy dinner, but the pain started to get worse making it hard for me to use my right hand/arm for anything. The pain kept on worsening, evolving from simple aches to more powerful pain spikes throughout my legs and arms, and extreme stiffness in my shoulders. That’s when I turn the intensity of my Quell up as much as I can handle.

With the Quell turned up as much as it can, I’ll start to huddle under blankets, trying to warm myself from this increasing chill. The blankets help, keeping breezes off me, as even a gentle warm breeze may trigger shaking. At this point the pain may be bad, but is usually manageable and I’ll pass out. This is what happened last night. As the air conditioner blew cool air throughout the house, I covered myself with blankets, turned the Quell up, and passed out for an hour.

Upon waking back up I will often find myself warm, unless it’s a particularly bad incident. Yesterday’s was one of these bad ones. Waking up was a struggle, I would pass back out for seconds then re-awaken. The chill had lessened, but I still chilled easily. My head felt like it was in a balloon and my muscles were hard to move. Took over a half hour before I could move from the couch without assistance (it’s why I keep crutches around the house). Once I was able to move, I could feel my body tiring again, but it was after 8pm and I was good enough to get ready for bed. I knew it was bad when I couldn’t get a new trash bag into the trash barrel, I gave up after a few tries.

Thanks to, what doctors and research tells me is the fibro, I barely slept for the first 5-6 hours in bed. I feel asleep for good around 4am waking up shortly before 8am. I felt meh when I woke up, I was still in a flareup. Shoulder muscles were stiff, walking wasn’t easy, and motor skills were definite reduced. I tried to put a trash bag in the trash barrel, then gave up. I wasn’t surprised when I had a second attack after lunch today, I didn’t try to stop it, I let myself pass out. I woke up an hour later and was able to resume work.

Even though I get foggy during some of these attacks, only the worst stop me from being able to work. It is far easier for me to type out a string of bash commands or code a routine than it is to come up with words during conversations. Even right now as I type this blog entry, if I try to talk to someone else in the room my speech is slow, my mind easily blanks, and I forget words. One of the reasons I was happy to go into software engineering was because it is easier for me to code than to hold conversations. I’m fortunate to have a career that I can maintain throughout these health issues.

I would be happier if these anemia attacks completely stopped, but they may not, it’s possible that there can be permanent damage. I used to experience anemia attacks like this when I was an undergrad 15+ years ago, rare but they would occur. I experienced them periodically throughout my 20s, maybe one a month. When the fibro became strong I started experiencing them weekly, the B12 treatments stopped that until recently. I’ve been told it can take a year to fully recover from anemia, even longer or never especially if there was any nerve damage. It’s time to double check my anemia treatment, get my blood tested again, make sure none of my other vitamins have gone wonky.

Note: Brain fog is an issue today, grammar may suffer.

The Florida summer is finally coming upon us here on the Space Coast. The summer used to not bother me, overall I enjoy the warmth and extra sunlight, but these days the heat will easily exhaust me. Sometimes I end up dehydrated as I am terrible at maintaining hydration in the heat. Other times the heat makes me sick, triggering overbearing headaches, muscle weakness, and exhaustion. I have experienced heat sickness and dehydration periodically growing up in New England and only occasionally in my twenties living in Florida. Since the fibromyalgia became strong in my early 30s I’ve experience this heat sickness regularly.

While I was in my mid-twenties I purchased a home in an area many of my friends refer to as ‘the middle of nowhere’ in Florida’s Space Coast. Where the house is there are only a handful of other homes. Most of the lots are undeveloped with extremely tall pine trees interspersed with palms and well maintained 3 or 4 bedroom homes. It’s a nice quiet place to live, 10-15 minutes from most stores and the highway, about 30 minutes from downtown Melbourne, Fl. Having a quarter acre lot I proceeded to start adding gardens around the house and throughout the backyard. I would spend most of the day outside working on the gardens and house. Back then I could hop on my bicycle and knock out 15 miles in the middle of July, with only a rare flareup of exhaustion the next day.

