I had just arrived back on the boat after two weeks in the UK, when my doctor rang with the results from my recent X-ray. He said there was a well-defined nodule in my lungs that needed further investigation and that I should have a CT scan. It sent chills down my spine.
Just that morning we had provisioned for 30 days at sea and were about to check out of Panama, ready to sail 4,000 miles to French Polynesia. The timing couldn’t have been worse. Our plans thrown up in the air by one phone call.
The news shocked and scared me. While in the UK, I visited my family doctor for a check-up to ensure my lungs had cleared following a bronchial spasm, a cough and tender lungs, that had plagued me for the last four months. I was hoping for a clean bill of health.
Worried Sick Fergus, was a total star and took to the internet and phone. Within two hours, I was at a first-rate hospital in Panama City, being seen by the most helpful English-speaking staff, who organised the CT-scan immediately. Their quickness and efficiency was startling and by the next morning they had emailed me, not only the results, but also images of the scan. It was impressive.
The CT scan showed there was more than one nodule and while we clung on to the positive side of the radiographer’s report, which suggested I have a check-up in three months’ time, my doctor urged me to see a chest consultant to review the results properly.
I was gutted. I had been psyched-up to sail away and instead of checking the weather and sending final messages to our family before lifting the anchor, we were googling consultants, nodules and causes.
It was Friday afternoon and I was very lucky to find a pneumology specialist, who worked alongside the Panama Pacifica Salud Hospital I had been to, who could see me three days later. In another impressive show of speed and technology, he chatted to me prior to the appointment on instant messenger and asked me to email all information and test results, so he could be up-to-date prior to our meeting.
The wait across the weekend was unbearable. It didn’t take much to turn me into a complete blubbering mess. I was worried sick, frightened of what it might be and couldn’t sleep. Ferg was my rock; as were our two close friends, who were anchored next to us on their boat. We had hoped to sail out of Panama together.
Conversations were difficult as the consultant’s diagnosis could signal the end of our sailing adventure. Not knowing if we would still be heading to the South Pacific, we put our boat jobs on hold. Then, put a brave face on it and went for a day out to explore some of the lovely parts of Panama’s Old Town.
Putting a brave face on it in Panama’s Old Town
CT Scan Diagnosis On Monday evening, at a clinic with the most amazing views over Panama’s waterfront, I met with the consultant, who was very quick to put me at ease, while at the same time explaining the complexity of my issues.
From the CT scan, he determined I have latent tuberculosis (TB). At some stage, while travelling in Central America over the last 14 months, I sat next to someone with TB in their lungs who coughed or sneezed and sent TB bacteria into the air.
I had contracted a very small number of TB bacteria in my body, which my immune system and BCG immunization had fought off. I am not sick, nor a carrier, nor infectious.
I have four nodules in my lungs (and nodules are not uncommon to have in lungs), three of which are fully calcified, which means they are basically scar tissue and are keeping the TB locked ‘asleep’ in a cell.
There is, however, one nodule that is being a bit boisterous and has not fully calcified yet. This particular one, has been the root of my problems as it’s slightly attached to my pleura, which explained the deep pain that I first had in my chest four months ago, and why I am still coughing. It’s also slightly bigger than the others, at just over the size of a centimetre marble. The size is also a concern and that it could turn into a more serious issue.
While it’s showing every sign of doing what the other nodules have done, a CT scan in three months’ time will give a clearer answer. My history of being a non-smoker means I am very low risk for it being anything else. But…and there it is…the word, BUT.
The consultant ran me through the options; leave it, have another CT scan in a few months and probably a modicum of worry that the nodule might be growing. Have a biopsy now to ascertain if it is benign or malignant; or have a PET CT-scan, which is non-invasive and will give a clearer picture and hopefully alleviate any further worries.
With the medical costs mounting up, and the PET CT-scan, which we opted for, an eye-watering figure, we’re so grateful for the foresight of taking out international health insurance.
Views of Panama from the consultant’s office
Latent TB The consultant advised that as the latent TB was currently ‘sleeping’ then it was best practice to leave it be, as I am such a low risk and we’re still travelling. There is a course of antibiotics, but they are fierce and should be medically monitored; not much good for a nomadic traveller. I will need CT scans for the next two years to ensure the size of the nodules doesn’t increase. And I will revisit the need for medication to stop it ‘waking up’ when we eventually pause on our travels.
Further research shows that latent TB is prevalent in Latin America and I was staggered to learn from a World Health Organisation (WHO) report that one-quarter of the world’s population has latent TB.
It’s interesting to note, I saw three local doctors while in Central America to treat my cough and tender lungs, and questioned if it could it be TB? But was told no; primarily because I didn’t have a fever or night sweats. Now, with more understanding of latent TB, I hope this diagnosis may help others who may have suffered flu-like symptoms and are left with a persistent cough. A skin test or blood test will determine if a person has been infected with TB bacteria.
So this is where part one of my story ends. My initial health concerns have been addressed, but I have one more hurdle to jump in testing the larger of the nodules to see if it carries any strains of cancer.
The PET-CT scan will take place on Tuesday and the following evening I’ll see my consultant. Finger’s crossed by next weekend, weather permitting, we will be able to leave Panama and continue with our travels as planned.
Panama Skyline
*****
Written, from the heart, by Jenevora Swann
© Two Drifters Travel