I haven’t heard of those before. And HMO insurance is very strict on what docs are in-network and covered and the prices they pay, so I doubt they would mix. Maybe if I had a PPO. Medical insurance in the US is a sore subject.
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You can always ask the docs what insurance they accept. You never know.
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Sounds like you have or had Pneumonia. The nasty thing is they are finding post COVID stuff seems to be different than if you found it alone. I would re-engage your medical team and have them check for long COVID. Until then, easy is the only way to be.
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I have a follow up with my GP on Wednesday. So I definitely some good questions and requests to bring with me.
I have had a few GI issues this past week, tho they could simply be part of my IBS. But could also be part of some larger body imbalance that’s hard to see with just a few blood tests and a CT scan. Could be intestinal. Or could be unrelated.
I would think pneumonia would have shown up on the CT scan. But maybe not. That’s been a thought of mine as well.
My nose seems clear and sinuses never swollen or sore, so I don’t think it’s the sinusitis like my GI doc seemed to be sure off. Did have some swollen lymph nodes a for a couple days a month or so ago but that’s gone away. Tho they do seem tight.
Seems antibiotics would help, but I don’t want to take random antibiotics if I don’t know what I’m taking them for. And my GP felt the same way which is why they first referred me to the GI docs
So many questions, so few answers. Probably need to push the long-COVID and extra testing and referrals.
My elevated temps never last a full day either. Usually wake up normal and then my temp goes up and down during the day and end up normal by the evening/night. Today it was 99.8 early. Then back to normal. Now back to 99.5. 
I did do 40 minutes in the bike this morning. Averaged 82W and kept my HR in Z1. That felt good.
But very little else to go on. Very frustrating.
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Is the difference between a temperature of 99.8 and 99.5 meaningful?
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One is closer to 100 than the other? Otherwise I don’t think the relationship to each other is important. Only likely important in their distance above normal and that they’re both different data points from the same day.
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What is the accuracy of the thermometer?
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Fair question.
Pretty accurate. And seemingly accurate enough. I only started checking when I actually felt hot and fatigued and feverish. When I’m not then it’s usually measuring normal.
In the past when I’m not sick it’s usually in the mid-97’s or mid-98’s.
When I take my temperature in the morning it’s also usually 97’s or 98’s.
I have a couple thermometers and they are usually about the same. Within .3F of each other.
They’ve been accurate with our and and kids’ thermometers enough to know when a temp is normal or not. I rely on the range more than the actual exact number.
So I trust the accuracy of the thermometers.
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The one aspect of this that seems to stand out from absolutely everything else is the none continuous and repeated elevated temperature 
.
Ditto I’m no Dr but that sounds so unusual enough to be a starting point for investigating.
I’ve had 3 episodes of illness between 2022 and 2023
Covid
Chest infection
Viral infection
All were preceded by unusual fatigue ( feeling ‘flat’) and I stopped training completely for a few days BUT made the mistake at least twice of ‘thinking I was better’ and starting back too hard only to fall flat on my face and having to stop again.
Ultimately I started with Z1 HR ( totally ignoring power) and kept local to home. At the first sign of ‘not feeling it’ I turned for home and only rode when I started to feel recovered from that ride - sometimes not for another two days. I kept away completely from riding with anyone else ( I’d fallen into that trap once before and barely made it home).
The point is ( from my experience) that after any bug of any sort that results in fatigue lasting more than a few days you can expect to take up to 3 weeks before you feel ‘normal’ again.
This 
sounds like you’ve got it nailed!
But I would persist with your GP and don’t accept guesses - you want specific answers to specific questions and the answers need to make sense.
I really hope you can get some answers soon.
I’m undergoing some cardio investigations as my fatigue capacity dropped off a cliff over a period of months - to a point last May when group rides became impossible as people that were always behind me were having to wait and I had to stop completely on a couple of rides to rest.
My BP was dropping during turbo sessions and I presented the results to a GP who told me to stop riding! 
I insisted on a referral to the Sports Medicine Clinic who told me to keep riding ( as my own pace) and arranged appts with Cardiologists which have lead to upcoming CT angiogram and echo cardiogram.
If I hadn’t been persistent then I don’t know if any progress would have been made.
My only point in telling you this is that sometimes ‘ them as don’t ask don’t get’ ( an old Yorkshire saying ) 
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Update: Went to see my GP yesterday.
Ended up being another different fill-in doctor which actually I was kind of happy about. Since it was a fill-in and a different doctor she actually had to look through all my files and recent documents ahead of time to get familiar with my case. And she actually talked to me like she was listening and trying to figure it out rather than being dismissive.
And at first she was said that with an infection or some auto-immune issue my HR would likely be higher than usual but my HR looked normal to her. So I told her about all the cycling and running I do and what my normal RHR is, and what my usual Z1 HR is, and what it has been lately. And she understood and said that made sense and while my HR looked normal it was actually high for me.
After that she started to consider along the lines that I have been thinking; that maybe my COVID infection triggered something - either a lingering or secondary infection or some type of auto-immune or other response.
So since my Prednisone course didn’t do anything, I am now on 5 days of antibiotics with a nasal spray. And I had another CBC blood panel along with a check for some auto-immune markers. And then I have a follow-up again in a month. This time with the doctor assigned to my office who will be my new PCP (and who I hope will stay with the clinic for at least another couple years).
So that’s some progress.
Best case scenario is it’s some kind of buried infection and the antibiotics knock it out and I’m feeling better by the end of the month. If not then at least that’s ruled out and we go from there.