When the fibro started to get strong I wasn’t able to do the physical labor of gardening, struggling to do the minimum maintenance. Many gardens died out and returned to grass, but I kept the largest most established gardens looking decent. Not only was the physical labor becoming difficult, but I was losing my heat tolerance, often becoming sick when outside. At the worst I would start to suffer heat sickness from standing outside too long. At one point I was on medication that made me highly prone to dehydration, thankfully that has since changed, but bad habits still lead me to occasional dehydration.

Hydration is super important, but I learned bad hydration habits growing up. I worked summers and most weekends helping my parents with their rental properties. While we would bring water with us, there were many times where we could only drink the water after we were done with our work. Same thing in school, you were only allowed water when they said you could drink. You learn to ignore the thirst, instead relying on the watch to tell you when you can hydrate, it is a very bad habit and hard to break.

Earlier this past week I was up on the roof trying to patch my skylights, I’m fairly sure the one above my kitchen is the reason for the bad roof leak(s). For the first half hour I was fine, but towards the end of the job the heat started to get to me, I was overheating badly. I was able to finish the work, get off the roof, grab a gatorade and lay down with the ice pack to help me cool off. I recovered from that by the next morning.

Come Sunday afternoon and a friend is borrowing my garage to do an oil change. I decide to work on the bus for the hour or so we’re outside. I go in and out of the afternoon sun many times, each time leaving me feeling a bit warmer than the last. Eventually I’m moving bus parts around and realize that I can no longer lift a door. Just minutes earlier I was able to lift the door without struggle, but now my leg muscles are starting to hurt as is my head. I struggle to put my work away, my friends are finishing their work. That’s when the dizziness starts to hit, I excuse myself and go inside to lay down with an ice pack. I made one big mistake that afternoon, I drank very little water or other hydrating beverages. Usually I’ll bounce back once i rehydrate.

I felt terrible for hours and even though I was rehydrating, my muscles were aching. I figured that I needed sleep and would be okay the next day. I’ve spent quite a few hot days outside working in the sun and heat, sometimes I’m fine, sometimes I get sick. I can be stuck in traffic in a car with weak AC and overheat, triggering a flareup. I can spend the entire day working on the yard and be fine, then the next week I will barely last two hours. Sometimes the fibro feels like rolling dice, you never know what you’re going to get on your next throw.

I woke up this morning feeling worse than when I went to bed, woke in a full fibro flareup. This is not normal for me, it may be the most severe reaction to overheating I’ve experienced, but nothing about living with fibro is normal. It was hard to move this morning, random pain sometimes triggered by movement, muscle weakness returned along with lots of stiffness. My wrists and hands ache, are stiff, and feel inflamed. My shoulders, arms, and legs are in a lot of pain. To add to it, I’m highly foggy, I lose track of what I’m typing easily and forget words. Luckily bad brain fog like this is rare and should be gone by tomorrow. I ended up having to take the day off from work so that I can recover. My day will be full of turmeric and ice packs, along with gentle yoga and stretches for the achy muscles.

The initial infections that prompted my earlier post on infections have almost all cleared up. I started back on a healthy probiotic, very high in helpful bacterias. I’ve been slowly migrating my diet back to a healthier one, along with drinking more water. I had a major deadline last week, which caused me to start slamming back two energy drinks (decently ‘healthy’ ones) per day. Now that deadline is over I’m back down to no more than one a day. But during deadline week I contracted a nice sinus infection.

If I was the only one with the sinus infection I would blame it on allergies, but one of my close friends came down with it around the same time I did, her symptoms were less severe than mine, but a very similar timeline. I expect that it’ll take at least another week to clear this infection up. It is not helping that pollen is so severe there’s a warning not to go outside. I have serious pollen allergies and springtime has triggered sinus infections since I was a child.

The sinus infection itself has been mild, aches, clogged sinuses and sinus headaches, chills late in the day as I wear down, post nasal drip, etc. At first I made the mistake of treating this infection with Sinex nasal spray. I was stressed and exhausted from work and only cared about getting enough sleep to function the next work day. After a few days on Sinex, it stopped working, then I began to suffer rebound effects.

