Latent TB Infection on going prophylaxis treatment at SLEC

[rjay2day 1]

Hi everyone!

So here is my case: In January 2016 I started taking preventive (prophylaxis) treatment for my Latent (Inactive) TB Infection (LTBI) through my private doctor. This treatment is to last for 6months accdg to my private doctor (so until July) My skin test was positive, Xray is positive but all sputum is negative. Then I had my Medical Exam at SLEC (St.Lukes Extension Clinic) in April. Same results: positive x-ray, negative AFB & Culture. I disclosed everything so by this time I was already transferred-in to SLEC and is expecting to end on July. However, I am confused, because the dr at SLEC told me that I can continue my prophylaxis treatment in the US once my Sputum Culture come out negative (which it did hung June pa). But until now they are still not releasing me. And told me that my prophylaxis treatment will be until Oct instead na July kasi daw based sa CDC dap at 9months at hndi 6months based on the meds that I am taking. Ok lang naman sana na 9months but I can continue this in the states why are they still not releasing me? They can't give me concrete answers. They just keep on telling me to wait, or they'll just inform me if I'm going to be released already or they're going to ask again their head or whomever. But its already been 1month since my negative culture came out and still I'm taking my meds at SLEC and I can't re-schedule my US Embassy interview because they are not releasing me.

Anyone here who had similar experience? Can you really continue your prophylactic treatment in the states? or dapat mo talaga tapusin dto bago ka magpainterview? My private dr told me na hnd ako dap at i-hold kasi hndi nmn contagious ang LTBI and that prophylactic treatment is not required but only recommended.

Please please help I don't know what to do. It seems they want me to finish it until Oct before I can be scheduled for interview, eh magexpire na yung medical ko by Oct so uulitin ko nanaman sya kasi diba 6months lang validity nyan.

[TBoneTX 45,273]

*** Country-specific thread is moved from the Work Visas forum to the Philippines regional subforum. ***

[Hank_ 9,174]

Hi everyone!

So here is my case: In January 2016 I started taking preventive (prophylaxis) treatment for my Latent (Inactive) TB Infection (LTBI) through my private doctor. This treatment is to last for 6months accdg to my private doctor (so until July) My skin test was positive, Xray is positive but all sputum is negative. Then I had my Medical Exam at SLEC (St.Lukes Extension Clinic) in April. Same results: positive x-ray, negative AFB & Culture. I disclosed everything so by this time I was already transferred-in to SLEC and is expecting to end on July. However, I am confused, because the dr at SLEC told me that I can continue my prophylaxis treatment in the US once my Sputum Culture come out negative (which it did hung June pa). But until now they are still not releasing me. And told me that my prophylaxis treatment will be until Oct instead na July kasi daw based sa CDC dap at 9months at hndi 6months based on the meds that I am taking. Ok lang naman sana na 9months but I can continue this in the states why are they still not releasing me? They can't give me concrete answers. They just keep on telling me to wait, or they'll just inform me if I'm going to be released already or they're going to ask again their head or whomever. But its already been 1month since my negative culture came out and still I'm taking my meds at SLEC and I can't re-schedule my US Embassy interview because they are not releasing me.

Anyone here who had similar experience? Can you really continue your prophylactic treatment in the states? or dapat mo talaga tapusin dto bago ka magpainterview? My private dr told me na hnd ako dap at i-hold kasi hndi nmn contagious ang LTBI and that prophylactic treatment is not required but only recommended.

Please please help I don't know what to do. It seems they want me to finish it until Oct before I can be scheduled for interview, eh magexpire na yung medical ko by Oct so uulitin ko nanaman sya kasi diba 6months lang validity nyan.

What is causing issues is you started this process with your private doctor, then started the medical before the 6 month treatment was completed. SLEC has to follow the rules dictated by CDC, so you will complete the DOT process according to the schedule SLEC set down, you may have to complete another SPUTUM test (don't know for fact as your case is very unusual). You will just have to be patient and wait for SLEC to release you before scheduling a new interview date.

[rjay2day 1]

Thank you Hank for the reply. So the nurse at SLCE already told me that I should already reschedule for an interview even if I am not yet released officially as I am to be released already. I think its already being processed. So I did and informed them of the schedule I got. They did not told me to cancel it or anything they just said that it was a wise thing to do so I could leave before my medical expires. So in short I rescheduled even if I am not yet released as long as they gave me the assurance that I will be released. Rather than wait to be released and then go online to reschedule which is risky because slots gone in split seconds! this is crazy!

