Primary Complex Thread 3

[leletmd]

Link to the previous thread:

http://www.femalenetwork.com/girltalk/index.php/topic,238463.0.html

@rhylie10:
There is such a thing as latent TB wherein the person has no symptoms, but has TB that is inactive. So hindi kailangan may nararamdaman para magpa-chest xray. I strongly urge you to have every adult in your household have a chest xray done, lalo na maraming adults na kasama.
TB infection develops only after prolonged exposure to a person with TB. Hindi ito nakukuha sa random stranger sa mall or sa playground. Ang una talagang suspected source ay ang mga kasama sa bahay kasi sila ang nakakasama ng matagal ng bata.
If you are able to identify the source and have the source treated, baka mas mapabilis ang improvement ng anak mo at hindi na ma-extend pa ang treatment period.
Did you ask your pedia for xray requests for your family?
Anyway, you can just go to any hospital or facility with a radiology department and have a chest xray done. Hindi naman mandatory na may request from a doctor.

[ankyneMD]

wow new thread. Ang haba na ng usapan natin. Thank you doc for your informative replies.. May concern po ulit ako:
June 7,2013 ang 6th month ng anak ko sa kids kit. And then nagpa-xray siya at partial retroggression ang naging result. So pinaextend ng pedia ang medication for 3 more months. September 7 natapos siya. Pagbalik namin sa pedia sabi niya ok na daw ang baby ko at stop the med na. Tanong ko lang po kung hindi na po ba kailangan x-ray ulit ang bata? Pano po malalaman kung clear na anak ko kung hindi na magpapa-xray ulit? Tapos idinaing niya po ngayon na sumasakit daw yung ilalim ng tenga niya. Bumabalik nanaman po yung worry ko. Possible po ba na kulani nanaman yun?

[leletmd]

^ As I mentioned several times in the other thread, you do not need to repeat the chest xray to determine if there is improvement or clearing of the infection. Xray is not mandatory when completing treatment. Sa clinical signs and symptoms pa rin dapat magrely.
If there is pain below the ear, best to have him checked for possible ear infection. If barado ang nose, pwedeng mag-infect ang ears. It can be unrelated to the PC.

[ankyneMD]

thank you doc lelet at naliwanagan ako. Thanks God naman po kung clear na talaga baby ko. Worry lang po ako kasi nga idinaing niya yung tenga nya na matagal na niya hindi dinadaing. Baka kasi hindi pa siya gumagaling from pc. Hindi naman daw sa loob masakit.

[leletmd]

^ If he complains of pain frequently, then it would be best to bring him to his pedia for check up. There are ear infections that involve the outer ear area only. It doesn't have to be pain inside the ear.

[eurickha]

good day doc lelet, as of now my 2 kids are already finished with their treatment and their doing good now . Masigla sila, nag increase in height ,nag gained ng weight as to what there ages at especially hindi na sila madaling nagkakasakit o madaling kapitan ng sakit very thankful kami na maganda ang result ng treatment sa kanila mas nakahinga na kami ng maluwag ngayun. Kaso doc lelet yung sister ko which is yun ang nakahawa sa 2 kids ko was still suffering from pain in the head nag start siya ng treatment july 4,2013 natapos niya ang 2 months treatment without any complains kasi wala siya work pa that time, after ng 2 months treatment niya nagka work siya night shift sa call center binago na ng doctor niya ang medicine niya after 2 months 1 medicine na lang kada isang araw for 4  months. Mag pa xray siya this nov 28 kasi sabi ni doc dec 4 ang tapos ng treatment niya if hindi siya ma extend. Since nag work kasi siya may time na nagkakainuman sila ng co workers niya at nakapag skip siya ng medicine. Nasa malayo siya nakatira at thru phone lang kami nag uusap complain niya is masakit parati head niya, nasisilaw siya sa lights, at ramdam na ramdam niya ang tibok ng puso niya. Niresetahan din siya ng doctor niya ng vitamin B complex at yng gamot sa Tb niya. At madalas para siyang may lagnat sa loob na hindi makalabas sabi niya . Yung sister ko po ba ay contagious pa din? kasi ang worry ko din baka pag napasyal siya dito sa amin ma trigger yung primary ng 2 kids ko. bakit kaya ganun ang health niya? malapit na mag dec 4 yet parang hindi nababawasan ang sakit niya?. Hindi kaya may ibang reason ang pag sakit ng ulo niya tumor? o migrane? nanlalabo din ang mata niya kapag sumakit na ang ulo niya nung minsan nga daw nag faint siya one time sa work niya . Hope for your response doc lelet .

