Tuberculosis

[Guest]

I had a positive PPD. Because of the "size" of the reaction, and the fact that I am diabetic, they decided I should go on INH for Preventative treament. (Chest Xrays showed that the TB was not active). I began the INH treatment about 2 mos. ago. I started feeling really bad within a week of the first dose.. But after 3 weeks, I was so sick I could barely function. My liver was enlarged. I had difficulty breathing from what seemed to be fluid built up in my chest. My regular nurse said that she believed I was on the verge on liver failure, and told me I should not take another dose of it. After a month, the health department put me back on INH . They did a liver panel but didnt wait for the results of it! The person who dispenses the medication at the Health department couldn't answer any of my questions and seems to know less about this than I have learned on my own through reading. She said that the symtoms I had were not caused by the INH. Then, she made me sign a contract promising that I would not miss another pick up, and that I would stay on the INH. She doesnt seem to care whether I am in danger of Liver failure or not. I told her before starting the INH that It was possible that I had hepatitus C from a blood transfusion and she said they didn't deal with that, and didn't know anything about it or if INH would cause the Hep C to go active. She told me that the symptoms I had read about everywhere that signal danger were just normal side effects of this drug and not to worry about them.. And that if I stopped taking it after starting, that I was increasing the risk that I would become active. (I know about the risk of becomming resistant, but this isn't what she was talking about) I am willing to do what I have to do to avoid becomming active and making my family sick, but I dont want to go into liver failure! Can anyone tell me what side effects ARE normal ?? I live in a state where treament is Manditory, and they seem to have the attitude that you are going to make up things to get out of taking it.! Can you tell me where I might find more answers to things like what to expect and what does signal danger? I am afraid that when I start this up again, it will be alot worse than it was before, alot faster.
I was given a vitamin B6 cpmplex with the INH that was suppose to lessen side effects. , It seems to make me sicker than the INH does. Is it absolutely necessary to take this with INH? (It contains 2500 times the daily requirment of vitamin b6) I know these are things I should ask a doctor, but they have not let me see one. The nurse at the health department talks to the doctor and then tells me what he said.When I ask her a question says she doesnt know and I shouldn't be looking it up on the computer because I'm not a health care professional. I am unwilling to just leave my future in someones hands that won't answer my questions.The fact that I was in pre-med when I had an auto accident makes me want more info than want to give me.Anything you all can tell me about this would be greatly appreciated.
Thanks

[Guest]

Jessie, some of the symptoms you describe could be due to the INH and you do need to have your liver function tested when you are taking it. There are other drugs you can take if you cannot tolerate the INH. Given that you are diabetic, you are at an increased risk of this becoming active TB so prevention is very important. The vitamin b6 prevents some of the neurological side effects of the INH but you do not have to take it if it makes you ill. I would strongly suggest you see your physician or perhaps a pulmonary group at a city or university hospital to help manage this if you are dissatisfied with the health department.
[quote] I had a positive PPD. Because of the "size" of the reaction, and the fact that I am diabetic, they decided I should go on INH for Preventative treament... [/quote]

[mrsibew]

I know that you wrote this in 2003, but hopefully if someone else reads this post with the same questions , I can be of help here. First of all, It is mandatory in all states to treat TB. It is an infectious disease covered by the CDC. I am a TB Dot provider. (Direct observation therapy) and I hate to admit it but the nurse who handled your case was way off base. One of the main things we watch for are liver and eye problems at our Health Department. Intolerance to INH is not unusual and we have meds such as Moxiflaxin and others to give patients who cannot take INH or some of the other regimen that we use normally. We have AIDS patients who's liver is already shot and we have to deal with that and we do. Treatment may take longer because of the change in meds that you are given which may not be as strong in treating it in shorter amounts of time, but we can adjust the medication to your medical needs. The B6 is used for cramping of the legs etc, that can be caused by the INH and other meds, That in itself should not hurt you as you can get that over the counter at any drugstore. They should have been doing blood workups and xrays on you throughout your treatment to check your liver functions and adjusting the meds accordingly. As for talking to the doctor... I have had a few patients who wanted to talk to him for various reasons, i.e. "I don't have TB," "He needs to tell me this info himself" etc, etc,..You know what the TB nurse, who is my boss, tells them? "Here's his number, call him." You make me greatful that I work for the counties that I do and with the people I do work with. Never take no for an answer and if necessary go to your own Doctor and have him make them change your regimen if you are having these kind of problems with it. We are here to help you, not cause you more unnecessary discomfort or health problems.