Pulmonary Tuberculosis(Active/Inactive)-History,Sputum Tests,6 mos medication...

[paguio]

Passport with visa received today!
to all forum mates in this thread, dont loose hope, everyone will get what our heart desire, just a matter of time and faith.
Goodluck....

Congrats!!

As what I had posted last time, I went to IOM this morning to get the result of my medical exam, unfortunately the doctor who handled me is on leave, but the medical result was endorsed to the other physician. She just handed to me the print out result together with a CD (I think it contains my x-ray based on the label).

I was referred to a pulmonologist in Makati Med and the reason for referral is "PTB 5". At first, I got nervous when I saw its classification as "PTB 5" bec. as I recall, when I was diagnosed in 2001, it was "PTB 3". So I asked myself, does it mean the infection get worst?!

Immediately, when I got home, I checked the google and somehow relieves my anxiety when I read that "PTB 5 means TB suspect, pending diagnosis". See below:

American Thoracic Society/Centers for Disease Control and Prevention (CDC) classification [1]

This classification system is primarily of epidemiological use and used for public health communication, reporting, and contact investigations:

Class 0: No TB exposure

Class 1: TB exposure, no evidence of infection

Class 2: Latent TB infection, no disease

Class 3: TB, clinically active

Class 4: TB, not clinically active

Class 5: TB suspect, diagnosis pending.


The doctor referred by IOM in Makati Med. was also on leave, thus, my scheduled check will be on Sept. 16. I am very thankful to the Lord because though I am little bit worry with the result, He gave a peaceful heart and I told myself, what ever the result will be, God always have a purpose.

True to His promise, God will never leave you in every trials, all we need to do is to believe in Him.

The result is still hanged, but I'm still praying for the best that could happen. In God, nothing is impossible.

Just keep on praying guys, who knows, like RCG, we will have our visa soon.

 

[rcg]

Congrets.

Wish you all the best for your journey ahead.
Can you pl share your timeline from CIO Sydeny to Visa received. and you are from which country.

atun999

hello there, all updates on my apps was listed on my profile on the left side, together with tne signatures below. Goodluck!

 

[rcg]

Congrats!!

As what I had posted last time, I went to IOM this morning to get the result of my medical exam, unfortunately the doctor who handled me is on leave, but the medical result was endorsed to the other physician. She just handed to me the print out result together with a CD (I think it contains my x-ray based on the label).

I was referred to a pulmonologist in Makati Med and the reason for referral is "PTB 5". At first, I got nervous when I saw its classification as "PTB 5" bec. as I recall, when I was diagnosed in 2001, it was "PTB 3". So I asked myself, does it mean the infection get worst?!

Immediately, when I got home, I checked the google and somehow relieves my anxiety when I read that "PTB 5 means TB suspect, pending diagnosis". See below:

American Thoracic Society/Centers for Disease Control and Prevention (CDC) classification [1]

This classification system is primarily of epidemiological use and used for public health communication, reporting, and contact investigations:

Class 0: No TB exposure

Class 1: TB exposure, no evidence of infection

Class 2: Latent TB infection, no disease

Class 3: TB, clinically active

Class 4: TB, not clinically active

Class 5: TB suspect, diagnosis pending.


The doctor referred by IOM in Makati Med. was also on leave, thus, my scheduled check will be on Sept. 16. I am very thankful to the Lord because though I am little bit worry with the result, He gave a peaceful heart and I told myself, what ever the result will be, God always have a purpose.

True to His promise, God will never leave you in every trials, all we need to do is to believe in Him.

The result is still hanged, but I'm still praying for the best that could happen. In God, nothing is impossible.

Just keep on praying guys, who knows, like RCG, we will have our visa soon.

Hi good to know there is a good sign on your apps. BTW what about the result of the sputum culture?

 

[pat1181]

Hi Guys,

Been quiet for almost a week after my husband's re-xray sched and pulmo clearance. The remarks on the lordotic Xray is
" Respectfully referring this 34 year old male (incorrect, he's only 33 tsssk tsssk) with minimal hazy infiltrates in the right upper lobe. Unchanged from prior xray study. Sputum smear and culture are all cleared and negative. please submit a pulmonologist report for his immigration purposes"

He was given a referral to go to Makati Med to see Dr. Ocampo and Unfortunately, the Dr. informed him that the very small mark is still there from your first medical and hasn’t been changed since then but they have to put him on a 6 months medication since it’s their protocol.

