Sputum Test, BCG, Family History, Very Worried

[Eve & Jim 4]

Eve went for her second day of medical today and was told she has to take the Sputum Test. Eve smokes, but has stopped in the last month and has been using the nicotine patches that I sent her from here. She had the BCG vaccine when she was young. After she gave birth to Mae who is 16 year old now, Eve had pnumonia. Eve had a chest X-Ray 2 years ago when she was hospitalized for what turned out to be a urinary tract infection and dehydration, and the report on that X-Ray stated that everything was clear. Unfortunatly, Eve didn't take that X-Ray with her to St. Lukes because she thought it was too old to be of any value. She really didn't understand why they would want an old chest X-Ray. The person at St. Lukes stated that there were possibly ilfiltrates in her X-Ray.

Her mother died of lung cancer in 2004 at age 72. I didn't know this until now, but prior to the lung cancer, her mom had been treated for TB, and the lung cancer apparently started in a area that appeared to be scaring from the TB which delayed detection of the cancer. Eve said her mom also had the scar from the BCG vaccine. Eve said that there were many years between the treatment for TB and the cancer diagnosis. At the time her mom was treated for TB, Eve was working in Japan and wasn't told about the TB until sometime after she returned from Japan to care for her mother.

Her daugher Mae's medical was fine but they delayed her vaccines due to Eve. Mae will be a K2.

She is scheduled for the sputum test on September 26, 27, and 28th.

Needless to say, this is very disappointing due to the 2 month delay, and I was at the point of getting ready to buy plane tickets. We were planning our wedding for 11-11-11 and certainly had plans for spending the holidays together. We were even doing everything possible so that we could spend her birthday together on Oct. 2nd.

I have a lot of questions.

1) Since she had the BCG vaccine, what are the chances of her needing to be treated for TB?

2) What if anything should we be doing between now and her scheduled test?

3) I know that there are test results that come back after 3 days or somthing from the sputum test, what if those are possitive?

4) What do we need to do from a paperwork point of view? The NOA2 says it is valid from 8/16/2011 to 12/15/2011 and this delay could push the timeline beyond 12/15/2011, so do I need to file for some sort of extension?

5) What about all the other supporting paperwork like NBI and CENOMAR, will any of that expire and need to be redone?

6) I know there are some pretty bad worst case timelines, but what is the best case for this kind of delay?

7) Is there any way to get a copy of the X-Ray that St. Lukes is using so that her private doctor could take a look? What about any of the blood test results?

I'm sure there are a lot more questions, and I'm sure a lot of them don't have good answers, but I would really appreciate any help or advice!

Thank you all for any help you can offer. God Bless.

--Jim

[TeddyHoney 42]

I am truly sorry to hear about your delay. My fiancee and I are already in second week of the 8 week culture test. I will try to answer some of your questions based on the experiences of my fiancee and myself and posts I have read here on VJ:

1) Since she had the BCG vaccine, what are the chances of her needing to be treated for TB?

- I'm not sure about this one. Having had the vaccine usually means she would probably test positive on the skin test. I don't think her having had that vaccine is going to impact things much either way at this point. Not as far as needing treatment goes.

2) What if anything should we be doing between now and her scheduled test?

- Definitely NOT smoke! Just try and keep her as heatly as possible as with foods she eats and what she drinks. Not just for the AFB smear tests but also for if she will need to be treated. Others may have specific things she can do heathwise and to prepare. My fiancee drank a specific kind of milk (I forgot). Whether that helped or not, I don;t know. She thinks it did and maybe it did. Her AFB smears have all boon negative.

3) I know that there are test results that come back after 3 days or somthing from the sputum test, what if those are possitive?

- If her AFB smear test come back positive, they will start her on treatment right away. I think it has to be 2 of the 3 smears that has to be positive for them to start treatment. Not sure about that. It may be just one positive smear. Others can confirm.

4) What do we need to do from a paperwork point of view? The NOA2 says it is valid from 8/16/2011 to 12/15/2011 and this delay could push the timeline beyond 12/15/2011, so do I need to file for some sort of extension?

- I don't think you need to do anything paperwork-wise. The SLEC will cancel your scheduled interview. Are you sure its only 3 months?

5) What about all the other supporting paperwork like NBI and CENOMAR, will any of that expire and need to be redone?

- That depends on when they were issued. You will want the most recent of those when it comes time for her interview. I think NBI is good for 1 year. Not sure about CENOMAR, but I don't think its 1 year.

6) I know there are some pretty bad worst case timelines, but what is the best case for this kind of delay?