What is causing issues is you started this process with your private doctor, then started the medical before the 6 month treatment was completed. SLEC has to follow the rules dictated by CDC, so you will complete the DOT process according to the schedule SLEC set down, you may have to complete another SPUTUM test (don't know for fact as your case is very unusual). You will just have to be patient and wait for SLEC to release you before scheduling a new interview date.

[Akago 0]

Hi there! Id like to ask if your visa was approved after finishing the prophylaxis course of your latent tb?

[Hank_ 9,174]

They haven't been back since last year.

[sunnyfLake_ 0]

Based on a cousin's experience, (she lives in San Diego, Ca) yes, you can continue your TB prophylaxis treatment in the US, and for free. The local health department contacted her a few days upon her arrival, which was last year, requesting her to undergo a series of tests and given her TB meds (same drugs as in the Ph) for some duration, I forgot how many months. Then they regularly set appointments for her to go to same clinic for routine lab works and to get med packets until treatment is done, had personally went with her one time and was surprise that there were a lot of clients there, mostly immigrants.  She had the same case, marked CXR but negative sputum culture. Although she didn't start the treatment via a private doctor but with SLEC. 

Edited July 20, 2017 by sunnyfLake_

[Akago 0]

Thank you for sunnyflake for answering. Im starting to get anxious since I will be undergoing medical exam anytime soon. Just so afraid of having acquired latent Tb,God forbid, since im exposed to patients with active TB in the hospital. Somehow,i am relieved by your reply. Thank you!

[Akago 0]

5 hours ago, sunnyfLake_ said:

Based on a cousin's experience, (she lives in San Diego, Ca) yes, you can continue your TB prophylaxis treatment in the US, and for free. The local health department contacted her a few days upon her arrival, which was last year, requesting her to undergo a series of tests and given her TB meds (same drugs as in the Ph) for some duration, I forgot how many months. Then they regularly set appointments for her to go to same clinic for routine lab works and to get med packets until treatment is done, had personally went with her one time and was surprise that there were a lot of clients there, mostly immigrants.  She had the same case, marked CXR but negative sputum culture. Although she didn't start the treatment via a private doctor but with SLEC. 

Thank you for sunnyflake for answering. Im starting to get anxious since I will be undergoing medical exam anytime soon. Just so afraid of having acquired latent Tb,God forbid, since im exposed to patients with active TB in the hospital. Somehow,i am relieved by your reply. Thank you!

[John Vincent 0]

I think we have a similar situation here. I decided to undergo check up at my private doctor at Lung Center and yes she provided me with Prophylaxis too (Isoniazid) that I must take for 6 months. The doctor says i was exposed to TB and I have what it's called Latent TB. I started taking it since last April 2018 and I took Isoniazid everyday. I was told to take it for 6 months so in my calculation it should end last September 2018. I had diagnosed Pneumonia with Emphysema when I was 4 years old and it was treated. I was told that a scar will be permanently visible at my radiogram tests. So, it's nothing new to me that any doctor would find out that I have these scars already. Come this June 2018, I had my medical examinations at SLEC and long story short, the doctor advised me to undergo 6 months medication (DOT) without even waiting for the culture results. I did 3 days of sputum exams last June 2018 and smear results came out negative. I did not understand why I was told to undergo medication. All they said was the Prophylaxis that was issued by my doctor at Lung Center got my pulmonary results at SLEC complicated. Which for me, I have no idea why they said that. They told me the compared my xray at SLEC and Lung Center Xray which was taken 3 months apart. They said that SLEC Xray results turn out to be the factor because it got worst since I took Prophylaxis issued by my private doctor. 
Now that I'm taking medications everyday at SLEC I have to deal with it and face it as if I have no more choice. Last August 2018, I got my sputum culture results from my first 3 sputum exams (Post DOT), all were negative. During my DOT, every month we have to undergo a couple of days sputum exams, but since the results came out, they reduced my sputum day to just one day only instead of the usual two days sputum. It was weird last September because they did not give any schedule for a sputum exam and I did for the first time again last October 1st. It got weirder I was told that I will have an Xray again this October 8 (Monday) and it was weird for me because I have not heard of anyone going to the US, that had Xrays in between their 6 months DOT. Except those going to Canada, Australia and New Zealand which they are required to undergo xray every 3 months between their medication period. 

