TB or not TB? That was the question-just in case you thought my life was perfect.
It started with a cough but then, Maurice almost always gets sick when we travel, especially overseas. So it was just par for the course when we arrived in Texas in September and he got a cold with a cough. We made a trip to urgent care and got a prescription for the cough. He seemed to get better until we went to Colorado. There my grandkids were all on antibiotics for strep throat. Maurice got sick again, with the usual cough. We were able to get what they called a Z-pac, strong antibiotics, through a doctor who was a friend of the family for only five dollars. Maurice still didn’t feel well although he managed to make it to Utah and do the really tough hike to The Wave. We made it back to Arizona and he started coughing again. We thought we would try a regular doctor this time instead of urgent care and went to a doctor my mother’s friend had recommended. The doctor couldn’t hear anything in Maurice’s lungs with his stethoscope and said he didn’t think Maurice needed antibiotics but he did order an x-ray. Two days later he called and said Maurice had pneumonia. We went back and the doctor then ordered a blood test and put him on antibiotics. The next day we flew to California to visit friends. We were there for only one day when the doctor called and told Maurice that the blood test came back positive for TB.
I called back and talked to the nurse a little later and she said that we shouldn’t fly, that TB was highly contagious. We had planned to drive up the coast of California to San Francisco but the reaction of our friend there stopped us. There had just been a nurse who tested positive for TB and she had exposed probably hundreds of babies to it and our friend was less than enthusiastic to a visit from Maurice who, by the way, was still coughing despite strong antibiotics. We decided to drive back to Arizona to my Mother’s home. I was worried about her as she is in her 90’s and rather frail and I was horrified that she might get TB as well. Between the time of arriving in the States and getting the TB diagnosis we had been in four states, on three airplane flights and had been around hundreds of people. I wrote all of my friends and relatives, including the parents of my grandchildren, about Maurice to alert them. One took her children to the doctor immediately and got all of them skin tested for TB-all were negative-and some did nothing.
We found a pulmonologist (lung specialist) and he ordered a scan. He also was kind enough to give me a TB skin test which was negative. Maurice had one too and it looked positive to me but all French children are given a TB vaccination and it will make a skin test react even if there is no TB. The scan showed that the pneumonia had cleared up but there was a worrying spot on his lung. The pulmonologist said Maurice should have a bronchoscopy so fluid and cells could be withdrawn from the affected lobe and tests and smears would be done to see if TB bacteria was present. This is where things got much worse.
Looking back on it, Maurice should have gone back to France as soon as he got that first positive test but he wanted to be a good citizen, as he put it, and not be on a plane possibly with TB. At this point, and indeed even now, we didn’t know if Maurice had had TB in his past, had latent TB or if it was active. I suppose if the tests from his bronchoscopy were positive, he would have been considered active. As it was, all of the tests were negative. Plus, he didn’t have any of the symptoms of TB: blood in the sputum when he coughed, night sweats, high fever. He just had a cough and felt tired. The pulmonologist told us that he thought Maurice wasn’t contagious but that he should wear a mask anyway when around people. He was also started on four very strong antibiotics used for the treatment of TB. They made him feel sick and he lost ten pounds. He was told that his liver could be affected and that he should have periodic blood tests to check for liver damage. His eyes could be affected by one of the drugs so he went to see an opthamologist when back in France. This was when the Public Health people got involved. Maurice decided to fly back to France where he would be more comfortable for any treatment. I stayed in the States for a few more days to visit with family. While I was there a public health nurse called and said Maurice shouldn’t have gone back to France before the third test came back negative-there were a total of six-and that he was wrong to have boarded a plane and exposed all the passengers to TB. By then, Maurice was feeling like a leper anyway, as no one wanted to be near him. He wore a mask around my mother and sat as far away as possible when around her. She wasn’t happy with the situation, believe me, and I took her to a doctor for her own skin test, which was negative.
Here’s the nightmare part, totally beyond possibly having TB: the medical costs. By now most informed people have read the articles about the horrific costs of medical treatment in the U.S. compared to other countries for the same procedures, but until it happens to you, you don’t realize how horrific it is. When Maurice checked in to get the bronchoscopy and the clerk taking his info found he had no insurance in the States, she said the cost would be $24,000. No that is not a typo. We were shocked to say the least. They must have realized how appalled we were because they then said that if we paid now-for what would amount to a twenty minute procedure-the cost would go down to $14,000! As we didn’t want problems we put it on our credit card. Even the surgeon, the anesthesiologist and nurse were totally shocked. The nurse even said we shouldn’t pay it. Someone advised us to call billing and see what could be worked out. So we went, and they immediately took off 78% of the total cost – just because we asked. It all felt like one of those Nigerian ripoff scams, or what it must feel like to deal with racketeers. After that, any time a bill came I would call and ask for a lower cost and there always was one. Had we not known to ask, we would have taken all the costs at face value. And the TB meds for one month alone were $700. The doctor and pathologist costs were more reasonable but we still haven’t received all of the bills.
One day, early in our four month time in the States, we were walking on a hiking trail and there was a small group of people trying to get signatures for Bernie Sanders, one of the candidates for U.S. President. Maurice said he was sorry but we weren’t from the States. I told the girl holding the clip board for signatures that we were from France and then held my arms up like Rocky and said, “Yay, socialized medicine!” She laughed and did the same thing. Many Americans have been made to think that socialized medicine is evil, and even associate it with communism, but I have to say that in France, I have found it to be excellent. In fact, they still do house calls here in France, a wonderful practice that used to be common in the United States. Yes, we pay more in taxes for it but everyone has access to excellent medical care. Maurice and I also have insurance to cover what isn’t paid by the government, and most medications are covered. For “grave illnesses” such as cancer, TB, diabetes and many more, treatment is covered 100% for the rest of your life. Itâ€™s a contract with society and people don’t end up in the poor house with their bank accounts wiped out because of an unexpected illness. Many people were shocked to hear about TB. They all thought it wasn’t around anymore but, believe me, it is. A friend of a friend was in jail one night for drunk driving and he was soon diagnosed with TB. He had to go in every day to get his meds or he would be arrested. There are a huge number of non-compliant people who stop taking their meds because, as we found out, it is very unpleasant. There is now a strain of TB out there that is resistant to antibiotics. In fact, in the future, antibiotics won’t work on any illness. Look at this, for instance:
So, we are back in France. The spot on Maurice’s lung has shrunk a lot after almost two months on the TB Meds. He can stop two of them at the end of February. We will never know when or if he even had TB but he still has to finish those meds. The pulmonologist here in Paris was shocked that the Public Health people had more power in saying if Maurice could leave for France than the doctor in the States, in fact, the public health nurse I talked to would have kept Maurice in the States until the third test came in negative, even if the doctor said he could travel, and we could have had to stay two or three weeks more. We are also hoping to get some refunds on airline flights cancelled or changed. Sadly, it wasn’t that the medical care wasn’t good, it was the cost. Our pharmacist here in Paris said they are getting more and more people in to get TB meds. Supposedly, Eastern Europe has a number of people with TB and with immigration and traveling more people are being exposed. One nurse told me, for instance, that TB was very common in Poland. Sometimes tourists return from visiting Europe and develop TB. And would you believe that most US cities have TB clinics? TB is far from over. Another “Who Knew?” in my life.
I saw this in Venice too. It’s by Bosch painted at the end of the 1400’s. Apparently, he had an after death experience like they write about today. It just seemed like a good painting for this blog posting, not that Maurice had one.