- Best case, I would say is that she gets all negative on her AFB smears and then has negative on her sputum culture results. Then completes her medical and interviews short after. Max delay minus days waited to do AFB smears is 9-12 weeks - I would say. BEST case.

7) Is there any way to get a copy of the X-Ray that St. Lukes is using so that her private doctor could take a look? What about any of the blood test results? I really don't think so. I don;t think SLEC wants any other professionals looking at thier x-rays. I my opinion its because many of the "abnormalties" THEY see do not really indicate the presence of active PTB. Imagine the mess that would be created if everyone who has medical at SLEC had thier x-rays reviewd by someone else after they've been told they have to have culture test? I would say no to this one.

God bles and I will pray for her smears to be negative as well as her culture results!

[Tahoma 2,292]

1) Since she had the BCG vaccine, what are the chances of her needing to be treated for TB?

2) What if anything should we be doing between now and her scheduled test?

3) I know that there are test results that come back after 3 days or somthing from the sputum test, what if those are possitive?

4) What do we need to do from a paperwork point of view? The NOA2 says it is valid from 8/16/2011 to 12/15/2011 and this delay could push the timeline beyond 12/15/2011, so do I need to file for some sort of extension?

5) What about all the other supporting paperwork like NBI and CENOMAR, will any of that expire and need to be redone?

6) I know there are some pretty bad worst case timelines, but what is the best case for this kind of delay?

7) Is there any way to get a copy of the X-Ray that St. Lukes is using so that her private doctor could take a look? What about any of the blood test results?

1) That's a good question. I don't know the answer.

2) I can't think of anything you should be doing between now and the sputum test.

3) St. Lukes will let her know the results of her three smear tests shortly after the sputum collection. I'm not sure what the threshold is for treatment, but it seems that some cases with positive results on the smear test go straight to TB treatment. Other cases with positive results seem to wait for the two-month culture before treatment.

4) Don't worry about any paperwork, and don't worry about your NOA2. St Lukes will inform the Embassy about your situation, and the Embassy will cancel your interview. They will also keep your case open because they know you are still trying to move forward with it.

5) I don't know whether you should update the NBI or the CENOMAR. If her two-month culture turns out negative, then she will have her interview shortly thereafter, and her NBI and her CENOMAR will be about three months old. I think it will be OK, but I hope others chime in about it.

6) The best-case scenario is that her smear tests and her two-month culture are negative, and she has her interview a week or so after she receives the results from her two-month culture.

7) It doesn't matter what her doctor says. St. Lukes has the final word. What blood test results are you talking about? On a side note, I believe there's a blood test for TB. St. Lukes does not use it, but you could probably have it done privately. I don't know how long it takes to get results from the blood test, but I doubt if it would take as long as the two-month culture.

St. Lukes seems to "see something" on a lot of people's chest x-rays. However, most of those smear tests and cultures turn out negative for TB. Best wishes.

[bestofboston 36]

The previous person is correct in that St. Lukes seems to "see something" on a lot of people's chest x-rays. However, most of those smear tests and cultures turn out negative for TB. Best wishes.

I would not over react at this point and accept the delay like so many others have to do. My wife was telling me that a lot of woman there the day of physical were required to have additional testing done.

My wife was one of the lucky ones. She does not smoke and she was a school teacher there. School teachers have to have an xray taken every year in order to teach. My wife did not bring her previous xray with her.

Good luck.

[Eve & Jim 4]

I think that one of my other concerns, and the reason for wanting to see the blood test results is to see if there are other things that should be addressed. Of course since there is a family history of lung cancer I am concerned that what they saw in the x-ray may be some kind of early indicator. I have to wonder if her mom was misdiagnosed years ago.

I double checked the NOA2 dates and it's only 3 months. That is a bit confusing to me because I thought she had up to 6 months to come to the U.S. and then 90 days to marry after entering the U.S., even though that was never the plan. I certainly don't want something to expire and have to go through this whole process again.

--Jim

[paul_kay 31]

I think the reason why she will undergo the sputum test is because she had a lot of TB related family history. With scarring or none, people will still be subjected to it as long as you answered YES to any of the questions of the doctor. Sorry about that but we can't do anything but to wait.

[Kevin&Lenith 36]

I think the reason why she will undergo the sputum test is because she had a lot of TB related family history. With scarring or none, people will still be subjected to it as long as you answered YES to any of the questions of the doctor. Sorry about that but we can't do anything but to wait.

