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Conflicted over starting INH

Nurses   (5,789 Views 29 Comments)
by MonkeyRN MonkeyRN (Member)

MonkeyRN has 9 years experience and specializes in Postpartum, Hospice, Ambulatory.

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I had a PPD last week for an adoption physical and it came back positive. My last PPD for nursing school was in July and was negative. I'm pretty sure I was exposed at a homeless shelter for the mentally ill that I was at for two days during my psych rotation. My chest xray was negative. My doctor's PA called to set up an appt with my MD and said that she'll probably want to put me on INH for 6 months. A friend of mine was on INH a few years ago and absolutely hated the way it made her feel. I'm worried about taking it because I don't want to feel like crap for 6 months. I also have a newborn at home and start my new job in August. I was hired before the PPD was done. My physical for my new job is in July. I know I'm going to have to tell them I'll need a chest xray instead of a PPD. I'm wondering if they'll be relunctant to hire me if I don't take the INH.

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6,487 Posts; 21,380 Profile Views

You've already been hired, so what's the issue?

As for the med, there are different TB meds out there. I don't know if INH is the only option for you but talk to your doc.

Last question: you have a baby at home and you're young and healthy. Do you really want to take the chance of not taking the meds? Not everyone suffers side effects to the same degree as other people.

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While I don't have an answer for you, I just wanted to say I'm in a similar boat. Had a positive PPD and really don't want to take the INH (I even have the pills here, filled the script, but havn't gotten up the nerve to take it!) I guess it's a good idea to take it in the long run, espeically coming from a young person's point of view. Still, it's scary to take a drug that can be so damaging. When I went to my doctor's office I saw the PA and INH was the only thing she offered me. I'm kind of wondering if I should go for a second opinion. Good luck with whatever you decide!

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34 Posts; 1,448 Profile Views

I was in the same boat about a year ago and went ahead and took the INH. I had no problems with it at all other than the doc not telling me that it acted as an alcohol enhancher (hammered on two beers). I never felt any side-effects and am glad I did it for peace of mind if nothing else.

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Ms.Hobbes has 15 years experience.

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I work for the public health department here in N. California as a PHN. Our TB patients have to take there TB meds under Direct observational therapy, this includes our latent TB infections, and if they do not comply can end up going to jail. I don't know what your policies are there but abviously not as strict. Did you doctor have you supply three sputum specimens, three days in a row? Our doctors usually do a thorough investigation and possible contacts, review symptoms, etc. I know for sure they would have to report this to your Public Health department.

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81Bubbles has 8 years experience and specializes in Dialysis, ONC, Peds, Peds HomeCare, NICU.

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I find that odd that they would put you on these meds without further testing. A positive PPD is not idicative of latent infection just of exposure. I'd request more tests.

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979 Posts; 8,157 Profile Views

I'm really, really tempted to get a BCG shot. I mean, it just might keep me from getting TB, maybe a 60-80% shot (English results) at not getting it if exposed. American health thinking is that BCG isn't so great because you'll turn positive for the rest of the life and they can't tell when you get it. What? Would any of us who are vulnerable prefer to have no shingles shot, even if it improves our odds against shingles only a little over half? So why should TB be any different? Because it's on public health turf? Hey, let me see . . . no vaccine, then take liver-killing meds that don't confer immunity, maybe after infecting my family, then maybe reactivation . . . versus vaccine that might preclude infection in the first place . . .

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Liddle Noodnik has 30 years experience and specializes in Alzheimer's, Geriatrics, Chem. Dep..

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I had a PPD last week for an adoption physical and it came back positive. My last PPD for nursing school was in July and was negative. I'm pretty sure I was exposed at a homeless shelter for the mentally ill that I was at for two days during my psych rotation. My chest xray was negative. My doctor's PA called to set up an appt with my MD and said that she'll probably want to put me on INH for 6 months. A friend of mine was on INH a few years ago and absolutely hated the way it made her feel. I'm worried about taking it because I don't want to feel like crap for 6 months. I also have a newborn at home and start my new job in August. I was hired before the PPD was done. My physical for my new job is in July. I know I'm going to have to tell them I'll need a chest xray instead of a PPD. I'm wondering if they'll be relunctant to hire me if I don't take the INH.

