Has anyone gotten a chest X-ray in the Philippines before the medical exam?

[Karen_and_Jay 2]

I was thinking of having my fiancee get a chest X-ray before the St. Luke's medical exam to find out if she will need a sputum test. I am 99% positive she doesn't have active TB now, but a neighbor in her village died from TB when she was a kid. She doesn't remember having a TB infection, but I can't rule out the possibility that she has latent TB or that something will show up on her chest X-ray that requires a sputum test. And I heard that the St. Luke's clinic is particularly strict with any abnormal speck or dot that shows up on a chest X-ray. So do you think an early X-ray is a good idea or not?

I want to go with her to the St. Luke's medical exam, but I can't stay in the Philippines long enough to wait for a sputum test or TB treatment if either is necessary. And I really don't want to have to leave the Philippines without her!

Can anyone just walk into a doctor's office or hospital and request a chest X-ray? Has anyone here does that before? If so, do you have any idea about the best place (hospital, clinic, doctor's office) to go and how much it will cost?

Thanks in advance for your help!

Edited February 27, 2010 by Karen_and_Jay

[Karen_and_Jay 2]

Another question: does anyone know if St. Luke's accepts sputum test results from a Filipino clinic or hospital?

[Scott and Mhay 57]

People have done the chest xrays just in case. Just have her go get the skin TB test (even though there are false positives on that)...but it will let you know about TB....now for the x-ray...people do them just in case St. Lukes says they see something so they have something to compare it to. I am 99% sure the sputnum test has to be done at St. Lukes (since it is immigration related and the medical extension there is the only one certified for it). I know that if she has to do treatment...she will have to stay in manila because she has to do it at St. Lukes from what I have read.

[Karen_and_Jay 2]

People have done the chest xrays just in case. Just have her go get the skin TB test (even though there are false positives on that)...but it will let you know about TB....now for the x-ray...people do them just in case St. Lukes says they see something so they have something to compare it to. I am 99% sure the sputnum test has to be done at St. Lukes (since it is immigration related and the medical extension there is the only one certified for it). I know that if she has to do treatment...she will have to stay in manila because she has to do it at St. Lukes from what I have read.

Thanks for the info, but I think it is better to do a chest X-ray instead of just the skin test, because the skin test can indicate the BCG vaccine and/or previous TB exposure, whereas the chest X-ray is a little more specific for previous TB infection.

A positive skin test would require a chest X-ray. If they don't see anything on the chest X-ray, they won't order a sputum test. So I think a chest X-ray for our own edification might be the best idea.

[Scott and Mhay 57]

True...but you need to have someone read it like they do in St. Lukes. We were a little worried about my wife's chest xray too...she coughs quite a bit (but i think it's from the pollution and other irritants here)...she got a clear chest x-ray with no problems. But if it will give you piece of mind...get the xray...it shouldnt cost that much...but I am pretty sure she would have to get the sputnum done at St. Lukes....but it will give you a heads up if they see something before your medical.

[Karen_and_Jay 2]

True...but you need to have someone read it like they do in St. Lukes. We were a little worried about my wife's chest xray too...she coughs quite a bit (but i think it's from the pollution and other irritants here)...she got a clear chest x-ray with no problems. But if it will give you piece of mind...get the xray...it shouldnt cost that much...but I am pretty sure she would have to get the sputnum done at St. Lukes....but it will give you a heads up if they see something before your medical.

Yeah, I bet you're right about St. Luke's requiring to do the sputum test there. Doing a chest X-ray elsewhere first would really just give us peace of mind! If something showed up on the first chest X-ray, she would need to go to the medical exam by herself before I get there!

[sjr09 155]

Most infections in humans result in an asymptomatic, latent infection, and about one in ten latent infections eventually progresses to active disease, which, if left untreated, kills more than 50% of its victims.

[mshopeful 1]

I was thinking of having my fiancee get a chest X-ray before the St. Luke's medical exam to find out if she will need a sputum test. I am 99% positive she doesn't have active TB now, but a neighbor in her village died from TB when she was a kid. She doesn't remember having a TB infection, but I can't rule out the possibility that she has latent TB or that something will show up on her chest X-ray that requires a sputum test. And I heard that the St. Luke's clinic is particularly strict with any abnormal speck or dot that shows up on a chest X-ray. So do you think an early X-ray is a good idea or not?

I want to go with her to the St. Luke's medical exam, but I can't stay in the Philippines long enough to wait for a sputum test or TB treatment if either is necessary. And I really don't want to have to leave the Philippines without her!

Can anyone just walk into a doctor's office or hospital and request a chest X-ray? Has anyone here does that before? If so, do you have any idea about the best place (hospital, clinic, doctor's office) to go and how much it will cost?

Thanks in advance for your help!

