You've got to be kidding

2 weeks ago my doctor called. I should have hung up on him. He called to tell me that the TB Gold test he'd thrown in "just in case" because I'm due to start a new TNF drug in July, came back positive. He was so nice about it. He'd already talked to my pulmonologist and gotten me a referral to an infectious disease specialist. And he felt bad about it, "You just can't seem to catch a break."

Tuberculosis? Seriously? Try that in a conversation, "Oh yes, my doctor called and it turns out I have Tuberculosis." Trust me, there will be a long pause before anything more is said!

So, I met with the infectious diseases doctor. She says it is Latent TB. Which means I'm not contagious. I have to preface with this to anyone who asks. NO, I can't give you TB. But, it is dangerous to me in that it could become active and since I'm still scheduled to start the TNF drug, which will kill off most of my immune system, it is important that I start treatment now.

Before we get to that, though, the first question that had to be answered was "How did you get this?" TB is pretty difficult to contract. You have to be in close contact with someone who has active TB. Usually people get it when traveling to countries that have a TB epidemic or if they have a suppressed immune system and are working in a hospital where there are TB patients. For me, it was none of those things. I got it because I help refugees.

Because of my work with the refugees, I know quite a lot about TB and Latent TB. Many of the folks I work with have Latent TB, and for the past few years I've accompanied them to appointments at the Refugee Clinic or the County Hospital. So answering the question wasn't difficult.

I got it because I keep working with the refugees while being treated for Sarcoid.

OK then, the next step was a chest x-ray to see if there was any lung involvement. For most people this is straightforward. Get a chest X-ray. If it's clear you have Latent TB, start the pills. If it's not clear then you have active TB and you need to start that treatment. In my case, it took several calls between doctors to decide what of the crap on my lungs was Sarcoid and what might or might not be TB. They decided to go with all of it is Sarcoid. Thank goodness for small blessings.

So now I'm on Isoniazid. This is the standard antibiotic treatment for Latent TB. 9 months with monthly check-ins to be sure the drug doesn't give me Hepatitis or liver failure.

Add it to the list. On the up side, between the TB drug and the Malaria drug, if I ever have a chance to go on a tropical vacation, I'm set!

The more difficult part of all of this is deciding what to do about my refugees. Both the infectious diseases doctor and my rheumetologist have told me not to go to any more clinics or hospitals. My immune system can't take it. There is also the realization (ok, whack to the head) that my work is making me sicker and that it has real consequences. What to do about this is more difficult. I haven't made any decisions yet, and frankly, I don't know what to do.