I don't know what to say and feel... I feel bad for my husband who doesn't have any signs and symptoms. Non smoker and healthy lifestyle will get this kind of assessment. He's emotionally stresses and depressed at the moment after we found out that one of his co-patient there were asked to get a clearance outside (their preferred Pulmo) and will only do chest Xray and not lordotic. So inaccurate on how they process and their Dr's have their own processing procedure that they follow which I think is so unfair and inaccurate!

So now, my husband got his meds for 2 months and paid P4,600 (which the Dr. told him is already discounted) and he paid 2,000 for the pulmo. He was asked to go back on Nov 4 and will do re-xray again in IOM (which is another P1400) then back to him for another set of medication...that I don't know?!!!!!!

Now my only concerned is my kids who are cleared and just waiting... Does he really need to finish 6 months? that will be on March 4 of 2015... and the validity of their medical is only 1 year which is on June 4, 2015... I just hope that once it's all done, they could update CIC right away so they don't have to do a repeat medical

 

[andy_7830]

Hi Pat,

I feel you. My mother also taking 6 months medication. Sad but at least happy they now treating my mother and she stop smoking now. I hope they telling the truth now that she stopped smoking. We paid 6 months treatment medication almost 12,000php.

Andy

 

[ellann]

hi andy,
What was the result of your mom's smear and culture and also the Xray? I am a bit anxious as the result's of my husband's sputum come closer. This week is 8th week but he was asked to go back on sept 19 for the result and X-ray. I am praying that everything will be alright.

 

[paguio]

Hi good to know there is a good sign on your apps. BTW what about the result of the sputum culture?

Hi, thanks for your question. I looked up again with the result they handed to me, and it's only the smear result and its negative.

Just now, i texted the IOM asking why there's no culture result, and yet they asked me to see a pulmo. They said, smear and cd containing the x-ray is ok already.

Is that right? It should be all the lab. result first before seeing a pulmo.

Sept. 18 is the exact 9th week after my last collection for sputum culture. From what I know, they have to know the result first before they give a referral to a pulmo.

Now, I am confused. Are they just going to rely with what will be the outcome of my check up with their pulmo? Actually, I had already a medical clearance from my pulmonologist, she is a Consultant Head of Pulmonologist in the Medical City, and happened to be my physician since 2001 when I got PTB and I had my annual x-ray and check-up with her since then. But of course, they will not honor it, right? I had it submitted when I undergo medical exam with IOM, since I had a previous infection and surely it will appear in my x-ray result. As expected, I need to undergo medical furtherance because of my X-ray result. But that was ok, it's their protocol.

I just hope they have the right medical assessment on my case. It's not ok to undergo medication if you don't have the PTB infection, it has side effects on your liver and kidney. That's why when I got treated before, my pulmo request blood test while having my medications to make sure that it has no side effects on my internal organs. I saw some comments here that there love ones advise to take meds for months though the result were negative.

 

[pat1181]

Hi Pat,

I feel you. My mother also taking 6 months medication. Sad but at least happy they now treating my mother and she stop smoking now. I hope they telling the truth now that she stopped smoking. We paid 6 months treatment medication almost 12,000php.

Andy

Hi Andy,

I just can't believed how they assessed their patients individually. My husband doesn't show any symptoms, non smoker n only drinks occasionally. We even consulted a pulmo after his first X-ray in IOM and was informed that there's nothing wrong with his lungs. That's why i am really frustrated with the outcome. I sent them an email for clarification. And their reply is not even justifiable.

Some part of my email:
After receiving the not so good news from the pulmonologist your clinic referred to my husband, with all the re X-Ray and sputum culture tests he went through (showing no significant changes from first results). He was still asked to do medications which will lead to delays, for not being so transparent in the first place.