[leletmd]

^ After the 1st 2 weeks of anti-TB meds, hindi na considered as "contagious" ang patient, but of course, kailangan niya macomplete at least 6 months of treatment para mawala ang TB. Please tell your sister to have a more thorough check up with her primary care physician since I am not in any position to give you a diagnosis regarding her headache and other symptoms. Diagnosis should be based on a good history and a thorough physical examination.
Also, she should refrain from drinking alcoholic drinks while ongoing treatment. Hindi siya dapat nagskiskip ng meds since this may lead to resistance, allergies, etc. Hindi siya gagaling ng maayos if hindi niya naiinom ng maayos ang meds niya.

[eurickha]

Thank you doc lelet for the response ...I hope mag concentrate ng husto sis ko sa medication niya and i push ko talaga na gumaling na siya ng sa ganun mas madalas na siya makapag stay sa amin. More power doc lelet

[switblububbles]

Hi Doc...

My 1 yr old baby was diagnosed primary complex last month. Her pedia in MMC gave her 1 med only which is curasid for 9 mos.

And then when we went back to her old pedia (the one where she get vaccines), she was prescribed 2 meds...the kids kit...
Her old pedia said there is no such  thing as one med for PC...its either 2 or 3 meds.

Im torn which one to follow? Im planning to consult pedia pulmo this time.

Pano yun doc naumpisahan na ni baby yung 1 med for 2 weeks na iniinom?

Thanks in advance Doc!

[leletmd]

^ If PPD positive and chest xray negative, usually, only 1 medication is prescribed (isoniazid) unless there is chance of resistance.
If there is a risk of resistance due to previous treatment or exposure to drug resistant TB, then 2 meds are given (isoniazid and rifampicin).
If unsure, you can bring your baby to a pedia pulmo for re-evaluation.
By the way, please try to look for the source of your child's exposure to Tb so that proper treatment may also be started for the source. 

[akire_ahkia]

Hi doc
Ok lang po ba painumin ng cough and cold medicine si baby habang nagtatake sya ng meds nya sa pc?
Thanks

[leletmd]

^ If it was prescribed by your pedia, there should be no problem with it. Please ask your pedia first prior to giving other meds to your baby to ensure that proper meds are given.

[ankyneMD]

hi po doc lelet. Is it ok to stop the med 1 week before macomplete ang treatment? My father po kasi (source of my daughter's pc) next week pa macocomplete yung ika 9 months treatment nya (dec.7). Kaya lang wala na kami mabilhan ng meds. Out of stock na ata sa area namin. Ok lang po ba yun?

[leletmd]

^ In my opinion, it would be better to extend than end treatment earlier than the scheduled date. Perhaps you can ask the doctor if your father can take other brands of the anti-TB meds. Marami namang brands na available and you don't need to stick to a particular brand unless that is what your doctor prefers.

[bvlgari]

Good Morning Doc lelet! 

