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    Old 12-17-2003, 12:24 AM   #1
    crabbycdn
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    Question Latent TB

    Anybody know much about Latent TB? Our local Health Authority requires those of us on "The Watch List" to provide yearly sputum samples for AFB testing and a yearly chest x-ray. So, here's the question. You provide your requisite samples and then a few months later get a viral, then bacterial illness that just won't go away for good. A productive cough, night sweats (4 nights out of 7), fever (3 days out of 5), stridor, general malaise (tired, icky, short of breath, feel like crap), can be attributed to a whole lot of other things. The kids I grew up with that actually GOT TB didn't even look sick. The Feds. (Health and Welfare Canada) in those days would just arrive in a Northern community and scoop up a bunch of kids and a few days later their whole families disappeared. Very freaky for us growing up.....now you know why I believe in aliens Wait, if you had seen our recently retired P.M. you would believe in aliens too. All the stuff I read on the NET about TB and it being an illness that you get REALLY sick must be talking about advanced disease. I can't get a whole lot of info. on what I am even supposed to be watching for. I sure don't want to run back to the doctor every time I get a cough.
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    Old 12-17-2003, 06:25 AM   #2
    mnemosyne
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    Re: Latent TB

    Quote:
    Originally Posted by crabbycdn
    Anybody know much about Latent TB? Our local Health Authority requires those of us on "The Watch List" to provide yearly sputum samples for AFB testing and a yearly chest x-ray. So, here's the question. You provide your requisite samples and then a few months later get a viral, then bacterial illness that just won't go away for good. A productive cough, night sweats (4 nights out of 7), fever (3 days out of 5), stridor, general malaise (tired, icky, short of breath, feel like crap), can be attributed to a whole lot of other things. The kids I grew up with that actually GOT TB didn't even look sick. The Feds. (Health and Welfare Canada) in those days would just arrive in a Northern community and scoop up a bunch of kids and a few days later their whole families disappeared. Very freaky for us growing up.....now you know why I believe in aliens Wait, if you had seen our recently retired P.M. you would believe in aliens too. All the stuff I read on the NET about TB and it being an illness that you get REALLY sick must be talking about advanced disease. I can't get a whole lot of info. on what I am even supposed to be watching for. I sure don't want to run back to the doctor every time I get a cough.
    I think that any active TB infection is likely to cause fairly severe symptoms. It's not a disease that causes a slow progression from okay to severe, but rather something your body either has control of or doesn't. If you have latent TB, your immune system is functioning well and keeping the TB bacteria in check. You're not infectious and cannot spread the disease to others. If you've been disease-free for many years, you're likely safe and probably only need to worry about developing TB if your immune system becomes somehow compromised: i.e. AIDS, diabetes, etc.

    I think you should look for a productive cough lasting 2 weeks or more, especially if you are coughing up blood, fever, chills, night sweats, etc. So, the symptoms you described can be - as you said - caused by a number of different viral or bacterial infections, or (perhaps) by TB. If I were you, I'd consider going to the doctor about a three-day long fever, especially if its high. If it is borderline high, (about 100 degrees), I wouldn't be as worried. Still, given your latent TB, I wouldn't worry about going to the doctor too quickly, etc.

    I hope I helped.

     
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    Old 12-17-2003, 08:02 AM   #3
    crabbycdn
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    Re: Latent TB

    Quote:
    Originally Posted by mnemosyne
    I think that any active TB infection is likely to cause fairly severe symptoms. It's not a disease that causes a slow progression from okay to severe...
    Contrary to what a lot of the professional medical writing says, I know this in fact NOT to be always true. I know this simply because I grew up in a northern community where there was LOTS of TB. It was only the elderly and those with very advanced disease that got REALLY sick. There were many (and I mean MANY) who as I remember it only appeapred to have bad "colds" for a long time. Granted, by the time the late 1960's, early 70's rolled around, the Feds. were doing a pretty good job of monitoring and anybody with new infection was rounded up in the bi-annual, "line 'em up, poke 'em or x-ray 'em".

    Quote:
    Originally Posted by mnemosyne
    ...You're not infectious and cannot spread the disease to others.
    Again, this is a gray area. Yes, a person is only infectious if they themselves are actively infected. However, new TB or Latent TB that has become active is not always easily seen on an x-ray. As well, the AFB tests take WEEKS to come back.

