Filipina Fiancee just got positive TB skin test results

[TeddyHoney 42]

I posted before that my Filipina Fiancee may have TB, I didn;t know whether to add to that thread or post knew because things are progressing. I decided to post new here. My fiancee was having cough and cold for a few weeks and it got bad and she went to a clinic and got chest x-ray. They could not determine if she had pneumonia or TB. They gave her a skin test and antibiotics for the pneumonia. She just got the results of the skin test today and they are positive. They started her on a 2 month treatment regime for the TB. She will start the 3 day Sputum on Monday and then have the cultures started. We know its 2 months for the cultures to grow and all that. I have several questions and really don't know where to begin:

First off we are October 2010 K-1 I-129F filers and have not recieved NOA2 yet - not due til this or next month maybe, so this clinic is not St. Luke's.

Should she start this 2 month treatment regime with this clinic and start her Sputum with them? I mean if at her K-1 medical exam St. Luke's does not honor any x-rays or test results from any other facility, then is this a waste of time to go thru this with this local clinic? I guess I'm asking if she should or should not begin this regime with this clinic and what will it do for her (or not do for her) when her time for her K-1 medical exam comes? I'm sure that's at least 2 months off. Okay, so let's say she goes ahead with this other clinic's 2 months treatment and Sputum and all that. Her cultures show negative but she shows spot on her lungs. The local clinic will continue the treatment fo rthe next 4 months for maitenance of the latent TB. What would happen at the K-1 medical exam? They see abnormal on her x-ray. Will they have her do Sputum again even she have her treatnebt record from local clinic?

So I guess back to main question of should she start this local clinic treatment and Sputum and culture test or is it waste of time as far as her K-1 medical exam will be concerned? She lives near Manila already and could easily go to St. Lukes everyday to take the treatment drugs there.

What should she do at this point, now, today (or Monday) in the best interest of her health first and her K-1 medical exam second?

Sorry this kinda all over the place but I'm waaaaayyyyy outta my league here - and all this going on there and me being here does not help at all!

Thanks in advance for any advice or experience sharing!

[Anh map 2,098]

A bit off topic: Once she starts the meds she needs to complete the entire process. Stopping midstream can have serious consequences. She could develop a drug resistant strain of TB and that is tough to fight.

Worst case scenario is what happened to my 2 brothers in law who were diagnosed, began the meds, stopped, and are now both deceased at 25 years old.

[Al422 221]

This is a serous medical condition that could claim her life if not correctly treated. She needs to make proper medical treatment her first priority and passing of the medical exam as a secondary one.

[TeddyHoney 42]

This is a serous medical condition that could claim her life if not correctly treated. She needs to make proper medical treatment her first priority and passing of the medical exam as a secondary one.

Yeah I thought I was asking in my question about what she/we should do with respect to her health first and K-1 medical exam second. If I didn;t I should have,

A bit off topic: Once she starts the meds she needs to complete the entire process. Stopping midstream can have serious consequences. She could develop a drug resistant strain of TB and that is tough to fight.

Worst case scenario is what happened to my 2 brothers in law who were diagnosed, began the meds, stopped, and are now both deceased at 25 years old.

That's what I am asking, should she start this 2 month regime or not start it and wait the K-1 medical exam and just do what they tell her? I'm sorry my OP wasn;t clear on that.

[TeddyHoney 42]

Maybe these meds this local clinic want her to start for these 2 months is just the first 2 months of six months treatment cuz she did say there was 4 month maintenance after these two months. So question is should she start this now or wait for her K-1 medical exam and do whatever they tell her then and there based on what they see, or what advantage is her starting this regime now? I am concerned first for her health and I can wait as long as it takes. Hell she waited for me for 2 years thru a nasty divorce and complicated kidney transplant among other things I can surely wait until she is free from a fatal disease. I'm just asking, based on the current situation what she/we should do with regards to her starting a drug regime now via local clinic versus waiting for her K-1 medical? Seems to me starting a regime as soon as possible is best for her health and then whatever the K-1 medical exam finds, they find and they instract from there with knowledge of her medical history. I would like to get pros/cons of her starting this rigime tomorrow with regards to her health first and and the affects if any starting this regime now may have on her K-1 medical exam whenever it is and at this pace being October 2010 filers at CSC that's probably at a minimum 2 months off from NOA2 whenever it comes.

