I have had a chronic cough since shortly after starting Kesimpta. Friday morning, my doctor prescribed an inhaled steroid for it. That evening, soon after using the inhaler for the first time, I became ill. It was nothing major. I was a little lightheaded and had some vertigo. I was still able to carry on with my plans that evening. The following morning I was hesitant to use the inhaler again. I did not want to ruin my entire day feeling ill. I skipped it. Soon enough, I still found myself sick again anyway.

I was playing a simple game with my dog, Wallace. It was storming outside, which meant he was not able to go for his morning walk. About ten minutes into playtime, I was hit with a wave of nausea. I fought it off. Then came the lightheadedness and dizziness from the evening before. I wondered if it was possible that I was still feeling the effects of the inhaler. I sat down for a moment to let it pass. Standing back up only intensified it. I rushed to the bathroom and plopped down in front of the toilet. The cold floor felt good. I sat there for several minutes until the nausea passed. I soon felt well enough to continue playing, but knew it was probably going to be a long day.

Bouts of sickness came and went throughout the day. I trudged through. I ran errands and did chores. By late afternoon, my body told me it was time to stop. That is not uncommon when I fail to pace myself. I often attempt to do as much as I can and as fast as I can while my body is cooperating. When my nervous system has had all it can handle, it pulls the plug and forces me to stop and rest.

I stopped. The fatigue hit me hard. I did not see any other option but to lie down and shut my eyes. I curled up with Wallace on the couch. The first thing I noticed was my breathing. I had been active but had rested enough that my breath should have returned to normal. Yet, I was feeling my chest quickly rise and fall. I shrugged it off. At my appointment the day before, my lungs were still wheezing significantly. I told myself it was nothing to worry about and my focus switched to my heart. Lying on my back, I could feel every beat. Two beats, then a pause. One beat, pause. Two beats, pause. I have become familiar with the feeling of fluttering when my heart does this, but it was something I had not felt lately.

I napped, showered, and continued to fight against mounting fatigue. As I stood at the stove making a fresh cup of tea to ease my tummy, I started putting it all together. Nausea, fatigue, shortness of breath, and heart palpitations were all of the classic symptoms of anxiety. As much as I wanted to think I had come to terms with starting a new medication, it appears I still had some subconscious apprehensions.

I did not come to the decision to begin treatment with Mavenclad because I did all the research and it sounded like an astounding idea. When you look at the side effects and my history with multiple sclerosis medications, it actually sounds like a horrible idea. I chose Mavenclad because I felt backed into a corner. Having MS and being off of therapy for nearly two months is like having a time bomb ticking inside your head with no idea when it is set to go off. I had to make a choice, and as much as it terrified me, Mavenclad was the best option in front of me. I thought I had come to terms with this. I put a lot of energy and thought into the decision. I told myself, when it comes to MS, the consequences of no decision had the potential to be worse than the consequences of a bad decision. It is that word though, potential, that makes it all so hard.

So many things about MS are unknown. I have no idea how bad my condition will get, or if it will worsen at all. Statistics say it will, but no one knows how much. I have no idea why I even have this disease. Some say it is diet, some say a childhood virus, and others say stress and lifestyle factors are the cause. Another unknown is the medications. There is no cure for MS. What we have are disease-modifying therapies. These drugs go in and wreak havoc on the immune system and change the way it functions or completely disable it. It might work. It might not. It might work for me, but not for you. It might work for me, but only for a short time. No one knows. If Mavenclad does not work for me, I am going to choose my next therapy by throwing a dart at a board with names on it. My chances for success will be just as good if I do that versus spending hours researching the efficacy and side effects.

I was due to start Mavenclad yesterday. I did not. I spent my work day staggering around and feeling awful. I cried when I finally made it to my car. Crying at the end of the day was a daily occurrence for probably the first year or so after my diagnosis. I had not done it for a while. I was so incredibly worn down and beaten physically and mentally that I could not control myself emotionally. It had been a busy day. I was over ten thousand steps at that point. My hip and ankles screamed from limping all day. My muscles were sore and my joints were aching. My heart also screamed from, once again, taking another step back in my health. After finishing two rounds of antibiotics and a round of steroids, I truly thought I was free of the damage Kesimpta had left behind. I had spent the entire week before practically prancing up and down the hallways and listening to my coworkers tell me how great I was walking. Yesterday, they ducked their heads and avoided eye contact as I held to the wall to keep my balance.

I had a pretty good hunch about what my issue was. A fever is the only thing that can take my legs from me that quickly and thoroughly. As soon as I got home I took my temperature. It was 99.8. I was sick again. My heart sank even further with the confirmation.

I would not be starting Mavenclad with an active infection. I stared at the bag it was packaged in with the hazardous material warnings stamped all over it. Fears be damned, I just wanted to get it over with. I did Google searches and read the Mavenclad website. The information was clear. I should wait. Instructions for taking the medicine include not taking any other medications within three hours. Once I had made my final decision, I took a fever reducer and resigned myself to the couch.

I woke up this morning with weakness. My temperature read normally at 98.1. My walk into work was hampered only by the usual limp. For all intents and purposes, other than lingering fatigue, I am cured of whatever nearly incapacitated me yesterday. I have checked my temperature nearly every hour and it remains in the 98-degree range. I asked the internet for help again. This time I wanted to know if was possible for anxiety to manifest as a fever. I learned a new term in doing so. A psychogenic fever is an increase in body temperature caused by stress and is sometimes referred to as stress-induced hyperthermia. A psychogenic fever can trigger flu-like symptoms such as chills, body aches, and fatigue.

I can not be certain that anxiety was the reason I felt so ill yesterday. I feel pretty confident it was. I am waiting until tomorrow to be sure my temperature does not rise again. If my temperature stays at bay, I plan to start Mavenclad then. In the meantime, I plan to stay as relaxed and distracted as possible. I will speak with my primary care physician about what happened. I feel a post about anxiety and its physical manifestations coming soon. Updates on starting Mavenclad (hopefully) coming soon, as well. I am ready to do this.