Could a chest cold cause St. Lukes to erroneously require the dreaded sputum test?

[AnonymousTraveler 2]

Hi everyone. Rainy season started early this year and it seems like all of the Filipinos are coughing and sneezing all around Manila around this time. My wife has a particularly bad cold and cough, which is making me nervous since we're at the final NVC stage waiting for them to schedule our interview, and I'm worried that if she has her medical at St. Lukes soon that they'll see "something" in her lungs (mucus) and delay her at least 2 months for the sputum rigmarole for no reason. Is this a possibility? Should we delay the medical until she's been feeling better from her cold for a week or so in order to avoid a 2-month or possibly 8-month delay from St. Lukes?

[teddy k 35]

Hi I have the same problem with my stepdaughter she's always getting these coughs from all of their cooking in the yard even though I bought them a nice stove and with the meds I send with every box and me telling them if she has a bad cough when in time for St. Lukes no telling what they would do

Edited May 28, 2016 by teddy k

[Hank_ 9,174]

Hi everyone. Rainy season started early this year and it seems like all of the Filipinos are coughing and sneezing all around Manila around this time. My wife has a particularly bad cold and cough, which is making me nervous since we're at the final NVC stage waiting for them to schedule our interview, and I'm worried that if she has her medical at St. Lukes soon that they'll see "something" in her lungs (mucus) and delay her at least 2 months for the sputum rigmarole for no reason. Is this a possibility? Should we delay the medical until she's been feeling better from her cold for a week or so in order to avoid a 2-month or possibly 8-month delay from St. Lukes?

I would believe the doctors will be able to differentiate between a cold and TB scarring of the lungs. Have her start taking cold medication for congestion and such, not a bad idea no matter

Edited May 28, 2016 by Hank_

[Caykay1 71]

Hi everyone. Rainy season started early this year and it seems like all of the Filipinos are coughing and sneezing all around Manila around this time. My wife has a particularly bad cold and cough, which is making me nervous since we're at the final NVC stage waiting for them to schedule our interview, and I'm worried that if she has her medical at St. Lukes soon that they'll see "something" in her lungs (mucus) and delay her at least 2 months for the sputum rigmarole for no reason. Is this a possibility? Should we delay the medical until she's been feeling better from her cold for a week or so in order to avoid a 2-month or possibly 8-month delay from St. Lukes?

Because she is coughing doesn't mean she has TB. Like others said let her start taking medication for cough and other issues and she will be fine. Doctors can tell when it's a TB and when it's not.

[AnonymousTraveler 2]

Because she is coughing doesn't mean she has TB. Like others said let her start taking medication for cough and other issues and she will be fine. Doctors can tell when it's a TB and when it's not.

Yes, I'm not concerned in the slightest that she actually has TB. I'm concerned because I've read so many stories on here that even if St. Lukes just sees *something* on the chest x-rays (no matter how small, even if it's just a spot or a blurry x-ray) they will send my wife through the 2-month long sputum process whether she actually has TB or not. I'm just wondering how long is a safe time to wait so that the x-rays don't pick up *something* that happens to be from her chest cold that will cause another 2-month delay for "the doctors to tell whether it's TB or not".

Edited May 28, 2016 by RevoPilot

[Greenbaum 12,259]

Their process and equipment is top notch. USEM requires that from SLEC.

Your statement "they will send my wife through the 2-month long sputum process whether she actually has TB or not" is confusing. How will SLEC know if she has it or doesn't have the TB virus if she is not tested further? Let the process work for you and her. If she has TB then you just saved your wife's life. Feel good about that. Best of luck to you guys.

[AnonymousTraveler 2]

Their process and equipment is top notch. USEM requires that from SLEC.

Your statement "they will send my wife through the 2-month long sputum process whether she actually has TB or not" is confusing. How will SLEC know if she has it or doesn't have the TB virus if she is not tested further? Let the process work for you and her. If she has TB then you just saved your wife's life. Feel good about that. Best of luck to you guys.

Ok, let me rephrase. If SLEC is going to delay us another 2 months to do their sputum test, I want it to only be because there's a legitimate sign of a problem on my wife's x-rays - not just because she has some leftover phlegm from her cold. Their equipment might be top notch but from what others have described on this site it seems like even if they see the slightest smudge on the x-ray then they'll automatically delay you for 2 months to do the test.

It also seems that the vast majority of people on this site that had to go through the 2-month sputum test turned out to be just fine (no TB), and you might argue that SLEC is just being on the safe side and that it's a good thing because it might save a life etc., but again if she has to go through that process I'd rather it be due to a legitimate sign/symptom on her lungs and not because we just didn't wait long enough until after her chest cold was gone.

