Medical Exam

[amdevito 0]

My wife and stepson completed day 1 of the US immigrant visa medical exam. Our son has been taking medication for primary complex for 1 month prior to the exam. However, even without the results of his xray at SLEC, the doctor told my wife that my son will have to undergo treatment everyday at SLEC for 5 months. From what I understand, he must first undergo a SPUTUM test at SLEC which may clear him for travel to USA to receive treatment there, given that children's cases typically are not infectious. Also, there is a chance he will be found to have a normal Xray. Why did the doctor tell my wife he MUST undergo treatment before the SPUTUM test and xray results were found? Thanks. -Tony, her husband

[Cathi 5,696]

• Tuberculosis is difficult to diagnose in children because a lot of the methods used to diagnose the disease, such as chest radiographs, have difficulty distinguishing tuberculosis in a child from other chest and lung infections, such as pneumonia. Testing the sputum coughed up by a child is the most reliable method of diagnosing the disease, but this is complicated by the fact that most children cannot produce the amount of sputum needed for the test. Because of these factors, tuberculosis in children is often diagnosed by identifying the symptoms. Almost 90 percent of the bacteria are killed within the first two weeks of treatment. However, treatment must be continued for six months to kill the remaining 10 percent. If treatment is not continued then there is a high risk of the re-infection.
  Fewer bacteria sit in the lungs of children infected with the disease, making them less infectious, but this does not mean they are not. Because it is so complicated to diagnose children, relying primarily on symptoms. They want to be 100% sure your child is not infectious.
  
  

[amdevito 0]

So based on your reply, if my son has undergone treatment for a month prior to his medical exam (which would result in 90%+ gone), there is a chance his xray will be clear and he wont have to do any of the treatment?

But, if its abnormal, he will have to go through 6 months of treatment IN the philippines, regardless of the result of his SPUTUM test?

Thanks. tony

• Tuberculosis is difficult to diagnose in children because a lot of the methods used to diagnose the disease, such as chest radiographs, have difficulty distinguishing tuberculosis in a child from other chest and lung infections, such as pneumonia. Testing the sputum coughed up by a child is the most reliable method of diagnosing the disease, but this is complicated by the fact that most children cannot produce the amount of sputum needed for the test. Because of these factors, tuberculosis in children is often diagnosed by identifying the symptoms. Almost 90 percent of the bacteria are killed within the first two weeks of treatment. However, treatment must be continued for six months to kill the remaining 10 percent. If treatment is not continued then there is a high risk of the re-infection.
  Fewer bacteria sit in the lungs of children infected with the disease, making them less infectious, but this does not mean they are not. Because it is so complicated to diagnose children, relying primarily on symptoms. They want to be 100% sure your child is not infectious.
  
  

[Cathi 5,696]

Most likely they will not be able to get enough of a sample from the sputum test. And even if there is only a 10% chance of him being infectious, it is still a chance. They will not let him travel to the US until he is done with the full course of treatment.

[Tahoma 2,291]

After he completes treatment, St. Lukes most likely will get sputum samples from him and perform both the smear tests and a TB culture. They will do this because they will want to check and see if he is free of TB. The culture will take eight additional weeks.

[amdevito 0]

Why can't they take sputum sample and culture before he completes his treatment, which will show its inactive due to his age (most likely) and then he can continue his treatment in the US? If they can't receive enough of a sputum from his lungs initially, whats the purpose to wait and attempt the test in 6 months after treatment? And why does he have to physically go to St Luke's every day for treatment for the remaining 5 months of treatment.

After he completes treatment, St. Lukes most likely will get sputum samples from him and perform both the smear tests and a TB culture. They will do this because they will want to check and see if he is free of TB. The culture will take eight additional weeks.

[Hank_ 9,174]

Why can't they take sputum sample and culture before he completes his treatment, which will show its inactive due to his age (most likely) and then he can continue his treatment in the US? If they can't receive enough of a sputum from his lungs initially, whats the purpose to wait and attempt the test in 6 months after treatment? And why does he have to physically go to St Luke's every day for treatment for the remaining 5 months of treatment.

Its the rules! You want the visa you follow the rules...

[amdevito 0]

It would be easier tot fly her to Mexico and have her run the border like the rest of the illegals than do this legally... ugh...

Thanks for the information.

Its the rules! You want the visa you follow the rules...

[Caryh 5,206]

It would be easier tot fly her to Mexico and have her run the border like the rest of the illegals than do this legally... ugh...

Thanks for the information.

Filipinos need a visa to get into Mexico to. Not sure how easy that is either, but I understand the sentiment behind your comment.

