To Be Confirmed (TBC)

I had my appointment with the infectious diseases doctor in the staff clinic at the Alfred hospital today.  So it is now pretty certain that I have Latent TB and after spending the last couple of weeks weighing up the pros and cons of treatment I have made my decision.

Someone with latent TB has a 5-10% chance of developing active TB, also if in later life you become immunosuppressed (i.e. go on chemotherapy) the risk of developing active TB increases dramatically.  So the treatment is 9 months with a drug called isoniazid, which gives you approximatly a 90% chance of complete eradication of the mycobacterium.  It does not give you any grantee however that you wont pick up the mycobacterium again later in life, and as you already have antibodies from the first exposure, it would be impossible to tell if this happened unless you later went on to develop full blown TB.

Isoniazid is an antibacterial that works directly on the mycobacteriums ability to build a cell wall, it therefore can kill all actively dividing mycobacterium and inhibits the growth of resting bacteria.  Unfortunately it has the potential to cause less desirable effects as do all medicines.  The most important potential side effect of isoniazid is liver toxicity, 10-20% of people treated with isoniazid will see some rise in liver transaminases within the first few months of treatment but this usually resolves on continued treatment with the drug, it is the more series drug induced hepatitis that is more of a worry, the risk is age related and the older you are when you start treatment the higher your risk.  The second big potential adverse effect from isoniazid is peripheral neuropathy, but the risk of this is dramatically reduced by taking it with Vitamin B6 (pyridoxine).  Other adverse effects include drowsiness, loss of concentration, changes in vision and acne like skin reactions, to name a few.

Despite all of this I have decided to go ahead with the treatment.  Before I can start they have to do a test of my baseline liver function so that any changes in liver function can be measured and assessed.  I think I am more worried about the liver function test (LFT) than I am about the prospect of 9 months treatment with isoniazid, after all I do enjoy a nice glass of wine, or pint of beer, or gin every now and again.  With Christmas and new year in the not to distant past I would not be surprised if I had a raised GGT! Because I have to what for the results from my LFTs I wont pick up my script until next week, that means one more week in which I am allowed to drink alcohol before 9 months of abstinence.

Yesterday we had the depressing job of taking down all our Christmas decorations, and so our first Christmas in Australia is over, although one final little Christmas present to ourselves arrived in the post today.  A photobook containing a collection of some of our best photos from 2012 which I created online after getting a special offer from groupon.  A lot of the photo's in the book, you will find in this blog.  I really do think photobooks are the best way of getting digital photos developed and have a much better professional finish than old fashioned albums.