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| Username | Post |
| 987654321 | Posted
on 25-Feb-04 05:27 PM
I came to the United States recently and it seems the problem in my life are just beginning. Recently I had continued chest pain that the doctors could not diagnose. After running from one doctor to another finally a doctor decided to do a PPD( test for tuberculosis) which came out to be positive. I was promptly started on preventive therapy and my sputum was cultured to confirm the diagnosis of tuberculosis. The doctors were very confident that the culture would come out negative and then they could stop the treatment but unfortunately the cultures came out to be positive. Now it is confirmed that I have tuberculosis but they say that it is in so beginning stage that it is not contagious so I am leading a normal life including having a room-mate(he is an american and he knows that I have TB). Well the doctors here seem to take TB very lightly( or I may be receiving inadequate care) but it scares the hell out of me. This certainly has been a distracting factor and I find it hard to concentrate on studies. I was just wondering if any other sebser was diagnosed with TB while in the United States and the way to deal with it. I would like help from fellow Nepalis to clear this mess in my life. People posting with their experience please use a pseudo-name as I am interested in your experience and not who you are. Also I have talked with my friends about this so I would appreciate anyone knowing who I am not to post my name in this public forum. Postings on how people dealt with other adversaries(ie other deadly diseases or situations) are highly welcome. Thanks for your help. God I do not want to die young so please help me. P.S: This is a serious discussion and unwanted silly comments are not welcome. It is nice to hear from someone knowledgeable. Let me write my drug regimen history here and ask for your information. 1. Firstly immediately after having a PPD positive, I was started on daily regimen of Isoniazid, Rifampin, Pyrazinamide, Ethambutol and Pyrodoxine(Vitamin B6). 2. My sputum smears were negative for three consecutive days at the beginning of the treatment. 3. After three days ethambutol was dropped because I had eye pain. 4. The daily regimen was done for two weeks and then twice weekly regimen was started. 5. The chest pain completely went away after 2 weeks of treatment. 6. However on the 4 week the chest pain started to come back slowly again. 7. In the 7th week they did a liver function test and stopped all medication for 4 days saying that my liver function test was elevated. 8. It was around this time that the culture report of my sputum came out as positive. 9. They did my blood test again and saying that the blood test was normal they told me they would add the medicine one by one. 10. So for one week I was given Rifampin only. 11. The Rifampin only medication did not help me and I felt slightly feverish while still on medication. 12. After a week Isoniazid was added. 13. Then after a week Pyrazinamide was added. 14. Now I am in this regimen for about 2 weeks. After about the week the pain was substantially less but I have moderate pain again. This resurgence of pain again is what worries me as I have been on medication for so long that all the pain should have subsided by now. Is there any way to tell if the medication is working? I am worried that since the pain is back something else might be going on. Someone mentioned me about doing chest X-Ray but they say my tuberculosis is in so early stage that it does not show up on the X-ray. On X-ray only suspected hilar adenopathy is noted. In order to check the progess I have to do a CT scan with an intravenous dye. The doctors tell me that all the CT scans suggest latent tuberculosis not active one. Therefore they are also investigating the possibility that the sputum culture was positive due to laboratory contamination. Aside from the views of incompetent doctors I have realized that after every CT scan there is a resurgence in chest pain that I get. I was wondering if the intravenous dye that they use for CT scan in anyway interferes with drug or anything like that. Also I read somewhere that garlic helps in killing mycobacteria so I am also having garlic supplement that I bought off the shelf at Walmart. It is a dried garlic supplement that is enteric coated to avoid the smell made for thinning the blood. I do not know if this supplement even works or in worser case makes it much worser by interacting with medicine or the actual bacteria. Please advise whether garlic supplement is recommended. Does baff line as we Nepalis call help in any way? Are there any thing else that could help? I mean things like herbs, supplements etc. Thanks a lot. |
| bardan | Posted
on 25-Feb-04 06:21 PM
what i wud ask ur doc is to rule out active tb. remember ppd +ve means u have the infection but not the disease.since ur sputum culture came back positive this lead them to put u onthe 4 drugs. if u had latent tb u wud have been one one drug only. so ask them to rule out active tb,if they think cultures were contaminated,then they might consder doing probes. but whatever is the case,TB is treatable.so u shouldnt worry much. regarding garlic,if it worked TB wudnt have been a worldwide problem as it is today. |
| GoberGanesh | Posted
on 25-Feb-04 09:47 PM
You sound pretty scared but there is no reason to. After seeing few freinds with TB, here in US, Its not a biggie. Take your medicine religiously, thats the key. You will not die young. I ll bet a dime. |
| batauli | Posted
on 26-Feb-04 05:25 AM
Frend, I am no daktar, but have you discussed the BCG vaccination (if you received it a loooong time ago...?) thing with your doctor? Sometimes, the Skin Test for TB shows positive esp. if the person received BCG. I am no daktar.. but ... -b |
| ladybug | Posted
on 26-Feb-04 08:35 AM
Agree with bardan. You shouldn't worry so much. In this day and age when so much is curable, tb is not such a big deal. you will live. just have faith in medical technology. :) and take your meds faithfully. |
| shirish | Posted
on 26-Feb-04 10:16 AM
hey numbers, its not unusal for us to especially with BCG vaccines in the past to have positive PPD test. Its the test called Monteux, that shows the antibodies. The parameter, or induration, ie the wheel you develop where the solution is depostied subcutaneously, determines the exposure and the level of antibodies. The recent guide line is 5 mm of induration with the monteux test. I went through the similar situation like yours, rather a prophylaxis not cocktail like yours. But not with +ve sputum. If Postive sputum, even with the negative chest x-ray, you better finish the course of medication, though they may have some side effects. If you develop any side effects, let your doctor know that immediately. Since you are young, and even goberganesh is wise enough to figure out that you will not die young, the damage to the liver will be overcome. Just take your medication and forget about the rest. MS |
| GurL_Interrupted | Posted
on 26-Feb-04 02:11 PM
Hi there, You sound worried, scared & stressed about uncertainity! And all of us go through it when hard times fall on us! so don't feel u are alone! I know it's one of the most difficult moments in ur lifetime, but the good news is you are in an age & place where tuberculosis is curable! As u mentioned in ur post u have been started on the meds...the key to ur healing depends solely (for most part of all) upon ur responsiblity to take ur meds religiously in a right way(right amount, right time) that ur doctor/nurse has instructed u to take them. Don't skip ur meds whatsover coz if u do u might develop a tb bacteria that is resistant to the drugs...which is even a worst case! So, I am hoping u will take each one of them until the time u have been prescribed. You mentioned about ur chest pain. Was that the only symptom that prompted you to go visit ur doctor? Hm...! Coz if you had other signs and symptoms of TB besides chest pain than I am sure ur doctors analyzed ur symptoms before giving u the diagnosis of TB. And did u see the specialist? or the general doctor? Coz reading ur post it appears to me that u don't trust them? Am I hearing u correct? Sorry dear, I am not trying to stress you more or anything. I hope u understand. Coz if it is only chest pain than it can be something else also. Don't take my words coz I am not expert as I am a novice like urself! About garlic, I don't know if it works or not. But lot of the times, some food or herbal medicines/over the counter drugs interact with certain meds. so If I were you, I would ask my doctor or nurse before taking it coz I don't want the effectiveness of my meds to be reduced becoz of that. And you also mentioned about ur elevated enzymes. Didn't ur dr. or nurse start u on B6? Coz if they did, than I think that should be taking care of it. And if u still doubt about the treatment & ur diagnosis, go talk to ur doctors/nurse and let them know about ur thoughts! I am sure they will be willingly to work with you. Lastly :-), try not to be a worry wart. I know it's easier said than done :-). But worrying is just going to drain u out more & make ur immune system wearker, which is a complete NO-NO at this point. So, relax urself, think positive...and about the things that make u smile. Coz worrying is not going to lessen ur problem instead it might just make ur problems worse. Eat healthy-exercise if u can. Clean the clutters of ur mind and throw them in trash :-)! RELAX! and do everything u can (non-pharmacologic interventions) to boost ur immune system up so that they can fight the bacteria :-)! Smile :-)! You can do it! You are on right meds if it is TB so you will be cured if you follow the regimen religiously! Don't worry about tomorrow coz all of us are in the same boat, uncertain of our futures. You never know what's going to happen next! See, you are the one worried here about ur future coz of TB...& I might be the one without anything but what guarantee is there that I will be here tomorrow :-)! Life is uncertain for everyone so don't worry. Cherish the moments you have & live it to fullest :-)! If it is being bitch-show it you are even bitchier :-)! Take care & get well soon. My prayers & wishes are with you. |
