Dreaded Sputum

[RO_AH 1,614]

Medical for my wife today and she got the dreaded sputum test. When does it all end? Now 3 more trips to Manila, then wait (I believe 2 months) for results?

Edited February 8, 2021 by RO_AH

[RO_AH 1,614]

I never worried much about the sputum just hoping it would not happen to my wife. Now that it has it brings up something that I have always wondered...Why? In the US they do the skin test or blood test. Why the sputum there?

 

https://www.cdc.gov/tb/topic/testing/tbtesttypes.htm

[Chancy 6,233]

1 minute ago, RO_AH said:

In the US they do the skin test or blood test. Why the sputum there?

 

Because the Philippines is in the list of countries with high tuberculosis burden.  For 2019, WHO estimate for TB incidence in the PH is 554 per 100k population.  Much higher than the CDC threshold of 20 per 100k.  https://worldhealthorg.shinyapps.io/tb_profiles/?_inputs_&entity_type="country"&lan="EN"&iso2="PH"

 

Here's the link for the CDC guidelines for TB testing for applicants for immigration -- https://www.cdc.gov/immigrantrefugeehealth/exams/ti/panel/tuberculosis-panel-technical-instructions.html#screening

 

Applicants ≥15 years of age who are living in countries with a WHO-estimated tuberculosis disease incidence rate of ≥20 cases per 100,000 population must have a chest x-ray. If an applicant has a chest x-ray with findings suggestive of tuberculosis disease, has signs or symptoms of tuberculosis disease, or has known HIV infection, the applicant must provide three sputum specimens to undergo microscopy for AFB, as well as culture for mycobacteria, confirmation of the Mycobacterium species at least to the M. tuberculosis complex level, and drug susceptibility testing for positive cultures.

 

[flicks1998 1,044]

1 hour ago, RO_AH said:

I never worried much about the sputum just hoping it would not happen to my wife. Now that it has it brings up something that I have always wondered...Why? In the US they do the skin test or blood test. Why the sputum there?

 

https://www.cdc.gov/tb/topic/testing/tbtesttypes.htm

Sorry to hear this has happened.  There have been one or two people posting in this Philippine section over the last 2-3 months who have had this happen.  I remember they posted a timeline but dont remember who it was or what that timeline is but its relatively current information.

[seekingthetruth 1,218]

1 hour ago, RO_AH said:

I never worried much about the sputum just hoping it would not happen to my wife. Now that it has it brings up something that I have always wondered...Why? In the US they do the skin test or blood test. Why the sputum there?

 

https://www.cdc.gov/tb/topic/testing/tbtesttypes.htm

Hoping for a quick and good outcome here!

 

[Hank_ 9,171]

3 hours ago, RO_AH said:

I never worried much about the sputum just hoping it would not happen to my wife. Now that it has it brings up something that I have always wondered...Why? In the US they do the skin test or blood test. Why the sputum there?

 

https://www.cdc.gov/tb/topic/testing/tbtesttypes.htm

They complete SPUTUM in the states also ... IF the skin/blood test is positive.

 

They do the IGRA (blood test) in the Philippines but only with children (14 and under), if positive then the child would complete SPUTUM  

[nelmagriffin 140]

Greetings!

I think the main reason of why skin testing is not used in the Philippines because most of the Filipinos are vaccinated with BCG vaccines. BCG vaccine can cause a false positive result for tuberculosis.

BCG vaccine:

Bacillus Calmette–Guérin vaccine is a vaccine primarily used against tuberculosis. In countries where tuberculosis or leprosy is common, one dose is recommended in healthy babies as close to the time of birth as possible.

During medical :

1.       15 years old and above will have a chest X-Ray.

2.       If the findings are abnormal then the applicant will undergo sputum testing to rule out TB.

3.       SLEC will culture these samples for 2 months. They may call you ahead if positive.  So if the sputum test is positive,  confirming TB bacteria is detected, then the applicant will undergo for 6 months DOT treatments.

(DOT, meaning directly observed therapy)

     After TB is confirmed SLEC requires the applicant to receive medication daily (5 days per week) at their facility for 6 months.

5.       SLEC will take three sputum testing with that 6 months DOT process.

6.       On the 7^th month you will have to get the final TB sputum result, get the treatment papers and redo your medical.

7.       So overall, more or less 9 -month process.

References:

BCG vaccine can cause a false positive result for tuberculosis | To Your Good Health | stltoday.com

BCG vaccine - Wikipedia

 

NOTE: SLEC may have changes. Best of luck, NG

Edited February 9, 2021 by nelmagriffin

[RO_AH 1,614]

What upsets me the most about this is what the Dr. told my wife. They said it could also be cancer 😲. Seriously? She is 31 years old and never smoked a day in her life and you want to make her think she may have cancer??? Her chances of having lung cancer are about as close to zero as you can get. Now I have to keep trying to convince my wife that she will be okay.

