TB medication

[Bamboo Grove]

My missus has just started TB-medication (the doctors are not sure whether she actually has the desease or just been in contact with the bacteria, it's not contagious, anyway, they say.) She must probably eat the medicine for at least six months. She will need to have an operation on her aorta after this and the doctors suspect that the enlarged aorta that she has, happened because of this TB bacteria. She will have an operation after the medication has finished.

Now, the problem is that the medication makes her feel very sick and she vomits for about 2-3 hours after taking the medicine. I will talk about this with the nurse tomorrow (she must go to the hospital 5 days per week to take the medicine) but does anybody know if there is a way to ease this vomiting? The doctor warned that this may happen and I know it's quite common with these medicines but would like to know if anybody has any knowledge to help this. Mr Plum?

[MorSage]

A few thought on your above post as you appear to need to clarify several issues.

1. TB is a contagious disease; kissing, inhaled contaminated sputum, etc. You need to be checked if in contact with her before the medication started.
2. TB sufferers on PROPER medication are not contagious. Hence the need for supervised medication, at hospital.
3. Medication normally is continued for about a year, no need to tell her, given FYI.
4. TB tends to establish in immune compromised individuals; HIV testing should be performed (TB nearly eradicated until AIDS epidemic provided a bank of infected for the rest of the population) and everything that boosts immunity / reduces stress is very useful (before antibiotics TB known then as 'comsumption' often responded to health building therapies (diet, environment, activities) in the original Swiss and Austrian Spas - Drs. Bircher Benner / Vogel.
5. Not having TB but only being in contact with it, and the enlarged aorta may be one of its' manifestations does not make sense and needs clarification.
6. TB can mimick virtually all other disease conditions and might have caused the aorta condition, possibly an aneurysm, that is normally a surgical emergency as it is an unpredictable time-bomb, but regardless of cause may not be operable with TB or medication for it.
7. The medication is a terrible experience, there are often several different medicines at differing price points you should ask the doctor what choices you have as a private patient.
8. Ginger tea, probiotics and St Mary's Thistle (Silybum Marinum), acupressure and other counter irritation or distraction techniques normally ease the nausea / vomiting as do but less effectively medical anti-emetic agents that she is probably already being given.

Good luck and get some much needed clarification about the issues I have listed.

[Bamboo Grove]

Firstly, thank you morSage and then some clarifications

1. All of my information come from the doctor. She said that there is a tb bacteria inside of her but it's not contagious. Talked with my mother who said that when she was a child she also had a tb bacteria in her system but it was somehow embedded there and caused no symptoms and was cured with medication. In my missus's case, the doctor said they will only find out the reality once the operation is done. However, they will need to give the medication to be sure that there is no inflammation on the aorta while they operate her.

2. The medication is being done in a hospital.

3. The doctor said, at least six months.

4. A lot of tests have already been done during the last two years that we have been back in Finland and no other problems, HIV or others, have been found. Only the tb has been a positive test.

5. Surely, a lot need still to be clarified but the doctors have (during these two years) done so and they have been trying to establish the reason for the aorta problem by cutting out options one by one and this one seems to be the only one left now. Naturally, they can't say for sure.

6. Ok, this is new information to me.

7. Yes, terrible it is, to feel sick 2-3 hours every day. As I mentioned, I will go with her to the hospital tomorrow and ask the nurse about this.

8. Ok, thank you, will talk about these things in the hospital as well. She has started drinking ginger tea already.

Thanks again, MorSage, for your advise, let's see what tomorrow brings along. We have about one week to try to ease her situation before her studies start again. Surely, it will be a big problem if all the energy goes to feeling sick.

[migrant]

Good Luck!

[PeteC]

Yes, all the best to her. I hope they find something that can offset the nausea. The body tends to adapt though. Hopefully it won't be so severe once that happens. Pete

[charlesh]

BG - get a 2nd opinion - maybe Singapore if possible!
Good Luck.

[margaretcarnes]

BG - I am so sorry to hear about Mrs BGs' condition - and wish her all the best for a speedy recovery.
Unfortunately my understanding of TB is that it is highly contagious. My own Mum was kept in an isolation ward for 3 months way back in 1964 due to Tubercular meningitis, and back then our home was fumigated, and we were tested and immunized for TB. It was a truly horrible illness, but hopefully methods of treatment have improved somewhat over the years.
But I can't recall any mention then of potential effects on heart function. I know that you have a medical professional in your family and can only suggest that you seek his advice - and use his contacts. Very best wishes.