The question is, does anyone know how long you should wait after a chest cold before the lungs will be clear enough to have the x-ray?

Edited May 28, 2016 by RevoPilot

[Hank_ 9,174]

Ok, let me rephrase. If SLEC is going to delay us another 2 months to do their sputum test, I want it to only be because there's a legitimate sign of a problem on my wife's x-rays - not just because she has some leftover phlegm from her cold. Their equipment might be top notch but from what others have described on this site it seems like even if they see the slightest smudge on the x-ray then they'll automatically delay you for 2 months to do the test.

It also seems that the vast majority of people on this site that had to go through the 2-month sputum test turned out to be just fine (no TB), and you might argue that SLEC is just being on the safe side and that it's a good thing because it might save a life etc., but again if she has to go through that process I'd rather it be due to a legitimate sign/symptom on her lungs and not because we just didn't wait long enough until after her chest cold was gone.

The question is, does anyone know how long you should wait after a chest cold before the lungs will be clear enough to have the x-ray?

TB in the Philippines is a very big concern. http://www.health.nsw.gov.au/infectious/tuberculosis/documents/countries-incidence.pdf

CDC sets the requirements that SLEC has to follow. TB kills. The common cold does not.

Relax.

[AnonymousTraveler 2]

Good news! We decided not to wait for her cough to go away (based on other scheduling reasons), and her chest x-ray was completely clear even though she was still coughing from her cold even while at SLEC. So I guess a chest cold doesn't show up on x-rays unless it turns into pneumonia or something. Anyway, the medical is done and she didn't need to do any sputum culturing and she just got her vaccinations today and we're all done! Woo hoo!

[Greenbaum 12,259]

Congrats. Sometimes we are our own worst enemy when it comes to second guessing. I'm glad you had smooth sailing through your medical.

[Hank_ 9,174]

Good news! We decided not to wait for her cough to go away (based on other scheduling reasons), and her chest x-ray was completely clear even though she was still coughing from her cold even while at SLEC. So I guess a chest cold doesn't show up on x-rays unless it turns into pneumonia or something. Anyway, the medical is done and she didn't need to do any sputum culturing and she just got her vaccinations today and we're all done! Woo hoo!

Good news!

- the doctors at SLEC can see the difference between a chest cold and TB

[AnonymousTraveler 2]

- the doctors at SLEC can see the difference between a chest cold and TB

You don't know that, and besides, that's not the point. In my wife's case her lungs were completely clear and didn't show up on the x-ray at all (all you could see were her ribs and spine), so there weren't any excuses the radiologists could use to warrant sputum testing. And even if the radiologists can see the difference between a chest cold and TB, the posted signs/placards in the SLEC waiting areas clearly state that any lung finding will require sputum testing, so if something shows up on the x-ray you're screwed.

I'm not trying to talk bad about the skill of the radiologists/doctors/staff at SLEC - they may very well be top notch and well meaning people - but the policy is clearly overactive when it comes to assigning visa applicants for the 2-month sputum testing phase. This fact is obvious by simply observing that the number of people forced to give sputum cultures is vastly greater than the number of people that end up having positive results (and therefore having to go through the DOT phase).

You might argue that it's better to be safe than sorry when it comes to preventing TB from entering our country, but so many Filipinos are being forced to undergo a painful process of coughing up sputum samples (literally), screwing up their travel plans (both domestically by having to travel to SLEC again day after day, and internationally by delaying the visa process 2 more months), and living with 2 months of stress wondering if they actually really might have TB and might have possibly spread it to their family and loved ones - all for "nothing".

I don't know the reason for the policy - or whether it came from SLEC or from the USA - but I wish they A) weren't so overactive about it, and B) let other clinics in the Philippines test and diagnose the patients, and C) started the medical exam earlier in the visa process. For example why not encourage visa applicants to get the TB test at the *start* of the visa process rather than waiting right before the interview? That way even if you have to go through 2 months of sputum culture plus 6 months of DOT at least you're doing it while waiting for the NOA1/NOA2 to get back to you.

Anyway, we were one of the lucky ones, and it looks like having a chest cold is nothing to worry about. There were actually a lot of people coughing in the reception/waiting rooms there (the ones doing the sputum testing were wearing masks). Both days we arrived around 5:00am and were done around 10:00am. The awesome guide on the web site is still pretty much spot-on, even though it's already 6-7 years old: http://www.visajourney.com/forums/topic/221658-st-lukes-medical-exam-walkthrough/ The only difference was that they had us go directly to x-rays as the first procedure in the morning (right after paying the bill), whereas the lady in the guide says they had her give blood first before doing the x-rays. In our case the x-rays were first then the giving blood was second.