It has been a few days since my last spray of Sinex, my sinuses are feeling better each day, but prone to inflammation and becoming clogged, especially at night while asleep. I’ve tried a couple of decongestants and an antihistamine, but the sinuses are stubborn. They wake me up every couple of hours, sometimes clogged, sometimes draining. Each night a little less severe than the last, but each day I’m a bit more worn out.

There’s a home sinus treatment I used to make with apple cider vinegar, I need to make time to run out and buy some ACV so that I can make it again, plus it’s time for me to find my humidifier and see if that helps. I monitor my heart rate and whenever I get sick it rises by 5-10 bpm. When the infection starts to clear up the heart rate will begin to drop. My heart rate appears to have peaked yesterday, and should be going back down now. If the pattern holds true I expect this infection to last at least another week. In the meantime I’ll find some combination of home or pharmacy remedies that will help.

One of the biggest issues I’ve had throughout my life has been infections. As a child I was prone to ear infections, had my share of eye infections and the standard chicken pox. These issues mostly went away when I was teen, only reappearing when the fibro became strong six years ago. At first I was only experiencing chaffing issues that started during my morning power walks. Luckily the issues stay minor until late last spring when I had a minor infection that cleared up quickly with a prescription, followed by summer when I picked up an intense infection that wouldn’t clear up easily.

Last summer’s infection grew and became itchy and painful, spreading across my left arm, but I was able to treat it and clear it up within a couple of weeks. The doctors believed I picked it when I stopped at a bench on a public park. I had a wound that hadn’t closed up yet and the doctors believe it got into the infection when I was sitting on the bench. That infection made it feel like my body was falling apart. At least it and every other infection I had seemed to clear up with treatment. The problem is, the infections kept on reappearing, which according to my doctors “they are most likely due to the fibro”.

The minor infection would sometimes reappear, but it was that bad arm infection that showed back up again. They showed up after experiencing chemical burns from a chemical that I’m highly allergic to. At first the chemical burns were puffy and itchy, but at first were healing. Soon them became infected, most recently they started breaking out with the same infection as last summer. This time I have cream on hand to treat the infection, but this means the infection was never fully cleared up. None of them ever cleared up

Based on what my doctors have told me and the research I’ve done, the issue is with the immune system. A side effect of the fibro is a weakened/compromised immune system. It’s why I’m almost guaranteed to get sick if I’m around another sick person, and why I’m prone to getting food poisoning from food that doesn’t make others sick. Because it’s an immune system issue, I may never be able to fully rid myself of the infections. The prescriptions are enough to make the infections dormant, but it only takes one trigger to reactive them.

I have hopes that an improved diet with probiotics will help. I used to take probiotics regularly, but stopped when I my IBS started to improve and become easier to manage. Probiotics help the stomach regulate its healthy bacteria, which over time can help improve one’s immune response. My diet has also been very mixed, sometimes very healthy other times pizza delivery. I’m not sure if these changes will actually help, but it won’t hurt to try and should at least help my digestion.

When I was a child the transition of seasons from summer through fall into winter brought with it a slew of sinus issues and a nasty cough. As I aged, fall and winter became worse for me. After high school I ended up in Florida for my undergraduate studies at a tech university. I and my body were happy to be away from the cold of New England. I had no clue why I sick less often and why my allergies and sinuses bothered me less now that I was in Florida, back then I did not care.

Seven or eight years ago I noticed the Florida falls and winters were getting harder on. By late fall I would suffer sinus infections that I blamed on working at a University or roommates. The reality is that my body was becoming weak, combinations of vitamin D deficiency and B12 anemia were making the fibro worse (or maybe the fibro was progressing making the deficiencies and anemia worse). Part of my diet was a B complex supplement that ended up masking the anemia from my blood tests.

Four years ago I would find myself shaking with a chill in a 71f room. I was still undiagnosed and the doctors were passing me from one specialist to another. I needed a space heater in my office due to the AC keeping the room 75f, which would trigger chills. I remember driving home from work on many occasions, heat on full blast at the highest setting, even when it was 80f outside.

