sputum test

[DennisMN 12]

Greetings,

First of all Bless You and your spouse.

We had to do just as you are now.

The three days of early morning sputum sampling.

Getting the "smear" test results of negative but, still need to wait for the 8 week "cultured" tests which were negative.

There is light at the end of the tunnel, but feels of lost of control and a predictable time table are definitely what we felt.

St. Luke's doesn't do a good job of communication to the client.  I started out being mad at them, but I have in my reading come a 180 degrees in accepting the reasons in the protocol that they are doing.  It is very hard to accept at this time in the "Visa Journey".  It freezes all of your plans or predication to making plans.

 

But once cleared we were able to do things quickly for an interview, got our VISA, CFO, Taxes, and plane tickets for the kids to start school this Fall in the US.

The very best.

[mbassett 288]

33 minutes ago, TXBill said:

Daily treatments at SLEC? It can't be at another hospital St. Luke's BGC/Asian/medical city?

 

How much more did it cost?

Daily treatments at SLEC is the quickest way to ensure success if needed

I have heard of people doing a 12 month program elsewhere and then doing the medical again

We were lucky and did not require treatment after the sputum culture but had decided to go the daily route via SLEC as a worse case

 

this has a good explanation of the treatment posted , hopefully you will not need it

also I do not believe there is a additional cost for the treatment

 

http://www.lovevisalife.com/2017/10/slec-new-fees-tb-skin-test-procedure/

[Hank_ 9,174]

51 minutes ago, TXBill said:

Daily treatments at SLEC? It can't be at another hospital St. Luke's BGC/Asian/medical city?

 

How much more did it cost?

 

Only at SLEC .. thus why it is call DOT - Direct Observation Therapy  (they want to see you take the medication)

 

Cost?  Included in the medical fee  ...         But being you when past the 6 month mark for the medical (thus visa validity) you would be required to pay for and complete a 2nd medical.    

[Hank_ 9,174]

23 minutes ago, mbassett said:

Daily treatments at SLEC is the quickest way to ensure success if needed

I have heard of people doing a 12 month program elsewhere and then doing the medical again

We were lucky and did not require treatment after the sputum culture but had decided to go the daily route via SLEC as a worse case

 

this has a good explanation of the treatment posted , hopefully you will not need it

also I do not believe there is a additional cost for the treatment

 

http://www.lovevisalife.com/2017/10/slec-new-fees-tb-skin-test-procedure/

 

IF... if a person were to complete the TB medication elsewhere than at SLEC it would add a year to the process ... AFTER completing the 6 months of medication.    That is 18 months twiddling your thumbs.

 

St. Luke's is the only CDC recognized hospital for this process.

Edited August 28, 2019 by Hank_

[ram1009 46]

3 hours ago, payxibka said:

Your preaching to the choir.  Not sure why you feel the need to show a Canadian link for a US policy that we have no influence over 

First, I didn't notice it was Canadian but I don't care either.  The point I'm making is that superior technology exists that would save many people much time and get needed treatment to more people much faster.  Don't you think those are worthy goals?  Living in the Philippines is like living on the moon sometimes.  Also, this is a prime example of how the entire US immigration machine is geared toward making the process as difficult and protracted as possible ie why use a 24 hour test when you can require 8 week test.  

[payxibka 10,048]

10 minutes ago, ram1009 said:

First, I didn't notice it was Canadian but I don't care either.  The point I'm making is that superior technology exists that would save many people much time and get needed treatment to more people much faster.  Don't you think those are worthy goals?  Living in the Philippines is like living on the moon sometimes.  Also, this is a prime example of how the entire US immigration machine is geared toward making the process as difficult and protracted as possible ie why use a 24 hour test when you can require 8 week test.  

It has nothing to do with the moon like Philippines,  has nothing to do with the immigration machine,  it has everything to do with the CDC.  Get the CDC into the 21st century,  the immigration machine will follow 

[Hank_ 9,174]

Point we are making is >  you want the visa .. you follow the "rules".   

 

 

You can come on here to rant and that is fine, but in the end .... you follow the "rules" or no visa.

 

In the case of TB, CDC makes the rules, has nothing to do with the Philippines

 

The Philippines being on the "hit parade" for countries high in TB just makes it more common for  SPUTUM and DOT.

[ADW & JOP 146]

As a point of clarification, Tb sputum testing is still the gold standard for exluding pulmonary Tb.

 

NAA testing is less sensitive than Tb sputum. It's primary benefit is rapidity at achieving a diagnosis, say you want to make a diagnosis early to start treatment, but the sputum culture, which is more sensitive, is the proper test to rule out pulmonary Tb.

