TB facts for patients

 WHY THIS PAGE?

This is a page dedicated to patients and relatives of TB patients searching for correct answers to their disease and problems. Many doctors in their busy practices don’t have time to discuss these issues. Neither the patient has the courage to question his/her doctor on the doubts and uncertainties of treatment. This page gives a brief introduction to TB, including what it is, different types of TB disease, and facts about TB tests, drugs & treatment. A TB patient may find these questions relevant and helpful without feeling awkward to question their doctors.

THE NEED NOW?

In the recent years, I see an increase in the number of patients with TB and Drug resistant TB in my clinics. This increase is because many of these patients are either mismanaged by doctors who are not specialized in the treatment of TB, and also due to the lack of knowledge among people about TB. Sometimes an average patient of TB has wasted 45-60 days, before getting a correct diagnosis and treatment to follow.

In my clinics, I could realize that an average patient has very less knowledge of TB, although it is one of the major cause of death in our country.

EVERY MINUTE 1 PATIENT DIES IN INDIA DUE TO TB

Here I present a dialogue with one of my patient who made me realize he knows nothing about TB and that such lack of knowledge should be addressed urgently among patients. Hence this page which depicts some common questions he and many others ask me daily.

WHAT IS TB?

TB is a bacterial disease which in humans is usually caused by an organism called Mycobacterium tuberculosis (M. tuberculosis). TB is an abbreviation of the word Tuberculosis and is how people usually refer to the disease. Few years ago it was believed that we can stop and eradicate TB from our country, and that it was no longer a problem. But now because of issues as drug resistance and HIV, it has become a major problem again.

I HAVE NO ONE IN MY FAMILY WITH TB?

HOW DID I GET TB?

Bacteria get released into the air by some person who is already infected with them. You get TB by inhaling TB bacteria that are in the air. When a person with TB of the lungs or throat coughs, sneezes, sings or talks, droplets containing the bacteria are released into the air. That is why people who think they may be infectious, should often hold something over their mouth when they are near to other people. People working in a health clinic may for this reason sometimes wear a mask.

CAN SOMEONE DIE WITH TB?

IS IT SO BAD LIKE   HEART ATTACK TO KILL SOMEONE?

Yes if not treated on time, TB can become a severe disease killing the person infected with TB. However a TB patient will not die suddenly in minutes like a heart attack but he will die suffering in pain for months together if not treated.

CAN IT BE CURED? WILL I DIE?

MY NEIGHBOURS SON DIED DUE TO TB

TB can usually be cured. The treatment usually consists of a combination of TB drugs that must be taken for at least six months. But the treatment will only be successful if the drugs are taken exactly as required for the entire length of time. Any default from your side in the treatment will bring bad outcomes and even death in some cases.

WILL EVERYONE WITH TB, SPREAD TB TO OTHERS?

WILL I SPREAD IT TO MY WIFE OR CHILDREN?

No. Not everyone suffering with TB will spread TB to others. Generally it is only people with TB of the throat or lungs who are infectious. People suffering from TB of bone, joints, spine, brain, skin and other organs do not spread it to others. Also, an important factor is whether someone is on effective treatment. TB treatment dramatically reduces the number of germs released by a person in the air.

BUT I HAVE SMALL ROOM AND BREATHE IN THE SAME AIR?

HOW LONG DO TB BACTERIA STAY ALIVE?

The bacteria can sometimes stay alive in the air for a few hours, especially in small places with no fresh air. Fresh air and sunlight make it harder for the bacteria to stay alive. The fresh air scatters the bacteria and the sunlight kills them.

CAN I EAT SITITNG ON THE SAME TABLE WITH MY WIFE AND CHILDREN?

SHOULD I STAY ALONE AND NOT MEET ANYONE?

Yes certainly you can eat, drink and live a normal life with your family. The bacteria are not transmitted:

·         through food and water,

·         or by kissing,

·         or by skin contact such as shaking hands,

·         or by touching a toilet seat

·         or by sharing a toothbrush.

A TB patient also deserves the same love, care and affection from his family members as any other. He might not be left alone like an untouchable. However you should wear a mask and cover your mouth with a kerchief while coughing.

HOW DO I PREVENT THEM GETTING TB FROM ME?

Cover your mouth with a cloth or mask to avoid spread while coughing and talking. Also important is take your medicines regularly so that the germs are killed and reduced in number. Eat good and nutritious food to increase your immunity. And if anyone in the family shows signs and symptoms of TB, see your doctor immediately

WHAT ARE THE SYMPTOMS?

The symptoms depend on which area of the body has been infected. If someone has pulmonary disease, which is TB in the lungs, then they may have a bad cough that lasts longer than two weeks. They may also have pain in their chest and they may cough up blood or phlegm from deep inside their lungs. Other symptoms of TB include weakness or fatigue, weight loss, lack of appetite, chills, fever and night sweats.

WHY DO SOME PEOPLE BECOME INFECTED WHEN OTHERS DON’T?

It is not known why some people who are exposed to the bacteria become infected when other people don’t. However the chance of becoming infected depends mainly on the immunity of the exposed person, number of germs in the air, and the length of exposure to a person with TB.

 I HAVE COUGH AND NOT GAINING WEIGHT, MY DOCTOR SAID IT IS TB?

It is very difficult to diagnose TB by a person’s symptoms on their own. This is because some other diseases have the same symptoms. Cough can be due to allergy, cold, viral infection, smoking, lung cancer and many other diseases as well.

A diagnosis is only certain when there is definite evidence of TB bacteria. Some of the TB tests used for diagnosis look directly for the bacteria. Tests for diagnosis include the sputum microscopy, the sputum culture test as well as the new GENEXPERT test.

Others such as the chest X-ray, skin test like Mantoux, lack accuracy as well as they aren’t definitive of any disease.

MY DOCTOR DID A CHEST XRAY AND PUT ME ON TREATMENT FOR 6 MONTHS?

Tests such as the chest X-ray, skin test like Mantoux, lack accuracy as well as they aren’t definitive of any disease. So to start treatment for TB based only on these tests is completely wrong. Sputum tests and/or Bronchoscopy should be advised to get a definite diagnosis before putting anyone on such a lengthy treatment.

MY DOCTOR SAID 3 MONTHS OF TREATMENT AND I WILL BE FINE?

No there exist no such treatment for 3 months. I agree that 3 months and you may feel better or normal however to be completely cured a minimum of 6 months treatment is a must. In some cases even 9 months treatment is deemed necessary.