Two and one half years ago I was diagnosed with a vitamin D deficiency and started treatment, I had hoped that would solve my temperature sensitivity. The worst of my pain lessened but I still had regular chills and of course the fatigue attacks.

Less than one year ago I was diagnosed with Vitamin B12 anemia and started treatment. Suddenly I was warmer than I had been in years. I no longer needed to set my AC at 78f-81f, but could keep it at 76f. I stopped getting chills at work and the fatigue attacks lessened. Along with cardio and stretches I felt like I was getting stronger for the first time in years, maybe winter would be easier to handle.

This is my first winter with all my deficiencies treated, I even traveled to New England in December. Winter is still hard on me, especially the cold weather. When the weather drops below 50f the fibro is prone to flaring. I feel stiffness in my joints, my muscles are sluggish and heavy, the chronic pain increases by a factor or two, and my sinuses act up. When I was up in New England I was miserable. The fibro was much worse up there, it made me slow and I felt sickly like when I was younger. While the New England trip reminded me of my health limitations, I was happy I made it there and was able to enjoy some of the trip.

These issues slow me down, but they are not nearly as intense as they were a few years ago. I am happy that I can sit in a 70f room and not suffer a chill. I am happy I don’t have to bundle up to go outside in 60f weather. I look forward to the weather warming back up, it is hard to exercise with muscles sluggish like this, and my hand pain always worsens, making work pain. I am not happy that the fibro flares in the cold, but as long as it only slows me down I will survive.

After months with only minor digestive issues, I had one of my nightmare IBS attacks last night. These attacks became common when my fibro first became bad, but have been under control for over a year. Last night’s attack was extremely intense and painful, triggering a vasovagal syncope. Even though that was nearly 12 hours ago, I’m still recovering from a residual migraine and widespread weakness.

My digestive system has been acting up since the new year. Until last night most of it was relatively minor, occasional minor IBS attacks and other minor tummy troubles. This pattern of last night’s attack was nothing new; digestion would appear to slow or stop, I would become bloated, start to feel weak and fatigued, eventual malaise, and then comes rumbling and cramps, you can feel the intestines contorting.

I took yesterday afternoon off from work to rest. I blamed it on having trouble getting reliable suppliers for some of my supplements and medicines since the move. I’ve recently had to switch to online for most, plus one of my vitamin supplements is no longer being produced. As I was winding down for bed I noticed that things didn’t seem to be digesting, I felt ill and extremely thirsty. I didn’t need to drink much water before I could feel it sloshing inside of me. That started the rumbling and stomach cramps. The first round felt like I was extremely constipated, my muscles grew weak and my head become light. I had trouble keeping myself upright and the pain was increasing tenfold.

After the found round of cramps subsided I started to feel very warm, but also very tired, I wanted to lay down and sleep. There were more rounds of cramps and bowel half movements. After another round had subsided I tried to grab my phone from the bedroom, incase something bad happened. The pain was intense and I was extremely dizzy, it seemed like the world was swirling around my head. I had to hold onto the walls and furniture to keep myself from collapsing on the ground. I managed to grab my phone right as the next wave of cramps began. This was almost too much for me, I stumbled back to the bathroom as darkness started to encompass me. I was no longer warm, now covered in sweat, I had started to experience the vasovagal syncope.

The last time I recall experiencing a vasovagal syncope was spring 2016, it wasn’t this intense. As I stumbled back to the toilet my sight was mostly blocked by darkness closing in on me. I managed to swing my arm around and drop my phone onto the windowsill. Thoughts swirled in my head as did what little I could see. I wanted to scream from the pain, but my mouth was too dry. Sweat poured down my skin, soaking the floor as I finally lost consciousness.

I don’t believe I was blacked out for long, most likely only for a few seconds. The constipation was gone and my body was now emptying itself. My entire digestive system felt empty and I needed water. I was still soaked from the sweat, head spinning, but recovering. I returned to my bedroom and tried taking a few sips of water, sending me straight back to the bathroom. I was exhausted, I needed sleep, but I needed to be able retain water first. I would repeat this trip back and forth a few more times.

