TB – How far we are from it?
TB – 我們與它有多遠呢？

Just like me before, it seems that TB is never near us. According to the doctor, it is very easy to be infected if you will visit mainland China. Is this a kind of prejudice? Not this time. For about thirty years, there were many migrated workers in Shengzhen, Dong Guan etc. They did not have medical insurance and because they were not local citizen, they had to pay a very high medical fee. So when they got sick, they just bought medicine themselves. Perhaps, a common cold or eating disorder could be treated easily. But if they had TB, then it is certain that they would never be fully recovered. Even the medicine is good, they had no advice from doctor and no test to be sure whether the germs were totally gone. This situation lead to a huge number of TB patients, infective and transmitted the germs all around.

正如我以前，肺結核TB看來絕不會是在我們身邊。根據醫生說，如果有上大陸，那就極容易染上肺結核TB。這是否又一個偏見呢？這次不是。三十年來，不少民工在深圳、東莞等地工作。他們沒有醫療保險而且由於不是本地人，需要付較昂貴的醫藥費用。所以當他們有病時只會購買成藥來醫治。可能一般著涼或腸胃不適等是容易解決。但當他們染了肺結核，可以確定他們是不會完全康復。即使有合適的藥物，他們也沒有醫生的指導及有關的測試來確定肺結核菌是否完全被消滅。這個情況導致大量肺結核病人，具有傳染力及把肺結核菌四處散播。

No one can know exactly where and when one had been infected. The TB germs will stay inactive in our lungs for a long time, years or tens of years. Germs wait for the right condition to become active. That is when we got the TB disease. What condition is for this? Unfortunately, it is the exact condition that type II diabetes creates. That is why in these years, we have many young TB patients. Most of them had type II diabetes first. Of course, I had similar situation, though I am not young. That is to say, if one has diabetes, he/she will be easily infected by TB germs.

沒有人可以知道在那時那處感染。肺結核菌可以在肺部隱藏很長時間達數年至數十年。肺結核菌是等待伯適的條件來變成活躍。這就是我們發覺染了肺結核病的時間。它們需要那些條件？不幸地正是2型糖尿病造成的環境。這也證明了近年多了年青的肺結核病例。他們多數是先有糖尿病出現。當然，我雖然不是年輕，但也是相同情況。這就是說當一個人患了糖尿病，他/她極會染上肺結核病。

At first, I never think of the relationship between diabetes and TB. It is now that after searching for information, I find that these two kinds of decease are called 'sisters'. From the Internet, it seems that the awareness of this relationship has been noticed within a couple of years. This is quite strange that medical information from India indicated that this environment had been noted a thousand years ago. Without full investigation, that is why we are lack of such knowledge. If I know that diabetes may lead to TB, I should either take a precaution or earlier checking of the lung instead.

最初我絕不接受糖尿病與肺結核有任何關係。在搜查有關資料後，我發現原來他們被稱為姊妹病。在查看有關資料後，我發現這兩個病是稱為姊妹病。在互聯網中，可以看到近年來才有提及這種關係的文章。這很奇怪猶為印度方面的醫療資料稱這個情況在一千年前已發現了。在欠缺全面的調查報告，這正是我們欠缺這方面認識的原因。如果我知道糖尿病會引致肺結核，我當然會採取預防或及早檢查肺部。

Is this just co-incident or some independent cases? No, according to the information, there are facts that diabetes will lead to TB. The acid environment induced by diabetes lower the body’s defense that favors the growth of TB germs. Also the high fat of diabetes is another factor for the germ's growth. The TB also affected the insulin making diabetes more serious.

這是否偶然或是一些個吟的例子呢？不，根據資料，這是有充份的證據說明糖尿病會引來肺結核。糖尿病產生的酸性環境是會降低身體的防衛力而有利於肺結核菌的繁殖。而且糖尿病產的高脂肪也更有利於肺結核菌的繁殖。而肺結核又會破壞胰島素使糖尿病加深。

To learn from my case, it is certain that if one has diabetes, the TB will be very close. Of course, if there are no TB germs either in the lung or around us, one is safe. Who knows?

從我的例子來說，可以確定當患了糖尿病後，肺結核就會在很近的距離。如果肺部及各環境沒有肺結核菌，我們就會安全。誰可肯定？

TB is now a curable disease. As for the rumors about the latest medication, I shall discuss in other posting. The worst thing is its infectiveness. No one would dare to risk because everyone will feel guilty if he/she infects someone else. Therefore, we must keep in mind about this because it is easy to have diabetes now.

肺結核現在是可治之症。至於有關最新醫治藥物的流言將在另外的文章討論。沒有人會冒險因為所有人都會對傳柒給他人產生罪惡感。因此我們必須記得這個情況因為現在很容易患上糖尿病。

The Summary of One Month after Confirming TB

After meeting with the doctor in a Chest Clinic, he said that I had to go to the hospital to find out whether I had TB or other problem. So on Apr. 20, 2009, I was taken to the Grantham Hospital.

This started my first encounter with western medication and experience in a hospital. All doctors and nurses were nice and friendly. At first, it was arranged for me to take a bed in the open room. Then after consultation with a doctor who indicated that I was 90% TB, they moved me to a room with five beds, all patients had TB. That was great; much better then the noisy open room. Afterward with unknown reason, they moved me again to another room. The bed was closer to the door and with better situation.

The next day, Apr. 21, 2009, the doctor, Dr. Gill, checked my case and had not yet sure whether I had something more than just TB. But that day, the chief doctor, Dr. Yew, came later. He said that since a big area of my lung had been infected, it would be better to start the treatment and checked the other problem later. Therefore, the next day, after the morning consulting by Dr. Gill and Dr. Fung, I was given the 1st line TB treatment, a composite of four medicines.

As usual, they needed to watch my condition for the next two weeks to be sure that there was no side effect of the medicine especially the liver problem. Fortunately, all went well. But Dr. Gill said that since my affected area was huge, they needed more time to watch. That was the reason of not releasing me after two weeks.

On May 19, 2009, I told Dr. Gill that I must be released from hospital because I could not stand the heat and already had not slept for two nights. He agreed because my conditions were OK. This started the rest of the nine months' medication. Daily visit to Chest Clinic with occasionally visit to doctor.

This time, I really astonish to know that TB is not far from us as I thought. After researching related information, it seems that anyone with old age and has diabetes, the body will be highly possible infected by TB.

Both doctors surprised me with their frankly and sincere manner, a great contrast to what we have known before. .

With a number of roommates, I found out that there was something we needed to know. A very high percentage of them did not know to have diabetes until check up after admitting to hospital. Not old, just between 40 and 50, it is quite sad because at such age, they still need to take care of their children etc.

I shall review my case and prepare something about TB here later. I believe that anyone should know about the dangerous of ignorance or misguided information. Just like what I was. I believed that if one had TB, he should have fever and chest pain. I was wrong. That mistake let me missed earlier treatment. As Dr. Fung said, my affected area indicated that I was 70% from the maximum. Perhaps any more delay would lead me to the coffin already.

One more thing, it is said that the TB medicines were hard to swallow leading to a lot of giving up cases that created drug resistant TB germs. The number of pills and famous big size of one would not be easy for anyone to take for months. Not so now, the total number of pills is just ten and the biggest one is 13 mm dia. 5 mm thick. Of course, the DOTS (Directly Observed Therapy, Short-course) is still enforced and it is easy for me to adopt because my work is not bound by office hours.