[ram1009 46]

31 minutes ago, payxibka said:

It has nothing to do with the moon like Philippines,  has nothing to do with the immigration machine,  it has everything to do with the CDC.  Get the CDC into the 21st century,  the immigration machine will follow 

Sorry, but I think you're being naive.  Someone in immigration would find a way to require an 8 week test over a 24 hour test no matter what the CDC says.  Just like they require patients to show up for their meds every morning for 6 months.  Such ludicrous policies would never stick on US soil.  Clearly, the goal of those and many other policies is to discourage compliance so as to reduce immigration.  I don't see how my fiance will be able to comply if she must do the 6 month treatment.

[ADW & JOP 146]

5 minutes ago, ram1009 said:

Sorry, but I think you're being naive.  Someone in immigration would find a way to require an 8 week test over a 24 hour test no matter what the CDC says.  Just like they require patients to show up for their meds every morning for 6 months.  Such ludicrous policies would never stick on US soil.  Clearly, the goal of those and many other policies is to discourage compliance so as to reduce immigration.  I don't see how my fiance will be able to comply if she must do the 6 month treatment.

Direct Observation Therapy (DOT) is the best way to ensure adherance of therapy. Why is this important? Because Tb develops resistance quickly, hence the importance of starting any patients with a presumed Tb with 4 agents. There are places in this world that has multidrug resistance Tb. This concept is used in North America, both in Canada and US.

 

As mentioned, the gold standard test to rule out pulmonary Tb is the sputum culture test. Even per your link, it mentions that you use rapid sputum test when:

• A person is thought to have TB, but confirmation is needed before sputum culture results will be ready.

 

This does not equate to using the rapid sputum test to exclude pulmonary Tb as the sensitivity of sputum culture is greater than the rapid sputum test.

Edited August 28, 2019 by ADW & JOP

[ram1009 46]

3 hours ago, mbassett said:

Excellent point, that is why we where diligent about getting the follow on once stateside

TB can and is a very serious disease, her health should be the most important thing at this point

Why not focus on the extreme inconvenience?  Do you actually believe it necessary to show up every morning at the SLEC door to take a pill.  More people are discouraged than encouraged by draconian measures like that.  It's clear to me they would prefer patients would never come back once diagnosed.

[ram1009 46]

8 minutes ago, ADW & JOP said:

Direct Observation Therapy (DOT) is the best way to ensure adherance of therapy. Why is this important? Because Tb develops resistance quickly, hence the importance of starting any patients with a presumed Tb with 4 agents. There are places in this world that has multidrug resistance Tb. This concept is used in North America, both in Canada and US.

 

As mentioned, the gold standard test to rule out pulmonary Tb is the sputum culture test. Even per your link, it mentions that you use rapid sputum test when:

• A person is thought to have TB, but confirmation is needed before sputum culture results will be ready.

 

This does not equate to using the rapid sputum test to exclude pulmonary Tb as the sensitivity of sputum culture is greater than the rapid sputum test.

Unless you are an MD please quote your sources.

[Lone Wolf 4]

10 minutes ago, ram1009 said:

Sorry, but I think you're being naive.  Someone in immigration would find a way to require an 8 week test over a 24 hour test no matter what the CDC says.  Just like they require patients to show up for their meds every morning for 6 months.  Such ludicrous policies would never stick on US soil.  Clearly, the goal of those and many other policies is to discourage compliance so as to reduce immigration.  I don't see how my fiance will be able to comply if she must do the 6 month treatment.

From experience I think you are wrong. My GF was sick, got chest X-Ray that did not look good at all, did the SPUTUM test and it showed NEGATIVE.  

Her symptoms and X-Rays convinced the doctor different and she was referred for treatment.

Another SPUTUM test was done, it was 3+ weeks before it showed positive. And she was seriously active already.  

I do not know why this can happen in some people, but I do believe it is the reason the guideline is 8 weeks. Short term SPUTUM can give a false negative.

 

[Lone Wolf 4]

10 minutes ago, ram1009 said:

Why not focus on the extreme inconvenience?  Do you actually believe it necessary to show up every morning at the SLEC door to take a pill.  More people are discouraged than encouraged by draconian measures like that.  It's clear to me they would prefer patients would never come back once diagnosed.

While I know it is a royal pain, the DOT is a "draconian measure" required at some clinics in the U.S. too. 

 

[ADW & JOP 146]

13 minutes ago, ram1009 said:

Unless you are an MD please quote your sources.

So happens that I am an MD. Trained completely in Canada, board certified in Canada and US and medical licensed in Canada/US.

 

I also volunteer in a developing country where I met my wife. We had our own Tb floor, and I order the rapid sputum test more than 100s of times, not because it is a more superior test to exclude Tb, but because the follow-up rates in the country are very low. Multi-drug resistant Tb is also a thing there.

 

The source I use is https://www.uptodate.com/contents/diagnosis-of-pulmonary-tuberculosis-in-adults. If you are so inclined to review it, it does cost money for a subscription. 

 

I am not arguing for or against immigration policies, I am strictly referring to the use of the test. Again, the gold-standard test to exclude pulmonary Tb is sputum culture.

Edited August 28, 2019 by ADW & JOP