TB - can't treat at St. Lukes?

[mwh710 1]

My best friend has a fiance'e in Manila, when she went for her Medical, they need for her to take sputum test. It came out positive and she has to go to St. Lukes every day for 6 months for a pill, then wait 2 months and get Physical again. She has been going for a month now, the medicine gives her a itchy rash, so she has to stay 1.5 hours and be monitored each day. Today she was asked to wait longer because the DR. wanted to talk to her. The Dr. told her that they could no longer treat her at St. Lukes, that she would have to go to the Lung Center for Injection treatments for 24 months, 6 days a week. Has anyone heard of that? They say that she isn't contagious, so why can't they let her come and get better/faster treatment here. Is there some exemption form that my friend can submit, would a Senator have any weight in a case like this? I feel bad for both of them....

[apple21 953]

First time I've heard of such case. Can't comment much but one thing is for sure, she won't be issued the visa without medical clearance. I don't think a Senator can help because SLEC is only following protocol set by CDC and DOS.

Good luck to them.

[luckytwo15 13]

The USC petitioner should call SLEC and talk to the Pulmonary staff about options, if there are any.

[Al422 221]

I have never heard of TB that cannot be treated at SLEC. Since there was mention of need for 6 day a week treatment, maybe that is why since SLEC is strictly M-F.

Things need to be explained clearly here so they make sense, so I go with have the petitioner call and find out exactly what is going on.

Is there an outside pulmoary doctor you can consult? He cannot do the treatment as he is simply not allowed, but maybe he can educate you on what is happening. We are not doctors and can only guess in areas where he would have specific expertise.

Edited February 9, 2015 by Al422

[Hank_ 9,174]

My best friend has a fiance'e in Manila, when she went for her Medical, they need for her to take sputum test. It came out positive and she has to go to St. Lukes every day for 6 months for a pill, then wait 2 months and get Physical again. She has been going for a month now, the medicine gives her a itchy rash, so she has to stay 1.5 hours and be monitored each day. Today she was asked to wait longer because the DR. wanted to talk to her. The Dr. told her that they could no longer treat her at St. Lukes, that she would have to go to the Lung Center for Injection treatments for 24 months, 6 days a week. Has anyone heard of that? They say that she isn't contagious, so why can't they let her come and get better/faster treatment here. Is there some exemption form that my friend can submit, would a Senator have any weight in a case like this? I feel bad for both of them....

CDC is the controlling factor here, a Senator can't over-ride CDC. It is what it is.

[VOL 425]

I have never heard of TB not being able to be treated at SLEC either

[Hank_ 9,174]

Very possible it is the resistant strain of TB that has become immune to normal meds.

[mwh710 1]

What about I-601? It is a waiver for inadmissability. TB is one of them that can be waived, if there is proof that she will be treated in US and non-contagious. Anyone know anything about this?

[manilaraf 28]

I'm an MD, but not a pulmonologist. I'm guessing that either: 1) she's having a bad reaction to one of the TB meds (I'm guessing Pyrzinamide) and the side effects are outweighing the benefits for treatment and that they're going to have to stop that and start her on Streptomycin (which is given as an IV or intramuscular injection), or 2) as Hank said, it's a resistant strain.

If either of the above, it's not treated by the standard DOTS-regimen and they have to go to another treatment regimen.

Call SLEC and ask what her complete options are. Because if it's due to drug resistance, it'll be necessary to move on to other drugs. But if it's due to the rashes and allergy, it's likely a liability and patient safety issue. They might be afraid (as I would) that continuing DOTS would lead to an anaphylactic reaction. This is a serious and life threatening allergic reaction.

Again, have her ask for ALL her options. Doctors anywhere will tell you what is the best option, but if you ask, they need to tell you all options, even those that are risky to the patient. Ask if taking a daily antihistamine would be appropriate even if it's to see if it lessens the reaction and if she's willing, say that she's willing to sign a waiver, if she's willing to continue DOTS with the rashes/allergy/risk for anaphylaxis.

Again there are risks to any treatment. And not having seen the rashes up close I can't tell you if I'd personally refer her to the next level myself or not. But if it's been occurring everyday for how many days of a certain severity, it's serious enough to consider referral.

And as much as we all want the immigration process to move faster than it is, you need to consider her personal health. But again, have her ask for her options at this point.

Edited February 10, 2015 by manilaraf

[manilaraf 28]

And as for the 24 month time frame, before DOTS, TB treatment was routinely 12, 18 months+ in duration.

And forgive me for the tone in which I wrote, I completely forgot that you were writing for a friend and not for yourself/your fiancee. D'oh!

[mwh710 1]

No problem, I didn't notice any "Tone". I just hope my fiance' passes she will taker her medical in 2 weeks. Thanks for all the Information, I passed it all on. I see you're from the "City" - 10 years in Hartford - New England is "Gods" country. Of course it is a bit snowy right now for me. We hit 80, which is unheard of in Feb. - even here in Vegas. All of my students are getting Spring Fever way too early... Thanks again for your advice/info.

[Hank_ 9,174]

We have been hitting 80 this last week... it is early, but I do like it.