Hi, I am looking for anyone who has undergone the TB medication course, completed or undergoing.

I am undergoing the medication for 2 months now (treatment under Institut Perubatan Respiratori) and I still continue to feel the chest discomfort/dull pain.
It is just like dull pain, pressure kind of discomfort. Is that normal?
Lately it gets more intense, but sometimes it fades away.
It is not those kind of Sharp Pain suppose to be, mentioned by doctor.

FYI, i have informed my doctor on it, they doesn't seem to care about it. Just say continue medication and see how.

Plus, how are they actually monitoring whether the medication is working?
Ever since started medication, I have been to several appointment so far, everytime only say "ok continue medication". No further test done etc.

TQ

Most likely is fiborsis of your lungs. Some part of the lungs are having scar. Hence the dull pain. Had any previous TB infection before?

Specutum analysis under microscope, x-ray are the ways to evaluate.

In the mean time, take lots of fruits and vege, fish chicken, tofu, tempe (proteins). Avoid fish oil, olive oil. Increase your intake (TB causes the body to use lots of energy - hence TB patients are usually wasted). Add virgin coconut oil to your food (high in calorie and easily ultilise by the body) Expose yourself to morning sun for 30 minutes to get vit D to enhance immune system. Take 5 cloves of garlic/day with food - to boost immune system.

Do you have serai, kayu manis, rosemary? Boil a pot of water until can see steam coming out, off the fire, cut them into pieces, chuck the serai, kayu manis, rosemary into the pot and put your face into the pot to inhale the steam. Cover yourself with a towel so the steam cannot escape. DO it for 10 minutes 2x/day. Essential oil works better for TB but since is hard and expensive to get pure essential in Malaysia, these will do. (if you want essential oils, PM me)

Also, since you are on TB drugs, take milk thistle, dandelion supplement to protect your liver.

DO NOT forget to take your TB meds even if you feel cure cause it needs 6 months to fully cure. Forgetting to take them will cause the TB to evolve into MDR/XDR-TB. Takes 1-2 years to heal with very bad sideeffects.

No, first time gets Tb infection.
I thought it was fibrosis as well, but a few other GP I consulted, they say that lung doesn't feel dull pain, the pain is something else. That's why its bothering me.
Even bothering part is my consultation with IPR doctor, they evaluate me only based on Q & A:
Doc: "How are you feeling? Feeling any better?".
Me: "Feeling just as usual, and the chest discomfort is still there."
Doc: "How is your cough and appetite?"
Me: "I mentioned already I don't cough since the beginning of diagnosed and my appetite is just as usual"
Doc: "Oh I think you are getting better"
Me: "Huh? No going to do any test? Liver function test? Blood test? Vision test?"
Doc: "No, no need for those. Just continue your medicine. When courses finish, if the pain is still there, then we explore other possibility"

The doctor is really giving me a feeling of "Do they know what are they doing?"

But meanwhile I still continue my meds haiz...

Usually they will evaluate you after 2 months like that. It's your right to ask them to do liver function test and vision test. TB drugs side effects affects the liver and eyes (etanbutol - for eyes)

You may feel frustrated taking those drugs, but if you don't take them, the TB will have to be treated for 1-2 years instead of 6 months. MDR/XDR-TB can lead to slow and painful death.
2nd/3rd line of TB drugs are less effective compare to first line.

MDR = multiple drug resistant
XDR = Extreme drug resistant

This post has been edited by Ramjade: May 2 2016, 05:11 PM

well.........

mostly clinical........

cough should reduce.
the fever, night sweats, weight loss should be absent
the sputum for AFB should reduce or be negative after some time of treatment

the strain and sensitivity of the tuberculosis would take a lot of time to test

The problem is, from the beginning I do not have any of those symptom.
No cough, fever, night sweats, and my Sputum AFB is negative.
The only thing is confirmed is I lost weight that's it.

Which is why if they base on those clinical ways, I don't see how is it going to help in my case you see.

Btw, these are beyond most gp level...
At least get a proper specialist if u wan go for additional opinion.

i see...........

then it is likely they treat you based on high suspicion of exposure and probably where tb is endemic, not an easy decision to start you on treatment.......unless no other cause of weight loss or very suggestive chest x-ray

I thought there are specific assay that can test for TB in Malaysia? I forgot what's call.

