Why does a sick person's body temperature rise at night?

When ill, your body has to fight the infection with antibodies. To speed up the production of these, the body heats up, as higher temperatures mean faster chemical reactions to do this, your body 'turns up its thermostat', and makes your body think that it is colder than it is, so your body heats up: it makes you fell cold, so you put on layers, turn up the heating e.t.c. (this is done by a small gland near the centre of the brain, the hyperthermos (not sure about spelling)). When asleep, you thermostat does not, like normal, cool down, but stays at the same level. 

So, at night, the body thinks it is cold, and cannot add layers (as you are asleep) so uses energy heating you up. This is one of the reasons that a sick person is often tired and hungry.

Fighting Cancer the Healthy Way

Lalania Hall was busy raising five sons ranging from age three to 11. She didn’t have time for herself, much less time for cancer. But in April of 2007, Hall was diagnosed with Stage IV breast cancer.

Under the care of Dr. Kimberly Blackwell, Hall’s oncologist at the Duke Cancer Institute, Hall began her regimen of chemotherapy soon after her diagnosis. Like many cancer patients, she experienced fatigue and aches and pains from the chemotherapy that left her lethargic and stressed.

“I have always been determined and tough, and my service in the Army made me even more disciplined,” explains Hall. “Before I was diagnosed with cancer, I had never asked for help, not even from my husband.”

Pathfinders Program

Recognizing the challenges Hall faced, Dr. Blackwell introduced her to Tina Staley and the Pathfinders Program in hopes that she would find a way to begin taking care of herself.

“I was scared, but I wouldn’t let anyone know,” says Hall. “Tina just held my hand. She has a way of connecting; you feel like she is walking through this with you. She can put your mind at peace.”

One of the first challenges that Hall and Staley addressed was Hall’s unwillingness to accept aid from family and friends.

“Tina helped me realize that it is OK to accept help,” says Hall. “She helped me realize that people don’t know exactly what to do, but they need to do something.”

Hall was able to ease her way into allowing people to help. She formed a team for the American Cancer Society, and her husband’s co-workers joined the team.

“Tina taught me that allowing people to help you is a gift to your friends and family,” says Hall. “My mom wanted to be there for me. I am her baby, and she needed to do something. Now I let her help.”

"In a Good Place"

Eight months after her diagnosis, Hall says that she is in a “good place.”

“I don’t want to say that cancer is the best thing that happened to me,” she says. “But because of Pathfinders, I am healthier than ever. I know that sounds crazy, but it’s true.”

Together, Staley and Hall have developed a plan that includes exercise, a new diet and stress-relieving activities.

“Soft belly breathing is awesome,” Hall says. “Even before my diagnosis with cancer, I had trouble sleeping through the night. Now, I am able to relax and settle things in my mind.”

According to Staley, there are many spices and foods that a cancer patient can add to his or her diet to help ease the effects of treatment. She suggested that Hall add turmeric, an anti-inflammatory, to her diet to help alleviate her aches, and garlic to boost her immune system.

Hall now receives treatment once a month and comes to Duke for scans every three months.

“Tina meets with me every other week,” says Hall. “If I need her in between times, she is there. I can call her or email. She is my advocate. Tina and Dr. Blackwell have been just wonderful. I call them my guardian angels.”

In the summer of 2007, Hall and her family had the opportunity to move from Durham, North Carolina, to Texas for her husband’s work, but they decided against the move.

“My husband and I talked it over, and we decided that we didn’t want to leave the care that we are receiving here at Duke,” says Hall. “I can’t imagine going through this without Duke and Pathfinders.”

Research Shows Positive Effects

Along with 54 other advanced breast cancer patients, Hall took part in a research study that evaluated the effect of the Pathfinders program on patient experience.

Despite advanced disease state and worsening symptoms, the Pathfinders program had a positive effect on a number of areas including patient distress, despair, and quality of life.

International Travel: Tips for Staying Healthy

Before you go

• Plan ahead. If you need any immunizations or vaccinations, see your doctor at least 6 weeks before you leave. Some vaccines don't reach the highest protection until about 6 weeks after you get the shots.
• Have medical and dental check-ups before your trip, to be aware of problems and to find out about medicines you might need to take with you.
• Be prepared. Find out what your health insurance will pay for if you see a doctor while you're in another country. Carry enough of your regular medicines in their original containers, along with extra prescriptions for them. Also bring your eyewear prescriptions. Wear a medical information bracelet if needed. Take a first-aid kit (see suggestions below).

Vaccines you might need

Your doctor will review the plans for your trip and decide whether you need any vaccines. The vaccines you got when you were a child also may need to be updated if you are not fully protected. Vaccines that you may need include the following:

• Hepatitis A or hepatitis A immune globulin
• Hepatitis B
• Influenza (the flu)
• Japanese encephalitis
• Measles-mumps-rubella
• Meningococcal meningitis
• Pneumococcal
• Polio
• Rabies
• Tetanus and diphtheria toxoids
• Typhoid fever
• Varicella (chickenpox)
• Yellow fever