The digestive system didn’t fully recover before bed, but I was able to sip enough water to not feel completely dehydrated. I didn’t sleep well as my stomach ached and I had to use the bathroom multiple times throughout the night. Eventually morning arrived, bringing a less upset stomach, a splitting headache, and minor weakness. Unless I flare up again, it’ll be another day or two before I completely recover.

There was a time where I was having attacks like these regularly, mostly in 2012-2015 when the fibro was at its worst, but I’ve had them as far back as middle school. I’ve never been able to identify triggers and only identified a couple of patterns that may trigger an attack. I started taking betaine hcl and digestive enzyme supplements in 2015, dropping the frequency and intensity of IBS attacks dropped from multiple a month to none most months. That’s why this attack and its severity caught me off guard. I’m sure my body isn’t happy about having to readjust to the new supplements, but I’m pretty certain this latest attack was old leftovers that didn’t agree with me. I need to be more careful when reheating leftovers, I can only assume it was some bad rice.

My health was doing really well, minor fluctuations, but overall the best I had been doing in a long time, and then I wore myself out. Work gave us an impossible deadline, immediately followed by another impossible deadline. While I do both front and backend development, my focus at work has been frontend. For months we have requested a middleware to handle the majority of the logic and admin tasks. For months we were told they would find a resource to build the middleware. The middleware was axed a few weeks prior to the first deadline. We rushed, working non-stop, just barely delivering a functional, but clunky and unrefined product. They gave us two weeks to implement additional features (including ones not yet available in the API and have no technical documentation) and refine the product.

It was immediately after they gave us two weeks for the next deadline, that both myself and my coworker literally fell apart. Both of us now have health issues that were not bothering us weeks prior to the deadline. I have been fighting constant flareups, unable to stop the pain that returned. At this point I am worn out, only barely able to type this post. Most recently my right arm has started hurting, an extreme pulsating pain that can be triggered by overuse/overextension of most of my right arm and hand. This is a very strong indicator that I’m worn out, it’s time to rest. It is a very good thing that weeks ago I requested tomorrow and Friday off, I have to lay off the computer for a couple of days and I might have been forced to take the days off regardless. Hopefully a couple of days of fun and not having to use the computer will help. Not sure if it will be enough, but maybe it’s also time to slow down at work.

Back in December I acted the part of rockstar programmer and pulled 3rd place (out of 78) in a global tech competition at work. I had come up with a basic idea, found a team that helped me refine it, then coded a simple mobile app in 12 hours. Pulling third was a major confidence boost, I felt great, although the fibro was still flaring up.

Fast forward a couple of weeks, the start of the new year, an old problem starts to act up, a tooth ache. I haven’t been to the dentist in years, not since I maxed out a couple of credit cards five or six years ago having dental work done. This tooth was the first one I had worked on, almost eight years ago, but never finished. It was time to return to the dentist. The tooth deteriorated over the past eight years, it was infected and had to go.

I went on a strong round of antibiotics, my fever shot up, I became very sick. I was out of work through most of this. The one day I go back I rockstar it, solve multiple issues, then the sickness got worse. After that I slowed myself down, forced myself into a slow pace while I recover. After a full week of antibiotics and rest, I was starting to feel better. Additional dental work was done, infection was dead, then I scheduled to have the bad tooth pulled.

Tooth has now been pulled, that was the easy part, and I am recovering. Right now I don’t feel my best, two days of a purely liquid diet and some strong medications have left my head in a balloon. I’m certain part of it is that it was a molar that had to be extracted, another part is that the infection has damaged the jawbone. The damage is going to take time to heal and the even through the infection is no longer active, it has to be flushed out of my system. I am definitely not rockstarring it right now, but I believe I will be once I’m recovered.

I’m feeling hopeful that once I’ve recovered from this, my fibromyalgia will be easier to manage. I won’t be cured of the fibro, there is no cure. I am hoping that this stops or minimizes the reoccurring low grade fevers, and it may even resolve a percentage of body aches. I have read reports of other fibro sufferers seeing a significant reduction in flareups and symptoms. Depending on how bad the infection was, it will take my body roughly three months to detox and recover. I look forward to seeing how well I’m doing come end of April, I have plans to do some rockstarring haxing in May.