They suspected based on X-ray, there are shadows shown.
In Sunway Medical, they run a PCR on my sputum and say confirmed its TB.
So I transfer myself to IPR and started my medication there cause Sunway would require me to go consultation every week which will cost a bomb and inconvenient to my work.

At IPR they only do triple confirm on the AFB test, which shown negative in all test including during in Sunway Mecical.
After consideration then they decided to start my medication.

Quantiferon TB Gold blood test

Wanna ask bout tb, what's the chances of one getting infected by someone who has tb? For those staying in the same house, are the chances high for them to be infected?

As long as on medication for 2 weeks, the patient is no longer infectious. Just make sure the patient wears a surgical mask with colour ones outside.

Open all windows day/night. In the daytime, let the sun in. Sunlight kills TB bacteria. On fan. Don't use Aircon.

Getting infected is one thing. One gets infected if untreated patients speaks, laugh, cough (think those foreign workers - which is a source if TB in malaysia). The question is whether the body can eliminate the bacteria/contain it. Eliminate means no more TB bacteria in the body. Contain = control it but the bacteria is still there. May remain asymptomatic for years until one point the body defenses drop and the bacteria will multiply.

So first line of defence is preventing bacteria from entering the body via N95 mask. Normal mask gives protection of only 40% but it works very well to prevent bacteria from spreading to the environment (patient must wear it tightly).

Second and last line of defence is your own immune system. Stress, cigarette smoke, junk/fast food all will decrease your immune system.

There are certain essential oils that can decontaminate a TB room (rapidly decreasing the no of TB bacteria in the air once the essential oils have been nebulised into the air.

Hope this help to answer your question.

Thank for you ur reply. So if the person's body managed to contain the bacteria that person is not infectious? What if that person suddenly starts coughing, will it be infectious? Usually when a person cough they usually brush it off as normal coughing. Will tb spread through sharing of drinks or food?

I have people continuously being exposed to the patient who is tb positive. The patient is also having lung cancer and she is 80 yrs old hence she requires people to take care of her all the time. Having her putting on a mask will create great discomfort for such an old lady. And worse, she is unable to take her tb meds because her intestine could not handle such heavy dosage of meds daily. She has Ben vomiting all the meds out Everytime she takes them.

Will her caretakers eventually be infected with tb once their immune system drops?

it is very hard for a healthy person to get infected and to have active pulmonary tb. everyone has been exposed to tb at some point of their lives'

it takes a lot of exposure and time with proximity to get infected.


anyway........if the person is missing medication or not tolerating the medication........time for a visit to the hospital/clinic.

there's only 1 type of mask that is "safe" for people handling with tb.........the n95 and above mask...........normal surgical mask do not help at all

also........if you know that you have been exposed to tb and you have a prolonged cough........better have it checked out to ensure it is not tb

This post has been edited by slimey: May 6 2016, 05:08 PM

She's already been admitted to the hospital to treat her intestine problems but those handling her doesn't seem to be bothered that they're handling a tb positive patient.

Now that's worse. If some kind of drugs managed to get into the system (without the full dosage), the TB will develop into multiple/extreme drug resistant strain which needs longer term antibiotics (1-2 years) with more severe side effects.

They can wear N95 mask to protect themselves. It's possible if no protection is worn. A normal mask (white side outside) offers only 40% protection. Can wear double or triple mask but no evidence shows how effective wearing multiple layers.

Again they can get infected but if body cannot contain the infection, a person gets TB. If TB is contained, the person is not infectious until it reactivate. So again, it comes back to the immune system.

Precautions can be taken other than mask. Buy the single gas burner/induction cooker/slow cooker, slowly simmer the following :
Cinnamon sticks (better if you can blend into powder)
Rosemary herbs
Serai
Pine leaves (make sure it have the fresh pine scent when you break them)

Replace them regularly like every 3 hours or else not effective in decontaminitaing the air.
The above is a crude DIY essential oil air decontaminator.
Best is if you can get 100% pure essential oil to disperse into the air.

TB is airborne, and spread through air which makes it hard to control. It don't spread through food.

on the subject of reducing the concentration of the tb microbs in the air the best method is still ventilation.

ideally have the room in "negative pressure" : something like a exhaust fan extracting air out of the room constantly and having only 1 opening which is closed most of the time, the door.

so the air in the room constantly gets replaced..........

if you want to be fancy you can install uv lighting in the air exhaust tube and also in the room(something like a uv tube on the inside of a pipe like structure and a small fan blowing air through it).

