Nov 24, 2010

You, Me, and TB.

This weekend I found my little white pills to be dwindling, so I planned my monthly trip to the TB clinic. This time, though, I was not going to be reduced to a bumbling, crying mess like last time so I brought in back up in the form of my dear friend Hannah.

Having a friend there didn't quite work the way I had hoped though, instead of turning into a sobbing hullabaloo I was an empowered angry person. An empowered angry person who looked down on this country for making me sick.

I need to work on my pride. I need to be reminded that people get sick in other countries, too, and that this could have happened anywhere. I need to not blame an entire country for my "sickness."

But it's just so easy.

Chi.na has the world's second largest per capita cases of TB in the world (second only to India). TB is the leading cause of communicable disease related death in Chin.a. There are 1,306,000 new cases of TB in Chi.na every year. There are 13,000 new cases each year in the USA, 40% of which are immigrants.*

Why is there so much TB in Chi.na? Well, let me tell you.

TB is spread much like the common cold. It is airborn. Every time a person who has active TB coughs, sneezes, or spits, TB germs are spread. Someone who has untreated active TB will spread the disease to 10-15 people a year.*

Well, in Ch.ina, people don't cover their mouths when they talk/eat/yawn/sneeze/ever. It is not uncommon to see a man (or woman) blowing their nose with their fingers on the side of the street or hawking up loogies. I quite often walk into puddles of spit and snot. And because diapers are so expensive, children pee and poo on the side of the street; over grates, trash cans, and just about anywhere else.

Also, TB affects bodies whose immune systems are not strong. HIV/AIDS is a growing problem in Chi.na because of lack of sexual health and awareness. HIV and TB are closely linked. So are TB and smoking. Becuase so many people smoke in Chi.na and the air quality is poor, people are more apt to become sick if exposed to TB germs.

Poor public hygiene/smoking/other disease = TB spreading like wildfire.

So...how did this happen to me? - a non-smoker, non HIV haver, random girl from Florida whose just trying to make a difference and live out my youth in Asia?

One word: orphans.

In the past 2 years I have spent many many hours in a hospital. I now even work in a hospital (ironic and awesome). Because I was exposed to sick babies, people, and not everyone gets vaccinated here, I was somewhere along the line exposed to someone who had active TB.

Those germs got in me, but could not penetrate me because I was vaccinated as a child, as per American law (God bless it). So my TB is latent, I'm just a "carrier." But carriers have a 1/10 chance of catching full-blown TB at some point in their lives so I have to be treated like I have TB.

Which is no fun.

My little pills make me barf, nauseous, anxious, and throw up blood. And living in a culture where the common answer to any mild medical ailment is, "drink hot water," makes for some frustrating interactions.

Take my texts yesterday for example:

I was throwing up blood again. Not a lot, but still not something to be taken lightly. I text my bff Michael who is a heart surgeon: "I'm coughing up blood again, what should I do?" His reply: "drink more water and vitamin C."

My reply: "So I shouldn't be worried?" Him: "Drink hot water and tell me if you feel bad."

Aiiiiyiiiyiyiiiiii.

Dear mom and dad, if I ever have a real medical emergency in Chi.na, just let me go to Heaven. I don't want to deal with these people.

There, it's in writing. I don't trust this place.

So now you're probably thinking, "why did she stay in Chi.na, is that smart?" My answer: it doesn't matter where I live. I have to take 3 pills a day for a disease I do not techincally have. These pills will make me sick no matter where I live. Being here is not harming me nor anyone else. The damage is already done, and in 3 mere months (half way!) this will all be over. I was cleared by the Florida Health Department for international travel, and the visa office in Hangzhou was given the opportunity to look at my medical paperwork (though they did not).

I am selective with whom I tell only because people give you a freaky look when you say, "I have latent TB." But I have been spilling the beans to more and more people because I like to joke about it and when I crack a TB joke and no one knows I have it, it's not so funny.

Whenever I see a man spit on the street I say, "TB!"

Whenever a friend is going out at night I warn them, "don't get TB!"

It's funny. Trust me.

The good news about TB in Chi.na is that there is currently a 5 year initiative program for the detection and treatment of TB in Chi.na being funded by the Bill and Melinda Gates Foundation. Through this program village health workers are being paid a bonus every time they identify a case of TB. (which can be hard because latent TB has no symptoms).

I guess what all of this is about (besides just wanting to get my thoughts out. I'm surprosed if anyone is still reading this...) is that health is a serious thing. (like, duh.)

I can't imagine what it would feel like to have something more serious. So many more people out there deal with things that make my 6 months with TB seem so trivial.

