Jill

Just got my INS medical and my TB test turned up positive. I wasn't at
all worried by this as I expected it to, due to having had a BCG.

They did the chest X-ray - it was clear - but they are still insisting
that i take 9 months of antibiotics to kill the TB.

I do *not* want to take any drugs I don't need, and I am not convinced
I have any kind of dangerous infection. I asked if I could wait and
get a second opinion before I decided what to do.

This resulted in my forms being marked with the information that I
"refused" the recommended treatment. At this, I backed down and they
gave me a bottle of antibiotics and a bottle of B6. They couldn't
find the patient information booklet, but assured me there would be
"no side effects", apart from "possible liver failure". (They already
had taken blood for a liver function test - came back OK). Now I have
to return to the clinic once a month for more pills and to be tested
for liver function.

I am really unhappy about this, I don't feel my questions were
answered properly. My current understanding is that if I don't take
the pills and don't return to the clinic monthly I will be reported to
the CDC and maybe to the INS. I have already spent over 9 hours on 4
separate visits to get this far.

Does anybody have any idea if this is correct? I have already made an
appt. to see another Dr. (not a civil surgeon) to discuss the matter,
but now I have my signed INS medical forms ready to go. Can I submit
them, or if I later decide not to complete the treatment, could I get
into trouble?

Has anybody else come across this issue? I thought it was par for the
course for Western Europeans and those with BCGs to have a +ve on the
Mantoux TB test - do I really have to take these evil antibiotics?

thanks

Jill

lairdside

Where did you get your medical ? I also came up as "borderline" on the TB test due having had a BCG in my childhood. I was sent for x-ray, came up clear and that was the end of the matter.

MrsLondon

Nearly everyone in the UK had the BCG at school. Surely they don't make everyone have 9 months of antibiotic for non existing TB? That's plain ridiculous. Don't take them, just say you did!

Hnchoksi

    >Subject: Re: TB test, BCG and 9 months of antibiotics
    >From: MrsLondon [email protected]
    >Date: 4/23/03 8:06 PM Eastern Daylight Time
    >Message-id:
    >Nearly everyone in the UK had the BCG at school. Surely they don't make
    >everyone have 9 months of antibiotic for non existing TB? That's plain
    >ridiculous. Don't take them, just say you did!

Still have to wait that long though...

dbark

If you don't mind my asking, which country/embassy are you going through?

Debbie

Andy Platt

It was highly recommended to me that I did that but of course I didn't; it's
unnecessary and the side effects can be bad. Plus you can't drink for that
duration - I'm nowhere close to being a heavy drinker but having a glass of
wine in the evening with dinner is good for your health! Having a clear
X-Ray is good enough. You do *not* need to take the antibiotics since you do
*not* have active TB. Of course persuading the consulate / medical official
they are wrong could be difficult.

Andy.

--
I'm not really here - it's just your warped imagination.
"Jill" wrote in message
news:[email protected]...
    > Just got my INS medical and my TB test turned up positive. I wasn't at
    > all worried by this as I expected it to, due to having had a BCG.
    > They did the chest X-ray - it was clear - but they are still insisting
    > that i take 9 months of antibiotics to kill the TB.
    > I do *not* want to take any drugs I don't need, and I am not convinced
    > I have any kind of dangerous infection. I asked if I could wait and
    > get a second opinion before I decided what to do.
    > This resulted in my forms being marked with the information that I
    > "refused" the recommended treatment. At this, I backed down and they
    > gave me a bottle of antibiotics and a bottle of B6. They couldn't
    > find the patient information booklet, but assured me there would be
    > "no side effects", apart from "possible liver failure". (They already
    > had taken blood for a liver function test - came back OK). Now I have
    > to return to the clinic once a month for more pills and to be tested
    > for liver function.
    > I am really unhappy about this, I don't feel my questions were
    > answered properly. My current understanding is that if I don't take
    > the pills and don't return to the clinic monthly I will be reported to
    > the CDC and maybe to the INS. I have already spent over 9 hours on 4
    > separate visits to get this far.
    > Does anybody have any idea if this is correct? I have already made an
    > appt. to see another Dr. (not a civil surgeon) to discuss the matter,
    > but now I have my signed INS medical forms ready to go. Can I submit
    > them, or if I later decide not to complete the treatment, could I get
    > into trouble?
    > Has anybody else come across this issue? I thought it was par for the
    > course for Western Europeans and those with BCGs to have a +ve on the
    > Mantoux TB test - do I really have to take these evil antibiotics?
    > thanks
    > Jill

Jill

thanks for everyone's responses.

