"I thought TB was something 'ordinary' people don't get"
Michael* suffered from tuberculosis after contracting the disease in Thailand, where he has been living since 2003. At first both him and the doctors thought it was ‘just a flu’ or a minor infection. But then symptoms got worse and antibiotics didn’t work. He tells TBVI:
How he got TB will forever remain a mystery.
How he felt ‘something’ was wrong.
How X-rays showed ‘clouded areas’ at the bottom of his lung.
How taking medicines was quite a challenge.
How he didn’t know anything about TB before he got it.
How he now takes better care of himself.
Forever mystery
“I would really love to be able to say how I got TB, but the reality is that I have no idea! It must have been somewhere in Bangkok around August 2007. Prior to being diagnosed, I didn't go any places that seemed particularly prone to TB. My doctor says you can even get TB by simply sitting in a taxi with a driver who has is. Or I might have caught it in a crowded bar or disco. What I do realize now is that at the time, my immune system was probably not so strong. I am convinced that this was a main factor that made me catch TB somehow. But exactly how I got it will forever remain a mystery...
In fact, I did get the BCG vaccination against tuberculosis in Denmark, my home country, when I was a baby. But according to my doctor, it had no longer any effect. And in any case, it is not a 100 percent guarantee against getting TB.”
‘Something’ was wrong
"I vividly remember the first time I felt that 'something' was wrong. I was walking down one of Bangkok's main shopping streets, and suddenly I felt this cold feeling all over my body. As it is always hot here, you normally never feel cold. I was baffled, but it only lasted for maybe a minute, so I thought it was just maybe the beginning of the flu or something.
A few weeks later, I began to cough and to feel pain in what I - at that time - thought was my back. It rapidly became worse and worse. Probably about 2 weeks after I first began coughing, I decided to go see a doctor at a leading international hospital in Bangkok. The first doctor I saw concluded that is was just an infection and gave me some antibiotics. As I didn't know I had TB, I thought she was probably right.
But taking the antibiotics didn't help. I was still coughing - sometimes with greenish/yellowish substance coming up - and the pain in my back was now so bad I could only sleep in certain positions. So I decided to go back to the hospital to see a lung specialist."
Clouded areas
"At first, the lung specialist concluded the same as the first doctor - that is was probably just some kind of flu or infection. But this time I insisted on getting an X-ray. That showed some large clouded areas at the bottom of the lungs. My doctor told me it was most likely either lung cancer or TB. She also asked if I would mind taking an HIV test, because a very large percentage of TB patients in Thailand have HIV before getting TB. Not exactly a great message to get!
The doctor immediately asked me to cough up some of the substance from my lungs in order to analyze it. In the meantime, I had gone to take the HIV test and was not sure what to be most frightened about: TB or HIV. Luckily, the HIV test turned out negative, so at least I didn't have to worry about that.
But the same day I got a text message from the doctor asking me to get back there as soon as possible. She was now certain: I did have TB. This was the result of the first analysis of the substance in my lungs. Another, specialized hospital would do a more in-depth analysis. This would take one week, and it later indeed confirmed the initial findings. But we didn’t wait for that, my doctor ordered me to start taking TB drugs right away. So that same evening, I began six months of intensive medication."
Medication quite a challenge
"My coughing quickly decreased after I began to take the medicines and my back/lung pain disappeared after the doctors removed the liquid substance in my lungs. They basically sucked is out with some advanced equipment. It was terrifying when they did it, but what a relief afterward!
Remembering to take medicines several times a day - and never miss - was quite a challenge. But when you know just how important it is, I think it is something you are really determined to do. Although I read that in 90 percent of cases, the body accepts the TB medicine, the question of "will I make it?" did pop up a lot in the beginning. And will I get any side effects from the medicine, like hepatitis? It was a bit weird that one medication made my urine turn almost red, but at least the doctor had told me that in advance. Also, alcohol is strictly forbidden during those six months treatment, so I had to completely stay away from drinking.
I took my TB medicine for six months, which is the standard treatment. The first few weeks were definitely the worst because of the uncertainty. The great danger of TB is that the symptoms often go away after a few weeks, and some patients then think everything is fine and discontinue taking the medicines. But the tuberculosis then comes back, and this time your body may be immune to the treatment. So although it was quite boring to take a lot of medicine on time for half a year, I knew how important it was."
‘Didn’t know anything about TB’
"I didn't know anything about TB at all before I got it. I thought it was something that a lot of alcoholics in Russia got, but certainly not "ordinary" people. If I had "only" had the coughing, I would probably have waited longer to go see a doctor. But in my case, I also had a lot of pain in what turned out to be my lungs, because of the greenish fluid that built up there.
Although having TB is of course not fun, the physical symptoms were luckily quite limited in my case. The first two weeks I had to wear a mask in public in order not to transfer TB to other people. That was not great because in Thailand most people know this means a person probably has TB. Especially since this all happened before the outbreak of swine flu which made many people wear masks."
Taking better care
"Thankfully, my family and friends were very understanding. I was very encouraged by the fact that just a few days after I got diagnosed, two friends came from Denmark to meet me, something we had planned before. I told them that for their own sake it would be better to cancel, but to my surprise they didn’t. They had gone to their doctor, who told them that if I wore a mask, there was practically no chance of them getting infected.
According to my doctor, right after a successful TB treatment, the chance of it coming back is biggest during the first two years. After I have stopped taking my medicines, I have tried to take better care of myself physically. I exercise to keep my lungs strong. Also, I am a bit more aware of where I go: I try to avoid getting too close to people coughing, and avoid very congested places. The most important thing, I think, is trying to keep the immune system strong. This means trying to be strong both mentally and physically. If I can manage that, I am convinced I have beat TB once and for all."
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* Because of the stigma associated with TB in Thailand, Michael prefers to only reveal his first name.