Saturday, July 4, 2009

Adventures in TB Testing!

chest x-rayImage by Aidan Jones via Flickr

Great News!! I'm TB negative!!
But oh what an ordeal to find that out!! o_O
I knew back in January when I applied to OT programs that I would need to get a 2-step TB test done, since I'd never had a test before. For those of you who are not familiar with the process, the TB test involves having some of a special solution injected just under the surface of your skin on your forearm. It forms a little bubble that quickly subsides. Two days later you go back to have it "checked." If it bubbles up again or becomes red itchy/inflamed then they measure the diameter of the reactive area. If it's bigger than a certain size it's considered "reactive" and you have to go for a chest x-ray to see if you have any active TB in your lungs (I believe... for truly accurate information, please refer to the Canadian Lung Association webpage). If the reaction is smaller than a certain area, or if there is no reaction at all, then it is considered "non-reactive" or "negative" for TB and you go on to step-2. The second step is exactly the same as step one, except that you're repeating it one to three weeks later.

So, I knew that I would need this test way back in January, but I was busy. I called the student health centre at my university and got all the information I needed about booking an appointment and cost and all that. But I thought I had time. I didn't need the results until summer! Why rush?
Well, in June after I'd accepted the offer from McMaster and got the health screening forms I called the university health centre again to book my appointment. Here's how the conversation went:
Me: I'd like to book an appointment for a TB test.
Her: Certainly, are you a Trent student.
Me: Yes, and I'm working for the university this summer.
Her: Okay great. Did you convocate this year?
Me: Yes I did! Just last week. :)
Her: I'm sorry we can't see you in that case. You must be a current student and you are now a former student. Our insurance won't cover us to see you and our director is adament that we not see any former students, no matter how recently they graduated.
Me: (grasping at straws) Okay, but I am an employee of the university otherwise I wouldn't bother you with this. Is there any way I could come in?
Her: Unfortunately, no.
Me: (thinking, no biggie I'll go elsewhere) Okay, can you refer me to where I can get a TB test done?
Her: Unfortunately, no. There is nowhere else in Peterborough to get a TB test done.
Me: ...
Her: You can call public health, but I don't think they'll do it. You'll likely have to go out of town. It really is the responsibility of your new school to provide you with testing facilities if they require them for your program.
Me: ??? (at a loss for what else to say) Okay, thank you for your time.
*Calls public health in Peterborough*
Me: I am wondering if you do TB testing.
Her: Yes we do. Do you believe that you've been in contact with it?
Me: No, I need to have a 2-step TB test done for admission to a grad program in Occupational Therapy.
Her: Oh, in that case, no. We can't see you.
Me: ...
Her: We don't have the staff or the funding to provide the service. A few of our doctors have left in recent years and they have not been replaced. We simply can't handle the extra volume that voluntary testing would create.
Me: (>_<) Okay, I understand. Can you tell me where I could go to have this testing done? Her: I'm really sorry, there's nowhere in Peterborough to have the testing done. I have heard of some students driving down to a clinic in Pickering. Me: Okay... Thank you. If I had to travel out of town for a TB test I thought I'd at least roll it into a visit with my family in Kingston. I called the public health unit and found that they do TB test administration on Tuesday mornings and TB test checks on Thursday mornings. I work Monday and Wednesday nights in Oshawa... so it was doable, but not ideal. And that's exactly what I did.
I have to say that the people who staff the immunization clinic at the KFL&A Health Unit are wonderful and efficient... but my travails did not end there.

Because I work on Monday nights and don't get home until about 11pm I had to pack up my things very quickly for the two weeks in Kingston and get on the road, so that I could get to bed at a decent time to be up the next morning for my test. I rushed. I got to my parents' in good time. I got out of the car and realized that I'd left my suitcase... with all my clothes and my laptop... standing in my driveway in Peterborough -_-. I was so mad at myself! lol... but at the same time, it was funny. So on Tuesday I had a TB test AND went shopping for something to wear.

On my first trip to the health unit I put out my right arm. The nurse prepped it, inserted the needle, loosed her grip on my arm and said "Oh! That's weird. Your arm pushed the needle right out! Oh well, we'll just have to do your left arm instead" and she put a cotton ball over the area where my arm had been pricked. She then injected my left arm with no issues, turned her attention back to my right arm, removed the cotton and said "Oh my! I must have hit a veiny area" (her words not mine). There was a black and purple loonie-sized bruise where the first injection had been!
And the next week... step 2... it happened again! Except this time was a different nurse and when I warned her about what my right arm did the last time she made sure to brace my skin securely... after injecting the fluid and removing the needle she said "Oh my, that's not right!" My arm, rather than forming a little bubble, pushed all the fluid back out the injection site, lol. I'm not even kidding. So I was left with another bruise on my arm and a total of 4 TB injections for the two steps. LOL... if not for the fact that I did not react to the injections, I don't think there's anything else that could have gone wrong with what is typically a very straight forward process.

The good news is that it's DONE! I also got my background check and the rest of my health forms completed... but I'll post more information about those later. I know this post is really long, so thanks for bearing with me.
Hopefully YOUR adventures in TB testing will be a little less adventurous than mine.
All the best!

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