TB or not TB? That is No Longer the Question
“I have the order here for your chest X-ray,” she says casually. “My what!?” is the only response I can conjure up, as the pit forms in my stomach. The well-meaning Office Assistant quickly realizes her mistake, that I hadn’t yet been told. She then says I have to contact the doctor. As I sit among my peers, I can’t hear their chatter. I can’t eat the sumptuous meal in front of me. Something is wrong. I know it in my bones. I try to reach the doctors. There is no answer. I receive a text during the next training session, “Megan, your blood test came back positive for TB.”
Tears stream down my face as my mind races and I enter go-mode. In the midst of crisis, my nurtured former Social Worker Self joins forces with my natured Planning Self, blazing a million steps ahead. Add to the mix my lack of knowledge about tuberculosis and I am adrift, out of my body, out of the moment. I think of long-term consequences, being labeled with a pre-existing condition. Questions abound, “Is this fatal? Will I live with this for the rest of my life? Am I infecting others? Where did I get this? Does this mean I’ll return to the States?” In the last several weeks, I’ve found answers to these questions. I’ve discovered resources. I’ve regained my grounding in many surprising ways.
I set out for my Mid-Service Training (MST) with what I thought was anxiety about seeing my cohort, the group of people with whom I arrived here in South Africa 16 months ago. The purpose of MST is to fuel Peace Corps Volunteers during a notoriously emotional slump, provide a midpoint medical check up and propel us to succeed in the second leg of PC service. In some ways, I look forward to the milestone and anticipated boost, but mostly, I feel I am lagging behind. Struggling to find my fit has been a theme during my service. On my third site, living with my third host family, not feeling like I quite fit into my assigned organizations and not feeling at home amongst my peers has been a challenge. What is supposed to be a time to recognize ourselves and our service quickly devolves for reasons other than the diagnosis I didn’t see coming. Maybe one day, post-service, I’ll speak more freely about MST.
Fast forward several days when I travel to the hospital for the aforementioned chest X-ray. Upon entering the room, I identify my anxiety and the friendly clinician tells me I have nothing to worry about. As I relay my blood result, she exclaims, “oh!” runs out of the room, rightfully returning in a surgical mask with a bit more hesitancy than before. Luckily, my chest X-ray is clear. Two days later, I’m offered a pamphlet on TB and 2 different treatment options. As I read about the symptoms of active TB, the fatigue and labored breathing I’ve been experiencing for the last several months jumps off the page. I urge further testing to determine my TB status, which is thankfully granted. The subsequent days are filled with multiple doctor and hospital visits, the low point being a lab tech pounding on my back for what feels like an hour in an effort to force sputum-producing coughs behind closed doors that earn me unabashed stares from the entire waiting room upon my exit (yes, as anxiety-provoking as wading your way through that sentence). Fortunately, my poor lungs are spared further trauma when I’m sent to the physiotherapist who administers proper sputum-production techniques over the next two days. I await results, which come back negative and point to a diagnosis of latent TB. I opt for the 4-month, rather than the 9-month course of treatment. I take half a dose, as instructed, and awaken at 3am with nausea, vomiting, vertigo and a whole host of misery that makes for one of the scariest experiences of my life.
A desperate call to my second Mama in the States prompts a even more desperate 4am call to the Peace Corps Medical Officer who at first diagnoses food poisoning, then tells me to refrain from my morning dose of the Rifampin and come to the office in a few short hours. I’m sent for a second opinion where we explore some of the other strange symptoms I’ve experienced over the last several months, including night sweats and joint pain. Additional blood tests and another sputum test is ordered.
As I await test results, the days and weeks go by, I am further disconnected from my village, my host family, my current projects and my support systems. My guilt mounts as I can’t effectively communicate my current health status, as I myself don’t have answers. Text, Facebook and WhatsApp messages increase as I press “pause” on my life. I experience some dark days as my fatigue is compounded by a lack of answers.
I bounce in and out of each of the stages of grief - denial, anger, bargaining, depression and acceptance, as I clamor to cope. From questioning the validity of medical tests to analyzing interpersonal interactions to feeling as if I’ve made a mistake pursuing the Peace Corps in the first place to finally recognizing the empathy cultivating within me for folks who endure chronic diseases, partner and family notification of medical issues and obstacles of all kinds. I dig deep to remain connected to the light within and around me.
