Monday, January 27, 2014

TB and Me  - A lesson I learnt and an experience I would like to share.

A year ago, a page in my diary reads “I am an officially declared TB free woman now” in bold with a wink, which I had later painted with a pink highlighter to mark this day of freedom every year, if not at least till I forget the pain. It was January 25 last year (2013), I remember how happy and relaxed I was, after completing my TB medication of 6 months. The moment was truly a proud moment for me, an emotion I had not felt even after passing the toughest papers in exam and more importantly, it was a relief for my family and friends who had genuinely worried for me. I felt more pleased to have gone through such pain and having come out of it as a stronger and a healthier person. I remember jumping three times in the hospital car parking and proudly recollecting what the doctor had just said. She said, my chest X ray displayed no infections and neither did my other tests show any remains of the dreadful disease, but the most exciting of all was that I had put on 7.5 Kgs extra weight. Finally a new record of 52.5 Kgs was set J. Ever since I had grown 155 cm tall, my weight always fluctuated from 48  to 50 Kgs and when I was said to be infected by Mycobacterium Tuberculosis in July 2012, my weight had reduced to 45 Kgs for the first time.  
TB is the acronym for Tuberculosis. It is a common and in many cases fatal and an infectious disease caused by mycobacterium tuberculosis, a bacterium that is spread from person to person through airborne particles. TB primary attacks the lungs, but can also affect other parts of the body. TB can be pulmonary and non pulmonary. Pulmonary TB is infectious and is spread through the air when people who have an active TB infection cough, sneeze, or otherwise transmit respiratory fluids through the air. Most people who are exposed to TB never develop symptoms because the bacteria can live in an inactive form in the body. But if the immune system weakens, TB bacteria can become active. In their active state, TB bacteria cause death of tissue in the organs they infect. Active TB disease can be fatal if left untreated.
How I knew I was infected with Mycobacterium tuberculosis and the Symptoms of TB:
I was a very unhealthy person since a child catching a cold every four seasons, getting a sore throat whenever I drank something cold (I had avoided ice cream parlors for this reason, I still do), a mouth ulcer whenever I ate some pan masala or doma (Betel nut), a tooth ache whenever I ate chocolates/candy, a loose motion/constipation every time I ate out and some more that I cannot remember now. As I grew, I got used to eating outside considering my studies at boarding schools, though I still had to think first if I was ready for an another pain before chewing panmasala, doma and drinking cold stuffs. Cold remained unavoidable and I continued to get one every season making it at least four times in a year. That week of summer, 2012, I thought it was my usual time of catching a cold as summer had just begun. As always, I started my dose of sinarest (a common medicine used for treating cold in my country), started my gurgling sessions, drank warm water, stayed away from cold water, wrapped myself with a thick scarf so that I could prevent myself from getting a sore throat, through experience I had known that the two together would be a horrible combination. However, in spite of such impressive care of myself, my condition was getting worst day by day. A mild fever and some joint pain had added up to my already worsening condition. My parents started getting worried and started asking my sister (who stays with me) to take me to a doctor. Even for me, the pain had started becoming unbearable and I thought I would at least get a painkiller from the hospital. I went to see the doctor. The usual Q&A session started, if I was married, questions about my fever, my appetite, dizziness, etc but the last one astounded me, I had not even thought about it in my wildest dream, the doctor asked me, if I had someone in my family who was suffering from TB. Of course I had none, but I felt something cold inside, a ‘could be’ kind of feeling suddenly started running in my head. The doctor gave me some antibiotics and some painkiller as expected and asked me to come back if my condition deteriorates after the dose was completed, it was for five days. I couldn't wait for five days as I had started coughing and the thought of getting diagnosed with TB did not leave me in peace. Though I had some basic knowledge about TB, I had never found it necessary to know more about the disease as no close one had been diagnosed with it. With the little knowledge I had about the disease, I at least knew that a person suffering from TB would look extremely weak/sickly, dark and would use a mouth mask. However, that night after getting back from the hospital, I Google (d) about TB and it educated me enough to stay prepared for the awful news that was on its way. On the third day, I went to the hospital again as I couldn't wait any longer. The doctor listed a series of test to be done, Sputum Test for three days, Blood Test and Chest X ray. I wasn't very surprised on the fourth day when I received a call from the hospital asking me to start my medication right away.
Most people who gets infected with Mycobacterium tuberculosis do not present symptoms of the disease. However, when symptoms are present, they include:

§  Weight loss
§  Shortness of breath
§  Night sweats
§  Chills
§  Loss of appetite
§  Fatigue
§  coughing that lasts for 3 or more weeks
§  coughing up blood
§  chest pain
§  painful breathing
§  Pain when coughing.
Some Lessons I learnt which I thought was worth sharing:
Our immune system does a remarkable job of defending us against diseases causing microorganisms. The bacterium entering the body cannot be destroyed if the body has a weak immune system. A weak immune system, I always had it in me, but I never thought it was so important that it needed some attention. Whenever, I got infected with some cold or cough or minor infections, I used to have a medicine and I would be fine in few days but I never realized that it was just a temporary remedy. However, I have started to give a boost to my immune system now. I learnt it only after the dreadful experience but you can learn it before one J :
Boost your immune system after changing your following habits:
1.    Don’t skip breakfast (at all) – I regret for not listening to my family, my teachers and my body and skipping my breakfast always as I would be in a hurry every morning rushing to school/college/office after waking up late. I never skip one now, I wake up early enough to have time for breakfast.