[Tahoma 2,292]

My fiancee was having cough and cold for a few weeks and it got bad and she went to a clinic and got chest x-ray. They could not determine if she had pneumonia or TB. They gave her a skin test and antibiotics for the pneumonia. She just got the results of the skin test today and they are positive.

The skin test is not a good way to diagnose a Filipino for TB. Many Filipinos will show a false positive to the skin test. An eight-week sputum culture is a very good way to find out whether she has TB. St. Lukes will perform three smear tests and an eight-week sputum culture in order to find out if she has TB. There is also a blood test that will diagnose TB very accurately. I don't know if the blood test is available in the Philippines.

They started her on a 2 month treatment regime for the TB. She will start the 3 day Sputum on Monday and then have the cultures started. We know its 2 months for the cultures to grow and all that.

Why would they start her on the TB treatment before finding out the results of her eight-week sputum culture? I don't understand this. It makes no sense to me.

Should she start this 2 month treatment regime with this clinic and start her Sputum with them? I mean if at her K-1 medical exam St. Luke's does not honor any x-rays or test results from any other facility, then is this a waste of time to go thru this with this local clinic? I guess I'm asking if she should or should not begin this regime with this clinic and what will it do for her (or not do for her) when her time for her K-1 medical exam comes? I'm sure that's at least 2 months off. Okay, so let's say she goes ahead with this other clinic's 2 months treatment and Sputum and all that. Her cultures show negative but she shows spot on her lungs. The local clinic will continue the treatment fo rthe next 4 months for maitenance of the latent TB. What would happen at the K-1 medical exam? They see abnormal on her x-ray. Will they have her do Sputum again even she have her treatnebt record from local clinic?

I would get a second opinion. I can't imagine starting a six-month TB treatment before obtaining an accurate diagnosis. There is no way a skin test is going to accurately diagnose TB.

So I guess back to main question of should she start this local clinic treatment and Sputum and culture test or is it waste of time as far as her K-1 medical exam will be concerned? She lives near Manila already and could easily go to St. Lukes everyday to take the treatment drugs there.

What should she do at this point, now, today (or Monday) in the best interest of her health first and her K-1 medical exam second?

If I were in her shoes, I would complete the full course of antibiotics. Then, I would go to a top-notch clinic or hospital. I would have another chest x-ray. If the x-ray showed any abnormality, I would get a TB smear test, and a eight-week sputum culture done in order to determine if I had TB.

Sorry this kinda all over the place but I'm waaaaayyyyy outta my league here - and all this going on there and me being here does not help at all!

Thanks in advance for any advice or experience sharing!

[JimVaPhuong 4,863]

Maybe these meds this local clinic want her to start for these 2 months is just the first 2 months of six months treatment cuz she did say there was 4 month maintenance after these two months. So question is should she start this now or wait for her K-1 medical exam and do whatever they tell her then and there based on what they see, or what advantage is her starting this regime now? I am concerned first for her health and I can wait as long as it takes. Hell she waited for me for 2 years thru a nasty divorce and complicated kidney transplant among other things I can surely wait until she is free from a fatal disease. I'm just asking, based on the current situation what she/we should do with regards to her starting a drug regime now via local clinic versus waiting for her K-1 medical? Seems to me starting a regime as soon as possible is best for her health and then whatever the K-1 medical exam finds, they find and they instract from there with knowledge of her medical history. I would like to get pros/cons of her starting this rigime tomorrow with regards to her health first and and the affects if any starting this regime now may have on her K-1 medical exam whenever it is and at this pace being October 2010 filers at CSC that's probably at a minimum 2 months off from NOA2 whenever it comes.

They start the treatment for two months on the presumption that she has TB, based on the test results so far. The results of the sputum culture will either confirm or deny that presumption. If it confirms, then she continues treatment for a further four months. If the sputum culture is negative then she can stop taking the antibiotics.

There is no earthly reason to postpone treatment. TB is serious and often deadly. The longer you wait to treat it, the higher the chances that the treatment will fail. The visa is secondary to your fiancee's life. Do the right thing.

As Tahoma has indicated, TB skins tests are not reliable in that part of the world. The skin test only checks for the presence of antibodies, and a large portion of the population there has been exposed to the bacteria that causes TB. In your fiancee's case, they did a chest x-ray first and that obviously showed something to be concerned about. That, combined with the positive skin test, is a sufficient reason for concern. The doctors are right to proceed under the assumption that she's infected with TB.

