It took us a couple of weeks to get into the pediatrician after we got home from China. It wasn’t a big deal that we were waiting so long though. We’d already seen a nurse practitioner for the urgent medical issues, a specialist for her documented special needs, and the medical visit in China. We were covered right?
When we finally got in I sat down with the head of the practice and a medical student. The medical student examined our daughter while the doctor and I went over the list of tests that had been recommended and pieced together our daughter’s medical history from her file, updates, and info we received in China. We settled on a few tests that seemed most important. One of the recommended tests was a repeat TB. I didn’t question the doctor even though the TB test in China came back negative. The doctor opted to do the skin test.
Over the next couple days I noticed a hard raised red area and did some quick research. Since our daughter had the TB vaccine in China she would always test positive with a skin test. It usually is not recommended that a person who has had the vaccine receive a skin test. I could relax. I almost forgot to have the test read.
In an attempt to avoid taking all four children to the pediatrician, the youngest two and I rushed to the pediatrician’s office and arrived just before their lunch break. We slid into the office with a whole two minutes to spare. I didn’t think it would be a big deal because a nurse just had to glance at our daughter’s arm and we’d be on our way or so I thought. The nurse glanced down at our daughter’s arm, frowned and looked a little closer. She looked at me with concern, “I am going to have to get a doctor to look at this. Can you step into the room?” Great.
The doctor came in glanced at her arm and walked back out. She came back in with some books and a ruler. She shut the door. That’s when I knew it was serious. She drew a circle on my daughter’s arm and measured. She told us that even with the vaccine our daughter’s reaction site should be no larger than 10 mm or 15mm at the most. Our daughter’s reaction site was 25 mm, very red, raised and hard. She’d checked all her resources while she was out of the room. She was sending us to get a chest x-ray immediately.
We left the pediatrician office and headed straight to get the x-ray. I was still in shock over the news I’d received so I didn’t even think about having my other three year old with me. When we were called back the receptionist graciously offered to watch my other three year old since she wouldn’t be allowed in the room during the x-ray.
Once the x-ray was over the waiting and educating began. The CDC website was hands down the most informative and accurate information on Tuberculosis that I found. I was reassured that children under 10 can’t typically cough hard enough to pass TB. I was relieved to know if the x-ray came back and she was positive at least she wasn’t contagious and my other children were safe. We received the call that the x-ray was positive. Our daughter has latent TB.
We would not have known until it became a problem had the doctor not requested a second TB test (the first being in country). We are very fortunate it was caught since untreated latent TB can lead to meningitis and of course active TB. After being diagnosed there was a lot of cooperation between infectious disease at two major hospitals, our specialists, our pediatrician and the department of health on the county and state level. It was decided the best course of treatment would be to meet at the local detainment of health once a week for 12 weeks so two medications could be administered to our daughter.
At first I was frustrated about the weekly trip, but I’m thankful for it now. My daughter is very resistant to taking the medication so with a nurse administering it outside the home, home gets to remain a place of comfort and I get to remain the good guy. We just make a special morning of it with lots of treats and a trip to the playground.
After her treatments are finished we will need to continue to monitor our daughter for symptoms, however, in the unlikely event that the TB ever becomes active it will be less severe since we treated the latent TB.
– guest post by an anonymous mom