positive TB test

[chinalover 0]

she's still taking them as we speak. we just want to find a way to get her here to the US asap, and if it can be shorten the better.

[Moonandstar 6]

she's still taking them as we speak. we just want to find a way to get her here to the US asap, and if it can be shorten the better.

Oh, well trust me, dont let her getting to the US of A ASAP be a factor in you two's decision. Her life is more important, wouldn't you agree?

I think you two should make this decision purely from a medical standpoint, and only consider which course of action is best for her health.

Besides, if the doctors dont agree with you two, there still is no way to shorten the wait.

Edited July 22, 2010 by Moonandstar

[chinalover 0]

the doctors agree that it's gone, BUT said it's mandatory that she finishes the 6 months as per US rules, that's why i'm here seeking advise because this is not only what we want ourselfs, but also with the Doctors blessings.

Oh, well trust me, dont let her getting to the US of A ASAP be a factor in you two's decision. Her life is more important, wouldn't you agree?

I think you two should make this decision purely from a medical standpoint, and only consider which course of action is best for her health.

Besides, if the doctors dont agree with you two, there still is no way to shorten the wait.

[Moonandstar 6]

the doctors agree that it's gone, BUT said it's mandatory that she finishes the 6 months as per US rules, that's why i'm here seeking advise because this is not only what we want ourselfs, but also with the Doctors blessings.

Oh, well that really sucks.

Yea, you can be sure the US laws ain't lookin out for ya. Much more so than the doctors.

Unfortunately, if noting else this translates into an automatic 6 month wait. I would stay on good terms with the doctors, and not continue the medicine behind-the-scenes if I were SURE that the TB was gone. For good.

In the mean time, if you get bored during the 6 months, you call always call the consulate every other day and bug them about it. Who knows, maybe a supervisor would be willing to listen.

Edited July 22, 2010 by Moonandstar

[Kikay K 1]

Hi! I've completed my TB treatment in 2008. I was completely asymptomatic -- no coughs, no fever, I was sputum negative -- except for a small finding in my lung. Nevertheless, I still underwent treatment. I understand how you feel. I had been in denial during the first few months of the finding (which is normal in illness), but I eventually accepted the fact that I had to undergo treatment. Before I started with the meds, I had been bargaining, just as you are now, for a shorter duration of treatment, especially since some books and some doctors mentioned this, and because I was asymptomatic. However, in reality, TB, whether active or inactive, is usually treated for 6-9 months. There is no way to make a shortcut, especially if your fiancee will be crossing borders and needing medical clearance. USA is very strict about communicable diseases, so there is no way that you can get away with the complete course of treatment. In your country, people who do not have any x-ray findings but have a positive skin-test would undergo 6-9 months of prophylactic therapy with Isoniazid. How much more if the x-ray already reveals something? All the more that there is a need for complete treatment. (By the way, I am in the medical profession.)

As for her kidney problem, I don't know its extent, but you are correct that anti-TB drugs can be toxic to the kidneys, but if she is young and strong, and if she undergoes regular kidney (and liver) check-ups, she'll be fine. It'll be ok. Even pregnant women can continue taking anti-TB drugs (except for streptomycin) without harming the fetus. Encourage your fiancee to complete the treatment without fail, she has to be compliant everyday, because it will show in her records. If she is not compliant or if she does not complete the recommended duration of treatment, she will be at more risk for relapse and having drug-resistant TB, which is one of the worst that could happen with faulty compliance.

[Moonandstar 6]

Hi! I've completed my TB treatment in 2008. I was completely asymptomatic -- no coughs, no fever, I was sputum negative -- except for a small finding in my lung. Nevertheless, I still underwent treatment. I understand how you feel. I had been in denial during the first few months of the finding (which is normal in illness), but I eventually accepted the fact that I had to undergo treatment. Before I started with the meds, I had been bargaining, just as you are now, for a shorter duration of treatment, especially since some books and some doctors mentioned this, and because I was asymptomatic. However, in reality, TB, whether active or inactive, is usually treated for 6-9 months. There is no way to make a shortcut, especially if your fiancee will be crossing borders and needing medical clearance. USA is very strict about communicable diseases, so there is no way that you can get away with the complete course of treatment. In your country, people who do not have any x-ray findings but have a positive skin-test would undergo 6-9 months of prophylactic therapy with Isoniazid. How much more if the x-ray already reveals something? All the more that there is a need for complete treatment. (By the way, I am in the medical profession.)

As for her kidney problem, I don't know its extent, but you are correct that anti-TB drugs can be toxic to the kidneys, but if she is young and strong, and if she undergoes regular kidney (and liver) check-ups, she'll be fine. It'll be ok. Even pregnant women can continue taking anti-TB drugs (except for streptomycin) without harming the fetus. Encourage your fiancee to complete the treatment without fail, she has to be compliant everyday, because it will show in her records. If she is not compliant or if she does not complete the recommended duration of treatment, she will be at more risk for relapse and having drug-resistant TB, which is one of the worst that could happen with faulty compliance.

^

Pretty sound advice. I'm no expert on how harmful the treatment is to kidneys.

