TB treatment at St Luke's questions

[badloss2 2]

We just received the horrible news yesterday. After doing the sputum testing, my fiance got a call 3.5 weeks after the last sample that she needs to go to SLMC to meet a doctor. We are assuming that the sample is positive. She is 26. After hearing she needs sputum testing 2 months ago we got an X-ray and went to another doctor for a TB test that both showed negative. From what I read, there is a very low probability of a 26 year old contracting TB. She also has no symptoms. 

 

Can you please tell me about the process from here? Is it really 6 months of treatment followed by another full medical and sputum testing for 2 months? Is there any way around this? I'm so tired of waiting that if more effort or money is involved to speed up the process, I would do pretty much anything at this point. 

[J.M. 230]

That is terrible news!  Unless things have changed lately, your 6 month treatment plan is probably accurate.  That is if you get treated at St. Luke's.  It is directly observed treatment.  They actually watch you take the medication.  If you get it done elsewhere, it will take even longer.  SLEC will not care that another facility gave her a clean bill of health.  Their say is final, and you have to comply with whatever they say if you want to get a visa.  There are others on VJ that have gone through this, but I don't see any that are very recent.  Maybe someone with recent experience will answer you too.  Be sure she listens carefully when they give her treatment plan options to be sure you understand if it will take longer if treatment is not done by SLEC.

 

Sorry for your bad news.

[RO_AH 1,659]

3 hours ago, badloss2 said:

After hearing she needs sputum testing 2 months ago we got an X-ray and went to another doctor for a TB test that both showed negative.

That was a waste of time and money. Also, the reason for the sputum test is that is much more accurate. This is why the just do the simple skin poke test that the other doctor did.

3 hours ago, badloss2 said:

Can you please tell me about the process from here? Is it really 6 months of treatment followed by another full medical and sputum testing for 2 months? Is there any way around this? I'm so tired of waiting that if more effort or money is involved to speed up the process, I would do pretty much anything at this point. 

Sadly there is nothing that you can do. The real shame is that we are letting millions through the southern border with no testing and we hand them a cell phone and cash when they arrive.

[top_secret 2,417]

Sadly, it is probably time to start looking at apartment options in Ermita.  Most of the time sputum testing turns out to be a big waste of time but realistically sputum testing is probably accurate and if positive the treatment is actually necessary.  It would be better if it could occur under better circumstances. 

[badloss2 2]

17 minutes ago, top_secret said:

Sadly, it is probably time to start looking at apartment options in Ermita.  Most of the time sputum testing turns out to be a big waste of time but realistically sputum testing is probably accurate and if positive the treatment is actually necessary.  It would be better if it could occur under better circumstances. 

Honestly, what you said rings deep. It's like I think the whole testing is BS and we already had multiple negatives, but at the same time, maybe my loved one has TB. She should be treated. It's serious. It just sucks because I want her here now!

[J.M. 230]

There was a study a while back about false positives in TB cultures.  They referenced 14 separate studies, each with over 100 patients.  Only 1 of the 14 studies had no false positives.  That means almost every lab produces SOME false positives.  However, the actual false positive rate was only 3%, meaning 97% of the time the culture result was accurate.  The most common cause of a false positive is cross contamination, when a positive specimen comes in contact with a negative specimen.  SLEC probably is at the high end of how many TB cultures they process compared to the rest of the world.  That should mean they are very good at it.  But it also means they have a lot of samples, increasing the chance of cross contamination.  Only India, Indonesia, and China have a higher incidence of TB than the Philippines.  In 2020, there were almost 600,000 cases in the Philippines.  That's about 1 out of every 200 people, making it pretty easy to come in contact with it if you are in a city.

[badloss2 2]

14 minutes ago, J.M. said:

There was a study a while back about false positives in TB cultures.  They referenced 14 separate studies, each with over 100 patients.  Only 1 of the 14 studies had no false positives.  That means almost every lab produces SOME false positives.  However, the actual false positive rate was only 3%, meaning 97% of the time the culture result was accurate.  The most common cause of a false positive is cross contamination, when a positive specimen comes in contact with a negative specimen.  SLEC probably is at the high end of how many TB cultures they process compared to the rest of the world.  That should mean they are very good at it.  But it also means they have a lot of samples, increasing the chance of cross contamination.  Only India, Indonesia, and China have a higher incidence of TB than the Philippines.  In 2020, there were almost 600,000 cases in the Philippines.  That's about 1 out of every 200 people, making it pretty easy to come in contact with it if you are in a city.

I'm basically living in world of small odds so maybe the doctor will do an additional sputum while treating the condition. That's my play for now. Everything I read said it's small odds for a young adult to contract and develope TB. This is so frustrating. 

[maryaaaaaaaaaaa 26]

Hello! 
 

How did it go with your fiancé? Hope all is well. 
 

I am in a similar situation. I just finished my sputum collection on June 25-27th and came back July 1 for pulmonary evaluation. The doctor told me that my smear test came back negative however, my x-ray shows suggestive PTB hence the negative smear will be disregarded same goes with culture results. We will no longer wait for the eight-week timeframe for the culture results because I’m gonna be on medication anyways for six months. 😭😭

 

I opted to go to daily to undergo medication because getting treated outside. Will add up one year on top of the medication. Prior to re-medical eligibility 😭 I can’t afford to stay apart longer from fiancé. 😖

[badloss2 2]

11 minutes ago, maryaaaaaaaaaaa said:

Hello! 
 

How did it go with your fiancé? Hope all is well. 
 

I am in a similar situation. I just finished my sputum collection on June 25-27th and came back July 1 for pulmonary evaluation. The doctor told me that my smear test came back negative however, my x-ray shows suggestive PTB hence the negative smear will be disregarded same goes with culture results. We will no longer wait for the eight-week timeframe for the culture results because I’m gonna be on medication anyways for six months. 😭😭

 

I opted to go to daily to undergo medication because getting treated outside. Will add up one year on top of the medication. Prior to re-medical eligibility 😭 I can’t afford to stay apart longer from fiancé. 😖

 

Hi Maryaaaa,

 

I didn't even know skipping the 2 month sputum test was an option? Did they present you with that option? I'm surprised you didn't want the 2 month test because if its negative, you don't have to do the 6 months. But idk your circumstances so I kind of understand too. 

 

My fiance is currently past the halfway point in treatment. I got her an apartment in Malate to be close to SLMC and make it easier. The first 2 months, you undergo intense treatment. Luckily, she had hardly any side effects. After 1 months and 2 months, you get a 2 month sputum test. After 3 months, they do another x-ray and compare it to the old one. Overall, the delay is horrible, but we try to think positive that she was sick and needed to get better. She goes daily at 9-930am. What is your time? 

 

I've heard bad things about getting treatment outside of slmc so I think you are doing the right thing getting treatment there. Did you have any other specific questions?