   2.   Eat Healthy diet - Eat a diet high in fruits, vegetables, and whole grains and low in saturated fat. I always liked to eat dried meat (Dry Fish used to be my favorite); no green vegetables; no fruits; Tea instead of water/fruit juice all the time and more adds up. I have changed my dieting habit now and I feel healthier every day.J
3.      Do exercise regularly. (Exercising, I used to feel like some kind of punishment, maybe because I was too lazy. Now I realize how important and exciting it is)
4.    Control your blood pressure. (I never checked my Blood Pressure unless I was asked by the doctor to do so. I check my BP once in three months now)
5.     Don’t smoke. (I didn't smoke either)
6.      Maintain a healthy weight. (I never did routine weight check, I do it every 3 months now)
7.      If you drink alcohol, drink only in moderation.
8.    Get adequate sleep. (I never used to get adequate sleep, I usually slept very late watching movies, reading on bed and had to wake up early enough to reach office on time. I hardly slept for 4-5 hours sleep which now I realize was very unhealthy for my body. Now I make it a point that I get at least 7-8 hours sleep daily)
9.   Take steps to avoid infection, such as washing your hands frequently and cook meats thoroughly.
 TB Medication and its side effects:
The medication they said would be for 6 months as mine was an initial stage. I saw the medicine on the table of the health assistant, it read as rifampicin and there was another capsule with the name pyrazinamide. Like the name, the medicines looked quite creepy too and I had to eat three rifampicin tablets and a pyrazinamide capsule in a day which means I had to eat 720 tablets to get rid of the mycobacterium. TB germs are said to die very slowly. Fortunately or unfortunately, I wasn’t admitted in the hospital as there weren’t enough beds. However, I was asked to stay in isolation for two weeks and to wear a mouth mask when I had visitors. I started the medication right away but I was asked to come to the hospital daily to get my medicine. Later did I realize that, it was because the hospital wanted to make sure that no patients miss any of their doses. It was very thoughtful; every citizen’s life was precious after all. J
Lucky that I was born in a country like Bhutan, else I bet the medicines would have cost me quite an earning. I am very grateful and I believe every Bhutanese should be.
The first few days, the medicines did not affect me much except for the change in the colour of my urine and a little feeling of dizziness. The following days, I saw hell. The side effects of the TB medication were terrible. I was asked to eat healthy. Forget about eating healthy, I couldn't eat anything, I had completely lost my appetite. I vomited the little food I swallowed, I still had high fever, terrible headache that kept me awake the whole night, fatigue, tingling and numbness in my hands and the worst of all was the itchy skin. I felt like soaking myself in cold water the whole night. One of those days, I had written in my diary, “I pray no one in this world be infected with this dreadful/awful/terrible/ disease, not even the worst people in the world. The pain is unbearable. God, please take me out of this quickly”. This year when I read it, I literally cried as I could still feel the pain. These were just physical affect. In addition, I used to feel very depressed/ lonely, I had become so forgetful, that one day I left the car on start and went to the vegetable market for shopping and didn't even realize it until I got back into the car. I had also started losing my temper.
My parents, my grandparents, my sister, my brother, my relatives and my close friends had been very supportive throughout this aching journey of mine. My grandmother used to stay awake with me throughout the night massaging my head, my legs and hands. My sister and my cousin would cook me healthy food and made sure I had it on time. My friends would always visit me every day and update me with the news outside. My parents came to meet me but had to go back as they had to get back to work but made sure that they talked to me every few hours. They always made me laugh and made me feel much loved. I am very grateful to all of them who made me feel better in their own special ways. I can’t thank them enough.
After two months of medication, after the physical pain finally vanished except for fatigue and headache, I joined office. I didn't have to go to the hospital daily to get my medicine then, they gave me for a week and every Saturday I had to get the dose for the following week.
If you are already diagnosed with TB, It is important to take some basic precautions to stop TB spreading to your family and friends.
  • stay away from work, school or college until your TB treatment team advises you it is safe to return;
  •  always cover your mouth when coughing, sneezing or laughing;
  • carefully dispose of any used tissues in a sealed plastic bag; 
  • open windows when possible to ensure a good supply of fresh air;
  • do not sleep in the same room as other people because you could cough or sneeze in your sleep without realizing it.                                                                                                                                 As a family and a friend of the patient, the following are important:
·         Don’t make them feel bad about the disease (Even if you think so, just keep it to yourself);
·     show your love, concern and support;
·         Cook them healthy food;
·         Clean their rooms daily;

With some research I did on the above drugs, I found out that these drugs are quite strong that they can have long run side effects (even after completion of your medication) like your deteriorating eye sight, trouble in your organs like heart and liver, your blood pressure.
Patients are also said to relapse after completing the treatment. Therefore, it is very important for the patients to take extra care of their health and develop healthy habits to boost their immune system.

I wish every one a healthy and a happy life. :)
                    Stay Healthy and Happy :)