Tuesday, July 10, 2012

Talking TB

Normally, my posts are all about the heart.

Today finds me blogging about the lungs again. Specifically, tuberculosis.

Unless you're living under a rock, by now you've heard about the TB outbreak in Florida that officials worked to keep under wraps, because it was only affecting, as they so quaintly put it, "the underclass." And in a case of worst timing ever, the governor has just closed the state's only tuberculosis hospital.

You know your problem has hit the big-time when the macros start showing up on Facebook, like so:

Tuberculosis kills. It's not like a cold, only worse. You have to follow a strict drug regimen for several months, sometimes a year or more, and sometimes, the drugs aren't enough.

My family has direct personal experience with this.

In the early 1950s, in her first year of nursing school, my mom had a positive TB titer. She was subsequently shipped off to the Mecklenburg County sanatorium. She also spent time at McCain, and at Black Mountain (link goes to handbook). 

In all, she was institutionalized for almost two years. Christmases, Thanksgivings, birthdays, all spent away from family and friends. Think about being 18-19 years old--even back then, even for a farm kid (they grow up fast), it was hard, never having been away from home and suddenly being cut off from your loved ones. You're on bed rest while they spend the next year or more going on with their lives, without you. A lot of the inmates had postcards like these made up:

Ultimately, she had to have a lung resection--that's where go in through your back and cut out the diseased part of your lung. In the mid 1950s, it was still a new and revolutionary treatment, and it couldn't have come a moment too soon for her.

I sent the link above for the Black Mountain sanatorium handbook to my parents and brother and sister. My mom emailed me back:

"I remember a lot of the rules, such as rest time 1 to 3pm, no reading, writing, or doing crafts, I got caught a few times... The picture made in the store had a young girl in the back of the picture that was there when I was, she was about 10 and had been there probably a year. She was everyone's pet because she was so young and had been there a while." [picture below]

She talked to Dick Gordon of The Story in 2007 and shared her experiences with him. It's a view of our past that not a lot of people remember--the days when you could be ordered into a sanatorium, and arrested if you didn't comply. 

Reading the rules for the sanatorium at Black Mountain is like taking a trip back in time. Smoking wasn't banned (surprising, for an institution specifically for people with TB), but drinking was an immediate cause for disciplinary action, and my mom knew of several people who were kicked out for drinking.

I asked her what happened to them then, because if they were under orders to be in a sanatorium for treatment, they were breaking the law by being kicked out. She told me that  some people moved from one treatment facility to another until they ran out of options. 

TB deaths in the US in the latter part of the 20th century had declined, to the point where a lot of sanatoriums were either closed or converted to other uses, but now cases are on the rise again. 

And in my opinion, pushing the problem under the rug like Florida did is not helping.
Another friend, who works in the pharma industry, says that no one is developing new antibiotics, and my mom's drug treatment--Isoniazid--is still a front line TB drug, even though it's been over 50 years now. Drug-resistant TB strains are cropping up, and no one is researching new treatments. 

It's a complex issue, and those rarely have simple solutions. We need to encourage innovation and development of new drugs, we need to not hide disease outbreaks, we need to remember the past so that we're not doomed to repeat it.

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