January of this year, I filed my application for a MBA program in one of the top university in the Philippines. After taking a general admission test, undergoing an interview and taking the proficiency test twice, at last the final results was released last June 6 and I was glad to see my name included in the list of examinees that were selected to enroll in the MBA program.
Other than the usual admission requirements in school, students were asked to submit a medical certificate from the university’s Health Service department. Immediately, I underwent a chest x-ray to fulfill the requirements. I knew that the impressions of the radiologist should no longer come to me as a surprise but it was always never the case. Since I got cured from XDR-TB, my x-ray and CT-scan results would always include among others, the words opacities, pleural thickening, infiltrates, volume loss, nodules and would almost always end up with “further clinical evaluation” as a recommendation. I still get goose bumps whenever I read my x-ray and CT-scan results that often result in me calling my husband, Stuart, as if reading to him the results would restore my lungs in its best state.
Obviously, simply presenting the x-ray reading to the university’s Health Service would not garner my needed medical certificate so Stuart and I ask the help of Dr. Lawrence Raymond, a pulmonologist, a former colleague from Tropical Disease Foundation (TDF) and one of the doctors who had been present during the critical stages of my XDR-TB treatment.
Dr. Lawrence was the one who discussed to me about the lobectomy procedure that I needed to go through when it was found out that I relapsed from my XDR-TB in March 2009. I vividly remember how I cried in his clinic while he’s explaining the details to me and Stuart. Everything to me that time was so gloomy. I was only listening and did not even ask anything at all. He was so sympathetic that time when I could not decide right then and there. September 2009, after finishing the intensive phase of my re-treatment, I was set for a lobectomy procedure. Prior to the operation, I had to take pre-evaluation tests to see if I am fit for a lobectomy. I failed the stress test and the pulmonary function test but Dr. Lawrence betted that I could still qualify for the operation considering other factors. September 14, 2009, I had a 6-hour lung surgery where he was one of the doctors who assisted during the procedure.
Going back to the present, when we showed to him the x-ray printout and written report, he said that he would need to see previous x-rays and CT scans to rule out the reading on the mid lung nodule at the seventh left posterior rib that was seen on my latest x-ray. He also recommended me to undergo sputum smear.
The following day, June 19, Stuart and I met with Dr. Mary Rosary (a.k.a. Dr. Rose) Taguinod, currently the head in one of the PMDT (Programmatic Management of Drug-resistant TB) treatment centers in Metro Manila and is also a former colleague from TDF. She was the doctor who notified us of my positive culture result in December 2010, two months before I was set to finish my 24-month XDR-TB retreatment. I was advised to take a leave from work for two weeks until my January culture result was released which turned out to be negative. May 2, 2011, barely one and a half month after we received the news regarding my December 2010 positive culture result, Dr. Rose happily sent Stuart a text message telling that my December culture result as re-tested by the National TB Reference Laboratory (NRTL) yielded a negative result.
Going back, we met with Dr. Rose to ask her help for my sputum smear request and also for a borrower’s request to get my previous x-ray films and readings from the hospital’s radiology department. She was, as always, accommodating to us. That same day, I was able to retrieve 3 previous x-ray results and had my sputum smear. That same day, the sputum smear revealed negative result.
June 20, I went to the university’s Health Service hoping that they would issue a medical certificate upon presentation of my latest x-ray result backed up by my negative sputum test believing that their concern would just be confined on me being infectious to others, but they didn’t issue a medical certificate. Instead, the doctor asked me to provide her a pulmonary clearance about the nodule seen in my left lung.
June 23, Stuart and I went back to Dr. Lawrence. Upon review of past x-rays and CT scan result, he verified that the node found on my left lung had been present since 2011 and so he gave me a clearance indicating that I am fit to study.
The following day, I went back to the school’s Health Service confident that this time, they would give me my much awaited medical certificate and they did.
What I had gone through in completing this school requirement is one of the downside of being a former TB patient. For somebody who is perfectly healthy, he could surely get this medical certificate in just one day. Stuart is right, the traces that TB left in me is something that I will have to deal with every time I would be required of a medical certificate. X-ray and CT scan result will never be enough. I will always need to prove that I am not infectious and will not be a threat to other people’s health.
I must admit that I sometimes feel upset having to go through all these even now that I am already cured but more than anything else, I would like to celebrate more God’s extension of his love to me through these people, Dr. Lawrence and Dr. Mary Rose, who gladly, readily and freely helped me to work out this school requirement. They are only two of the many people who helped me cope up XDR-TB. And as I had prayed years ago, God, up to now, has been putting people in my life to help me get through life in the real world.
If only these type of people who have a heart for service could multiply faster than the TB bacteria, the world would definitely be a lot better place for TB patients.
And to you Lord who has been faithful to me, thank you for showing me that there is indeed a good life after TB.