Coley's Toxins IV #13 - Revamped fever charts. Figuring out the dry cough.

I've programmed a chart that's hopefully easier for folks to see how the Coley's Toxins fevers progress over time. I did it mainly for ourselves to be able to visualize how a given fever compares with the prior one - and also how it compares with the "best" fever thus far. The best one she's had is fever #2. It was long and protracted, and she stayed well above 102.5F for a good 2.5 hours.

Now, back to today's fever. Since the prior fever was a good one that reached 104F, we chose to stay at the same dose level. That's what the MBVax protocol calls for.

Chills

The chills took a while to develop - but they did come eventually. The chills were frequent but very gentle this time. Mainly a light cool sensation on the back, arms, back of head. Remember now - she has a full body far-infrared heating pad along with blankets and a second chest heating pad. These are turned on and put in place right from the start, before the chills. Again, the purpose is to ward off violent chills and shakes which happen when the body resets it desired temperature point upwards and tries to generate internal heat.

The gentle chills foretold of a lesser fever. Still, she managed to hit 103.1F (39.5C). In all, I estimate that she stayed above 102.2F (39C) for a good 1.5 hours. The plot of this fever (#13) versus the prior one shows a more or less similar curve, except with a lower peak. This indicates her body is beginning to develop tolerance to this dose level (hence the lower peak). We will need to think about whether to increase dosage for next Monday.

Figuring out the cough

For today's infusion, we worked with the doctor here at Issels and decided to eliminate their pre-infusion vitamins and minerals (all prior Coley's infusions were preceded by an IV infusion of B vitamins and minerals to strengthen the body. This was mixed into 500ml saline). For today, all that was given was 250ml of pure saline. The reason we did this was to see if the pre-infusion was contributing to the dry cough that happens each time she gets Coleys.

The doctor also listened carefully to her lungs before infusion, and during the fever, when the cough started up. Here's what we found:

1. Her lungs sounded very clear before infusion (when there was no cough)
2. During this fever, the cough was noticeably less than the prior fever (#12). Three differences in today's fever are
   • Smaller volume of infused liquid (250ml versus 500ml)
   • No B vitamins + multi-minerals
   • No Coley's dose increase (hence a less intense reaction than #12)
3. During the fever cough, the doc listened again very carefully and noted the following:
   • When breathing normally, her lungs sound clear -- i.e. no evidence of general bronchial constriction that may be indicative of allergic reaction due to Coleys.
   • However, when coughing, it does sound like a "wheeze" (only during the cough).

The doc suggests one possibility is a small tumor that might be pressing on a nerve. Coley's causes tumors to inflame. This might be an explanation for why the cough comes during infusions. The doc didn't think it was a pleural cough. The doc said that a pleural cough would be triggered when one breathes in deeply -- and would manifest in a sharp spasm/pain in the sides. (In her case, she does cough whenever she breathes in deeply, but there are no sharp pains).

Is the dry cough due to general inflammation?

Another possibility that we're pondering is general inflammation caused by Coley's. We've been observing minor but noticeable aches and pains here and there - like on a finger tip, behind the knee cap, in the hip. These generally occur during the peak of the fever.

We can't help but to make an association with an episode 2 years ago when she was given a single shot of Depot Lupron before chemotherapy. This led to all sorts of pains and aches on her chest, ribs, jaw, scalp, shoulder... and it also caused a dry cough. All our doctors and oncologists were totally stumped. CT scan, X-ray, nuclear perfusion tests, blood tests were negative. The ER doc suggested that her cough could be caused by inflammation in the pleura surrounding the lungs. In the end, we did a little experiment, based on the hunch that what we were seeing was generalized systemic inflammation. So she took a single dose of ibuprofen, and that IMMEDIATELY killed the cough and aches and pains. It was like magic - really. Coleys almost definitely causes temporary inflammation. So, you can see why we might believe that the dry cough, aches and pains that we're seeing are due to a generalized inflammatory process.