Diving during latent TB treatment

[mbram]

Hello! I just signed up for my open water class today and one of the questions on the med questionnaire was about lung disease. I had a positive PPD after I got back from Afghanistan earlier this year. My chest x-ray was negative and I've had no symptoms or any problems with the medication (Isoniazid and B-6), but I'm on my 7th month of treatment, 2 months left after this one.

My question is do you think I'll be cleared to dive even though I'm still being treated? I'll be making an appointment with the doc tomorrow, just wanted to get an idea beforehand. Thanks!

 

[Dirty-Dog]

Obviously, your best bet is to talk to pulmonologist familiar with dive medicine, but I think it's likely that you will be cleared. A positive PPD does not mean you have TB; it means you've been exposed and triggered your immune system. Given the negative CXR (and by negative, I presume you mean it shows no sign of TB, not that it shows healed TB) and lack of symptoms, it's likely that your treatment is precautionary. Without it, you'd have a significant chance of developing active TB.

I'm actually suprised you've had no problems with the meds. The INH makes an awful lot of people miserable.

 

[mbram]

Yes, I meant the x-ray showed no signs of active TB. The doc explained to me that it was precautionary treatment, she said without it I'd have about a 10% chance of developing active TB at some time in my life. After treatment she said it drops to less than 1%.

I'll be talking to the nurse that's I've been dealing with every month and hopefully that'll be that, if not I'm sure she can point me in the right direction to find a local doc experienced with diving. I'm in PCB, FL so I imagine there are one or two nearby.

Thanks for the reply!

 

[ZenDiver.3D]

I have a question. Did you receive the vaccination for TB before you went or while there? If you were vaccinated, you will show up hot for TB for up to 7 years. I was told this little gem by my kids' pediatrician after the doctors here in Kuwait gave them the vaccine. So my stateside ped. told us not to list it on their shot records here, because if it is listed, they automatically get the test and will come up hot. So my question is were you vaccinated?

 

[mbram]

No TB vaccination, I didn't even know there was one.

I spoke with a nurse practitioner at my doc's office yesterday. I have an appt to come in, she's going to review my records and she said barring something heretofore unseen she'd be able to get the clearance paperwork signed. Thanks for the help!

 

[ghost8404]

If you want to waste money by going and talking to some NP, go ahead. I'm not a doctor. I was a Hospital Corpsman in the Navy for 6 years. I had a positive PPD and dove. I had to speak to Internal Medicine about it because I have a jacked up liver so I asked the doctor there. He said that as long as you don't show any S/S of active TB. You should be good to dive. If you cough up blood or start to get any discomfort in your chest or throat, you need to go see a doctor. INH is a low dosage antibiotic and won't treat a severe infection from TB. I hope this answered your question. Like I said, I'm not a doctor, just an HM who went through the same thing. If you still want to speak to the NP, go ahead if it makes you feel better. I'm just trying to help out. And good luck and have fun on your Open Water Cert.

 

[mbram]

If you want to waste money by going and talking to some NP, go ahead. I'm not a doctor. I was a Hospital Corpsman in the Navy for 6 years. I had a positive PPD and dove. I had to speak to Internal Medicine about it because I have a jacked up liver so I asked the doctor there. He said that as long as you don't show any S/S of active TB. You should be good to dive. If you cough up blood or start to get any discomfort in your chest or throat, you need to go see a doctor. INH is a low dosage antibiotic and won't treat a severe infection from TB. I hope this answered your question. Like I said, I'm not a doctor, just an HM who went through the same thing. If you still want to speak to the NP, go ahead if it makes you feel better. I'm just trying to help out. And good luck and have fun on your Open Water Cert.

Hey, thanks for the advice, if I had to pay for the appointment I'd definitely be taking your word. Luckily the health department treats communicable diseases for free, so there's no cost to me. Even if they didn't I'd be getting the treatment from the VA for free since it's service connected.

 

[Cruisin Home]

I cant believe Uncle Sam didnt give you the "round the world" set of shots before sending you outside of CONUS??? if they di it is likely you will show positive. I did too years back, thanks to Uncle Sam, but I have always dived and never came down with acute TB.

 

[ghost8404]

You don't get a immunization for TB. The shot old boy was talking about is Bacillus Calmette- Guerin vaccine. They usually hand it out in southeast Asia and places like that. It is like the smallpox vaccine that you receive before going on deployment. Everyone knows this one, or at least those of us who are in the real military and not desk pilots, it is the 3 pokes. I hate to say it but it isn't really smallpox, it is just something really close. If you get BCG, you get a positive PPD but you aren't immune to TB. If you want a good reference, use BUMEDINST 6224.8. It is the Navy TB control instruction. There is one more recent but it isn't online. Plus most of the information is the same. FYI, service members do not receive PPDs due to cost. They are switching over to a health risk questionaire. If the member shows health risk, then a PPD is placed. Also, how is your TB service connected? Just curious. You can send me a PM with that.

 

[mbram]

You don't get a immunization for TB. The shot old boy was talking about is Bacillus Calmette- Guerin vaccine. They usually hand it out in southeast Asia and places like that. It is like the smallpox vaccine that you receive before going on deployment. Everyone knows this one, or at least those of us who are in the real military and not desk pilots, it is the 3 pokes. I hate to say it but it isn't really smallpox, it is just something really close. If you get BCG, you get a positive PPD but you aren't immune to TB. If you want a good reference, use BUMEDINST 6224.8. It is the Navy TB control instruction. There is one more recent but it isn't online. Plus most of the information is the same. FYI, service members do not receive PPDs due to cost. They are switching over to a health risk questionaire. If the member shows health risk, then a PPD is placed. Also, how is your TB service connected? Just curious. You can send me a PM with that.

Not really sure how the smallpox vaccine and the TB test are related. Everybody gets the smallpox vaccine before going to Afghanistan or Iraq, I was the only one from my team that came back with a positive TB test on this deployment. I was in routine close contact, largely indoors, with local nationals throughout the deployment.

I'm also not sure what you mean about service members not receiving PPDs either, I got one when I first joined, before and after each deployment, and after my latest PCS. But not after my first 2 PCSs though.

The TB is service connected because I was exposed to it while I was in the service... All vets who had boots on the ground in Iraq or Afghanistan are covered medically through the VA for 5 years after separation.

My latest deployment had me on 227 mounted combat patrols throughout Nangarhar province. 1 big IED, several small ones, more tics than I can remember, and 5 brothers who didn't come home with us, I would say that qualifies as the real military.