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TO BE OR NOT ‘TB’

May 25
12:16 2019

By: Dr. Abigail Joseph

It is not uncommon for doctors to be the center of scrutiny or accused of something based on misinterpretation. Many times we do things in the best interest of others, but our actions are interpreted as scornful. I can only speak for myself and my experiences and I have had several instances where my actions have been misconstrued. Now, I am of the opinion that many are still ignorant as to the purpose of personal protection protocols as well as patient protection policies. One day at the clinic a patient made mention to the other patients in my waiting room that the reason the nurse gives them masks to wear when they are coughing is because I, the doctor, scorns them. Another woman posted mean comments about my practice on Facebook because I asked her and her daughter to wear face masks while at the clinic.

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Firstly, it is not I who made the face mask policy – I don’t make the rules. I simply enforce them. Secondly, when a person is coughing or has a cold it is important to understand that it is highly contagious and each person may have a different strain of the virus. The person sitting next to you may seem to have the ‘flu’ just like you but there are over a hundred different viruses that can cause a cold and it may just be a different cold. In addition, it may be a completely different thing altogether. It could be pneumonia, even Tuberculosis.

Imagine having all these random people, all in one enclosed space, coughing and sneezing and breathing in all these droplets of viruses and bacteria. By the time you leave the doctor’s office you may have left with an additional bacteria or virus! Practicing good hygiene and utilizing the safety techniques explained by the triage nurse makes a great deal of difference. Wearing a face mask filters the air you breathe in regardless of the sneezing and coughing in the waiting room. It protects you from others and protects others from you. Health practices should extend not only to you wearing a face mask for coughing, but I implore you to be mindful of the fact that sick people wait in waiting rooms. It is a space of high risk and is riddled with germs on every level…you probably shouldn’t have your kids on the floor or touching the walls. Just a thought.

Think about it. When we cough or sneeze some people cover their mouths with their hands. They then touch the chair handles or the walls. Other people who give very little thought to how their actions affect others may cough in the open air – these droplets are projected in the air at a high velocity and may fall to the ground or over on the shoe of the person across from them. Sometimes children play on the ground, they breathe in the droplets and contract a different virus – then as parents we may complain that the child was getting better but then he or she got worst – new infection. These are just examples of how our actions play out in everyday life.

Now let’s talk facts. The common cold is something patients self-diagnose very quickly and to be honest, at times we tend to misdiagnose and assume that it is a cold when in reality it is not. Pulmonary Tuberculosis (PTB) is an infectious disease caused by a bacteria known as Mycobacterium Tuberculosis (MTB). TB can be categorized as extra pulmonary (an infection that affects other parts of the body) and Pulmonary TB. However, most people are concerned with Pulmonary TB because it is the contagious form of the infection. Pulmonary TB is transmitted from person to person by breathing in the bacteria that causes TB present in the air. A person infected with active pulmonary TB releases thousands of infected micro-droplets when they speak, sing, cough or sneeze. The distance at which you would find these droplets from the infected patient depends on the velocity when the patient speaks, coughs or sneezes.

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