Boon_Retsam

I'm a medical student, and oddly enough, my TB skin test just turned positive this year, despite having had the BCG vaccine as a kid. So I'm probably going to be taking INH (isoniazid) as well for a while. Fascinating how much this drug has helped people. Some places, it's not working super well anymore, but to work for over 60 years when so many other bugs have become resistant to drugs is pretty amazing!

Oh! Basically, in America we just check for tuberculosis by sticking a little bit of the biomarker/antigen under your skin. If your body attacks it, making it red and angry and knotty (sometimes black, even), then that shows that it recognized the marker/antigen, meaning it might have found the real bacteria in the past.

We measure how big the reaction is. Depending on if you have AIDS, diabetes, work in hospitals, or are a random healthy person, there's cutoffs for what we consider a "positive" reaction.

There's a vaccine for tuberculosis that a lot of the world uses called BCG. If you have it, you can get a positive reaction even if you never got tuberculosis bacteria inside you. I'm an immigrant, so I had that vaccine. My brother did too, and gets a reaction all the time, so that TB skin test isn't useful for him. Now, it might not be useful for me either.

Unfortunately, I've had both the BCG and a history of negative tests. So now the question is, is this a true positive? It could be from the vaccine (my body just seeing a lot of TB tests and freaking out a little bit more each time), or it could be that while in a VA hospital somewhere, that one guy whose hand I shook had TB (that also actually happened. His tests came back positive while I was in the room with him, unknowing).

So we use this medicine called isoniazid, or INH, to kill off the bacteria. You can have some of it linger, without really making you sick, for years and years. I'm not actually sick, my lungs aren't full of the bacteria (I looked at the Xray with some other doctors) but my body reacted to the TB test, so I might have to take the INH anyway.

That's because sometimes when you're older and your immune system goes down, if you've had the bacteria lingering all quiet in you for a while, it basically decides to go on a jailbreak, and explodes and expands all over your body, which is really bad. But the medicine itself can kinda hurt your liver and nerves, which is why they give you some vitamin B6 to help your nerves from getting messed up.

So, basically, my immune system showed that it recognizes that TB skin test biomarker/antigen, so there's another test I can have to see if it's because I actually had some bugs try to get in me or because of my vaccine, and the medicine is a bunch of horse pills for a few months to make sure that if I have it, I really kill it off and don't die from it at the age of 75.

Yeah, I just barely hit the 11mm required. Previously, I'd get a small bump or some redness, but nothing major. Some of the docs around me didn't think the BCG roughly 24 years out would be likely to cause the positive reaction (I think it's typically only protective for 10-20 years).

I'm in the process of getting an IGRA/quant gold ordered, though, to see what's really going on. I believe the current recommendation, at least in my neck of the woods, is 1x/week giant doses of INH and rifapentine for 12 weeks with some extra B6 to try and avoid that nerve injury.

If it is truly positive, though, I don't want to get reactivated TB at 75 right after they do some surgery to replace my eyes and legs with cyborg parts, or whatever they'll have by then.

Oh god. Did you tell them about 9/11? PLEASE TELL ME YOU DID

I've seen some interesting suggestions that sometimes cancer cells themselves can become senescent, and therefor be relatively protected from a lot of the common ways we attack cancer.

And that, then, if those cells shift back into pluripotency, they can trigger recurrence of cancer. Essentially... some of the leftover cells that survive and just stay quiet for a long time can kick back in.