When my doctor was first over-reacting to my positive testing, I had a flashing thought that this is what it's like to be told you have cancer. Now, that is dramatic, because my case does not even compare to cancer, but any negative health news is freaky.

I feel like in all of this I am being prepared for something and I don't know what it is. I've learned so much about international health statistics, vaccinations, child care, and sanitization standards. I am witnessing the sick, the dying. I am lining up with people whose X-rays are cloudy, who yell at the doctor bartering for their monthly medications. I am in the clinic with people who will not live a full life because TB will eat their lungs before they have a chance to realize their dreams.

I'm one of them.

But I will be ok. Not every person in that clinic is so blessed as I am.

For me, I will take my pills, barf a little, and then it will be done. This will all become a rather amusing few chapters in the book I will write about this Chin.ese blip in my life.

But for some of the people I encounter, there is a different path. I don't know why I am being given these things to witness, but I know that someday in my future I will look back on this time and say, "Oh, so that was what this was for." Maybe I am supposed to be more empathetic towards human suffering. Maybe I will have to share my new-found knowledge of TB treatment with someone. Who knows? All I know is that this random time in my life is preparing me for something later, something unknown. There is a reason for this that I do not know yet.


Outside the clinic with my hott pig mask on and my new bottle of meds!

there's no waiting rooms in China! Everone piles in (cuts in line) and listens to each other's prognosis and looks at each other's X-rays. This is unbelievable to me.

I. hate. those. pills. Please notice how I am "Jesska." I am in the system only as "Jesska." No ID, no passport number, no last name, no address. Just, JESSKA.




Be thankful for your health today. Or at least to be alive. It's a gift.

Walk slow. xoxo.


*all factual information taken from the World Health Organization web site: www.who.int.









5 comments:

Jenna said...

i read the whole thing.
just so you know.
i wanted you to know that someone read the entire blog. i'm very recently very addicted to your blog. and i am oh so much more informed because of it. please feel free to crack TB jokes with me any time you like.
please read john 9:1-6 and smile big.

agapelife said...

I've been frustrated with some healthcare stuff here....well no longer, thank goodness for perspective, I'm sorry you have to be the person to give it to me ;)

Jessica said...

Dearest Jesser, I truly enjoy reading about your TB adventures, not because I enjoy the fact that you have TB, but I find it interesting. Did you really get vaccinated against TB when you were a kid? That vaccine is rarely (if ever) used in the US, but is used quite frequently in other countries. Receiving the vaccine can produce a postive TB skin test. Another thing, coughing up blood (hemoptysis) is never a good thing. I'm sure you know, but hospitals in the US are equipped with reverse isolation rooms for those with TB or suspected TB. Everyone who enters the room has to be wear a special kind of mask that has been fitted to that person specifically. One hospital I was at placed anyone who had a mycobacterium lab ordered on them, even if it was documented to be non-tubercular. Hope all is well dear one. Happy Thanksgiving!

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Ke Xiao Mei said...

Jes I am so glad you are reading because I really trust you about medine. :) I really know nothing about the vaccine, though I've read about everything published about latent TB. (ok, exaggeration, but I did go nuts for a weekend and read everything I could google).

My doc told me I was in the clear because I had been vaccinated as a child. Not sure what vaccine that means though. I do know that I tested negative for TB 2x in my life. Once in college and after my first year in China. This is why my doc thinks I picked it up in China.

Also, the cough/blood thing. My blood test results last month came back with high TB levels and high something else. Around this time the coughing blood started. They made me come in to do it again and that was was fine they said. No one around here seems to be too worried bc TB is so common. I have another blood test this week.

You are so smart! Please tell me anything you know!

@all 3 of you: love and miss.

Jessica said...

Hmm...still not sure on the vaccine deal, it would be really rare for you to have gotten it, and even if you did, (depending on which one you got) they have variable effectiveness (usually not the greatest). I also chatted with Hannah this morning to bounce some thoughts off of her, since she is soon to be a doctor while I am the soon to be pharmacist. While I don't want to freak you out, I don't want you to be pacified by people telling you things aren't a big deal. There are many instances when things that seem big turn out to be nothing, but there are also instances when big things are brushed aside to later find out they should be been delved into a little deeper. I'm happy to hear you getting more tests, and you know your body best, so you will be the best to judge to know when something is wrong. And again, not to freak you out, but coughing up blood is a sign of active TB, with latent TB you usually don't have symptoms, just a positive blood test. However, I am by no means an expert on TB - seeing as there is not much of it in the states, especially not in rural Iowa. And while it very well could be nothing, I just don't want something like coughing up blood to be pushed aside - best to catch something early before it progressive, or best to find out it is nothing to worry about. Love you dearly - ever concerned about your health, don't take it for granted.