While you're traveling

• Eat carefully if you're going to a country with an increased risk of traveler's diarrhea. Steaming-hot, well-cooked food is usually safest. Avoid eating foods from street vendors, unpasteurized dairy products and raw or uncooked seafood. Peel fruits yourself. Drink water from commercially-sealed bottles or drink carbonated beverages. Avoid ice. Use bottled water when you brush your teeth.
• If you're going to a country with an increased risk of mosquito-borne disease, protect yourself against insects. Insect repellents that contain DEET work the best. Wear permethrin-coated clothing and use bed nets while you sleep.
• If you're going to a country with a risk of malaria, your doctor may prescribe preventive medicine for malaria. Remember to start taking your malaria medicine before you leave on your trip, take it during your travels and keep taking it for 4 weeks after you get home.
• Avoid swimming and other water activities in freshwater lakes and streams. Schistosomiasis (also called bilharziasis) is a disease you might be exposed to in some African streams and lakes.
• Try to avoid taking overcrowded transportation. Try not to ride in vehicles without safety belts. Wear a helmet if you'll be riding a motorcycle. Try to avoid driving at night or in unfamiliar areas without local help and directions.

Mind/Body Connection: How Your Emotions Affect Your Health

What is good emotional health?

People who have good emotional health are aware of their thoughts, feelings and behaviors. They have learned healthy ways to cope with the stress and problems that are a normal part of life. They feel good about themselves and have healthy relationships.

However, many things that happen in your life can disrupt your emotional health and lead to strong feelings of sadness, stress or anxiety. These things include:

• Being laid off from your job
• Having a child leave or return home
• Dealing with the death of a loved one
• Getting divorced or married
• Suffering an illness or an injury
• Getting a job promotion
• Experiencing money problems
• Moving to a new home
• Having a baby

“Good” changes can be just as stressful as “bad” changes.

How can my emotions affect my health?

Your body responds to the way you think, feel and act. This is often called the “mind/body connection.” When you are stressed, anxious or upset, your body tries to tell you that something isn’t right. For example, high blood pressure or a stomach ulcer might develop after a particularly stressful event, such as the death of a loved one. The following can be physical signs that your emotional health is out of balance:

Back pain

• Change in appetite
• Chest pain
• Constipation or diarrhea
• Dry mouth
• Extreme tiredness
• General aches and pains
• Headaches
• High blood pressure
• Insomnia (trouble sleeping)
• Lightheadedness
• Palpitations (the feeling that your heart is racing)
• Sexual problems
• Shortness of breath
• Stiff neck
• Sweating
• Upset stomach
• Weight gain or loss

Poor emotional health can weaken your body's immune system, making you more likely to get colds and other infections during emotionally difficult times. Also, when you are feeling stressed, anxious or upset, you may not take care of your health as well as you should. You may not feel like exercising, eating nutritious foods or taking medicine that your doctor prescribes. Abuse of alcohol, tobacco or other drugs may also be a sign of poor emotional health.

Why does my doctor need to know about my emotions?

You may not be used to talking to your doctor about your feelings or problems in your personal life. But remember, he or she can’t always tell that you’re feeling stressed, anxious or upset just by looking at you. It’s important to be honest with your doctor if you are having these feelings.

First, he or she will need to make sure that other health problems aren’t causing your physical symptoms. If your symptoms aren’t caused by other health problems, you and your doctor can address the emotional causes of your symptoms. Your doctor may suggest ways to treat your physical symptoms while you work together to improve your emotional health.

If your negative feelings don’t go away and are so strong that they keep you from enjoying life, it’s especially important for you to talk to your doctor. You may have what doctors call “major depression.” Depression is a medical illness that can be treated with individualized counseling, medicine or with both.

How can I improve my emotional health?

First, try to recognize your emotions and understand why you are having them. Sorting out the causes of sadness, stress and anxiety in your life can help you manage your emotional health. The following are some other helpful tips.

Express your feelings in appropriate ways. If feelings of stress, sadness or anxiety are causing physical problems, keeping these feelings inside can make you feel worse. It’s OK to let your loved ones know when something is bothering you. However, keep in mind that your family and friends may not be able to help you deal with your feelings appropriately. At these times, ask someone outside the situation--such as your family doctor, a counselor or a religious advisor--for advice and support to help you improve your emotional health.

Live a balanced life. Try not to obsess about the problems at work, school or home that lead to negative feelings. This doesn’t mean you have to pretend to be happy when you feel stressed, anxious or upset. It’s important to deal with these negative feelings, but try to focus on the positive things in your life too. You may want to use a journal to keep track of things that make you feel happy or peaceful. Some research has shown that having a positive outlook can improve your quality of life and give your health a boost. You may also need to find ways to let go of some things in your life that make you feel stressed and overwhelmed. Make time for things you enjoy.

Develop resilience. People with resilience are able to cope with stress in a healthy way. Resilience can be learned and strengthened with different strategies. These include having social support, keeping a positive view of yourself, accepting change and keeping things in perspective.

Calm your mind and body. Relaxation methods, such as meditation, are useful ways to bring your emotions into balance. Meditation is a form of guided thought. It can take many forms. For example, you may do it by exercising, stretching or breathing deeply. Ask your family doctor for advice about relaxation methods.

Take care of yourself. To have good emotional health, it’s important to take care of your body by having a regular routine for eating healthy meals, getting enough sleep and exercising to relieve pent-up tension. Avoid overeating and don’t abuse drugs or alcohol. Using drugs or alcohol just causes other problems, such as family and health problems.