Physical exam at St. Lukes, Manila Philippines

[chrism07023 4]

My wife just completed her 2-day physical exam ordeal at St. Lukes only to find out she has a "spot" on her X-ray and someone at the hospital now tells her that they will email the Embassy to cancel our July 1 interview date. She's told she has to go back 3 times next week, all for additional checks and tests (apparently for TB). As we're both obviously very disappointed and somewhat confused as what to do next, I'd be curious to hear from others who ended up in the same situation; how long can we expect the treatment to take if she's diagnosed with TB? Does the interview get scheduled during treatment or after treatment is verified completed? I never realized TB is such a deal breaker if that is what she has. I recall an American doctor in the Philippines telling me he thought the majority of Filipinos would test positive for TB antibodies. My wife has never been sick, never had even a cough... thanks, Chris

[Jay & Cici 3]

I am sorry to hear about your wife's medical result. She has to know what type she was diagnosed for. I believe there are may types of this disease but there are 2 classification very known. 1) TB active disease - you have the germs and its growing. 2) LATENT TB - you have the germs but its inactive, asymptomatic and can not be spread to people. MY daughter got her TB skin test positive with 11 mm size. Bad thing way in that clinic, they never told us of what she has. Kids dont undergo x-ray just the skin test. Since they found she got positive, they ask us for an xray to verify but still no words from them. They made us come back for like 3-4 times that week. Because of being blind of whats really happening, i did some readings and i think the one my daughter has is the latent because they still let us fly. With regards to the terms of medications, some says it depends on how your body react, some got treated for like 2 weeks or 2 months instead of 6 months having the active one. Some research says that Filipinos are usually get a positive TB Skin test because of the vaccine BCG, it is the short name for the "bacilli calmette-guerin" vaccine which is given to try to prevent TB disease. In the Philippines where TB is common, they want new born to receive that vaccine which is MAY alter the result of tb skin test.

[DanTes 21]

My wife just completed her 2-day physical exam ordeal at St. Lukes only to find out she has a "spot" on her X-ray and someone at the hospital now tells her that they will email the Embassy to cancel our July 1 interview date. She's told she has to go back 3 times next week, all for additional checks and tests (apparently for TB). As we're both obviously very disappointed and somewhat confused as what to do next, I'd be curious to hear from others who ended up in the same situation; how long can we expect the treatment to take if she's diagnosed with TB? Does the interview get scheduled during treatment or after treatment is verified completed? I never realized TB is such a deal breaker if that is what she has. I recall an American doctor in the Philippines telling me he thought the majority of Filipinos would test positive for TB antibodies. My wife has never been sick, never had even a cough... thanks, Chris

As you can see from my timeline, my wife had to undergo the 3 day sputum smear test, and then wait for 2 months for the sputum culture results. It is definitely the most nerve wracking experience we had with the whole immigration process. IF she had been positive on the 2 month culture she would have had to undergo DOT (directly observed therepy) at St. Luke's. This would entail moving to Manila so she could go to St.Luke's daily to take the TB medication for 6 months. Luckily, her 3 smears and the 2 month culture were negative. We did the medical as soon as I knew her NVC case number, so the 2 month culture was finished before her interview. Even at that, we were cutting it real close. She got her results on the 10th and went to the interview on the 11th. Stay positive and PRAY. Everything will work out for you in the long run. My wife received her 10 year green card in the mail yesterday. Thank God we are finished with immigration until 2014 when she can apply for U.S. Citizenship.

[chrism07023 4]

Thanks Jay and Dan, that is very useful information and I'm kicking myself for not getting the medical immediately after the NVC number was available, that seems so obvious in retrospect but I had no reason to think my wife would have a problem; of course, I think even if we had done the medical day 1 after the NVC # was emailed, that would have put us just past the July 1st interview.

So frustrating.. to help calm us down and make us feel better, we just did our own skin test at a local clinic while we wait for next week's 3-day testing back at St Lukes. We should know in a couple days the results. I'm guessing it won't be conclusive but a negative would be great to hear.

I underestimated TB and feel wholly ignorant of it now that I see it is such a "big deal"....as an American, TB is something from the history books and only spoken of in the context of immunity disorders, homeless and elderly. I never knew it was so hard to treat.

[Markieboy 104]

My wife just completed her 2-day physical exam ordeal at St. Lukes only to find out she has a "spot" on her X-ray and someone at the hospital now tells her that they will email the Embassy to cancel our July 1 interview date. She's told she has to go back 3 times next week, all for additional checks and tests (apparently for TB). As we're both obviously very disappointed and somewhat confused as what to do next, I'd be curious to hear from others who ended up in the same situation; how long can we expect the treatment to take if she's diagnosed with TB? Does the interview get scheduled during treatment or after treatment is verified completed? I never realized TB is such a deal breaker if that is what she has. I recall an American doctor in the Philippines telling me he thought the majority of Filipinos would test positive for TB antibodies. My wife has never been sick, never had even a cough... thanks, Chris

I'm really sorry to hear your wife's med results. I can only imagine how disappointing that must be.