Did 43 minutes of Z1 this morning. Kept my avg HR under 100bpm. So hopefully I’ll at least re-build some of my Z1 base endurance during all of this.
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Progress is good!
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I’m older then you, in fact older than most people in the forum at age 78. got covid aug 23, so similar timing. On and off recovery where fatigue kept getting worse, especially a couple of days after even easy exercise. By early October I was diagnosed with long covid with PEM - post exertional malaise. Have you talked with your son’s doc about auto immune system issues and mention that you had covid.
the good news is that after strictly pacing myself to avoid exhaustion, I am starting to see some progress. don’t push it. i’m a long way from getting on a bike but still think it will happen.
You’re right in trying to understand your illness. a no pain no gain approach will delay progress.
best of luck in your recovery.
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My CBC panel came back with everything still normal. No signs of an infection. No markers for auto-immune issues.
Finished my course of antibiotics on Dec 23.
No change.
Still the same elevated temps
12/18 - 98.9 - Dr Appt & Blood work
12/19 - 99.5 - Antibiotics Day 1
12/20 - 100.6
12/21 - 100.2
12/22 - 100.6
12/23 - 99.6 - Antibiotics Day 5 (final day)
12/24 - 100.2
12/25 - 99.7
12/26 - 99.6
12/27 - 99.4
12/28 - 100.2
Did a 43 min Zone 1 ride on Dec 18 (avg 66w). And a 26 min Zone 1 ride on Dec 23 (avg 59w). Since then I’ve been using the holidays for sleeping in and resting.
Once the holidays are over I’ll use my referral to the ENT and talk to my PCP again.
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Have the doctors ruled in/ruled out a fungal pulmonary infection such as Valley Fever?
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Based on my blood panels, CT scan, pulse-ox (98%) and lack of other symptoms they don’t see any signs of any infections - fungal or otherwise. Doesn’t mean there isn’t one hiding somewhere, but based on the current tests and results they don’t think that’s a possible cause. But there doesn’t seem to be signs of any cause. So…
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Any chance its a hormone issue?
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So sorry to read about your struggle. So frustrating not to be able to figure out what’s going on.
You mentioned IBS in your thread–any chance it’s related to that somehow or perhaps to a change in any medication you’re taking?
Also, please be sure to double check that your blood mineral levels (iron, potassium, magnesium)are within normal range. I have hemachromatosis and when my iron is too high or too low I start feeling like shit.
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Sir Evan, I too experienced some sort of respiratory illness last Feb-Mar. While I didn’t test positive for COVID, I wonder if it was RSV which was prevalent here in Boston at the time. I eventually had to get an inhaler from my doc which helped as I wasn’t getting better regardless what OTC I tried. Does your doc follow any functional or integrative medicine principles to help get to root cause? There are herbs which you can use in teas that help support the lungs (of course look into drug-herb interactions before you do). I’m hoping to get my aerobic capacity back this winter, though I may not be able to get through the upcoming ToS. 
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@DameLisa Haven’t testing my hormones specifically. Something I need to ask my GP about at my next visit.
@Michael_Robertson My IBS is somewhat minor and don’t take any meds for it except for the occasional lactose pill or antacid. I try to have limited dairy and try not to mix caffeine and dairy and that helps with 95% of my IBS issues.
@RoseYarrow my oxygen and breathing is good. Tho I have woken up with congestion randomly for the past 4 or more years. I know I have a deviated septum that causes some of those issues. But my blood oxygen is usually 97-98%. It’s really only my temperature and HR that is elevated. And my HR could be elevated simply because I haven’t done much if any exercise in 4 months. And even then my HR is still normal. It’s just high for me compared to when I’m in good shape. When I was taking Prednisone and when I use the NasaCort nasal spray I can tell me nose is a little bit clearly than usual. But when I don’t take them my breathing is still good.
In the past two weeks since I quit taking the Prednisone I’ve started to have some sinus headaches, even tho I didn’t have that problem at all before I took the Prednisone. I don’t know if that means I do have a sinus issue, or if I’m just having a rebound effect from being on Prednisone for 3 weeks and not being weaned off it slowly.
@RoseYarrow Also, my PCP left, so when I go to my GP office I keep seeing new docs because they are all fill-in’s because it’s flu season and are super busy. The next doc will be the 3rd doc I will have seen, but at least he’s the new resident doc for the office and I can start seeing him regularly, now. So I hope he has a better long-term plan for figuring out what’s going on.
I have my next PCP appt on Jan 17 and am trying to make my ENT appt. So hopefully they will help me get some answers because now that we’ve been trying solutions and doing more blood tests and nothing has changed or popped up I’m starting to get somewhat frustrated. I just want to feel normal again.
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Thanks Sir. I ask as I was also having low BP and some dizziness in the spring. I wondered if it was related to the respiratory illness. I traced it to having too much cinnamon which I was using for taste and helping lower my cholesterol. A side effect can be lower BP which can be helpful for those who need it but for me who didn’t, it wasn’t. As someone who uses many natural remedies (herbs and foods) it is important to keep an eye on symptoms, dosages, and drug interactions. I offer this as there may be other factors, like foods, that could be contributing to as well as supportive for what you are experiencing.
I hear ya on feeling normal again. I have Raynauld’s which has gotten worse and am waiting to see a rheumatologist to see if it’s turning into something more complicated. It sucks to not have the answers; keep asking the questions. Until I get my answers, I’m looking into a warmer climate for next winter. Wishing you all the best, Sir Evan.
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