Diagnosed with active TB, need some help

[paca110]

Hi guys...I really need your help

[Background]

In February 2020, I went to the IRCC approved medical institute in Beijing to do the upfront medical exam. The x-ray picture showed that I've got an unknown shadow on my lung. Even though I haven't been suffering from any symptom of TB (no coughing or low fever of any kind), the doctor filed the case to the IRCC anyway, then the IRCC requested me to do a sputum test at another individual institution. The result of the test came out in May and it showed that the mycobacterium culture is positive, but the identification of the mycobacterium is "nontuberculous mycobacteria (NTM)". Then on May 22, based on this result and the x-ray picture, the doctor concluded that I'm TB active, and reported to the IRCC. Today, the IRCC requested me to begin tuberculosis treatment in 10 days, or my application may be terminated.

[Questions]

(1). Can I postpone IRCC's tuberculosis treatment request? Because I have reasonable doubts that the diagnosis is inaccurate, and would like to confirm my "active TB" case through a rather standardized exam in a TB specialized hospital in Beijing.
As far as I know, a TB exam should also include a blood test and a skin test, or at least a thorough CT scan, but I've been given none of these diagnoses other than a sputum test and a blurry x-ray scan. Wouldn't it be too hasty to jump to a conclusion that may cast a shadow for the rest of my life? Besides, as I recall, the nurse of the sputum test center asked me to give the sputum sample on the LAWN outside the test room, I believe the sample is likely contaminated, which may result in me tested positive for nontuberculous mycobacteria (NTM), an environmental organism which could also be found in soil, dust, and water. Therefore, I would like to redo the test in a TB specialized hospital in Beijing, and the whole process generally takes 2 months to complete but may provide more accurate results. I would like to know if this extension is allowed? And how do I manage to achieve this? (already filled a webform at the IRCC website and sent an email to the Canadian embassy in Beijing, they don't answer questions by phone )

(2). If my active TB case were to be confirmed, may I obtain TB treatment in any TB specialized hospital in Beijing (as this will be covered by my medical insurance), or if I have to go to an IRCC approved hospital only?

(3). How long the application window will remain open for me to complete my TB treatment? A general treatment plan will take a minimum of 6-12 months, so would I still be able to continue my application once I complete my TB treatment? And if my IELTS result expires after the treatment, would I need to renew my test report then?

Much obliged guys, and thanks for your valuable time!

 

[paca110]

anyone? Please...

 

[Islander216]

It's a bit of a special case, it's hard to provide advice on it. I will say i find it very difficult to believe you have TB, but i don't know what your personal history is like.

I would definitely get a second opinion, but i would try to get it from another panel physician. Explain your circumstances and say you want to undergo a specific TB test.

If you're unconvinced by the test results, you need to figure out if you have TB or another medical condition first and foremost, then the other immigration issues can be solved subsequently.

Have you already received an ITA?

 

[navinball]

They only gave you 10 days to begin treatment. Given any response from ircc takes atleast 2 to 3 weeks and how unlikely it is that they will start fsw draws, I'd suggest you follow their direction to avoid rejection.

 

[canuck78]

The best way to diagnose TB (the only way I think) is to do Sputum culture. You can receive treatment at any hospital and your application will be on pause until you do another sputum culture and x-ray after your treatment.

Skin test shows exposure to TB. Blood test will only confirm antibodies not active infection.

 

[vicky0143]

Skin test is a basic preliminary test and it doesn't prove anything. Blood test or TB gold is also a basic preliminary test which doesn't prove anything. Both these preliminary tests will require further investigation and more thorough tests.

CT scan or pet scan is usually done when they can't find anything in x Ray and ultra sound. After the x Ray or CT scan or pet scan shows some signs, culture test will be done in lab which will take months to further confirm it and to determine appropriate medicine.

You had culture test like you said and you had x Ray. X Ray showed signs and culture test confirmed it.

Nothing wrong in getting second opinion from a different doctor. Not sure if IRCC allows that.