I didn't know that it is possible to have their medication in the US tho. Wherever you are buddy hope to hear your experience during your ordeal. 

[Hank_ 9,174]

19 minutes ago, John Vincent said:

I think we have a similar situation here. I decided to undergo check up at my private doctor at Lung Center and yes she provided me with Prophylaxis too (Isoniazid) that I must take for 6 months. The doctor says i was exposed to TB and I have what it's called Latent TB. I started taking it since last April 2018 and I took Isoniazid everyday. I was told to take it for 6 months so in my calculation it should end last September 2018. I had diagnosed Pneumonia with Emphysema when I was 4 years old and it was treated. I was told that a scar will be permanently visible at my radiogram tests. So, it's nothing new to me that any doctor would find out that I have these scars already. Come this June 2018, I had my medical examinations at SLEC and long story short, the doctor advised me to undergo 6 months medication (DOT) without even waiting for the culture results. I did 3 days of sputum exams last June 2018 and smear results came out negative. I did not understand why I was told to undergo medication. All they said was the Prophylaxis that was issued by my doctor at Lung Center got my pulmonary results at SLEC complicated. Which for me, I have no idea why they said that. They told me the compared my xray at SLEC and Lung Center Xray which was taken 3 months apart. They said that SLEC Xray results turn out to be the factor because it got worst since I took Prophylaxis issued by my private doctor. 
Now that I'm taking medications everyday at SLEC I have to deal with it and face it as if I have no more choice. Last August 2018, I got my sputum culture results from my first 3 sputum exams (Post DOT), all were negative. During my DOT, every month we have to undergo a couple of days sputum exams, but since the results came out, they reduced my sputum day to just one day only instead of the usual two days sputum. It was weird last September because they did not give any schedule for a sputum exam and I did for the first time again last October 1st. It got weirder I was told that I will have an Xray again this October 8 (Monday) and it was weird for me because I have not heard of anyone going to the US, that had Xrays in between their 6 months DOT. Except those going to Canada, Australia and New Zealand which they are required to undergo xray every 3 months between their medication period. 

I didn't know that it is possible to have their medication in the US tho. Wherever you are buddy hope to hear your experience during your ordeal. 

So you went to a private doctor to address a, potential, TB issue and started medication outside the CDC guidelines that SLEC has to follow?   Then during the time you are taking the medication from your private doctor you started your medical at SLEC?   Hmm ~ 

 

You were told to undergo medication, DOT,  through SLEC because of what you started with a private doctor ...  as your private doctor isn't certified by CDC .. only SLEC is in the Philippines.

 

You raised a lot of red flags by starting the TB process outside of SLEC.   And in the long run caused more delays.

[John Vincent 0]

16 minutes ago, Hank_ said:

So you went to a private doctor to address a, potential, TB issue and started medication outside the CDC guidelines that SLEC has to follow?   Then during the time you are taking the medication from your private doctor you started your medical at SLEC?   Hmm ~ 

 

You were told to undergo medication, DOT,  through SLEC because of what you started with a private doctor ...  as your private doctor isn't certified by CDC .. only SLEC is in the Philippines.

 

You raised a lot of red flags by starting the TB process outside of SLEC.   And in the long run caused more delays.

Well, i decided to check up my lungs just to be sure and my doctor from the LCP said i have latent tb. So she issued me Isoniazid, how can I not take it? How am I supposed to know that I shouldn't have gotten a check up before my medical exams? I know it got complicated because I took a check up and followed my doctor. How in the world should I know that I should've not taken meds so it wouldn't cause more delays? None.
It's already there and I'm undergoing DOT now and I can't do anything to stop it anymore. Have you encountered anyone here who had an XRAY in between their DOT period of 6 months? I'm pertaining to those who are strictly going to the US. Everyone I asked at SLEC, they told me for people going to the US, they had a radiogram test once only. BTW, all my sputum test since from the start up to now are all negative. Smear and culture results are negative of TB. I still don't know why am I not released yet.

Edited October 3, 2018 by John Vincent

[Hank_ 9,174]

1 hour ago, John Vincent said:

Well, i decided to check up my lungs just to be sure and my doctor from the LCP said i have latent tb. So she issued me Isoniazid, how can I not take it? How am I supposed to know that I shouldn't have gotten a check up before my medical exams? I know it got complicated because I took a check up and followed my doctor. How in the world should I know that I should've not taken meds so it wouldn't cause more delays? None.
It's already there and I'm undergoing DOT now and I can't do anything to stop it anymore. Have you encountered anyone here who had an XRAY in between their DOT period of 6 months? I'm pertaining to those who are strictly going to the US. Everyone I asked at SLEC, they told me for people going to the US, they had a radiogram test once only. BTW, all my sputum test since from the start up to now are all negative. Smear and culture results are negative of TB. I still don't know why am I not released yet.