[Adventine 3,187]

@RO_AH that's awful. I'm the same age as your wife, non-smoker, and it's a ridiculous thing for any doctor to say.

 

[RO_AH 1,614]

When my wife went in today for sputum her number was 43, and that is only the line for sputum test. I think the need to clean the lens on their x-ray machine 🤣

[Allovertheworld 355]

6 hours ago, RO_AH said:

What upsets me the most about this is what the Dr. told my wife. They said it could also be cancer 😲. Seriously? She is 31 years old and never smoked a day in her life and you want to make her think she may have cancer??? Her chances of having lung cancer are about as close to zero as you can get. Now I have to keep trying to convince my wife that she will be okay.

I sent my gf in Davao City to get a depo shot, two refused to give it to her. One doctor told her it would make her sterile.

 

I can see silliness like this in the province, but at SLEC you would think they would have better trained doctors

[flicks1998 1,044]

9 hours ago, Allovertheworld said:

I sent my gf in Davao City to get a depo shot, two refused to give it to her. One doctor told her it would make her sterile.

 

I can see silliness like this in the province, but at SLEC you would think they would have better trained doctors

You would think, but that kind of diagnosis is rife in the International hospitals as well.  I cant tell you how many examples Ive heard of people diagnosed with "cancer" and actually started radiation when in fact it was never cancer.  It goes the reverse way as well.  I had a team members father who really did have cancer, but was diagnosed in Manila Hospital as having a spell cast upon him for having a mistress behind his wife's back.  We had to take her to the only known good cancer specialist in the country at Asian Hospital just to be properly diagnosed but by then it was too late. 

[Lemonslice 4,549]

13 hours ago, Allovertheworld said:

I sent my gf in Davao City to get a depo shot, two refused to give it to her. One doctor told her it would make her sterile.

 

I can see silliness like this in the province, but at SLEC you would think they would have better trained doctors

Same happens in the US, with doctors saying hormonal contraceptives are abortifacient and refusing to prescribe them.  Unfortunately, stupidity can be found everywhere.

[angeljolie 183]

Had my medical exam earlier this month and I, too, have been flagged for an "unclear" PA chest xray and have been subjected to this dreaded sputum test. It came as a surprise because I never had problems with any of my xrays in the past. I also just had chest xrays (3 views) in December for my annual medical exam at work and they all came back normal. Being subject to SLEC's sputum testing is a hard pill to swallow. I was really devastated and, for days, I felt uninspired to go on. I had sleepless nights. I had so many questions going in my mind-- why me? What if I'm really sick? When will I see my husband again? Although I have no signs of TB at all, it made me doubt my own health, which was really stressful. 

 

The first day of sputum collection, I arrived at 6:00 AM and was 74th (!) on the queue. Second day I was 21st, and third day I was 15th. Since I didn't have a cough, getting sputum out was nearly impossible. On the last day of sputum collection, I was asked to see the pulmonologist for the pulmonary evaluation. All 3 samples came out smear-negative. The doctor showed me why she recommended sputum testing-- on the PA view, she saw infiltrates on my upper left lung. I didn't see anything, tbh (not that I knew what to look for, but it wasn't any different from my December xray). She also told me that these infiltrates were not visible on the AP view (they asked me to do this on the 2nd day of medical exam and this was supposed to be a better view, btw). But since one view had an abnormality, then the sputum testing. 

 

After I was told I had to undergo the sputum test, I began reading about TB diagnosis. I didn't really understand why they had to do chest xrays first but I read that an estimated third of the world population had at some point been exposed to TB (but not necessarily developed TB disease), and therefore would probably test positive on IGRA. The skin test has been proven to be less reliable. So there.

 

Anyway, the waiting begins again. I feel very anxious every time I get calls or text messages from numbers not in my phonebook. The only thing I can do is keep praying that the culture will come out negative so we can all move on. This will be the longest 8 weeks of my life for sure. It's very stressful, to say the least. 

 

On a side note, the embassy revoked my B1/B2 visa 3 days after they sent me an interview appointment (which obviously has been cancelled by SLEC). Was supposed to visit the US this month. The bright side is I got the revocation notice before getting my confirmed booking ticketed (I went as far as booking my flights but encountered an error after entering the payment details). Story of my life.

Edited February 10, 2021 by angeljolie

[Adventine 3,187]

@angeljolie That's a terrible combination of bad things happening all at once... I'm very sorry to hear about all that.

 

Silver lining, based on your timeline, your spousal visa process has been going quite fast (petition filed in Aug 2020 and inteview already in Feb 2021). Maybe a small consolation.