Thursday, December 22, 2011

TB or Not TB:
An Antibody Positive Freakout

I'm cross-posting more of my columns from the Let's Talk HIV series over the Edge Network site, and today I'm sharing an abbreviated essay about testing positive for TB. You can read all of the posts in this 60-day blogging project from myself and the two other writers, River Huston and Earl Plante, at this link. My column:

Don't Mess With TB

As I approached my fiftieth birthday, it was time for me to get several regular tests, including one for tuberculosis. It used to be that I was pricked in a forearm and had to wait a few days before returning to see my doctor, so he could look at the prick marks and see if they indicated a positive reaction.

But that all changed with the development of a blood test for TB antibodies, one that was much better at detecting positivity. I was pleased that, instead of four pricks, only one prick in my vein would be necessary - a relief when I also had a blood draw for T-cells, HIV viral load, and related tests.

Less than a week after the draw, my primary care physician left me a voice mail saying my TB antibody test came back positive and that I needed to immediately start taking drugs to treat it. A nurse from the TB clinic at San Francisco General Hospital also called, urging me to come to the drop-in clinic the next day.

Thus began my crash course in the world of TB issues. I freaked out, thinking the result meant I was infected and would soon experience symptoms, and that my partner and husbear Mike may have been infected by me. He spoke with his doctor, took the test and we were relieved he was negative.

Two possible drug regimens were presented to me, the first being five-months on ribavirin, a drug with a mediocre success rate among patients, versus nine-months on isoniazid, or INH for short, and a much better track record of preventing the development of full-blown TB. After reading up on the disease and clinical research involving INH, and asking my doctor lots of questions, I quickly began treatment with INH.

Every month I dropped in at the TB clinic, where plenty of fans were always in use, keeping the air well-ventilated, and visitors who had coughs were encouraged to wear masks. The nurses drew blood, took chest x-rays, asked how I was coping, and gave me a month’s supply of INH.

They told alarming stories about patients not adhering to the regimen, going off INH and feeling better for a short while, only to receive a diagnosis of active or drug-resistant TB, requiring more difficult-to-tolerate medicines and additional medical problems.

All of a sudden, I went from living with AIDS to living with TB antibodies and contending with the side effects of the new drug I added to my daily cocktail.

Two times every week I sought out acupuncture treatments at a low-cost community clinic, getting physical and mental relief from all the additional stress. Acupuncture has long been a favorite healing modality, and during the nine months of INH, nothing quite relaxed me like the needles working the right points.

I also increased my daily exercise routine and tried drinking more water, because both things gave me a sense of being in greater control of my health during this period. There were times when my mental health was so negatively impacted by the INH, I fully understood why some patients stopped taking it.

My level of newfound fear of TB led me to open windows at political meetings when there was too much hot air and no circulation. At cafes, in movie theaters, and on public transit systems, when someone nearby coughed hard or more than once, I moved away and found another place to sit.

Why risk more exposure from potentially infected TB people in closed quarters?

Ageing with AIDS is complex and challenging enough just dealing with HIV, existing infections, and side effects of my regular cocktail. Throwing TB into the personal medical mix was certainly a bummer, but it was crucial to remember the benefits of the routine testing for TB antibodies. Better to fight off just the antibodies and not come down with a case of active TB.

At the end of the nine months of treatment with INH, I patted myself on the back and sought praise from my traditional medical health-care providers and alternative healing practitioners, for completing the course.

This story and advice is shared with readers to remind other persons with AIDS to regularly test for exposure to TB antibodies, quickly determine a treatment plan if positive to antibodies, and develop a plan to counter the side effects.

Don’t mess around with TB.

No comments: