<s>[INST] my mother is 76 has end stage COPD and has had Rheumatoid Arthritis for over 10 years.  She has not been hospitalized over this winter for her respiratory issues, but has complained of feeling extremely cold these past few months.  Each day she awakens, takes her medications, and has breakfast and then has to return to bed for almost 3 hours under heavy blankets to finally have feeling in her hands and feet.  Does this sound like anything you have ever heard of?  Thank you. [/INST] Thanks for your question on Chat Doctor. I can understand your concern. Your mother is having fever with chills. So we should first rule out dengue and malaria. So get done CBC with PSMP and dengue NS1 and IGM levels. If all these are normal then no need to worry about dengue and malaria. COPD and rheumatoid arthritis make her prone for respiratory infection (pneumonia) and this can also cause fever with chills. So get done chest x-ray. If chest x-ray is showing pneumonia then she will need antibiotics and other supportive treatment. Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother. Thanks. </s>