I am diagnosed with shistosomiasis, the second most common tropical disease next to malaria, that somehow no one’s ever really heard of. Shisto, as it’s so lovingly referred to among those of us who now know it well, can live in the body for up to 40 years. The parasite can cause some major damage. Amazingly, the treatment is only one day, but as the worms die, the body can react in a variety of ways. I spend the next several days asleep. Doctors tell me it will be months for my body to adjust to life without the shisto present in my body. Unfortunately, that I have to start the TB meds before then. It's likely I won't feel like I've got my body back until the TB medication finishes. More days pass. During a follow up appointment at which I’m expecting my new TB treatment, I leave with a prescription for a broad-spectrum antibiotic because something is still out of balance. The doctor determines that I’ll try the 9-month treatment for latent TB once I finish the course of antibiotics. I’m told I can return to site.
Panic sets in. Many conversations take place. I decide that starting TB meds back at site, in light of my reaction to the last medication, is a non-negotiable. Living in a rural village several kilometers off a paved road precludes me from accessing proper medical care should another reaction occur. I will start the TB meds in the capital. The antibiotics are uneventful until I get what feels like a cold during the last two days of the therapy. The doctors attribute the symptoms to my body being “drug naïve” and the medication increased my susceptibility to illness. Three days later, symptoms disappear and I start my 9 months of TB medication without incident.
I return to my village this week, I speak with my current and former host families to notify them of my diagnosis, the reasons for my absence and my lack of communication. I fear stigmatization and blame and, instead, am greeted with acceptance, understanding and words of affirmation. The dynamics among myself and others in the village shift positively in the direction of curiosity and appreciation. I look forward to the work to be done, the relationships to be forged and health, wellness and balance to be regained.
Through these illnesses, I’ve learned to recognize my privilege. Many people don’t get treatment for latent TB. As a Peace Corps Volunteer, I need to take the prescribed medication to prevent my latent TB from progressing to active TB. After taking the regimen, there is a 90-95% chance that I will never get active TB in my lifetime. I’ve taken an active role in educating myself over these last few weeks. Spending countless hours of internet research combined with conversations with friends who have connected me with friends and relatives who have lived with (and survived) TB has been invaluable. I’ve had the luxury of a second opinion, self-advocacy, additional testing and support and urging others to listen to the wisdom of my body. Had I not had such a severe reaction to the first TB medicine, I would not have discovered the shistosomiasis and remedied symptoms that have been plaguing me for months, maybe years.
As the last 50+ days have seen me hyper-focused on what’s wrong with me, Angels greet me along the way, stretch my comfort zone and remind me of what’s good. In an epic, yet very non-Peace Corps kind of day, I fill my belly with Mexican food and tapas, then digest before grooving at my first pole dancing class with two new soul sisters and dance the night away on table tops at a local pub. The level of empowerment from this combo is highly recommended. Why don’t we dance on more table tops, people? Days later, I attend a beer festival, odd for someone who doesn’t drink, I know. I go for the music and sunshine and am given the opportunity to dance my way back into my Self. A dear friend comments that she’s not seen me so happy in the last year and a half. I agree. Both days have been among the best I’ve had since arriving in South Africa. I am gleefully reminded of how much music and dancing juice me up and how much my heart yearns for time with soul sisters.
I’ve claimed that I came to the Peace Corps with tools I didn’t have when I burnt out of the helping profession. Admittedly, I haven’t been employing these tools as much as I could have. The day before I started my TB treatment, I integrated Access, a series of 5 energy healing techniques from BodyTalk, meant to balance the entire system, into my daily routine. I’ve also started listening to this chakra balancing meditation nightly right before bed. The acquisition of TB and shisto has been a wake up call on many levels. As I reground and more readily awaken to the present, I’m increasingly aware of the beauty and culture around me. I’m increasingly aware of the tools and I have at my fingertips, and recognize that it’s up to me to actually utilize them. I’m increasingly grateful for this precious experience that is my Peace Corps service, despite, and quite possibly because of, the twists, turns and myriad of challenges it’s thrown at me. And perhaps I’ve returned to my village from my Mid-Service Training with exactly what was intended, the treatment I didn’t know I needed, a reminder of what’s important and, indeed, the fuel to continue on this journey. ♥
This entry feels like a departure from my regular writing style. Gratitude to you for walking this journey with me. I aim to provide honest and vulnerable insights into my emotional and spiritual process that is Peace Corps, this 27 month chapter of my life. All my love ♥
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