I would like to know, does your Doctors have different ways of processing the X-Ray and pulmo referral?
It's because I was informed by my friend, who's husband also did his medical and sputum test in your clinic, that her husband was given a referral to get a clearance from a pulmonologist his choice prior to re x-Ray on the 3rd month. In addition to that, he was also requested to perform only a chest X-ray wherein my husband was asked to do the lordotic X-ray.


Lastly, we are all aware that their medicals are only valid for one year.
What would be the final step after he finished all the medications? Will it be processed accordingly by then.

*i emailed them yesterday n just got their answer 4:00AM EST

 

[pat1181]

How can they say that they based on the medical history of each patients wherein their Doctor didn't even bother to look into my husbands previous Xray (from his general executive check up dated April) and latest from our Pulmonologist last June. Maybe if they could have just look into that then they can have their basis for their decision. I am just worried cause what if it's just a mark ther that's inactive or not even infectious, then my husband is taking a very strong medication. :-[

I don't know....should I still answer back or just let it go. Now, I am anxious since within that 3 month period that they're waiting, my kids (all minors) have been exposed already?

This is their reply:

We understand your concern regarding the additional procedure needed to finish the medical requirement.

As each patient have different medical history, the evaluation done on each patient is also individualized. Rest assured that we are strictly following the guidelines provided by the Canadian Embassy in terms of processing and evaluation. According to his assigned Physician, your husband will have a repeat chest x-ray after the 2nd month of treatment and after 6 months of treatment. A final Pulmonologist Report will also be submitted after treatment.

Once completed, all the results will be forwarded directly to the Embassy and is indeed valid for 1 year.

Should your husband require further information, he may book an appointment and visit the clinic for additional explanation from his doctor.

 

[rcg]

Hi, thanks for your question. I looked up again with the result they handed to me, and it's only the smear result and its negative.

Just now, i texted the IOM asking why there's no culture result, and yet they asked me to see a pulmo. They said, smear and cd containing the x-ray is ok already.

Is that right? It should be all the lab. result first before seeing a pulmo.

Sept. 18 is the exact 9th week after my last collection for sputum culture. From what I know, they have to know the result first before they give a referral to a pulmo.

Now, I am confused. Are they just going to rely with what will be the outcome of my check up with their pulmo? Actually, I had already a medical clearance from my pulmonologist, she is a Consultant Head of Pulmonologist in the Medical City, and happened to be my physician since 2001 when I got PTB and I had my annual x-ray and check-up with her since then. But of course, they will not honor it, right? I had it submitted when I undergo medical exam with IOM, since I had a previous infection and surely it will appear in my x-ray result. As expected, I need to undergo medical furtherance because of my X-ray result. But that was ok, it's their protocol.

I just hope they have the right medical assessment on my case. It's not ok to undergo medication if you don't have the PTB infection, it has side effects on your liver and kidney. That's why when I got treated before, my pulmo request blood test while having my medications to make sure that it has no side effects on my internal organs. I saw some comments here that there love ones advise to take meds for months though the result were negative.

Hi i dont know why they wont wait for the result of your sputum culture or give it to you. Whats the use of doing it and paying for it if that is not that important. That is the gold standard for diagnosis so i guess whether negative or positive will help a lot in your assessment.

 

[rcg]

@Paguio
maybe the result of your culture is already forwarded to the doctor cause if not and they will only rely on your smear which is negative and your repeat xray then why did they bother you waiting for almost 2 months if indeed that result is unnecessary for assessment. Just my point of view though.

 

[ragluf]

How can they say that they based on the medical history of each patients wherein their Doctor didn't even bother to look into my husbands previous Xray (from his general executive check up dated April) and latest from our Pulmonologist last June.

The answer is as listed below - this is why medical results of the patient (from another doctor) may not be significant to eliminate furtherance.

This is their reply:

We understand your concern regarding the additional procedure needed to finish the medical requirement.

As each patient have different medical history, the evaluation done on each patient is also individualized. Rest assured that we are strictly following the guidelines provided by the Canadian Embassy in terms of processing and evaluation. According to his assigned Physician, your husband will have a repeat chest x-ray after the 2nd month of treatment and after 6 months of treatment. A final Pulmonologist Report will also be submitted after treatment.

Once completed, all the results will be forwarded directly to the Embassy and is indeed valid for 1 year.

