Having latent TB in Minnesota versus having latent TB in California (which is where it was first detected) were distinct experiences. Wouldn't have guessed that, would you have?
I believe four different nurses in California read my skin test results. Three of the four were nurses whose sole job was to work with TB patients. They knew what they were doing and they did it like it was the most important thing in the world.
I imagine them going to happy hour together once in awhile and sitting back to talk about all the TB cases they'd had that week. "Ooh, that blood and septum case, goodness!" One would say, needing catharsis about the most advanced patient of the week. "It's a good thing we can drink 'cuz that guy has enough antibiotics to shut down his liver in a week if given alcohol! We have to call him every day and make sure he's complying with his meds!"
When I did my own research and got scared of the side effects of the prophylactic antibiotics those nurses tried very hard to convince me to start immediately, I stopped talking to that clinic. Then, another county nurse started to call me. About once every two months for a year I got a call from her. She was calling to see if I'd started my meds yet and if not, did I need more information? Was I sure?
The thing about taking the latent TB meds is that it's not required, but due to a worldwide public health campaign to deal with the current TB epidemic, there are all these TB police out there calling people like me. Pimping out their meds. Losing sleep at night over the ones who refuse. Sigh.
In Minnesota: I got a primary doctor, walked in, said, "I have latent TB. I think I want to take the meds." He said, "Oh. I'll get you a prescription after we do another skin test. And, well, since you're not quite 30, we don't have to do any routine blood tests. You'll be fine. Just take it." I had to educate him about the side effects. I speculated that I was the first patient he'd seen with TB exposure. He was scarily laid back about it. Then, I get meds, and nothing more from him or the clinic.
If those nurses in California had ever heard a yes from me they'd probably have thrown a party, in the bar. They'd have had a drink for/over me and reinforced their clout with each other. "See? We just have to believe in this work. It's so important. We can eradicate TB, one person at a time!" I imagine they'd have no fights with their spouses for a good, long week after that.
Instead, I'm in Minnesota. Not California, the land of immigration where "foreign" communicable diseases drift in like pollen pods. Minnesota doesn't have as much TB. So, the doctors and nurses who don't work with many refugee/immigrant populations don't see many TB cases. I
know, we have refugees and immigrants here; we have a lot of them. But nothing compares to places like California and New York for immigration, and the nurses there have a whole different job cut out for them.
So, in Minnesota, I get major patient autonomy and I get to take my meds in peace. I get to schedule my own blood work at the end of my treatment when I please. Hell, I think they'd just forget about me if I never mentioned anything about ending. I really liked having ease, privacy and complete control over this decision.