Last week lang po na-diagnosed ang father in law ko na PTB active and for 6 months medication siya. so lahat po kami na nandito sa bahay (MIL, Husband and me) pinag-undergo sa chest x-ray and PPD test. sa chest x-ray po namin 3, all with normal findings po. yung PPD po bukas (monday) pa i-interpret ng doctor (pulmo specialist).

while po sa daughter ko na 2years and 7 months old (15kilos) ay PPD test lang pinagawa nya. Sa palagay ko po kaya hindi pina x-ray ng doctor dahil binanggit ko po sa kanya na nagka-pneumonia si daughter last month (october 4 to be exact). pinag PPD po siya ng doctor at ang result po ay positive daw. Nagprescribe po ang doctor ng Kidz Kit 2 sa kanya for 4 months po para daw prophylaxis.

ito po mga tanong ko para kay daughter:
1. ok lang po ba na hindi na sya magpa x-ray ulit?
2. Kidz kit 2= 1/2 tsp. once a day
- dito po medyo nalilito ako, hindi niya po kasi nabigyan ng linaw sa akin kung before o after meal at kung ano ang pinaka best time to give the medicine. ano po ba ang dapat?
3. dapat ko po ba pa-check din si daughter sa PEDIA niya talaga maliban pa sa pulmo specialist na nauna tumingin sa amin.?

Thank you po in advance!!

God Bless!

[leletmd]

^ I suggest you bring your daughter back to the pedia and inform her regarding your father in law's diagnosis. Your pedia is the best person to ask regarding need for repeat chest xray. Pwede siya magpa-xray ulit if there are findings suggestive of PC/TB. Did the doctor explain why 4 months lang ang treatment with kids kit 2 for your daughter?
Kids Kit 2 contains Isoniazid and Rifampicin. Both meds should be given on an empty stomach so best to give this first thing in the morning and 30 minutes before breakfast to ensure good absorption of the meds.

[bvlgari]

sige doc, i will bring my daughter sa pedia niya rin talaga. sabi nya po 4 months lang nya ibibigay yung kidz kit 2 for prophylaxis dahil exposed nga daw si baby kay Father in law. pero pinapabalik ni doctor siFather in law and Daughter sa Dec.14 para babawasan yung dosage or para ma-evaluate siguro sila ulit. hindi ko pa po in-start yung kidz kit 2 ni daughter kasi medyo marami pa ako gusto linawin dun. ok lang ba yun doc?

regarding kay Father in law: di ba po critical ang first 2 weeks of medicating ni Father in law, paglalayuin ko po ba muna si father in law and daughter? anyway parang hiwalay din naman kami ng bahay kasi sila MIL and father in law sa baba po nakatira and kami naman ni Hubby and Daughter dito sa 2nd floor may sarili po kami door paakyat. si daughter po kasi ang iniingatan talaga namin dahil baka matuloy sa PC.

Thank you doc.

*edited

[leletmd]

^ I agree with not starting meds until your daughter gets evaluated by the pedia. Better if she is seen first and the meds are computed based on her weight. Also, for prophylaxis, we give the meds for 9 months, not 4 months.
Yes, the 1st 2 weeks of treatment is critical. After this, hindi na considered as contagious ang father in law mo. Limit exposure of your daughter muna to your father in law during this time.

[bvlgari]

Thank you so much Doc Lelet! will update po later kung ano ang result ng PPD namin 3. I believe weather it is positive or negative we still have to take meds. for prophylaxis. the question is kung gaano kaya katagal ang ibibigay ni doc pulmo.. 

Thank You Doc and God Bless You!!

[bvlgari]

Good day Doc lelet! Nalaman na namin ang result ng PPD namin.. si MIL- positive, si Hubby- positive and ako- negative.. si MIL and Hubby will take Fixcom for 4 months, ako naman po rimactazid for 2 months.. si daughter napa-check ko na rin sa pedia. dinagdagan ng PZA yung meds niya. so kidz kit 3 ang take niya ngayon. medyo mahirap ipainom kay daughter yung rifampicin(strawberry) kasi medyo thick yung pagka-syrup niya kaya sobrang bolahan pa.. napansin ko na naging soft (minsan parang tubig pa) ang stool niya at naging frequent pa ang pag-poop simula ng mag-take siya ng meds same with hubby, yun ang nirereklamo niya sa akin.. bakit po kaya? Thanks..