 

[Shivaprasad94]

Hello Vicky

Thanks for your earnest and clear replies, I am not able to produce any sputum from my lungs and my sputum cultures got rejected 11th time by now.
Am not able to find any solution what to do, my physician only says me to see google and do it, i really dont know what to do.

 

[paca110]

It's a bit of a special case, it's hard to provide advice on it. I will say i find it very difficult to believe you have TB, but i don't know what your personal history is like.

I would definitely get a second opinion, but i would try to get it from another panel physician. Explain your circumstances and say you want to undergo a specific TB test.

If you're unconvinced by the test results, you need to figure out if you have TB or another medical condition first and foremost, then the other immigration issues can be solved subsequently.

Have you already received an ITA?

Really really thanks for your reply
It’s a very difficult time for me.
Yes I received the ITA in December, and I built my application profile on January.

I strongly agree with you that I should get a second opinion, after all I haven’t shown any symptoms even up to this second...the problem is that the current panel physician has already marked me as TB active in my health file, so the IRCC is now wondering why I haven’t stated my treatment yet, and left the ten days deadline. But any standardized test takes more than two months...So I have to convince the IRCC for an extension, and I don’t know how...via the current panel physician maybe?

Thanks again!

 

[paca110]

Skin test is a basic preliminary test and it doesn't prove anything. Blood test or TB gold is also a basic preliminary test which doesn't prove anything. Both these preliminary tests will require further investigation and more thorough tests.

CT scan or pet scan is usually done when they can't find anything in x Ray and ultra sound. After the x Ray or CT scan or pet scan shows some signs, culture test will be done in lab which will take months to further confirm it and to determine appropriate medicine.

You had culture test like you said and you had x Ray. X Ray showed signs and culture test confirmed it.

Nothing wrong in getting second opinion from a different doctor. Not sure if IRCC allows that.

Thank you very much! Your answer clears a lot of doubts for me!! I thought those tests were absolutely necessary...

I’m just a bit confused for one thing, the test result shows the mycobacterium culture is positive, but the identification of the mycobacterium is "nontuberculous mycobacteria (NTM)", is this the same as TB?

 

[Islander216]

Really really thanks for your reply
It’s a very difficult time for me.
Yes I received the ITA in December, and I built my application profile on January.

I strongly agree with you that I should get a second opinion, after all I haven’t shown any symptoms even up to this second...the problem is that the current panel physician has already marked me as TB active in my health file, so the IRCC is now wondering why I haven’t stated my treatment yet, and left the ten days deadline. But any standardized test takes more than two months...So I have to convince the IRCC for an extension, and I don’t know how...via the current panel physician maybe?

Thanks again!

I think you need to inform IRCC that given the diagnosis and the fact that you don't feel you have symptoms consistent with contracting TB, you are looking to get a second opinion to ensure it is the proper course of action to undergo treatment for it.

Why don't you try doing the medical with another panel physician? Tell them the situation, and say you have doubts about the diagnosis.

My concern is that IRCC will give more credence to a panel physician who is certified to provide medicals for immigration than to a standardised test which is performed at a facility they may not recognise. You know what i mean?

I would look at the other panel physicians and see whether they work for a clinic which is well known.

 

[paca110]

I think you need to inform IRCC that given the diagnosis and the fact that you don't feel you have symptoms consistent with contracting TB, you are looking to get a second opinion to ensure it is the proper course of action to undergo treatment for it.

Why don't you try doing the medical with another panel physician? Tell them the situation, and say you have doubts about the diagnosis.

My concern is that IRCC will give more credence to a panel physician who is certified to provide medicals for immigration than to a standardised test which is performed at a facility they may not recognise. You know what i mean?

I would look at the other panel physicians and see whether they work for a clinic which is well known.

Thanks for your patience and time. I just tried to book other IRCC approved panel physicians, but they said that the IRCC only allows the candidates to do the upfront medical exam once a year, so they can't help or give any second opinion, besides, they said that all the immigration sputum exam are performed at the same place above mentioned

Now I informed my current panel physician to see if they can buy me some time with the IRCC since the only way I can directly contact the IRCC is via the webform, which I did the day before yesterday, unsurprisingly, no reply.