I am a British citizen, England born and raised, coming originally
from London. I came out on an H1B to San Diego where I met my
Californian husband. Now my visa is expired (company went out of
business), we have moved to Chicago and I guess I will be filing with
the Chicago office.

The medical took place at a medical facility in the near northwest
part of Chicago.

On the TB test, I didn't come up "borderline" - I had a clear positive
on the Mantoux TB test. But my X-ray was crystal clear. The doctors
and nurses - several different staff - all told me that it was
'regulations' that *anybody* coming up +ve on the Mantoux had to take
the treatment. I told them over and over again that I had had a BCG,
but that cut no ice. The examining Dr. (from some asian country, i
don't know which) even said she had had the BCG in her country and had
come up negative on the Mantoux.

My objections to the treatment were deemed irrelevant.

At first I asked if I could have some time to think it over, get a
second opinion, come back to complete the paperwork some other time.
The Dr. said, sure, but proceded to complete the paperwork including
comments that I had refused treatment. When I went to pick up the
paperwork from the nurse, she questioned me further, handing me a
cartoon sheet picturing the evils of tuberculosis. She asked if I
realized how serious a disease it was - "you could die"! I couldn't
get a clear answer on how the INS would react to this paperwork - I
even told them, please don't fill it in, there's no point if I'm going
to send it in and be refused. Anyway, eventually the pressure got to
me and I said, OK, I'll take the darned pills (they dismissed my fears
of side effects, saying there really are none).

So they redid the paperwork and gave me a bottle of Isoniazid tablets
- a month's supply - and a bottle of B6 to take with them. They also
would not let me leave the clinic until I had made another appointment
for a months' time. I have to go back each month to get more pills
and to have my liver function tested. I was warned that the clinic
had to submit reports so I had to complete the treatment.

I haven't taken any of that medication yet - I won't touch it until I
know what the hell I'm putting into my body. I've made an appointment
with a private doctor so I can get a second opinion.

In the meantime, do I go ahead and submit the paperwork that says I am
being treated for TB infection? If I do that, and then - under a Dr.s
supervision - decide not to have the treatment, will I get reported?

Or should I just start the process all over again with another Dr.?
It has already taken me 9 hours and 4 separate visits (and $150) to
get this far!

I am sooo angry/confused/upset disappointed.

Thanks for listening and for any advice/insight.

This also comes on top of them having administered a full set of
unnecessary repeat vaccinations - did not want to discuss me obtaining
my medical records from abroad. (London Dr. has them but will only
give them to me or my representative calling in in person, will not
mail them - I wanted to see if the US Dr. might be able to contact him
and have him send them to them).

lairdside

GET A SECOND OPINION.

Almost everyone will test postive if they have had their BCG within 10 years. After this many will not test positive - but many will continue to test postive for life. By 'borderline' I meant that I was outside of the negative range - therefore I was positive, if only just. My examining GP also took my word for my vaccinations when I explained that I had and why I had been unable to obtain my childhood imms. As for varicella, I offered to show them my scars..lol (They declined but took my word for that too).

Yes, your GP in the UK ought to do a physician-to-physician transfer of your medical records. Otherwise someone has to call in person, this is standard protocol, they aren't being difficult.

In addition I'd complain about the Dr that did your first medical.

I'm going to go off and grumble about this on my own now.. I've seen too much ignorance in the Healthcare profession in my time so this gets my goat somewhat........I've also seen many of my "colleagues" get away with murder because people who are ill are less likely to complain (they tend to have enough on their plates).

lairdside

Btw - if you speak to another physician talk to them about the issue of vaccinations/tb testing before you have the medical. The first 5 minutes of any consult are basically a sales pitch anyway.

Not sure of the professional ethics and law in your state but it is possible that they may have a "don't stab your colleagues in the back" professional rule, either officially or unofficially so I wouldn't mention the prior exam unless specifically asked.

Jill

OK, talked to my lawyer and looks like what happened was this:

The clinic i went to is actually part of the Chicago District Public
Health system.

They did the medical by the books, didn't ask questions and
administered the Mantoux TB test.

According to the instructions, a Mantoux reaction of over 10mm (mine
was 12) should prompt the Dr. to refer you to the public health dept.

Evidently as I was already there, they moved right on to focusing on
treating me for the TB.

My lawyer advises me to go and get the medical repeated by a private
doctor.

Blah! I don't have a lot of spare money! and i want to get this over
with !!!

Dekka's Angel

Please forgive my ignorance....but what is a BCG?

lairdside

I ranted about this in a previous thread but I'll spare you the script and just post a quote.