[Bamboo Grove]

Thanks all.

charlesh - this actually is the second (or third) opinion. Singapore is a bit too far as we are in Finland.

Mags - Thanks for you nice words. My mother has also had tb a long time ago (30's or 40's) and she was a pharmasist and said that tb was quite common in 50's and that she has sold a lot of medication for the disease. Not every case is contagious, the disease has different forms and I think the bacteria can be
located in various parts of the human body.

It's quite obvious that they need to place a tube to support the aorta so that that condition won't get worse. There have been at least three different doctors discussing her case; a cardiologist, pulmonologist and vascular surgeon. In the tb test it was found that she has been in touch (whatever that is) with a tb bacteria and they are not sure whether it has caused an infection in the aorta (there are no signs of the actual disease at the moment). If it has, the aorta can't be operated so they have decided to give the tb medication to make sure there is no infection. The real situation can only be seen, when they do the operation.

Now, whether the aorta condition was caused by the tb or not, is naturally unclear until the operation. As they have decided to operate her rather sooner than later, they want to establish the reason why the aorta problem has happened. Many other possibilities have already been eliminated and the real reason may never be found. The main thing is that with the operation, the risk of a rupture in aorta will diminish remarkably. In Thailand they actually diagnosed the aorta having a rupture which caused me to bring her to Finland to have that second opinion.

Now, we don't feel that all this is un-necessary (the medication and the operation) but the big problem is the nausea. It's very violent and goes on for about 2-3 hours every day, causing headaches and general tiredness and that's what we want to ease. The doctor was not in yesterday but the nurse promised to talk with her and hopefully today we will get a prescription for a medicine that would help her to carry on without feeling sick. Her studies will continue next week and if there is no change in the effects, she will not have enough strength to sit in the classes.

Mags, I've naturally been in touch with my relative about these matters and he hasn't voiced a different opinion about the condition. However, this is not his special area so he can only give general advise. Anyway, I would like to hear if others have any experience in easing the nausea.

[Bamboo Grove]

Yesterday didn't bring any relief to the situation. She was given Primperan (10 mg) to ease the nausea but that was of no use. Even this morning when we went to the hospital to take the medicine, she vomited the glass of water she was given. So that was eight days of feeling sick and not much strength left.

We insisted on seeing the doctor (which is not always so easy here as there is a shortage of doctors in government hospitals) and after some wait he came and gave another prescription. This time the medicine to ease the nausea was taken 2 hours before the tb medicine and now it worked (this one is called Zofran Zydis 8 mg, which is also given to cancer patients for the same purpose).

However, after about 5 hours after taking the Zofran she started having cramps in the legs which she also said were feeling hot. There was also some headache. These are side effects of Zofran and luckily they were over after about one hour during which I and my daughters tried to help her by massaging her legs. Luckily the nausea didn't come and she has been able to eat and drink starting this afternoon.

So tomorrow she will have only 4 mg of Zofran and if that keeps the nausea away and the cramps are not too bad, we have taken a long leap forwards.

[Big Boy]

Let's hope that she's turned the corner. Hopefully if she can start eating normally, that will give her the strength to fight whatever it is.

[margaretcarnes]

As Big Boy says - let's hope she has turned the corner and can gain some strength now. But from what you say I'm amazed that she hasn't been kept in hospital BG? Surely some intravenous fluids etc would help?
Anyway very best wishes and keep us up to date with progress.

[Bamboo Grove]

The medication ends this Thursday. Thankfully, it went well after the initial problems. Today BBC has an article about TB vaccination and the story also tells us that the bacterium can live inside one's body and never become an infection. So I suppose this was the case with my wife and now the risk of an infection has been eliminated.

http://www.bbc.co.uk/news/health-12224172

[Bamboo Grove]

The medication ended at the end of January and her aorta was operated last Thursday. The operation went well and took about 4 hours. There is now a support around her aorta and she was released from the hospital today.

Three years ago we decided to leave Thailand and come to Finland to take care of her illness. Three years is a long time to worry about a weakened aorta but thankfully all went well. The rehabilitation will go on for about three months after which she should be able to return to normal life.

[sharonbaker]

Very nice information what you have shared with us.... Thanks for sharing....