I originally wrote this in early September, but seems appropriate as these issues have continued to re-occur throughout the month.

Early September:

The fibro pain has decreased a lot over the past few weeks. The intense pain episodes have become less and less common, but I still get sick. When the storms, remnants of a hurricane that fizzles, came through here, my sinuses went haywire. This isn’t that unusual and will usually alleviate itself within a couple of days, unless it becomes a sinus infection. Tuesday I went out for my morning power walk, got rained on a few times, came back and put in a full day of work.

I felt decent that day, but my sinuses were clogged and not recovering. I woke up Wednesday with a sinus headache and clogged sinuses, so I worked from home. That afternoon I had what I thought was a fibro fever, low grade, but none of the usual pain, mostly fatigue. I assumed it was the fibro, and why not? Fibro symptoms love to change, randomly, without warning.

Two days later I’m still fighting a fever that hovers around 100.0f, my fibro fevers rarely go above 99.8f. My sinuses are barely starting to recover, but they are. I’m not the only one, friends and one of my doctor’s have been having allergy or sinus problems this week. Probably something in the air, the pollen count has been higher lately.

I have been experiencing sinus infections like this for at least twenty years. Sometimes I will go months, but they always return. One year I had reoccurring sinus infections most of November and December. I discovered that Oil of Oregano in between meals administered orally helped me recover, and tea tree oil in my humidifier would help my sinuses clear up a little. Fibro flareups remind me a lot of sinus infections, except they usually don’t affect my sinuses. Since my sinus issues are usually allergy related, I always blame this on the fibro. Maybe some day I’ll learn the difference for good.

I still believe that I will overcome this. I continue to exercise and work to keep my diet healthy. My energy levels have improved significantly, fatigue is not nearly as bad as it was six months ago, and I’m getting strong. A healthy lifestyle may not cure my fibro, but it’s the best chance I have at managing it.

I get fibro fevers a lot, usually weekly. When I’m active, exercising, and eating health, they’re much easier to manage. I caught my boyfriend’s cold last week, I recovered from it Thursday, here it is Saturday and I have a 100.1f fever. I don’t always notice them, I’ll be at the doctor’s for a checkup and the nurse will say “Did you know you have a fever?”. That fever is always low grade, usually upper 99fs, rarely above 100. Today is a bad one, not sure what triggered it, but it reminded me of when I would get sick growing up.

My parents and I bought my first modern computer in 1997, the year prior relatives gave me an old Mac Plus and I was hooked. I figured that even if I was sick, I could still work on the computer and I tried. My pattern of illness was almost predictable, major sickness at least once a season, and sick during every major school vacation. I’ve gotten sick during many major vacations and trips, sick in the Bahamas more than once, sick in Ireland and Holland, had to push myself to keep on going during a trip to South Africa, and most recently had an intense IBS attack and vasovagal episode during my first night in Orlando for a InfoSec conference. Sickness during the holidays are the ones I remember the clearest.

Sick during Christmas isn’t much fun. You have to force yourself out of bed ignoring the aches and stiffness, wrap yourself up in robes and blankets while struggling to stay warm, and pretend to be well enough that no one else notices. I would sit in front of the computer, open a computer game, try to work on a project, minutes at best, but it would end up exhausting myself and I would have to rest. It was no different during college and no different as a young adult. I hated that sick feeling, quickly putting those memories out of my mind as soon as I was better.

When I have these fibro fevers I feel the same way, I’ve made this connection before on many occasions, but I keep on putting it out of my mind. This makes me wonder if I’ve always had fibro. Either the fibro or the fever makes the joints and muscles ache, often times the muscles feel like they’re burning, and I have more of those electrical like shocks. Being idle makes it worse, it’s why constant exercise is so important.

I’m still not sure if there’s a link between the fibro fevers and caffeine, but I did have a thai iced tea yesterday, first caffeinated beverage in almost a week. The caffeine may have been too much as I crashed last night, then had intense fatigue late this morning. I’m going to keep an eye on my temperature over the next week or three, I’m avoiding caffeine for many reasons and hope it reduces the number of fevers.