So if you have had a family member that has had TB, yet have been tested. Is it ur opinion that by just saying yes to family history question puts you at risk for a possible spetum test? If thats so, is it still the best thing to do to answer that question yes? Ihave also seen people talking about bringing a recently taken xray with them to the interview does that mean anything to st Lukes?

Edited September 13, 2011 by Kevin&Lenith

[Eve & Jim 4]

I think the reason why she will undergo the sputum test is because she had a lot of TB related family history. With scarring or none, people will still be subjected to it as long as you answered YES to any of the questions of the doctor. Sorry about that but we can't do anything but to wait.

We could understand and deal with this all a whole lot better if we were really given all the information instead of some little slip of paper and the words of a receptionist. There is really only one person in her family that had TB and that was over 10 years ago, and I very seriously suspect that her mom may have been diagnosed and treated incorrectly because by the time her lung cancer was determined, she was in stage 3 or stage 4. There are also blood tests that produce results much quicker than waiting 8 weeks for a culture to "maybe" grow.

I am certainly most concerned about Eve's health and I certainly wouldn't want to expose anyone to something like TB simply because we didn't want to wait for some test. My biggest problem with the whole thing is that they aren't doing what is in the best interest of the patient. This is the U.S. government doing this, not the Philippine government. Using better testing methods that produce results in reasonable times are possible and not being used. The U.S. is a "super power" and one of the most advanced countries in the world, but we are subjecting people to this kind of treatment? While I am very thankful that up until this point our processing has gone quicker than normal, I honestly feel like by trying to do the right thing we are being punished by a mountain of paperwork and red tape while people who illegally flood our borders everyday seem to get better treatment. How many thousands of illegal aliens are in the U.S. without any of the right medical exams, tests, and vaccinations, yet when someone tries to do the right thing and follow all the rules they lose years of their lives to what everyone on this forum sees everyday.

--Jim

[VanessaTony 3,567]

She has 6 months to enter after getting the visa, not after getting the NOA2. The NOA2 should be automatically extended.

Here:

- http://www.visajourney.com/forums/topic/274054-noa2-expires-before-interview-date/

- http://www.visajourney.com/forums/topic/294069-should-i-extend-noa2-approval/

Stress less about that side. Focus on getting her healthy. If I were you I would have her see her own physician to get a complete medical for your peace of mind. Or you can wait until she's in the US, up to you. If you've got insurance it might work out cheaper there, and at least she can relax and say her goodbyes while waiting for this process to be over.

[VanessaTony 3,567]

I have a lot of questions.

1) Since she had the BCG vaccine, what are the chances of her needing to be treated for TB?

2) What if anything should we be doing between now and her scheduled test?

3) I know that there are test results that come back after 3 days or somthing from the sputum test, what if those are possitive?

4) What do we need to do from a paperwork point of view? The NOA2 says it is valid from 8/16/2011 to 12/15/2011 and this delay could push the timeline beyond 12/15/2011, so do I need to file for some sort of extension?

5) What about all the other supporting paperwork like NBI and CENOMAR, will any of that expire and need to be redone?

6) I know there are some pretty bad worst case timelines, but what is the best case for this kind of delay?

7) Is there any way to get a copy of the X-Ray that St. Lukes is using so that her private doctor could take a look? What about any of the blood test results?

1. The BCG vaccine gives a false positive for the skin test and so she would require further testing in the form of the sputum test. According to this: http://www.uptodate.com/contents/patient-information-tuberculosis (go to Active TB) some people do the treatment for TB while waiting for the results of the sputum test. In your case this would be beneficial and cut down on wait time.

2. I would ask (the panel physician) about starting TB treatment to get a jump start on it.

3. No idea what test you're talking about.

4. No. See my previous post.

5. No idea. Are there expiry dates on the documents? I think someone else answered this above.

6. No idea again I'm sorry. I know it can take up to 2 months to get the sputum test results. Do you get to jump to the front o the line for interviews? Or are you back at the end? I would say you are highly unlikely to be getting married 11.11.11 and possibly wont be together in time for Christmas.

7. I don't believe so but it couldn't hurt to ask and see what they say could it? I mean you DID pay for the tests. I'd ask.

[David79 7]

We could understand and deal with this all a whole lot better if we were really given all the information instead of some little slip of paper and the words of a receptionist. There is really only one person in her family that had TB and that was over 10 years ago, and I very seriously suspect that her mom may have been diagnosed and treated incorrectly because by the time her lung cancer was determined, she was in stage 3 or stage 4. There are also blood tests that produce results much quicker than waiting 8 weeks for a culture to "maybe" grow.