[JimVaPhuong 4,863]

The panel physician has to follow the 2007 CDC guidelines, but they do have some discretion. If the sputum smears are positive but the cultures are negative then they can choose whether or not to continue treatment. If the cultures are positive they don't really have any choice - they have to treat it or they can't clear the applicant to travel to the US.

If you're interested in reading the latest CDC guidelines for panel physicians regarding TB screening and treatment:

http://www.cdc.gov/immigrantrefugeehealth/pdf/tuberculosis-ti-2009.pdf

[chinalover 0]

thanks Jim, you have alot of insight. thanks so much for chiming in. YES that is exactly what happened. she did the meds for 3 months already and it's taking a toll on her, that's why since the recent monthly cultures are negatives, i don't get why they won't shorten it.

If the sputum smears are positive but the cultures are negative

The panel physician has to follow the 2007 CDC guidelines, but they do have some discretion. If the sputum smears are positive but the cultures are negative then they can choose whether or not to continue treatment. If the cultures are positive they don't really have any choice - they have to treat it or they can't clear the applicant to travel to the US.

If you're interested in reading the latest CDC guidelines for panel physicians regarding TB screening and treatment:

http://www.cdc.gov/immigrantrefugeehealth/pdf/tuberculosis-ti-2009.pdf

[cris and tina 1]

Yea dude just tell her to dump the pills, tell the doctor she took it.

#### that, it's the doctors in this case that are bad for her, if that TB really is fine.

Its her body, not theirs.

he cannot do this...he cannot just stop taking the pills cz tuberculosis is a serious communicable disease but it is very much curable if the treatment is continuous and religiously.If the doctors said that he still need to continue the meds for 6 months he should follow it for faster recovery,and healing.Cz the causative agent of TB becomes immune with the antibiotics if the meds does not taken regularly or as prescribed by the MDs....eventho its gone already there are instances it comes back and when it does its much harder to cure....so stick with the meds as long as it is prescribed.

[JD63 4]

As a health professional, I would strongly encourage you to take the medication. TB is notorious for evading diagnostic tests.

[JimVaPhuong 4,863]

thanks Jim, you have alot of insight. thanks so much for chiming in. YES that is exactly what happened. she did the meds for 3 months already and it's taking a toll on her, that's why since the recent monthly cultures are negatives, i don't get why they won't shorten it.

If the sputum smears are positive but the cultures are negative

I've only read briefly about the protocol for treatment. I don't know if they do cultures monthly. I do know that a culture can take a long time to grow. It can show positive signs of the bacteria within weeks, but it takes two full months before they can conclude it's negative. The scenario where the smears are positive but the cultures are negative would generally mean they see bacteria on the slide, but it either doesn't grow in the culture (it's inactive) or it's a bacteria other than TB. In that case, the panel physician uses their "clinical judgment" to decide whether or not to continue treatment.

There is always a serious risk when you stop a treatment program involving antibiotics. The early stages of treatment usually kill off the weaker strains of the bacteria. If you stop treatment at that stage then you leave the more virulent strains of the bacteria to flourish. Having survived the initial treatment, the new infection is often much more difficult to treat because it develops a resistance to the drugs, which means the physician has to use more potent drugs with potentially more harmful side effects to treat it.

If you decide to stop treatment then the panel physician is not going to clear your fiancee to travel to the US. She will be classified inadmissible. The upside is that the drugs will no longer be doing potential damage to her organs. The downside is that the infection could return with a vengeance, and could require longer treatment with stronger drugs. However, if you are really convinced that the drugs are doing damage to her kidneys then you should consult with a physician who has experience with TB. You need qualified advice from someone who understands the risk and can help you make a decision. Just understand that if you pull the plug on treatment then she's not coming to the US.

[doug and leann 0]

Dude, you should be happy of the current result that sputum tests are negative. Did you know that TB is an infectious disease and caused by a strain of bacteria? Hence, the series of antibiotics she needs to take for months to prevent the bacteria from developing antibiotic resistance. If she stops taking the meds now (after 3 months of taking them), the bacteria could become drug resistant and it would be harder to treat it. As you said, it is mandatory to finish the medication to completely get rid of the bacteria. Please research about Tuberculosis before you make any decisions. It's your wife's life that's on the line. Plus, the US is very strict about infectious diseases like TB. If she stops medication right now, it might come back to haunt her. When she gets here, she will be required to get checked for TB.

[Dan J 277]

Cutting short TB treatments is the primary reason why drug resistant strains have developed. TB can still return even if the person shows no symptoms for a period of time, and if it returns its likely to be more resistant to common treatments. Making the problem much more dangerous.

[Terry Martin 1]

How damaging is the medicine to the liver vs the risk of not taking it? Six months is surely a long time, but TB is nothing to mess with.

[Robert B 1]

As a nurse I would strongly advice you (her) to not stop taking it. I believe a lot of medications are over-prescribed and overused, but not in the case of TB. I don't know what your health insurance situation is, but trust me, treating this in China is relatively cheap. If she were to come here and infect you on top of it, and you don't have good health insurance you'll be wishing you had waited. I know it sucks having to wait, but in the long run it is worth it.