    [QUOTE=mnemosyne]...If you've been disease-free for many years, you're likely safe and probably only need to worry about developing TB if your immune system becomes somehow compromised: i.e. AIDS, diabetes, etc. [QUOTE]
    Also, not out there for information is that "etc." includes repeated viral/bacterial infections, chronic respiratory infections, and basically anything else that poops on your immune system. Oh, and yes I am diabetic as well as a lot of "etc."

    [QUOTE=mnemosyne]...I think you should look for a productive cough lasting 2 weeks or more, especially if you are coughing up blood, fever, chills, night sweats, etc. So, the symptoms you described can be - as you said - caused by a number of different viral or bacterial infections, or (perhaps) by TB. If I were you, I'd consider going to the doctor about a three-day long fever... [QUOTE]
    So that's the trouble you see, because I have such a crappy immune system, I get frequent viral infections with these exact symptoms.

    Quote:
    Originally Posted by mnemosyne
    ...given your latent TB, I wouldn't worry about going to the doctor too quickly, etc.
    EXACTLY! But there have been many recent cases exactly like mine. Personally, I don't gives a rat's patootie about myself....I just worry about having early active TB and infecting others without knowing it.
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    Last edited by crabbycdn; 12-17-2003 at 08:04 AM.

     
    Old 12-17-2003, 12:17 PM   #4
    mnemosyne
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    Re: Latent TB

    Quote:
    Originally Posted by crabbycdn
    EXACTLY! But there have been many recent cases exactly like mine. Personally, I don't gives a rat's patootie about myself....I just worry about having early active TB and infecting others without knowing it.
    You really know what you're doing, except for the not giving a rat's patootie about yourself: you should! You're as important as anyone else. In your position, I think I'd go to the doctor with most fevers and/or with lower-grade symptoms that last longer than two weeks, no matter how prone to them I am. Otherwise, you're doing all you can...

     
    Old 12-17-2003, 03:33 PM   #5
    wrin
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    Re: Latent TB

    The night sweats thing makes me worry. That's really all it is. When you really come down to it, a chest x-ray and AFB doesn't take that long -- ask your doctor (family doc) next time you see him about that, and see what he says. My personal feeling is that it wouldn't be such a terrible idea for you to have lab stuff done when you get the night-sweats cold thing coming on and see what the AFB comes back as.

    I'm assuming by 'the watch list' they mean the people with a positive mantoux?

    And is a possibility for you to GO to a lab and get the specimen-type stuff done? I mean, I'm not sure what kind of lab access you have up there. You say "northern community" and I immediately think fort mcmurray.

     
    Old 12-17-2003, 05:53 PM   #6
    crabbycdn
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    Re: Latent TB

    I was born and raised in the Northwest Territories, so when I say "northern community" I mean up there. Yes, when I say "watch list", it is because I have been a "postive reacter" (Mantoux) since I was a child.

    The tests are not processed here. They are sent to Edmonton. X-Rays are also sent to the TB clinic in Edmonton. What I am really wondering is if it is possible that the problems I am having with my throat (larynx) could be TB?

    Anyway, thanks for the advice. I will try to get in to my doctor after Christmas if things have not settled down.

    Last edited by crabbycdn; 01-04-2004 at 07:29 PM.

     
    Old 12-17-2003, 06:49 PM   #7
    wrin
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    Re: Latent TB

    That would make perfect sense.
    Also the bit about the tests having to be sent to Edmonton -- I didn't think you'd have a microbiology lab up north that's capable of handling TB specimens.

    It's tough to say. Sometimes wheezy sounds from the lower airways can be transmitted up and sometimes the stridor is transmitted back down and they sound like one another. I would say that the chances tuberculosis would infect your larynx and give you vocal chord stridor would be pretty much nil -- Tuberculosis loves the top bits of your lungs (the bits up by your shoulders) because they get exposed to more oxygen that way and the TB bug looooves its oxygen.

    And you have the right attitude -- you're fine now, there's no freaking out to be had, if things don't settle down, meh, it can wait 'til after christmas, if things do settle down, wait 'til your next routine physical... or whatever you're comfortable with!

    Growing up in the NWT makes perfect sense for why you'd be more at risk for TB. Very isolated communities like that have a harder time keeping the TB bug at bay simply because of access to things like microbiology labs, powerful antituberculosis drugs, etcetera.