Should your husband require further information, he may book an appointment and visit the clinic for additional explanation from his doctor.

The guidelines for investigation of TB are here: http://www.cic.gc.ca/english/department/partner/pp/pdf/IMEI_Tuberculosis.pdf
See:
TB investigation
Upon submission of the complete IME, the RMO may decide to further the client for additional TB investigation in order to verify abnormalities detected on the chest x-ray and to rule-out active TB.
Standard and acceptable TB investigation includes:
• Repeat chest x-ray 3 months after the initial chest x-ray; and
• TB smears and solid cultures done on 3 sputum's collected under direct observation on 3 consecutive mornings; or
• If sputum production is impossible, chest x-ray must be repeated 6 months after the initial to ensure stability

However, the clinic (more specifically the panel physician) is granted leeway to prescribe treatment, additional tests to rule out significant items seen in the medical results. The clinic is following what is prescribed under the IMEI guidelines as per Canadian Health guidelines. The medical history taken from your husband's doctor, even if it shows a healthy individual, is not done under these guidelines/protocols set for immigrants (by the Canadian Health authorities). This is unfortunate, but is the process.

If all our medical histories and examinations done in the PH (and all other countries) were up to their guidelines - then we do not need to undergo an IME as part of the application. Their health authorities will know individuals immigrating generally are no risk to the population. It is not that case, as they also need to think about the protection of the general populace primarily, so immigrants need to have an IME, in order to screen and reduce the possibility of any medical issue that may affect the general public.

CIC does have the authority to extend medical examination validity, so even if your kids medical validity expires before he finishes his treatment, their IME can be extended. Please always communicate with the VO when the expiry is nearing.

Knowing and you are confident your husband will be cleared based on his history now is better - the clinic is just following procedure and doing what is instructed of them to rule out active TB which can be grounds for medical inadmissibility. Think of it this way - the clinic is eliminating reasons for his inadmissibility. Note that if one of you is found inadmissible, then all of you are inadmissible.

../atb

 

[pat1181]

I read that if the Doctor ruled out that it's suspicious then they should have referred the person right away to a designated physician. But our case is different, Lungs are hazy and uncleared that's why he was asked to do a sputum test and after 3 months of waiting, both smear and culture are negative. Regarding the repeat Xray on the 3rd month, it says "minimal hazy infiltrates and unchanged prior to study".

Now, my only concern is what if it's inactive/ non infectious mark and he was given a medication that might be too harsh for his liver. Will the embassy re-check all test and Xrays or they will just based it on what the clinic will give them.

 

[paguio]

@ Paguio
maybe the result of your culture is already forwarded to the doctor cause if not and they will only rely on your smear which is negative and your repeat xray then why did they bother you waiting for almost 2 months if indeed that result is unnecessary for assessment. Just my point of view though.

@ RCG

Yes, exactly, why they asked me to wait for 2 mos. for the culture result, then just rely on my smear result. They haven't forwarded my culture result to the doctor bec. they are the one who told me yest. that the result is on the 9th week, it's not yet on their system bec. this week is only on the 8th week.

 

[ragluf]

I read that if the Doctor ruled out that it's suspicious then they should have referred the person right away to a designated physician. But our case is different, Lungs are hazy and uncleared that's why he was asked to do a sputum test and after 3 months of waiting, both smear and culture are negative. Regarding the repeat Xray on the 3rd month, it says "minimal hazy infiltrates and unchanged prior to study".

First they (PP) needs to do an investigation of whether it is Active TB or not. Then a referral is made. The investigations listed in the IMEI pertain to the TB investigation to rule out Active TB.

Now, my only concern is what if it's inactive/ non infectious mark and he was given a medication that might be too harsh for his liver. Will the embassy re-check all test and Xrays or they will just based it on what the clinic will give them.

You always have the option of discussing any medication that is detrimental or if you have doubts - with the clinic. Did you sit with the clinic and discuss the side-effects and potentials of the prescribed treatment and air your concerns?

The RMO or specifically, a medical officer at an RMO will look at all the results and grades for the examinations conducted and will make a medical assessment based on this. Whether the applicant will get recommendations for surveillance (for inactive TB) or anything else will be based on the results of the tests.

.../atb