I took the INH after my PPD converted (was negative my freshman year and pos my senior year). I did experience an allergic reaction after 3 mos., possibly to the INH, and doc said it was ok to stop it. I was also on another med but I don't remember what it was.

When I tell employers I need a CXR and why, and that I can't have the PPD again, sometimes they are confused, but they will understand once you explain it to them.

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vamedic4 has 23 years experience as a EMT-P and specializes in Peds Cardiology, Peds Neuro, PICU, IV Jedi.

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I had a PPD last week for an adoption physical and it came back positive. My last PPD for nursing school was in July and was negative. I'm pretty sure I was exposed at a homeless shelter for the mentally ill that I was at for two days during my psych rotation. My chest xray was negative. My doctor's PA called to set up an appt with my MD and said that she'll probably want to put me on INH for 6 months. A friend of mine was on INH a few years ago and absolutely hated the way it made her feel. I'm worried about taking it because I don't want to feel like crap for 6 months. I also have a newborn at home and start my new job in August. I was hired before the PPD was done. My physical for my new job is in July. I know I'm going to have to tell them I'll need a chest xray instead of a PPD. I'm wondering if they'll be relunctant to hire me if I don't take the INH.

First off, are you sure it was a "positive" positive?? What I mean is..

You can have different reactions to the PPD. You can have a localized reaction to the test...redness around the injection site...this doesn't necessarily mean you have tested + for exposure. If you had any induration however, things change.

My TB story...

When I went away to medic school in the early '90s, I had my TB done as was required. The health department nurse looked at my red but not raised mark on my arm AND SCRAPED IT WITH HER KEYS...eliciting an immediate skin reaction that she deemed a positive. Not knowing any better I took the INH and Vitamin B supplement for as long as I could stand it.

Bear in mind this: they warn you NOT to drink alcohol while on INH. THEY MEAN IT WHOLEHEARTEDLY. Just take it from me and don't do it, if you do you'll wish you were dead.

Oh, and BTW...I've NEVER tested positive since that day...and we get TB tests yearly here at the hospital.

vamedic4;)

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Liddle Noodnik has 30 years experience and specializes in Alzheimer's, Geriatrics, Chem. Dep..

4 Articles; 3,789 Posts; 42,564 Profile Views

I took the INH after my PPD converted (was negative my freshman year and pos my senior year). I did experience an allergic reaction after 3 mos., possibly to the INH, and doc said it was ok to stop it. I was also on another med but I don't remember what it was.

When I tell employers I need a CXR and why, and that I can't have the PPD again, sometimes they are confused, but they will understand once you explain it to them.

Looked it up (it was around 1981) and it was Rifampin also that I was on.

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Liddle Noodnik has 30 years experience and specializes in Alzheimer's, Geriatrics, Chem. Dep..

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.........AND SCRAPED IT WITH HER KEYS...

GROSSSSS!

Mine was definitely raised - mega raised - I did take care of a pt who was later ID'd with TB - he was on a vent in ICU - and had coughed in my eye at LEAST - so probably I breathed it in also.

Lots of precautions we did not take back then.

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Liddle Noodnik has 30 years experience and specializes in Alzheimer's, Geriatrics, Chem. Dep..

4 Articles; 3,789 Posts; 42,564 Profile Views

GROSSSSS!

Mine was definitely raised - mega raised - I did take care of a pt who was later ID'd with TB - he was on a vent in ICU - and had coughed in my eye at LEAST - so probably I breathed it in also.

Lots of precautions we did not take back then.

Oh, and my sister had the active disease around 1970 - I remember her being so sick, and in isolation, and I couldn't go see her :( (I was about 12)

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