There's a journal regarding dispersing eucalyptus oil in a TB ward. The conclusion shows eucalyptus oil drastically decrease the no of TB in the air.

Hi there tekoo are you considered healthy, and clear of TB now ? Or TB is under "Latent TB" controlled unactive stage?

My father was under suspicion of TB by HKL (non-Respiratory related body organ), somehow was told to go to IPR for TB screening.
Checked Chest X-Ray in IPR was cleared, they kept on collected tons of blood and saliva samples every time my fathers visits them for appointment, and it has been like 3-4 months we didn't hear back from them.

It is very scary that the doctor consulted her superior mentor, and they just gave out antibiotic drugs out without waiting for the TB results.

This post has been edited by iSean: Aug 1 2022, 02:50 PM

Cleared long time, after finish the meds course of six months.
My initial test done was in private medical centre which they confirm me positive of TB. Thereafter I went to IPR for meds course since it's almost free. Hence I don't really care if their test is done or so.
And yes, every visit they will collect sputum sample since mine is lung. My understanding is they are trying to cultivate the bacteria, but it doesn't necessarily mean they will success lol.

Congrats being cleared.
Well, any recommendation which type of TB Screening to take?

Your one only collect sputum for lung?
My dad went multiple times, always "sputum" the saliva and they go collect "blood sample"
Wait for multiple weeks but no results.

Do you feel that your body is very weaken by Antibiotics at the 6 months of treatment?

My dad was given TB Medication, when HKL suspect my dad has TB in other parts of his body.
Ask my dad go IPR do Chest X-Ray, then was consult some young doctors getting some family background, say chest x-ray is clear no issues.
But, since under suspicion of TB, the young doctor consult with her supervisor, the supervisor pass down to the doctor say for "safety precaution" just put on TB Antibiotics medications.

Then I follow my dad go through the long briefing session on TB medication.

I feel something not right, then go consulting doctors in private as second opinion.
The private doctor say better don't start.

Few months later, my dad weight loss is increasing, I now suspect is TB causing issues.
And IPR macam not transparent with my dad's conditions la, after waiting so long, no sound on the culture results.
Then since we not on the TB Antibiotics treatment, they mentioned that we 'declined' treatment over their side. When themselves can't even confirm whether my dad has TB

Also I don't feel safe bringing myself and my dad go to IPR, with people there coughing and patient with poor hygiene all the time...
Sendiri Tak ada Lung Disease, will easily contracted with TB/Lung disease.

I went there few times really packed in the morning session...

I was having shadow in my lung and unexplainable weight loss. Went private medical centre, they did the Mantoux Test.

Weaken? Not really.

Well if already suspected with TB, didn't the private hospital did their checking when you seek for second opinion? To sit on it doing nothing is dangerous no...?

Tbh even after completing the 6m course, both private & IPR also failed to culture the bacteria. So I guess it's normal for your case as well.

I see.

Weaken as in due to heavy antibiotics causing side effects. Because I heard the pharmacy doctor say
will cause pee orange, skin rash and sticky sweat...



Well we actually visit private first, then also go to GH as back up and go there get cheaper medication.

Private Hospital did some biopsy on the body organ and sent to outsourced pathology lab, report come out have some bacteria that looks like TB in the slides. (not sure the actual way to describe this)
Then my parents took the report to GH as well, doctors suspect it is TB, then send to IPR do Chest X-Ray. But nothing in lungs, seems healthy.
The we thought might be Latent-TB become active in other parts of body when my father get UTI. (My father did surgery in GH to remove a mass on his nose in January, I wonder is it at surgery there tools not clean get infection la.)

After first visit at IPR, they told my dad start 6 month long treatment, I feel something not right in the procedure. Go to the private hospital on the same day hear second opinion from the doctor.
Private Doctor advise he will request from pathology lab to do slide reading again, confirmed it isn't TB, and told us not to take the TB medication at the mean time.
So we just follow private doctor's instruction.