BCG is bacillus Calmette-Guerin. It is however derived from a bacterial strain that causes TB in cows. Yet BCG is not administered routinely in the US and many other countries because the efficacy of BCG is variable, and the vaccine sensitizes individuals to the diagnostic test for TB.


If you really want to be bored to tears look at :-

http://britishexpats.com/forum/showt...g&pagenumber=2

Paul

If I were you, I would get another doctor to give me second opinion. I
wouldn't submitt the medical examination now and would start medical
examination with another authorized INS physician all over again.
Mantoux test is just screening test for TBC, and sometimes it can show false
positive/false negative.
Usually mantoux test result will be combined with chest X-Ray, and smear
test to make positive diagnosis for TB.

Dewi


"Jill" wrote in message
news:[email protected]...
    > thanks for everyone's responses.
    > I am a British citizen, England born and raised, coming originally
    > from London. I came out on an H1B to San Diego where I met my
    > Californian husband. Now my visa is expired (company went out of
    > business), we have moved to Chicago and I guess I will be filing with
    > the Chicago office.
    > The medical took place at a medical facility in the near northwest
    > part of Chicago.
    > On the TB test, I didn't come up "borderline" - I had a clear positive
    > on the Mantoux TB test. But my X-ray was crystal clear. The doctors
    > and nurses - several different staff - all told me that it was
    > 'regulations' that *anybody* coming up +ve on the Mantoux had to take
    > the treatment. I told them over and over again that I had had a BCG,
    > but that cut no ice. The examining Dr. (from some asian country, i
    > don't know which) even said she had had the BCG in her country and had
    > come up negative on the Mantoux.
    > My objections to the treatment were deemed irrelevant.
    > At first I asked if I could have some time to think it over, get a
    > second opinion, come back to complete the paperwork some other time.
    > The Dr. said, sure, but proceded to complete the paperwork including
    > comments that I had refused treatment. When I went to pick up the
    > paperwork from the nurse, she questioned me further, handing me a
    > cartoon sheet picturing the evils of tuberculosis. She asked if I
    > realized how serious a disease it was - "you could die"! I couldn't
    > get a clear answer on how the INS would react to this paperwork - I
    > even told them, please don't fill it in, there's no point if I'm going
    > to send it in and be refused. Anyway, eventually the pressure got to
    > me and I said, OK, I'll take the darned pills (they dismissed my fears
    > of side effects, saying there really are none).
    > So they redid the paperwork and gave me a bottle of Isoniazid tablets
    > - a month's supply - and a bottle of B6 to take with them. They also
    > would not let me leave the clinic until I had made another appointment
    > for a months' time. I have to go back each month to get more pills
    > and to have my liver function tested. I was warned that the clinic
    > had to submit reports so I had to complete the treatment.
    > I haven't taken any of that medication yet - I won't touch it until I
    > know what the hell I'm putting into my body. I've made an appointment
    > with a private doctor so I can get a second opinion.
    > In the meantime, do I go ahead and submit the paperwork that says I am
    > being treated for TB infection? If I do that, and then - under a Dr.s
    > supervision - decide not to have the treatment, will I get reported?
    > Or should I just start the process all over again with another Dr.?
    > It has already taken me 9 hours and 4 separate visits (and $150) to
    > get this far!
    > I am sooo angry/confused/upset disappointed.
    > Thanks for listening and for any advice/insight.
    > This also comes on top of them having administered a full set of
    > unnecessary repeat vaccinations - did not want to discuss me obtaining
    > my medical records from abroad. (London Dr. has them but will only
    > give them to me or my representative calling in in person, will not
    > mail them - I wanted to see if the US Dr. might be able to contact him
    > and have him send them to them).

lairdside

Mine was in the 12 range too if my memory serves me correctly. No-one mentioned anything about a referral. My BCG was administered over 20 years ago.

vze33hss

in article [email protected], Dekka's Angel at
[email protected] wrote on 4/24/03 4:14 PM:

    >
    > Please forgive my ignorance....but what is a BCG?
    >
    > --
    > Dekka's Angel
    >
    >
    > Posted via http://britishexpats.com


Dekka,

The Bacille Calmette-Guerin (BCG) vaccine is one that contains an attenuated
tubercle bacilli. It is routinely given in many foreign countries to produce
increased resistance to Tuberculosis (TB). These people routinely test
positive for TB in America because the test we use here to detect TB, the
Mantoux test has been determined by the CDC as the most reliable. Usually, a
chest x-ray, (CXR) is ordered for people who test positive on the Mantoux
test. If the CXR is clean and the client does not have symptoms such as
fatigue, lethargy, nausea, anorexia, weight loss, irregular menses and/or a
low-grade fever, they are ruled out for TB.

Toria