In the meantime, I booked a quick CT scan at the local TB specialized hospital, the CT result can be collected today, I'll see what doctors can find on that scan.

Thanks again!

 

[canuck78]

Skin test is a basic preliminary test and it doesn't prove anything. Blood test or TB gold is also a basic preliminary test which doesn't prove anything. Both these preliminary tests will require further investigation and more thorough tests.

CT scan or pet scan is usually done when they can't find anything in x Ray and ultra sound. After the x Ray or CT scan or pet scan shows some signs, culture test will be done in lab which will take months to further confirm it and to determine appropriate medicine.

You had culture test like you said and you had x Ray. X Ray showed signs and culture test confirmed it.

Nothing wrong in getting second opinion from a different doctor. Not sure if IRCC allows that.

pet scan is done to identify cancer so not related to TB. CT scan will show things like scarring, inflammation, etc. which can be due to current health issue or show damage from previous infections or medical condition. Skin and blood tests shows exposure of some sort and that you have produced some antibodies.


x-rays are done to see if there is any visible sign of lung damage or current abnormalities. If there is anything concerning it is compared to an x-ray done around 3 months later to see if lungs look better or if anything like scarring looks the same which would likely indicate damage from a previous infection or medical issue. If sputum is clear and x-rays look better or the same TB is ruled out.

 

[canuck78]

Thank you very much! Your answer clears a lot of doubts for me!! I thought those tests were absolutely necessary...

I’m just a bit confused for one thing, the test result shows the mycobacterium culture is positive, but the identification of the mycobacterium is "nontuberculous mycobacteria (NTM)", is this the same as TB?

Are you sure you weren’t able to give a sputum culture? How were they able to find mycobacterium in your sputum culture? The other doctor will read the lab results as well so it is slightly pointless to get a second opinion. If anything you should request to do another sputum culture and use another lab if possible because you don’t feel like you were able to give a sample. You also don’t feel sick but that is still possible with TB. Unless you have other medical conditions and are quite sick you are unlikely to be suffering from a non-TB mycobacteria infection.

 

[canuck_in_uk]

Thanks for your patience and time. I just tried to book other IRCC approved panel physicians, but they said that the IRCC only allows the candidates to do the upfront medical exam once a year, so they can't help or give any second opinion, besides, they said that all the immigration sputum exam are performed at the same place above mentioned

Now I informed my current panel physician to see if they can buy me some time with the IRCC since the only way I can directly contact the IRCC is via the webform, which I did the day before yesterday, unsurprisingly, no reply.

In the meantime, I booked a quick CT scan at the local TB specialized hospital, the CT result can be collected today, I'll see what doctors can find on that scan.

Thanks again!

The Panel Physician can't buy you time. They don't work for IRCC and have no say in the actual medical decisions. That is done by IRCC medical officers. You can try contacting the relevant RMO but I'd guess they won't do much but tell you to get the treatment. https://www.canada.ca/en/immigration-refugees-citizenship/corporate/publications-manuals/panel-members-guide.html#sec3.1.2

 

[canuck78]

Thanks for your patience and time. I just tried to book other IRCC approved panel physicians, but they said that the IRCC only allows the candidates to do the upfront medical exam once a year, so they can't help or give any second opinion, besides, they said that all the immigration sputum exam are performed at the same place above mentioned

Now I informed my current panel physician to see if they can buy me some time with the IRCC since the only way I can directly contact the IRCC is via the webform, which I did the day before yesterday, unsurprisingly, no reply.

In the meantime, I booked a quick CT scan at the local TB specialized hospital, the CT result can be collected today, I'll see what doctors can find on that scan.

Thanks again!

CT scan can’t confirm you don’t have TB. Sputum culture with mycobacteria is why you are being diagnosed with TB.