[KYLEandUAN 1]

Wait for the sputum test result before undergoing TB treatment. If its positive, then there's a need to start the medication right away. Then when you're I-129f is approved (NOA2) maybe its best to coordinate with st. luke's on what's best to do. To continue with TB treatment then it's up to st. lukes. Probably sh will undergo another x ray and sputum test and culture again.

[TeddyHoney 42]

Thanks for your response and information. I will chat my fiancee later today and I will ask her to find out for sure about the medicines she is to start taking tomorrow. I will ask her to find out for sure if they are for the TB or maybe they are for the pneumonia they think she may have, cuz you're correct that they don;t know yet if she have the active TB so why would they begin treatment for it now. Thank you for raising that questions. This is the kind of stuff I'm looking for. I will post what she finds out.

[TeddyHoney 42]

They start the treatment for two months on the presumption that she has TB, based on the test results so far. The results of the sputum culture will either confirm or deny that presumption. If it confirms, then she continues treatment for a further four months. If the sputum culture is negative then she can stop taking the antibiotics.

There is no earthly reason to postpone treatment. TB is serious and often deadly. The longer you wait to treat it, the higher the chances that the treatment will fail. The visa is secondary to your fiancee's life. Do the right thing.

As Tahoma has indicated, TB skins tests are not reliable in that part of the world. The skin test only checks for the presence of antibodies, and a large portion of the population there has been exposed to the bacteria that causes TB. In your fiancee's case, they did a chest x-ray first and that obviously showed something to be concerned about. That, combined with the positive skin test, is a sufficient reason for concern. The doctors are right to proceed under the assumption that she's infected with TB.

Okay thanks for your response. So then she should go ahead with this current regime then. At the rate we are going her Sputum test results will probably be available before any K-1 medical exam can be scheduled (probably - I'm just guessing for this scenario) so if her Sputum results show positive for the culture groth after two months and then she is scheduled for her K-1 medical exam soon after can she present that results to St. Luke's during the K-1 medical exam and then St' Luke's will have her continue the treatment for the remainder of the six months treatment period under thier supervision? Maybe? Or after this Sputum she will start tomorrow and then wait 2 months for the culture and it show positive then soon after she has scheduled K-1 medical exam and she present the positive sputum they will x-ray her and maybe see something and have her do Sputum again regardless that she did Sputum now and results are positive already?

Just trying to figure out what will happen at her K-1 medical exam after her 2 month Sputum maybe show positive what will St. Luke's do? Any idea?

Or what if the Sutum she takes now comes back negative in 2 months and she present that to St' Luke's? They probably want thier own Sputum right and then we will wait the two months from that point. That would be fine with me.

Thanks again for any thoughts you may have.

[TeddyHoney 42]

Wait for the sputum test result before undergoing TB treatment. If its positive, then there's a need to start the medication right away. Then when you're I-129f is approved (NOA2) maybe its best to coordinate with st. luke's on what's best to do. To continue with TB treatment then it's up to st. lukes. Probably sh will undergo another x ray and sputum test and culture again.

Thanks for your reply and information/advice. All of these are helping me to understand cuz as I said I am way out of my league here. So it seems to me that its good to have her go ahead and start this treatment and then whenever the NOA2 comes it comes and whenever the K-1 medical is then they will do what they do and find what they find and go from there. Okay thanks again.

[ThomKimQC 14]

Yeah I thought I was asking in my question about what she/we should do with respect to her health first and K-1 medical exam second. If I didn;t I should have,

That's what I am asking, should she start this 2 month regime or not start it and wait the K-1 medical exam and just do what they tell her? I'm sorry my OP wasn;t clear on that.

Being in the medical industry I say to you that she needs to start the TB treatment ASAP! At this time the VIsa/medical can wait your fiancee's health is in question now and TB is nothing to take light.

[wizardfitz 13]

First of all, did your fiancee go to a pulmonologist or just a regular doctor?

Positive skin test is not a tb diagnosis. Philippines is prone to tb so most anyone who gets a tb skin test WILL come out positive. Have her go to a pulmonologist!

As far as the treatment, there is no 2 month then 4 month, it needs to be a 6 month treatment period. Best advice I can give you, once she is correctly and properly diagnosed BY a pulmonologist, get the 6 month treatment.

St Luke's will not accept anyone who has not gone through the full treatment and if she only does the 2 month, she will be made to go through the 6 month treatment at St Luke's if they feel it is unacceptable. So save yourself some time and do it right, no shortcuts.