 

I have bumped into others, that were pondering what you did, from time to time, with some they are at the talking stage of seeing an outside doctor thinking if there are TB issues that they will save time by addressing it early.  And with them we try to point out the procedures SLEC is required to follow.   Hoping to keep them "from shooting themselves in the foot" .   Partly why I made some comments wasn't really directed at you it was for those following, so they can read and learn.

 

As for the multiple x-rays, you are the first I have read of regarding that, but then you are a first with how you were addressing the latent TB and the medical also.    For the majority, that didn't  go to an outside doctor but kept everything within SLEC control none had multiple x-rays as you are stating that I am aware of.   Your situation is very unique.

 

 

[John Vincent 0]

1 hour ago, Hank_ said:

 

I have bumped into others, that were pondering what you did, from time to time, with some they are at the talking stage of seeing an outside doctor thinking if there are TB issues that they will save time by addressing it early.  And with them we try to point out the procedures SLEC is required to follow.   Hoping to keep them "from shooting themselves in the foot" .   Partly why I made some comments wasn't really directed at you it was for those following, so they can read and learn.

 

As for the multiple x-rays, you are the first I have read of regarding that, but then you are a first with how you were addressing the latent TB and the medical also.    For the majority, that didn't  go to an outside doctor but kept everything within SLEC control none had multiple x-rays as you are stating that I am aware of.   Your situation is very unique.

 

 

Thanks for pointing it out Hank. It still kept me thinking why did they didn’t let me have a sputum exam this September and had a scheduled Xray this October. When i asked the nurses why do I have an xray scheduled, their response was “Doctor’s order”. All those at DOT that has the same time slot as I am knows that all US applicants are only required to undergo xray once during the medication period. They were particular to people whose medication is on the 5th or 6th month already. Meaning close to finishing their DOT. They also pointed out that they do not know anyone that had a negative result at the sputum exams (both smear and culture) and still undergone DOT. Which you are correct, my case is truly unique. When i found out that my sputum results were all negative, i asked the doctor about it and his answer is not a straight one. He uses the word, “case to case basis” in which I asked of the possibility of shortening my DOT in lieu to all my negative results to both of sputum exams. I do not have a single positive result on each of my sputum exams which is why it was questionable to me why am I still here. Also, this was also the first time that i had a sputum exam (October 1st) and still i have not advised to see the doctor on the same week. Those who finished their DOT, had at least one positive result on their sputum exams. I do not recall anyone with the same situation as I had. 

Edited October 3, 2018 by John Vincent

[Hank_ 9,174]

17 minutes ago, John Vincent said:

Thanks for pointing it out Hank. It still kept me thinking why did they didn’t let me have a sputum exam this September and had a scheduled Xray this October. When i asked the nurses why do I have an xray scheduled, their response was “Doctor’s order”. All those at DOT that has the same time slot as I am knows that all US applicants are only required to undergo xray once during the medication period. They were particular to people whose medication is on the 5th or 6th month already. Meaning close to finishing their DOT. They also pointed out that they do not know anyone that had a negative result at the sputum exams (both smear and culture) and still undergone DOT. Which you are correct, my case is truly unique. When i found out that my sputum results were all negative, i asked the doctor about it and his answer is not a straight one. He uses the word, “case to case basis” in which I asked of the possibility of shortening my DOT in lieu to all my negative results to both of sputum exams. I do not have a single positive result on each of my sputum exams which is why it was questionable to me why am I still here. Also, this was also the first time that i had a sputum exam (October 1st) and still i have not advised to see the doctor on the same week. Those who finished their DOT, had at least one positive result on their sputum exams. I do not recall anyone with the same situation as I had. 

 

TB has become a bigger issue in the past couple years, and CDC has changed some of the rules and requirements.  SLEC has to follow CDC... so the doctors tell you "because"    

 

.. and a big part of the WHY for the "case by case" response from the doctor you already know ... because of what you did in the beginning.      I hope it all goes smoothly for you from here forward.

 

Hopefully others will read your postings and take heed.