Friday, August 8, 2003

Some good news, relatively

OK, so here where we are. We went to the hospital to pick up Katherine's blood test results (she was so brave at the hospital, I was so proud even though I told her it would be just fine to cry and say Ouch, she didn't shed a tear) and then walked across the puddles next door to the Makati Medical Center to visit with the pediatrician, Dr. Butler.

Now, I've heard horror stories about her, and in fact yesterday was warned by the Clinic doc that while she's great with kids she has no tolerance for parents. I steeled myself. We walked in and immediately Jonathon started in with "Toy! Toy!" as the waiting room had a stack of toys. Cool. We were brought right into the office with Dr. Butler and she took a look at Katherine's arm, pronounced her definitely positive (her test site measured 12mmX14mm and anything over 10mm is considered a positive reaction in moderate risk groups) and then we talked about what a positive reaction meant, what medication and how long, why medication, what the side effects are, what the follow-up care would be and what risks there were to others. The doctor was great. Down to earth, straight forward, answered my questions, helpful and reassuring.
A positive reaction means that Katherine was exposed and has been infected by tuburculosis. This doesn't mean that she has the disease.
She will be on a course of INH, isoniazid preventive therapy, for 6 months. It seems that there's a continuing discussion of the protocol length between 6 and 9 months. It's a single pill every morning.
Why should be take medication at all if she's just a carrier? TB is a slow and stubborn disease. At present, she is merely a carrier, but if left untreated she would have a 20% chance of developing the disease in the next 5 years.
The side effects are harsher on adults than kids, but the risk is there that the INH can affect her liver. Which is why a test was done to check her liver function as a base line and she'll be monitored monthly to make sure no damage is being done. There is a chance she could be allergic to the medication, showing up in a rash. If so, she'll stop taking it and be switched to an alternate.
She is not contagious. She does not have the disease so she cannot spread it. How did she get it? It's something that usually spreads through prolonged contact with individuals, but she has spent very little time with our housekeeper (and those of us who've spent more time are negative), who would be the greatest risk to our family. We'll never really know where it came from.
Katherine will be just fine.
(And so will I. Last night, I just wanted to cry about what she'll be going through, but I know that she's stronger than this. In the grand scheme I keep hearing "Oh, it's no big deal." It is for me, this is the first time one of my kids has been sick with something so out of my control and I can't help but think "If we had stayed in the States...")

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