[Hank_ 9,174]

It would be easier tot fly her to Mexico and have her run the border like the rest of the illegals than do this legally... ugh...

Thanks for the information.

Jeez!! Hate driving down a road and have a sign "illegals crossing" drive slowly...

[six7one 17]

My wife and stepson completed day 1 of the US immigrant visa medical exam. Our son has been taking medication for primary complex for 1 month prior to the exam. However, even without the results of his xray at SLEC, the doctor told my wife that my son will have to undergo treatment everyday at SLEC for 5 months. From what I understand, he must first undergo a SPUTUM test at SLEC which may clear him for travel to USA to receive treatment there, given that children's cases typically are not infectious. Also, there is a chance he will be found to have a normal Xray. Why did the doctor tell my wife he MUST undergo treatment before the SPUTUM test and xray results were found? Thanks. -Tony, her husband

We are in a similar situation. My Fiancee took two months of medication for suspected TB back in her province. When she had her CXR at St.Luke's they saw the spot and of course gave her the Sputum tests. When she informed SLEC that she had been taking the medication for suspected TB, they informed her that she needed to complete 4 additional months even though her Sputum tests were negative. I didn't understand why until I read the CDC requirements for Immigrants to the US. You can read more at http://www.cdc.gov/immigrantrefugeehealth/pdf/tuberculosis-ti-2009.pdf

Page 14 in the requirements outline "For applicants who present for the medical examination already on tuberculosis treatment begun elsewhere.." Because treatment (the medication) was started somewhere else, my Fiancee's fit this category. I am assuming your step son also falls into this category.

[amdevito 0]

We are in a similar situation. My Fiancee took two months of medication for suspected TB back in her province. When she had her CXR at St.Luke's they saw the spot and of course gave her the Sputum tests. When she informed SLEC that she had been taking the medication for suspected TB, they informed her that she needed to complete 4 additional months even though her Sputum tests were negative. I didn't understand why until I read the CDC requirements for Immigrants to the US. You can read more at http://www.cdc.gov/immigrantrefugeehealth/pdf/tuberculosis-ti-2009.pdf

Page 14 in the requirements outline "For applicants who present for the medical examination already on tuberculosis treatment begun elsewhere.." Because treatment (the medication) was started somewhere else, my Fiancee's fit this category. I am assuming your step son also falls into this category.

Yea, who thought taking initiative would be punished... My wife hasn't submitted a "detailed" medical certificate. I told her to say she can not get one cause the doctor moved to the US to leave the corrupt Philippines. hah! Hopefully, that might void my wife's word he's taking medication. Who knows. Ano biyan.

[six7one 17]

Yea, who thought taking initiative would be punished... My wife hasn't submitted a "detailed" medical certificate. I told her to say she can not get one cause the doctor moved to the US to leave the corrupt Philippines. hah! Hopefully, that might void my wife's word he's taking medication. Who knows. Ano biyan.

My Fiancee is also required to provide certification from her doctor in her province as proof of being being administered the medication. What we have provided so far is not good enough and a more detailed one is required. It's difficult for us to obtain it now that she's in Manila undergoing the DOT but we are still trying. Hopefully, we can get what SLEC requires soon. My fear is that SLEC may require the complete 6 month instead of the 4 she is already required to do if we can't obtain the certification document soon.

If you have the opportunity to select a time slot for DOT, chose the one between 12:00 - 2:00 PM. SLEC is less crowded because it is the lunch hour and going in for the DOT takes all of about 3 minutes. I went with my Fiancee once and it was in and out. It took longer to walk there than it did to get administered the medication and sign her card. She went early once before 9:00 AM and said the que for DOT in the morning slots is MUCH longer.

[Tahoma 2,291]

Why can't they take sputum sample and culture before he completes his treatment, which will show its inactive due to his age (most likely) and then he can continue his treatment in the US? If they can't receive enough of a sputum from his lungs initially, whats the purpose to wait and attempt the test in 6 months after treatment? And why does he have to physically go to St Luke's every day for treatment for the remaining 5 months of treatment.

The child has already been diagnosed with primary complex and has started treatment. The child must physically go to St. Lukes every day for treatment to make sure the treatment regimen is being followed. To be effective, the medicine must be taken daily for the duration of the treatment period. If the treatment is interrupted, the child may develop drug-resistant TB.

How did the child's doctor originally determine that the child had primary complex? What tests were done?

[amdevito 0]

Skin test followed by an xray. We are completing the treatment at St luke's as required. If i would have known the rules, I wouldn't have mentioned anything to SLEC and completed his treatments on our own.