[lakambini 1]

I posted before that my Filipina Fiancee may have TB, I didn;t know whether to add to that thread or post knew because things are progressing. I decided to post new here. My fiancee was having cough and cold for a few weeks and it got bad and she went to a clinic and got chest x-ray. They could not determine if she had pneumonia or TB. They gave her a skin test and antibiotics for the pneumonia. She just got the results of the skin test today and they are positive. They started her on a 2 month treatment regime for the TB. She will start the 3 day Sputum on Monday and then have the cultures started. We know its 2 months for the cultures to grow and all that. I have several questions and really don't know where to begin:

First off we are October 2010 K-1 I-129F filers and have not recieved NOA2 yet - not due til this or next month maybe, so this clinic is not St. Luke's.

Should she start this 2 month treatment regime with this clinic and start her Sputum with them? I mean if at her K-1 medical exam St. Luke's does not honor any x-rays or test results from any other facility, then is this a waste of time to go thru this with this local clinic? I guess I'm asking if she should or should not begin this regime with this clinic and what will it do for her (or not do for her) when her time for her K-1 medical exam comes? I'm sure that's at least 2 months off. Okay, so let's say she goes ahead with this other clinic's 2 months treatment and Sputum and all that. Her cultures show negative but she shows spot on her lungs. The local clinic will continue the treatment fo rthe next 4 months for maitenance of the latent TB. What would happen at the K-1 medical exam? They see abnormal on her x-ray. Will they have her do Sputum again even she have her treatnebt record from local clinic?

So I guess back to main question of should she start this local clinic treatment and Sputum and culture test or is it waste of time as far as her K-1 medical exam will be concerned? She lives near Manila already and could easily go to St. Lukes everyday to take the treatment drugs there.

What should she do at this point, now, today (or Monday) in the best interest of her health first and her K-1 medical exam second?

Sorry this kinda all over the place but I'm waaaaayyyyy outta my league here - and all this going on there and me being here does not help at all!

Thanks in advance for any advice or experience sharing!

Hi,

If your fiancee is really positive and the doctor recommends treatment, then go get her treated (her health is important).

As for her medical exam in st. lukes, they will rely on their own medical findings and will disregard medical exams done outside their clinic.Should they found something, they will start their own treatment; but your fiancee can tell them that she is under treatment.,(if she is)when that time comes.

[TeddyHoney 42]

First of all, did your fiancee go to a pulmonologist or just a regular doctor?

Positive skin test is not a tb diagnosis. Philippines is prone to tb so most anyone who gets a tb skin test WILL come out positive. Have her go to a pulmonologist!

As far as the treatment, there is no 2 month then 4 month, it needs to be a 6 month treatment period. Best advice I can give you, once she is correctly and properly diagnosed BY a pulmonologist, get the 6 month treatment.

St Luke's will not accept anyone who has not gone through the full treatment and if she only does the 2 month, she will be made to go through the 6 month treatment at St Luke's if they feel it is unacceptable. So save yourself some time and do it right, no shortcuts.

I don't think I asked for a short cut for this in my OP. If it seemed that I was asking for that then I apologize for my wording. As far as if she saw a pulmonologist or not I don;t know. She went to a clinic and told them her condition, they examined her, took several x-rays and decided to give her a skin test. The skin test was positive and they have started her on medication. As far as I have read one cannot be properly diagnosed unti the sputum test is complete and that takes two months, so pulmonologist or not she will not be properly diagnosed until the Sputum is completed. I didn't know St. Luke's aceppted or denied VISA applicants based on wether they had full six month treatment or not. I thought they examined anyone who scheduled thier exam with proper case number and what they need to schedule and they they determine things from there. I don;t see any harm in her starting treatment now and then when time for her K-1 medical exam they will either continue her treatment or start her on 6 month treatment based on thier own findings. This is what I have concluded based on these post and other information so this is the path we are taking. Thanks!

Hi,

If your fiancee is really positive and the doctor recommends treatment, then go get her treated (her health is important).

As for her medical exam in st. lukes, they will rely on their own medical findings and will disregard medical exams done outside their clinic.Should they found something, they will start their own treatment; but your fiancee can tell them that she is under treatment.,(if she is)when that time comes.

Yes this is what we have concluded based on responses her and also other information and will take this path. Thanks for your response and information.