Yes, majority of Filipinos are TB-positive when given a skin screening test (Mantoux test). This is due to the BCG vaccine that is given to Filipino newborns. However, this is not 100% diagnostic of TB. Culture is the gold standard of diagnosing TB. For this reason, your wife will need to submit sputum for the culture.

Wish you all the best during this process! Good luck and Godspeed!

BTW, you may want to have this moved to the Philippines regional sub-forum.

Edited June 22, 2011 by Markieboy

[PhilAmTx 14]

My wife just completed her 2-day physical exam ordeal at St. Lukes only to find out she has a "spot" on her X-ray and someone at the hospital now tells her that they will email the Embassy to cancel our July 1 interview date. She's told she has to go back 3 times next week, all for additional checks and tests (apparently for TB). As we're both obviously very disappointed and somewhat confused as what to do next, I'd be curious to hear from others who ended up in the same situation; how long can we expect the treatment to take if she's diagnosed with TB? Does the interview get scheduled during treatment or after treatment is verified completed? I never realized TB is such a deal breaker if that is what she has. I recall an American doctor in the Philippines telling me he thought the majority of Filipinos would test positive for TB antibodies. My wife has never been sick, never had even a cough... thanks, Chris

hi your wife and i have the same date of medical.. i just had my 1st day med yesterday and just got my result today..and sad to say too,i have to go back next week on 28th for sputum test.. this is very depressing moment for me.. il be glad to have a talk with your wife... il be leaving in manila on friday,i have k2 and i have to fly back home for my son and back here on monday... may i know where is you wife from in Philippines? thanks

[TeddyHoney 42]

Sorry to hear about the sputum tests and culture. I feel ya! 8 weeks is really not that long to wait considering what is at stake - your fiancee's health and her visa. Even if she has no symptoms there could be something there that could spring up someday and cause serious problems and this is one way it may be nipped in the bud. More than likely, if she has had no symptoms, then she has probably just been exposed to PTB like most Filipinos and her body's immune system has already protected her from it growing and no cultures will grow. This we will pray for.

God bless you both is this....

Yes when we find out during the medical that we or our fiance(e) needs to undergo 3 day sputum then culture test and wait 8 weeks, we feel (or at least I did) that everyone that knows they will apply for VISA should see a pulmonologist as soon as possible and schedule a chest x-ray and medical exam with focus on PTB before they even file - if possible. If there is any suspicion or PTB or exposure to it then ask pulmonologist if treatment should be started. And if pulmonologist suggests, then start the treatment. I mean doing this as soon as you know you will file for K-1 visa or any other visa that requires the medical exam. I would guess they all do and this also if you are in the Phils or petitioning for someone there or any country that still has not eradicated the disease.

But I'm not sure this would help much. I don't see this being offered as advice - to get pulmo eval and CXR so far in advance and begin treatment asap if needed. I have read here on VJ even that some have done this and received mixed responses from local physicians about x-rays some saying they are clear only to have SLEC find something. Some say they had treatment already and SLEC won't accept their previous treatent documents and make them start over the treatment. I have heard so many different accounts, it seems there is no way for one to find out if they have or not have PTB except for sputum culture which, again from what I have read here and other places, local physicians or those in clinics and hospitals other than SLEC are reluctant to give especially if they know you are going to or already applied for visa (in the Phils anyway).

I wonder now how others feel. Do you feel there would be any advantage to beneficiaries of visa petitioners, once they know for sure they will file for visa, to get pulmonary evaluation and chest x-ray looking specifically for signs of PTB and to start treatment ASAP under doctors orders in effort to have completed the treatment before their medical at SLEC so that worst case you will only have sputum culture test and wait the 2 months - cuz even if you have been treated there can still be scars or marks or something on lungs and you will still have to do sputum culture and wait 2 months? I don't know. It seems that if there were real value to this and consistant outcomes then this type of advice would be offered often and I don;t see that.

We see this so many times that people don't find out there is some suspicious thing on their lung until the medical exam at SLEC. What should beneficiaries do as early as possible with regards to the medical exam and PTB specifically when they know they will be applying for visa?

Just wondering what others think about this.

[chrism07023 4]

Thanks everyone for the information and outpouring of friendly words of hope. Really appreciate it; what a wonderful site this is. I wish I knew about it when my wife and I started our "journey" 2 years ago+.