    At least they KNOW you have a positive mantoux. It's something they're pretty concerned about -- they make (as far as I know) all healthcare workers in the Edmonton region go for a Mantoux every year to check their TB status if they're negative.

     
    Old 01-03-2004, 06:49 PM   #8
    crabbycdn
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    Re: Latent TB

    So, the pain in the lungs is much WORSE. Night sweats are worse. Blood tests today showed "very high white cell count" and x-rays showed "something". So now I just sit and wait until the x-rays come back I guess. I requested they do an AFB but the doctor would like to wait and see what the specialist says about the x-rays. Pneumonia would truly be a drag right now but I am at a bit of a loss for what else could be causing this much lung pain.
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    Old 01-03-2004, 10:45 PM   #9
    wrin
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    Re: Latent TB

    For crack's sake.

    I can't believe your doctor is holding off doing an AFB this much. It's super-simple when compared to like, a culture, or whatever, which is best for a diagnosis anyway.

    GAH.

    X-rays are just fancy photographs and are subject to the same pitfalls -- over and underexposure, fingerprints, shadows, screwy tech knowledge, that kind of thing.

     
    Old 01-04-2004, 11:44 AM   #10
    crabbycdn
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    Re: Latent TB

    Quote:
    Originally Posted by wrin
    For crack's sake.I can't believe your doctor is holding off doing an AFB this much. It's super-simple...
    Welcome to health care in Siberia. The worst thing about AFB sampling is knowing that the icky stuff is sitting in your fridge for a couple of days.
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    Last edited by crabbycdn; 01-04-2004 at 04:43 PM.

     
    Old 01-04-2004, 02:25 PM   #11
    wrin
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    Re: Latent TB

    Don't talk to me about sub-standard healthcare in Alberta -- I've worked in some of the most beautiful hospitals I've ever seen, here in Edmonton. We're fairly well taken care of when you really come down to it. If the doctor's making a bad decision, it isn't Ralph's fault -- and don't listen to what the nurses are saying, they're the highest paid in the country and would rather leave our healthcare system hanging nurseless (illegally). They'd rather that the extra cash go into their pockets than to help buy better equipment for the hospitals (the Mis just recently got a brand new CT scanner) and they're my personal pet peeve. Ralph's been catering to them for years and the rest of the country looks at them like they're a bunch of idiots.

     
    Old 01-04-2004, 04:41 PM   #12
    crabbycdn
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    Alberta Healthcare

    Quote:
    Originally Posted by wrin
    Don't talk to me about sub-standard healthcare in Alberta -- I've worked in some of the most beautiful hospitals I've ever seen, here in Edmonton.
    I can't speak for healthcare in Alberta as a whole. We consider ourselves "Siberia" in many ways. UofA has a pretty spectacular reputation as do some of the other "city hospitals". Unfortunately, as you get away from the larger centres, the quality of care dimishes significantly. The sad joke here when somebody has been seriously ill is when you ask them how they are doing the response is, "They haven't managed to kill me yet." I have personally experienced and witnessed some pretty serious medical errors. I apologize if I present the impression that ALL healthcare in Alberta is bad. I speak from what I know and I sure do not have much confidence in our region's healthcare system. Check out Macleans Magazine's study on healthcare in Canada. THIS region received the WORST rating of ANY region in Canada. I believe the Edmonton-Capital Region scored pretty high. I apologize if I offended, this was not my intent...
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    Last edited by crabbycdn; 01-04-2004 at 09:35 PM.

     
    Old 01-04-2004, 08:32 PM   #13
    wrin
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    Re: Latent TB

    I guess what you say is true -- but I still maintain that crappy doctors are not Ralph's fault -- though he does make a very convenient scapegoat.

     
    Old 01-04-2004, 09:32 PM   #14
    crabbycdn
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    Quote:
    Originally Posted by wrin
    crappy doctors are not Ralph's fault -- though he does make a very convenient scapegoat.
    Yup. Around here we use "Ralph" as a descriptive for the provincial government in general. Just like in the U.S. they would use "Uncle Sam" to describe the U.S. govt. Complaining about government is one of our great national past-times. Right up there with hockey, curling and ice fishing Good grief, when its -40 and the cable is out what else are we supposed to do?

     
    Old 01-05-2004, 12:30 AM   #15
    wrin
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    Re: Latent TB

    The locations match so therefore I understand where you're coming from

     
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