This is based on my experience, I had an early x-ray because i had cough that lasted for a month, the result was clear no scar, no enlargement of the heart so i thought i was ok. But when my time(that was after a year i had a cough, i havnt had flu or colds before my medical) came to go to St. Lukes for my medical they found a scar on my lungs, so i needed to have a sputum and culture test. Good thing the result was negative but i waited for two months for the result. They didn't honor results from other hospital they will only compare it but still their findings will prevail. I have seen people there who have general check up before going to St. Lukes but they still found something from them and needed to go sputum and culture tests.

If your fiancee feels she's healthy and there's no one in her family who was infected by TB, I think getting early medical is just a waste of money. Just relax and pray that she pass the medical exam.

[Karen_and_Jay 2]

Most infections in humans result in an asymptomatic, latent infection, and about one in ten latent infections eventually progresses to active disease, which, if left untreated, kills more than 50% of its victims.

Thanks for the helpful graphic, but I do know about latent TB since I am doing research on it! hehe, thanks!

[Karen_and_Jay 2]

Thank you SOO much for relating your experience, mshopeful!

They didn't honor results from other hospital they will only compare it but still their findings will prevail.

I thought that might be the case, but thanks for confirming that!

If your fiancee feels she's healthy and there's no one in her family who was infected by TB, I think getting early medical is just a waste of money.

Her neighbor had TB when she was a child, and she went near him. As far as she remembers, she never had symptoms of TB, but I thought it would be good for our peace of mind if she checked her lungs ahead of time. Of course it won't be a guarantee that she will pass, but it is a good idea. She has never really had any problems coughing before...

Edited February 27, 2010 by Karen_and_Jay

[osen74 4]

i had flu a week before my medical exam.. i was so worried too about having to take sputum tests if they find any irregularities in my xray.. so i decided to have a chest xray before i went to my med exam just to have peace of mind.. and the results showed my lungs were clear.. i didn't bother to bring my xray film anymore as what i have learned St. Luke's would only honor their own results.. good thing is I passed the medical!.. thank God!

[sjr09 155]

Thanks for the helpful graphic, but I do know about latent TB since I am doing research on it! hehe, thanks!

Latent tuberculosis is where a patient is infected with Mycobacterium tuberculosis, but does not have active tuberculosis disease. Patients with latent tuberculosis are not infectious, and it is not possible to get TB from someone with latent tuberculosis. The main risk is that approximately 10% of these patients will go on to develop active tuberculosis at a later stage of their life.^[1][2] The identification and treatment of people with latent TB is an important part of controlling this disease

Tuberculin conversion Tuberculin conversion is said to occur if a patient who has previously had a negative tuberculin skin test develops a positive tuberculin skin test at a later date. This is strong evidence for significant exposure to TB. The UK recommendation is that the two tests be done at least six weeks apart; the U.S. recommendation is that the two tests can be done as little as one week apart.Interpretation of tuberculin skin tests

According to the U.S. guidelines, latent tuberculosis is diagnosed on a Mantoux test if there is more than 10 (recent immigrant, under age of 4 or have other risk factors for the disease) or 15 mm (no risk factors) of induration. In high risk groups, such as those who are HIV positive, the cut-off is 5 mm on induration. The U.S. guidelines recommend that a history of previous BCG vaccination should be ignored. For details of tuberculin skin test interpretation, please refer to the CDC guidelines (reference given below).

The UK guidelines are formulated according to the Heaf test: In patients who have had BCG previously, latent TB is diagnosed if the Heaf test is grade 3 or 4 and have no signs or symptoms of active TB; if the Heaf test is grade 0 or 1, then the test is repeated and. In patients who have not had BCG previously, latent TB is the Heaf test if grade 2, 3 or 4, and have no signs or symptoms of active TB. Repeat Heaf testing is not done in patients who have had BCG (because of the phenomenon of boosting). For details of tuberculin skin test interpretation, please refer to the BTS guidelines (references given below).

Given that the US recommendation is that prior BCG vaccination be ignored in the interpretation of tuberculin skin tests, false positives are possible as a result of: (1) people who have previously had BCG (even many years ago) may still have a false positive Mantoux test, and (2) serial testing with tuberculin skin tests boosts the immunological response in those people who have previously had BCG, so these people will falsely appear to be tuberculin converters. This may lead to treating more people than necessary, with the possible risk of those patients suffering adverse drug reactions. However, as Bacille Calmette-Guérin vaccine is not 100% effective, and is less protective in adults than pediatric patients, not treating these patients could lead to a possible infection. The current US policy seems to a reflect a desire to err on the side of safety (of the general public).

The U.S. guidelines also allow for tuberculin skin testing in immunosuppressed patients (those with HIV, or who are on immunosuppressive drugs), whereas the UK guidelines recommend that tuberculin skin tests should not be used for such patients because it is unreliable.