Acrossthemiles - my wife would love to talk to you, I'm sure. please PM me your contact details. God bless and take care.

[calibob 73]

Hang in there, the hard part is over.....we're another member of the sputum club...

Bob

[medic75 0]

After reading this I saw some familiar things I heard from my mother-in-law when she got back from St. Lukes this last monday June 20. SHe also had a small spot on her lung and has to return for three days then get results in two months. The sputum test is one of the least accurate for TB. They only use it so that they can get more money from people they believe are rich. In the US we use a Purified Protein Derivative (PPD) test. If that is positive which yes for most Filipinos it is from the BCG they receive when younger. So they get a chest x-ray and see if it is clear or not. It is easy for a "trained" person to do all of this. Now due to lack of these personnel in this medical extension numerous people have a once in a lifetime chance slowed or revoked. I urge you all to contact the US Embassy Manila and have them investigate. From the start it is not right to have only one clinic authorized in an entire country for medical clearance. I am currently undergoing talks with the embassy to get to the bottom of this.Good luck all.This website below is just one many explaining the TB and the various ways to uncover it.

http://www.tbdots.com/site/en/doctor_section_tb_diagnosis.html#2

[chrism07023 4]

After reading this I saw some familiar things I heard from my mother-in-law when she got back from St. Lukes this last monday June 20. SHe also had a small spot on her lung and has to return for three days then get results in two months. The sputum test is one of the least accurate for TB. They only use it so that they can get more money from people they believe are rich. In the US we use a Purified Protein Derivative (PPD) test. If that is positive which yes for most Filipinos it is from the BCG they receive when younger. So they get a chest x-ray and see if it is clear or not. It is easy for a "trained" person to do all of this. Now due to lack of these personnel in this medical extension numerous people have a once in a lifetime chance slowed or revoked. I urge you all to contact the US Embassy Manila and have them investigate. From the start it is not right to have only one clinic authorized in an entire country for medical clearance. I am currently undergoing talks with the embassy to get to the bottom of this.Good luck all.This website below is just one many explaining the TB and the various ways to uncover it.

http://www.tbdots.com/site/en/doctor_section_tb_diagnosis.html#2

This is interesting and I've considered this in other instances where we've done business with local clinics (and businesses in general) - god knows the problem of unethical and corrupt business and government practices in Phils is notorious the world over - but I would have hoped St. Lukes was above that given their reputation and general good standing (and their being selected by the US Embassy and others as the clinic of choice). I'm told the $215 is a package deal inclusive of the sputum and other tests to follow next week, is that not the case? Are these extra? I know the slec.ph site did say extra x-rays are not included but thats it. If they hit us up for extra fees next week, i think you have a really good point here.

[TeddyHoney 42]

This is interesting and I've considered this in other instances where we've done business with local clinics (and businesses in general) - god knows the problem of unethical and corrupt business and government practices in Phils is notorious the world over - but I would have hoped St. Lukes was above that given their reputation and general good standing (and their being selected by the US Embassy and others as the clinic of choice). I'm told the $215 is a package deal inclusive of the sputum and other tests to follow next week, is that not the case? Are these extra? I know the slec.ph site did say extra x-rays are not included but thats it. If they hit us up for extra fees next week, i think you have a really good point here.

Yeah seems to me that they would make more money by charging the fee and NOT forcing people to do the 3 day sputum and then cutlure test and also the treatment if needed is also included (6-9 DOT). My fiancee is taking medication there now and she does not pay for it. The only thing she pays for is transportation to and from and her breakfast and lunch depending on how long she stays. They do a weigh-in on Tuesdays so she stays longer. They also do sputum test and x-rays during the treatment that are also no extras charge.

So how does SLEC make money by forcing people to go thru 3 day sputum, sputum culturea dn even 6-9 month treatment if neccessary? Seems a lot to cover in the cost of the medical exam.

[PhilAmTx 14]

Yeah seems to me that they would make more money by charging the fee and NOT forcing people to do the 3 day sputum and then cutlure test and also the treatment if needed is also included (6-9 DOT). My fiancee is taking medication there now and she does not pay for it. The only thing she pays for is transportation to and from and her breakfast and lunch depending on how long she stays. They do a weigh-in on Tuesdays so she stays longer. They also do sputum test and x-rays during the treatment that are also no extras charge.

So how does SLEC make money by forcing people to go thru 3 day sputum, sputum culturea dn even 6-9 month treatment if neccessary? Seems a lot to cover in the cost of the medical exam.

hi just wonder when she knew she is positive and start the medication?right after the smear or after the culture test? i had my sputum last week and i'm mentally tortured..