So, let's start from the beginning. This summer, I am shadowing a pediatrician at a hospital and to work in a hospital, we need confirmation that we do not have TB. So, I get the usual TST or tuberculin skin test that pumps TB antigens under your skin that react if TB antibodies are present. And needless to say, the skin test turned out positive. Why does this happen? When I was little, I got a BCG vaccine in China (TB vaccine), which causes the body to produce TB antibodies. All international babies get the vaccine, and as a result, they produce the antibody such that even adults who were born in China have positive TSTs. Anyway, I get this checked at the pediatrician's (embarassed) office, and they say I have latent TB. Why is that? Because the U.S. protocol does not recognize the BCG vaccine as a valid vaccine for producing TB antibodies and providing immunity against TB. So what? Just because the U.S. doesn't recognize the vaccine in it's protocol, when actually it is quite legit since it is reacting with the tuberculin, means that all aliens have latent TB? Anyway, my doctor said I needed to go on TB medication and get a blood liver test once a month (because the medication is damaging to the liver) without even checking if the positive reaction was due to BCG or to actual latent TB. She never even told me the second blood test option that does not result in false positives until 10 minutes after telling me I needed to go on medication and ordered the liver sample test.
After a lot of waiting and difficulties contacting my doctor over the phone, she finally scheduled a TB IGRAS blood test for me that tests both latent and active TB without worry of false-positive results as in the TST. I went to get my blood taken Tuesday, and the result came back today: liver blood sample test.
I am so fed up with this. First of all, TB is one of the most serious, basic infectious diseases. If you are going to be a primary care provider, you should know what is going on with the disease and all of the options a patient has if they possibly have TB. And if you don't know, look into it first before putting your patient on potentially harmful and completely unnecessary drugs. Second, the U.S. protocol does not make any sense. Just because the U.S. does not recognize a certain vaccine does not mean it is invalid. This results in excess false-positives and patients being treated for diseases they don't have. Waste of resources and harmful.
One positive thing about all of this: I learned what kind of doctoring is ineffective and causes a patient distress. All I can do is be a better doctor in the future and try to make some changes to certain policies.
