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Improving the health of the population in Romania by increasing TB control

Project financed by the Norwegian Grants 2009 - 2014, within the RO 19 - Public Health Initiative.

 

Vasile C. knew nothing about tuberculosis when he was diagnosed with multidrug resistant TB. He doesn’t know who he got it from but, being from Bucharest, he says he could have gotten it from anyone in the crowded capital city buses, from citizens together with whom he stood in line to pay the bills or just as easily from the street. He can hardly wait to get out of hospital in order to catch a few beautiful days of autumn to go fishing in the Delta. Then, he can return without worries to his office where he works as an interior designer.

 

“I discovered I had TB at the beginning of the year. I had a coronarography done for a heart problem and then, among other investigations, they also performed a chest X-ray. And they told me that I had certain lesions and that I was a TB suspect. Without having any symptoms whatsoever, at any time, without even coughing… I first went to “Victor Babeș” (e.n. – the “Dr. Victor Babeș” Clinical Hospital for Infectious and Tropical Diseases in Bucharest), the doctor looked at my X-ray and said: “Mr C., it doesn’t appear to be tuberculosis, so don’t worry.” That was immediately after the holidays, in January.

Then, for my own peace of mind, I also went to the Vitan dispensary, where they recommended me to get a tomography exam. Indeed, on the first X-ray, you could not see very well what it was, but the CT showed very clearly that I had TB. Then, I started hospitalisation, first at “Victor Babeș” for three weeks. I got out of the hospital feeling better and I continued the treatment at home for another month, through the dispensary. When the antibiogram result came they found out I had resistance to Sinerdol and Isoniazid and since then, I’ve been here. So, for three months or so.

I knew nothing about tuberculosis. I knew it was a rare disease, and that for the most part it had been eradicated, but I had no idea. I didn’t even know how it manifested, how it is treated, for how long… The only thing I knew was that this disease causes coughing. But I didn’t know one feels tired, drowsy…

I didn’t even know that it was contagious, that you take it from other people. I have no idea from whom I took it. Neither from whom, nor when. I realise now that I could have taken the disease from the public transportation means, from the post office where I would go to pay the bills, from the family doctor’s office too, because it’s crowded… from anywhere. Now I am very well informed about what it means. When I was diagnosed I started asking about tuberculosis, I did some research to see what this disease meant. I had this state of anxiety at first, because I had had absolutely no symptoms. Not a single one! No cough, no fatigue, I didn’t even lose two pounds…

I don’t know whether this happened because I arrived at the doctor’s when the disease was in its early stage, if this is even so, because the X-ray showed a cavernous area – a hole – but probably the body resisted longer. What I was told at the dispensary about the absence of symptoms was that had I waited for a month or two, the symptoms would have certainly started.

My daily treatment consists of 17 anti-TB drugs, plus one injection, for six months. This is in addition to the supplements I take to mitigate the side effects of the anti-TB drugs, which are vitamin B1, two liver supplements, two pills for the stomach… When I found out how many drugs I was going to take… The first time, at “Victor Babeș,” I was shocked. There, I would take 14 pills. When I saw them, they seemed quite many, when I came here, I was given even more! At “Babeș” it wasn’t so hard for me to take them, because I wouldn’t take them all at once. I would take one pill every ten or fifteen minutes and would not feel any side effects. Instead, here I take them all at once… It’s not hard for me to swallow them, but afterwards, when they start working, I feel sort of dizzy, I feel discomfort in my stomach for half an hour or so… In the end, it is a handful of pills… It’s a state of general sickness, but I’ve gotten used to it. As for side effects, I have nothing except the pain in my knees which is caused by the increased uric acid that cannot be eliminated properly. Nevertheless, thank God, I don’t have serious problems!

I have become negative, this is what the first two tests showed, now I’m waiting for the results on the third. It’s a little less than three months since I’ve been here, I could be discharged in a week or so. I also had an X-ray done, and Dr. Popa said it looked pretty good, that the evolution was favourable.

What I do know is that this treatment will not affect my job, because my work does not involve physical effort, staying in the sun and so on. I work mostly at the office. I do field work too, from time to time, but I will not be doing that for a certain period. I am on medical leave but I will work out a schedule for my medication anyway. Now I cannot work, I have the injections too, but afterwards I will go to work. I announced all my colleagues, they had their tests done, everyone is fine.

I didn’t have any problems because of the disease. Neither my bosses, nor my colleagues who are closer to me and with whom I work said anything about it. It’s something that can happen to anyone and it simply happened to me. My colleagues didn’t know anything about tuberculosis either, but I told them. I explained it to them, they also had their X-rays done… My family members also had their tests done and have no problems. I talked to them about tuberculosis, because they didn’t know anything either.

I see this period of my life as a trial. It just happened, it’s nobody’s fault. It is hard, it’s true. One whole summer in the hospital… It will remain a less pleasant memory but I will get over it. I didn’t need private counselling, meaning to talk to the psychologist here, but the group therapy sessions were helpful because I got very good information from Ms Andreea Dumitrescu. She gave us homework, so that we could read a thing or two, she encouraged me… These meetings were very useful. But it’s good that I didn’t lie in bed, that would have made things very hard. Perhaps the first week was the most difficult for me, because I kept thinking that I was going to stay here three months, but then I got used to it. I told myself that was how things were, I was to stay here for three months, get better and be done with it!

When I leave this place, it’s all up to me to take my pills and that’s it. My friends know about my disease, they are by my side, I have no problems from this point of view. Just like my family, they came to see me in the hospital, we talked, they didn’t shrug away from me, I didn’t feel marginalised.

The very first thing that I am going to do when I get out of here, out of “Nasta,” will be to go to the dispensary and work out a treatment schedule. Then, for what is left of the autumn I want to go on a small trip to the Delta. I like fishing. In fact, what I am most sorry for is this, that I couldn’t go fishing. Then, in two years, when I finish the treatment, I hope I will be completely cured.”

 

* The patient’s name was modified upon his request.
Article by the Romanian Angel Appeal Foundation