Also, I was going to post a copy of the x-ray image in this thread so everyone could see what an x-ray of a chest cold looks like, but the guy at the counter told us "do not open" the x-ray cd-rom so we're just going to leave it sealed until the whole visa process is complete and we're already home in the U.S.

[Hank_ 9,174]

You don't know that, and besides, that's not the point. In my wife's case her lungs were completely clear and didn't show up on the x-ray at all (all you could see were her ribs and spine), so there weren't any excuses the radiologists could use to warrant sputum testing. And even if the radiologists can see the difference between a chest cold and TB, the posted signs/placards in the SLEC waiting areas clearly state that any lung finding will require sputum testing, so if something shows up on the x-ray you're screwed.

I'm not trying to talk bad about the skill of the radiologists/doctors/staff at SLEC - they may very well be top notch and well meaning people - but the policy is clearly overactive when it comes to assigning visa applicants for the 2-month sputum testing phase. This fact is obvious by simply observing that the number of people forced to give sputum cultures is vastly greater than the number of people that end up having positive results (and therefore having to go through the DOT phase).

You might argue that it's better to be safe than sorry when it comes to preventing TB from entering our country, but so many Filipinos are being forced to undergo a painful process of coughing up sputum samples (literally), screwing up their travel plans (both domestically by having to travel to SLEC again day after day, and internationally by delaying the visa process 2 more months), and living with 2 months of stress wondering if they actually really might have TB and might have possibly spread it to their family and loved ones - all for "nothing".

I don't know the reason for the policy - or whether it came from SLEC or from the USA - but I wish they A) weren't so overactive about it, and B) let other clinics in the Philippines test and diagnose the patients, and C) started the medical exam earlier in the visa process. For example why not encourage visa applicants to get the TB test at the *start* of the visa process rather than waiting right before the interview? That way even if you have to go through 2 months of sputum culture plus 6 months of DOT at least you're doing it while waiting for the NOA1/NOA2 to get back to you.

Anyway, we were one of the lucky ones, and it looks like having a chest cold is nothing to worry about. There were actually a lot of people coughing in the reception/waiting rooms there (the ones doing the sputum testing were wearing masks). Both days we arrived around 5:00am and were done around 10:00am. The awesome guide on the web site is still pretty much spot-on, even though it's already 6-7 years old: http://www.visajourney.com/forums/topic/221658-st-lukes-medical-exam-walkthrough/ The only difference was that they had us go directly to x-rays as the first procedure in the morning (right after paying the bill), whereas the lady in the guide says they had her give blood first before doing the x-rays. In our case the x-rays were first then the giving blood was second.

Also, I was going to post a copy of the x-ray image in this thread so everyone could see what an x-ray of a chest cold looks like, but the guy at the counter told us "do not open" the x-ray cd-rom so we're just going to leave it sealed until the whole visa process is complete and we're already home in the U.S.

TB policy is dictated by CDC ... and err on the side of caution is a good policy in regards to TB. SLEC follows policy - TB kills

Identifying Persons From High-Risk Countries

• Local epidemiologic profiles are the most useful resource to identify countries of highest risk. Health care providers should base testing and treatment decisions on local immigration patterns and epidemiology.

• In 2011, approximately 62% of TB cases in the United States occurred in foreign-born individuals.
• The majority of U.S. cases among foreign-born individuals are in people from 7 countries (Mexico, Philippines, Vietnam, India, China, Haiti, and Guatemala).

• For a list of high burden countries and profiles of these countries, see the Stop TB Partnership website.

• Note that the ranking of countries changes yearly.

http://www.cdc.gov/tb/publications/ltbi/appendixb.htm

Rant away.... get it off your chest

(now to seal our southern border and further control TB issues)

[amaada 18]

Hi! I had a mild pneumonia like 3 months ago. I'll have medical at St. Luke's this Wednesday.

I'm wondering if spotting that pneumonia in my lungs would be grounds for sputum test?

Thanks for answering!

[Greenbaum 12,259]

amaada, on 17 Jul 2016 - 05:11 AM, said:

Hi! I had a mild pneumonia like 3 months ago. I'll have medical at St. Luke's this Wednesday.

I'm wondering if spotting that pneumonia in my lungs would be grounds for sputum test?

Thanks for answering!

The answer is no. The Doctors see thousands of cases, many like yours, and with today's technology and training, a Doctor will be able to judge whether you have TB or just the common cold or in your case residual pneumonia.