Then we just go back IPR told them, we don't want to take medication until the culture say positive for TB then only start take medication....
But IPR never came back with culture results despite my dad did few blood and sputum collections in GH and IPR...
So we kinda gave up on Government Healthcare side...

==========================================
But 6 months later TS, you finished your TB Medication, but negative from the initial culture (first sputum) sample. Then I feel weird lah, since initial Mantoux Test you say positive edi, kinda weird they can't grow it...
If you say 6 month later, you did another sputum test, the lab didn't managed to grow the TB sample, that one would be normal, means you cleared from TB.

"A normal sputum culture can take 1 to 8 weeks to provide results. A rapid sputum test can tell if a person has TB within 24 hours."

This post has been edited by iSean: Aug 2 2022, 11:18 PM

Ahh you mean the side effects during the course of meds. Yea I got Orange pee only as far as I can remember. But if the patient's age is high, the side effects will be more severe.

Since you decided to trust the private side, maybe it's time to revisit them to get some idea on the continuous weight loss.

As for the culture, if you read about it, you will see it is actually difficult in culturing them, and long time as well. Even my initial sputum submitted to private side, also fail to do so.

TB is not restricted to the lungs.

It can spread to other parts of the body.

What is the result from the private pathology lab?

Yes.

First report propose is
observation of Granulomatous Inflammation

bring dad to HKL they suggest TB

after that go private, doctor email patlab do rereading the slides :
does not surmount to a diagnosis of TB

Granulomas mixed with inflammatory infiltrate could suggest an underlying infectious aetiology with TB

bacterial/fungal/parasitic causes /saecoudosis / inflammatory bowel diseases also possible

private say dont continue TB meds

then balik IPR for follow up appointment tell them we dont want follow up with them, since scare will weaken immune system also got risks of antibiotic resistance develop, but IPR will continue to collect sputum, blood sample to screen for TB for a few weeks lo 😶

If active TB, go take CRP and ESR. It will be elevated. If want more specific take Ca-125 blood. It's a tumour marker for ovary cancer.
But if it is raised along likely it's TB.

TB takes like 2 months to grow and another 2 months for antibiotic sentivitiy.

Wear n95 or those kf94 mask. Make sure it's properly sealed.

Even though clear, can reactive again many years down the road. Just get ready for it. In the mean time load up on vitamin D and go into the sun. Vitamin D and sunshine helps the body to prevent and speed up recovery process.

This post has been edited by Ramjade: Aug 8 2022, 04:04 PM

Hi Ramjade,

It has been said many times that TB is not spread easily, meaning to say you need long term exposure to someone with TB to be infected with TB.

But I've spoken to some who had been infected and what they told me seems to contradict the above. They said they do not know how they got infected. They have not stayed with someone with TB, neither have they cared for someone with TB, neither they have any colleagues suffering from TB.

It goes to show that they got it randomly from someone somewhere, whether in a train, flight, in a lift, etc. And they don't even know where.

So, is it still really true that TB is not easily spread? It seems to me otherwise.

It is airborne and theoretically they said people with good immune system will be able to suppress it. I know a friend in mid 20 no known medical illness, pick up TB of the kidney. Another 20 year old pick up TB spine.

I am still not going to bet that it doesn't spread easily. If you are in US, UK, Canada, Singapore where TB is not endemic, ok, You are in malaysia where you have indonesia which have high TB rates, foreign workers from india, bangladesh nepal who knows whether they are screen before entering Malaysia. At least singapore screen all their foreign workers. Make them all do chest xray and mantoux.

TB is a perception disease. People think they won't get it cause they are young, no illness and hence no need precaution.

Prevention is key.

This post has been edited by Ramjade: Aug 10 2022, 12:08 PM

Most Malaysians should have been vaccinated with BCG during their schooling years which should provide some protection against TB. Unfortunately there are many foreign workers in Malaysia and their pay/living conditions are bad which pushes up the overall TB prevalence rate 10x that of western countries.

Foreign workers who came to Malaysia through the legal route have to go through FOMEMA screening which includes tests for TB and STDs, I saw it on the form and my servant had to have an x-ray done. But I'm not sure that was always the case and I think there is no requirement to get vaccinated which I think should be mandatory.

BCG only protect kids. For us adult BCG is practically useless.

BCG is meant to prevent meningitis TB but not very effective against lung TB.

dont stop taking your meds, long duration i think