γ-interferon testing

The role of gamma interferon tests is under going constant review and various guidelines have been published with the option for revision as new data comes to hand.CDC:MMWR Health Protection Agency:UK

There are currently (26 March 2009) three commercially available interferon-γ release assays (IGRAs): QuantiFERON-TB Gold, QuantiFERON-TB Gold In-Tube and T-SPOT.TB. These tests are not affected by prior BCG vaccination, and look for the body's response to specific TB antigens not present in other forms of mycobacteria and BCG (ESAT-6). Whilst these tests are new they are now becoming available globally.

CDC:

Edited February 27, 2010 by sjr09

[~happyndinlove~ 540]

I was thinking of having my fiancee get a chest X-ray before the St. Luke's medical exam to find out if she will need a sputum test. I am 99% positive she doesn't have active TB now, but a neighbor in her village died from TB when she was a kid. She doesn't remember having a TB infection, but I can't rule out the possibility that she has latent TB or that something will show up on her chest X-ray that requires a sputum test. And I heard that the St. Luke's clinic is particularly strict with any abnormal speck or dot that shows up on a chest X-ray. So do you think an early X-ray is a good idea or not?

I want to go with her to the St. Luke's medical exam, but I can't stay in the Philippines long enough to wait for a sputum test or TB treatment if either is necessary. And I really don't want to have to leave the Philippines without her!

Can anyone just walk into a doctor's office or hospital and request a chest X-ray? Has anyone here does that before? If so, do you have any idea about the best place (hospital, clinic, doctor's office) to go and how much it will cost?

Thanks in advance for your help!

St. Luke's does not honor any medical results from a different clinic. However, it is a good idea to have your fiancee do the chest x-ray prior to the medical. Be sure to speak with the radiologist though, this way you'll know if her St. Luke's medical will have no problem. This will also help your plan on coming to the Philippines to pick her up. My visa interview was scheduled July 7th. My husband came over June 24th for the medical, interview and fly to the US with me. But the entire plan was completely changed caused St. Luke's. Prior to that, I had 2 clear chest x-rays but St. Luke's did still find something suspesious on mine and we had no choice but to follow the "3-day sputum 2 month culture test" rule. Having a pre-medical from a different clinic wouldn't do anything really other than you know what to expect when it's time to do the dreaded medical at a very strict tight clinic in Manila, St. Luke's.

Good luck!

[Tahoma 2,291]

I was thinking of having my fiancee get a chest X-ray before the St. Luke's medical exam to find out if she will need a sputum test. I am 99% positive she doesn't have active TB now, but a neighbor in her village died from TB when she was a kid. She doesn't remember having a TB infection, but I can't rule out the possibility that she has latent TB or that something will show up on her chest X-ray that requires a sputum test. And I heard that the St. Luke's clinic is particularly strict with any abnormal speck or dot that shows up on a chest X-ray. So do you think an early X-ray is a good idea or not?

My wife had an early x-ray. We thought it would be a good idea because it gave us some peace of mind. Also, it's easy to get an x-ray...just walk into the clinic and pay the 250-300 Php.

However, keep in mind that the early x-ray she gets is going to be taken by an x-ray machine which is not nearly as hi-tech as the one at St. Lukes Extension Clinic. The one at St. Lukes produces a higher resolution x-ray than the average x-ray machine. That means the St. Lukes machine will likely catch spots on the lungs that other machines may miss.

My wife is a Registered Nurse who has seen perhaps a dozen different x-ray machines at hospitals and clinics around the Philippines. She said that the one at St. Lukes is very modern and hi-tech.

I want to go with her to the St. Luke's medical exam, but I can't stay in the Philippines long enough to wait for a sputum test or TB treatment if either is necessary. And I really don't want to have to leave the Philippines without her!

Chances are very good that she will pass the chest x-ray and have no problems.

Can anyone just walk into a doctor's office or hospital and request a chest X-ray? Has anyone here does that before? If so, do you have any idea about the best place (hospital, clinic, doctor's office) to go and how much it will cost?

Yes, it's easy to get an x-ray. Your fiancée will know where the clinic is located. Maybe she can ask around her barangay for the best clinic.

Thanks in advance for your help!

Walang anuman.

[marklovetina 52]

reading all these posts here, guys i am just wondering... if st. luke's don't honor other x-ray results in other clinic then those people who want to have an advance x-ray i mean if we want to know if we will gonna have any problem in our lungs then we can go to st. luke's to have an x-ray right..? what i mean is that the x-ray that we will gonna bring on the med. is the x-ray too that comes from them... its the x-ray result from them too... i have a friend here in my place she was married to a fil-am there in USA and she had an advance test also about this here in my place and her dr. here is the head on that area, and she is found negative of course but when she got her med. in st. luke's the result of the x-ray she have a scar... ohhh its scary.... so i am just thinking if we want to be safe then lets go directly to st.luke's and have our x-rays there...

i am just only thinking about this guy.. bcoz if its my turn i want to have a check also on my x-ray bcoz i am expose everyday on money at work.... and there was also an employee at our bank before when she got her med. she was delayed too for several months bcoz she needs to deal firsr her test at st.lukes...