Do you guarantee cure???

One of my patients asked “Do you guarantee cure?” And I wondered what do I say? Is there a guarantee that if you take the shortcut you will reach your home faster? Or once you move outside my clinic you won’t meet with an accident? or our neighboring nation wont attack us? The answer to all is “NO”.

Last week I answered the question, “How can “I” get TB? Today I answer the second question and talk about the dreadful form of resistant TB, MDR (multidrug resistant) and XDR (Extensively drug resistant) TB. Labeling a person as a TB patient makes some of them depressed, but if it doesn’t, labeling them MDR or XDR surely does! Well as I said earlier, TB is an infection and can be treated if doctor’s advice is followed. When a patient doesn’t respond adequately or totally fails to respond to the standard first line treatment (drugs used to treat patients having the disease for the first time), he/she is called to have something called as resistant TB. It is a more dreadful form of TB because the treatment is prolonged (and sometimes unsatisfactory); drugs are costly and have quite a few side-effects.

            So how do you get this dreadful form? How do you confirm its MDR? What’s so dreadful about it? How long does one take the medicines? Can it be treated completely? Can a person die due to it? And many more questions linger around the topic.

            As they say, man is the most dangerous animal and this dreadful disease is sometimes called man-made. What I mean to say is that one of the most common causes of getting this disease is improper treatment of TB, by the patient or the doctor. If you do not take your TB treatment medicines regularly or adequately, the TB bacteria may become resistant to the treatment you took making those medicines useless for you. Also, you may also spread the resistant TB bacteria to other people. A person can acquire such resistant TB bacteria and for no fault of his/her get this dreadful form of the disease from the beginning. The dreadful thing is that the treatment is longer, the drugs required to manage it are costlier and with quite a few side-effects. If untreated or poorly treated IT CAN KILL a patient, (usually slowly). The sad part is that even in the best of scenarios, not every patient can be cured. The choice of drugs, their dosages and frequency and duration of treatment varies from patient to patient and it is always good to take a specialist opinion. Follow your doctor’s advice, take a healthy diet and you have the best chance of cure.

Once I see such a patient I explain them the whole process of treatment, the expected cost and side-effects and chances of success and answer their 1001 questions that they usually have. But still in the end, nearly every patient asks, “Do you guarantee cure?”. I am still searching for an appropriate response to that question.