| gsubedi | Posted
on 26-Feb-04 07:35 PM
Your problem is probably complicated because of the fact that you have received courses of anti-tb drugs already.Your doctor is your best advocate and have a trust on him.Your frustrations are understandable.You should not get into herbal preps as none of these work.All patients need multiple drug regimen as Tb bacteria is slow growing and not killed by single agent and the fact that you already had some lelevated liver enzymes, will put at high risk to have further problems if you add any otc herbal preparation on top of your drug regimen.In fact you probably better off even avoiding otc pain pills, alcohol etc all together. No one can tell you from posting whether your pain is from Tb or not but the fact that your had improvement on treatment is supportive of it being from Tb.TB sxs heal slowly as well and do not be desperate and listen to what your health care provider is saying.If your sxs were got better with few days of treatment, then it likely that they had nothing to do with the treatment. Swollen chest lymph nodes likely to from TB if your sputum culture is positive.Chest CT can help you doctor to make your case. One could have done a brocoscopy if you were suspected of having TB but cultures from sputum were negative. In this country you HAVE to have full course of treatment once your sputum is positive. After about six weeks of giving sample they can positively identify whether the AFB (kind of bug that causes TB) is truely M.mycobacterium(the one that causes TB) or the one that looked similar but harmless on most of cases unless one has AIDS or cancer etc. In certain circumstances you can do a gene probe to the sputum that that has AFB (which takes about 48 hours) to see if the bug(AFB) on your sputum have the same genetic codes as M mycobacterium. If the gene probe is positive or the culture after 6 weeks is positive for M mycobacterium, you can do yourself big favor by taking medicines as prescribed and by working with your doctor rather than being desperate and calling him/her incompetent.Art of Medicine is not perfect science where everything is black and white.There are a lot of gray zones in Medicine and decisions are based on keeping patients best interest first which most Americans Lawers do not want know. Good news is that people rarely die from Tb. One last advise to you is that eat a nutritious diet. Remeber Tb is used to be disease of poor people as they were immunocompromised because of malnutrition and lived in crowed houses where it spread from one person to another. If you have any questions and I could help, free feel to write to me at babita_da@yahoo.com. no dirty replies please. Thnak you. |
| gsubedi | Posted
on 26-Feb-04 07:43 PM
pls correct the bug that causes Tb to Mycobacterium tuberculi and the others harmeless one for normal people are Mycobacterium avium complex etc etc. Little sleepy out here:) |
| missgrg | Posted
on 26-Feb-04 11:28 PM
Dear number, Yah it’s stressful when you are ill from such infectious disease like tuberculosis. Well, you haven’t mentioned which city you are in and when did you come to United States! And if you are new comer then you might have had contact with Active TB patient in Nepal. We don’t know your history. Anyway you don’t need to worry about the disease. Most of us have the pathogen of tuberculosis called tubercle bacillus. When you have poor immunity system, poor diet, poor hygiene, stress, air pollution and smoking activate the pathogen. TB medication have lots of complications like eye problem, liver problem, you will have orange or red colour urine and many others. Doctors might stop your regimen because you are not tolerating ( had complication like eye pain and change in liver enzymes) and changed them. The best thing you need to do - take good nutrition, take rest, good ventilation (where u lives and the place u work), and take care of hygiene and of course continue taking medication that has been prescribed. Lastly don't worry be happy! Fully agree with Mr Subedi. Don't know whether Mr number got my points or not. Feel free to mail me in missgurungd@hotmail.com I will try answer ur ques. as soon as possible. Thank you Missgrg |
| Poonte | Posted
on 27-Feb-04 12:15 AM
bardan has a point too. Many yrs ago, when as friend of mine was required to have a medical certificate to be able to register for the upcoming semester, he was tested positive for TB too. The clinic doctor who examined him prescribed some medication and recommended a follow up test with the hospital. The hospital doctor(s) comfirmed that normally Asian people who have had BCG vaccination as infants, test positive for TB. Later on, we found out that all other Nepalis and some Indians at the same college also tested positive for TB for the same reason. Apparently, few developing countries still administer BCG vaccination, which has been stopped in many other countries. |
| bardan | Posted
on 27-Feb-04 02:48 PM
recent recommendations are that previous bcg vaccination dont alter the ppd results in anyway.ie if uare ppd postive,pervious history of bcg doesnt matter.u still have to take the INH for nine months. |