That Time I Thought I Had TB


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Subtitle: And by “That Time” I Mean a Month Ago When I Went to State Med for My Medical Clearance AppointmentNote: I do not have TB. So don’t worry. But judging from the reaction I had to the skin test, I thought I did.tuberculosis skin test result, TB skin test reaction, positive TB skin test, negative TB skin testI finally got my medical clearance to accompany Kail abroad. (Spouses have to get medical and security clearances, the latter of which is still pending/may or may not have started yet.)A few weeks ago I scheduled my appointments at State Med: One to get bloodwork done, a referral for a chest X-ray (standard for everyone) and the aforementioned TB skin test, and the second 48 hours later to have the results of the TB skin test read and to receive a complete physical examination.You can imagine my reaction when I awoke 24 hours after my first appointment to a HUGE RED WELT on my arm that was itchy as hell. I immediately logged on to WebMD to look up everything about tuberculosis. Within oh, two minutes I had convinced myself that ohmygodIhaveTBwhatamIgoingtodo?!The “firm, red bump” on my arm was definitley larger than 5 mm, the minimum threshold for a positive skin test result. Turns out it was 8 mm in size, smaller than the 10 mm threshold for a positive result according to State Department guidelines.foreign service medical clearance, efm medical clearance, security clearance, usaid medical clearanceI didn’t know this at the time though, so I proceeded throughout the next 24 hours in a mild panic about what this meant for our lives. Kail kept reassuring me that I did not have TB — I was obviously healthy and there was no way I had it.I, however, kept thinking about where I could have possibly contracted TB. Do people in the U.S. have it? Was it because I take the Metro everyday? Damn that public transportation! Or maybe it was from that trip to China. That’s why everyone wears surgical masks!I arrived for my second appointment prepared for the worst.We discussed my medical history and the requisite medical records I needed to have a couple of my doctors fax over in order to process my clearance.“Any other questions before we do your physical?” the doctor asked.“What about my TB skin test result?” I asked, pushing my sleeve out of the way to reveal The Bump.“Oh yeah, that looks like a positive result,” the doctor said, nonchalantly. “The chest X-ray will confirm the results.”I had gotten the X-ray done right before my second appointment at GW so the results weren’t immediately available to her.“So … I might have TB?” I asked in disbelief.“There’s a chance you might have been exposed to it, which is why you have this reaction, but that doesn’t mean it’s active tuberculosis.”I was in such a state of shock that I didn’t say anything else, so we proceeded with the physical examination. Afterwards, I met with one of the nurses to get the necessary release forms for the medical records they needed and discuss next steps.“So … is this a positive TB result?” I asked.“It might be,” she said, pulling out a small ruler to measure it. Upon seeing the look of terror on my face, she stopped. “Let me be clear: You do not have TB. You’re healthy. You may have just been exposed to it.”Apparently we’re all just walking around, potentially breathing in tuberculosis germs — in densely populated urban areas (hello, DC), on airplanes, public transportation, etc. Most healthy people don’t actually get TB even if they are exposed to it — your immune system fights it off. But if you’ve been exposed to it, the skin test causes those same immune cells to react at the test site, resulting in the bump.(Or something like that. I’m not a doctor. Or a nurse. This is based on my memory of our conversation plus research on the internets. Do not take this as medical advice.)And as I mentioned before, the bump was smaller than what the State Department considers a positive result (10 mm). And the chest X-ray came back all clear. So that was good.I still had to wait a couple weeks for all of this to be processed, along with records from my other doctors, before I was in the clear. And even once the doctor at State Med signed off, the paperwork went to another office at the State Department that handles medical clearances (different from the Office of Medical Services, which actually administers medical services like physical exams, bloodwork, etc., and different from the Travel Medicine & Immunizations office, which handles all the vaccines that are required for different posts).Even though I was in the clear when it came to TB, I actually was slightly concerned my medical clearance would be held up because I have a form of hyperthyroidism called Grave’s Disease (not as scary as it sounds) that requires daily medication and annual exams/labwork. But my endocrinologist signed off on my traveling the world.Next up: Fun with vaccinations.Does anyone else make a habit of freaking themselves out by reading WebMD?

Published by La Vie Overseas

I'm Natasha -- writer, runner and wife to a Foreign Service Officer with USAID. Current location: Frankfurt, Germany.

11 thoughts on “That Time I Thought I Had TB

  1. What a scare!!! I do freak out but only when it comes to the kids. I thought they had, autism (he’s 2 weeks old and isn’t smiling!), some genetic disorder, bronchitis, etc. The husband tells me to stop reading and if I’m really concerned go to the doctor….With your worldwide clearance you can go anywhere! Congrats!

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  2. Congrats on passing med clearance!! I’m going through that now- gah, what a process, right? Can’t believe your TB skin test came back with a trace amount of TB- that happens a lot with the folks posted here in China, but I’ve never heard of it happening in the states. Totally no big deal though, and really, it’s just a fun(ny) story to share, right??Also, I definitely think I have meningitis every time I have a headache.

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    1. Thanks! Yeah I am really glad it turned out OK — and that it gave me something to write about! I went to China for two weeks a few years ago so I don’t know if that has anything to do with it. One clearance down, one to go (security — no idea what is going on with that right now).Good luck to you!

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  3. I tested positive last time for the first time and I heard that I would always test positive. I don’t know when I got exposed, but I know it happened in Indonesia where I currently live. I was bummed about that.

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    1. How scary! Does that affect your ability to travel to other countries? I assume you are healthy otherwise, just with a positive reaction to the test. I guess that is one the risks of living abroad — exposure to diseases and other dangers, but it seems like a worthwhile tradeoff for everything you get in return!

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  4. Glad you passed! I think I would have been pretty anxious, too. Take plenty of Vitamin C in the days before and after your vaccinations– that will help you process them and have less reaction symptoms. These tedious parts are all exciting steps before your adventure begins– enjoy!

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