What is a Fever? And the 98.6 degree myth.

A discussion of the origin of the myth that normal body temperature is 98.6, as well as a discussion of what temperature we should use to define the presence of a fever.

Select References (Sorry, some of these are behind a paywall):

#fever #COVID #COVID19

[subliminal-damage]

Thank you for the validation. Often when I feel feverish with full body aches and pains, I "only" hit 99.1F although in some rare cases I've been as high as 103

[jndominica]

Fever comes with symptoms that can be felt without using a thermometer: feeling unusually cold, pounding blood in the head, pain in the eyes, disturbing dreams stuck in a loop. When I was a kid, I was told that 36.6 is a healthy temperature, but the thermometer had 37 marked. These days I measure with a meat thermometer in the mouth, it has a durable probe. Currently running a fever of 39°.

[crackers]

This was such a nightmare for students during Covid coming in for temperature scans after walking through a hot parking lot

[StrongMed]

tl;dr: It depends. (And ultimately, is arbitrary)

Erratum: Argh! I misspeak @3:30. I should have said "36.4 Celsius or 97.5 Fahrenheit", NOT "37.4 Celsius or 97.5 Fahrenheit". Thanks to Dan for catching that!

[tessaoshea]

I'm all for someone who can use aformentioned in a sentence without missing a beat.

[Geekdcore]

This encapsulates all of medicine. Practitioners use hard cutoff too literally, such as ST elevation, hemoglobin levels etc for management. Context is everything, just as fever in this video. Great work.

[Brendawallingbear]

I've noticed all my adult life that I'm usually between 96.8f to 97.9 when I am not sick. Sometimes when I feel sick the temp is 98.9 and I'm not considered to have a fever but I feel like I might be getting it.

I'm interested in a discussion of the temperature/ fever that's killing a virus or bacteria infection and when to be concerned about it getting too high for safety.

[worldsokayestmedic]

Knowing how variable temps are, a better cue for me is the subjective, tailored approach. Example: When the patient complains of feeling unexpectedly colder than normal, esp when coupled with feelings of malaise ("chills and aches"), they have a fever, regardless of temp. Confirmation is easily obtained when, after taking tylenol or other antipyretic to reset hypothalamic thermostat, the patient feels warm and better, i.e. physically not aching or sick, or if asleep, wakes up sweaty and hot, tossing aside the blankets that had felt so necessary an hour before.

[KitKat_]

i have run into serious problems with work where i have a flu but my temperature never breaks much above 98 or 99, and my supervisor does not take me seriously and believed i was lying/being lazy or dramatic. i would see an urgent care and be diagnosed with a flu, assigned written instructions to stay home from work for 1-2 days by this doctor. but since i never "ran a temperature" that would not count in my bosses mind and she would declare i should be fine, i'm not contagious and was expected to come into work. still sick as a dog and feeling feverish even if the numbers didn't match the myth.

since i work with disabled children i would choose to call out despite my bosses refusal to mark it as a sick day, it was not safe for me to be out of my mind in a fog and physically weak with kids who can easily have a fatal accident if i'm not all there mentally to monitor them. we have a very clear policy that you must stay home if sick both to avoid getting kids and staff sick but for safety concerns. the policy stated that we could not and would not be penalized for missed days due to illness! but since i did not have a fever this woman was incredibly stubborn that my PHYSICIAN diagnosed flu was a cold and no excuse. i was eventually let go due to "attendance problems" despite these all being calling out with the flu in accordance with the office and child safety policy. in her mind, without a fever i was faking 😐

some supervisors have a huge ego about their small amount of power and are incredibly arrogant enough to think they know better than doctors and will punish their staff for it.

even when i have caught covid and tested positive i did not run a fever. it can be devastating when medical myths create such unreasonable and frankly unsanitary working conditions

[Fxhealth]

It always makes me happy seeing that Dr. Strong uploaded a new video

[bartwilson]

I have autonomic dysfunction. When in an ER I am always helping the healthcare worker to contextualize my temperature readings, though even with my condition they still sometimes have a hard time believing or adjusting their protocols. I also have chronic ‘Wet’ left ear post several radical mastoidectomy procedures which gives me a significantly higher left ear temperature if taken by ear. It’s all very confusing. Lol.

[toRIP]

wouldn't patient feedback help determine if there is a fever?...like hey i have the chills and shivering with a headache...

[lindayoung]

Thanks...you are GOOD. The way you present this info peaks and sustains interest as well as imparts knowledge.

[ZantherStone]

Anyone notice how rare it is to get patients with 98.6 and above? It’s almost always in the 97’s and low 98’s.

[caterscarrots]

My family is a great example of temperature baseline variation. I tend to average 98.6 F, but my mom averages 1 degree cooler than me and my dad averages 1 degree hotter than me. That combined with the hard work that my dad does means that he always has a hotter skin temperature than I do.

[sunving]

So now I don’t even know what is the cut off now. You insert doubt into my not so good memory. Thanks Dr I nearly miss this video despite I click the bell to notify me.

[DestDest]

My temperature at 9:54 PM today was a 100.4. I’m not sick but I ovulated 4 days ago and at the time of ovulation 7:27 PM my temperature was 99.01. The morning before I ovulated my temperature was 98.07 when I woke up. My temperature is always anywhere from 98.04-98.08 before ovulation and then it’s 98.08-99.01 after ovulation. I suffer with PCOS but not hyperthyroidism.

[raxonsidd]

I have persistent feverish feeling.When I touch my skin, it feels very hot. But when I check my temperature through thermometer, it shows 98.8 in the morning and 99.1 in the evening.What can I do? Please suggest me

[matronista]

Been telling docs for years my normal temp is 97.3 to 97.7. (My last temp was 96.9).
They look at me like I am an idiot.

[remixadda]

Post covid recovery my temperature is persistently above 98.6 below 99.5