I am certainly most concerned about Eve's health and I certainly wouldn't want to expose anyone to something like TB simply because we didn't want to wait for some test. My biggest problem with the whole thing is that they aren't doing what is in the best interest of the patient. This is the U.S. government doing this, not the Philippine government. Using better testing methods that produce results in reasonable times are possible and not being used. The U.S. is a "super power" and one of the most advanced countries in the world, but we are subjecting people to this kind of treatment? While I am very thankful that up until this point our processing has gone quicker than normal, I honestly feel like by trying to do the right thing we are being punished by a mountain of paperwork and red tape while people who illegally flood our borders everyday seem to get better treatment. How many thousands of illegal aliens are in the U.S. without any of the right medical exams, tests, and vaccinations, yet when someone tries to do the right thing and follow all the rules they lose years of their lives to what everyone on this forum sees everyday.

--Jim

So true!

[David79 7]

We could understand and deal with this all a whole lot better if we were really given all the information instead of some little slip of paper and the words of a receptionist. There is really only one person in her family that had TB and that was over 10 years ago, and I very seriously suspect that her mom may have been diagnosed and treated incorrectly because by the time her lung cancer was determined, she was in stage 3 or stage 4. There are also blood tests that produce results much quicker than waiting 8 weeks for a culture to "maybe" grow.

I am certainly most concerned about Eve's health and I certainly wouldn't want to expose anyone to something like TB simply because we didn't want to wait for some test. My biggest problem with the whole thing is that they aren't doing what is in the best interest of the patient. This is the U.S. government doing this, not the Philippine government. Using better testing methods that produce results in reasonable times are possible and not being used. The U.S. is a "super power" and one of the most advanced countries in the world, but we are subjecting people to this kind of treatment? While I am very thankful that up until this point our processing has gone quicker than normal, I honestly feel like by trying to do the right thing we are being punished by a mountain of paperwork and red tape while people who illegally flood our borders everyday seem to get better treatment. How many thousands of illegal aliens are in the U.S. without any of the right medical exams, tests, and vaccinations, yet when someone tries to do the right thing and follow all the rules they lose years of their lives to what everyone on this forum sees everyday.

--Jim

By the way, my fiancee is having her 2nd day at St Luke's today too! It will be a few hours before I hear about what the results are. I am not really worried about her health (I am confident she is in great health) as much as they'll find something that will require "more tests" and will delay the whole process.

[Tahoma 2,292]

We could understand and deal with this all a whole lot better if we were really given all the information instead of some little slip of paper and the words of a receptionist. There is really only one person in her family that had TB and that was over 10 years ago, and I very seriously suspect that her mom may have been diagnosed and treated incorrectly because by the time her lung cancer was determined, she was in stage 3 or stage 4. There are also blood tests that produce results much quicker than waiting 8 weeks for a culture to "maybe" grow.

I am certainly most concerned about Eve's health and I certainly wouldn't want to expose anyone to something like TB simply because we didn't want to wait for some test. My biggest problem with the whole thing is that they aren't doing what is in the best interest of the patient. This is the U.S. government doing this, not the Philippine government. Using better testing methods that produce results in reasonable times are possible and not being used. The U.S. is a "super power" and one of the most advanced countries in the world, but we are subjecting people to this kind of treatment? While I am very thankful that up until this point our processing has gone quicker than normal, I honestly feel like by trying to do the right thing we are being punished by a mountain of paperwork and red tape while people who illegally flood our borders everyday seem to get better treatment. How many thousands of illegal aliens are in the U.S. without any of the right medical exams, tests, and vaccinations, yet when someone tries to do the right thing and follow all the rules they lose years of their lives to what everyone on this forum sees everyday.

--Jim

St. Lukes uses the best testing methods for TB; smear tests followed by a culture. Blood tests for TB are unreliable and are not recommended by the World Health Organization.

So true!

Not.

[Tahoma 2,292]

So if you have had a family member that has had TB, yet have been tested. Is it ur opinion that by just saying yes to family history question puts you at risk for a possible spetum test? If thats so, is it still the best thing to do to answer that question yes? Ihave also seen people talking about bringing a recently taken xray with them to the interview does that mean anything to st Lukes?

When Chinook had her medical at St. Lukes, they didn't ask her anything about being exposed to TB. Like everyone else, they gave her a chest x-ray.

By the way, why in the world would anyone not divulge their exposure to TB if asked? If the person actually had TB, they could spread it to others.

St. Lukes will look at x-rays you bring to the medical for comparison purposes, but they (and their x-ray) have the final word.

[David79 7]

Not.

Somebody has their panties in a wad! hahaha

Edited September 14, 2011 by David79