Sun treatment for tuberculosis. Sanatorium and resort treatment of patients with tuberculosis

Non-drug treatment methods occupy an important place in the treatment of tuberculosis, as more and more patients are developing forms of mycobacteria resistant to anti-tuberculosis drugs.

Non-medicinal methods of influencing the body include climatotherapy, including aerotherapy and heliotherapy (treatment with air and sun).

Climatotherapy includes everything beneficial effect on the human body natural factors a certain area with a particular climate.

However, when modern level knowledge, we can say with confidence that tuberculosis can be successfully treated in any climate, when patients have unlimited access to fresh, clean air. Therefore, the main component of climate therapy is aerotherapy.

Fresh air is the main healing factor for patients with lesions of the respiratory system of any nature. It has a pronounced tonic and hypnotic effect, increases appetite, activates the central nervous system and the body's natural resistance to infections.

In local sanatoriums, aerotherapy is carried out year-round. Its possibilities are especially wide in the summer, when patients may be in natural conditions during the day and on the so-called covered verandas at night, that is, the treatment with fresh air is not interrupted for a minute. The air of a coniferous forest is especially beneficial.

In addition to fresh air in special climatic zones, solar radiation and geographical factors.

The following types of climates are most useful for tuberculosis patients:

• mountainous (foothill climate is distinguished from 300 to 700 m above sea level,
• mid-mountain - from 700 to 1400 m above sea level,
• alpine - from 1400 to 1900 m above sea level (supermountain - above 1900 m - not indicated for patients),
• nautical,
• flat (ordinary and steppe).

The maritime climate acts on the body as a tonic and hardening factor. The peculiarities of the marine climate are rich insolation, constant humidity, as well as sharp daily temperature fluctuations.

Treatment by the sea is indicated for patients with various extrapulmonary localizations of tuberculosis, as well as for the majority of pulmonary patients with tuberculosis in the stage of reverse development.

The maritime climate is also indicated for children with tuberculosis infection, especially with frequent colds. But during primary tuberculosis infection, one should not forget about caution, since during this period immunity is not yet fully formed, therefore, during the first year after infection with tuberculosis, it is better to heal the child in local conditions.

The mountain climate is also characterized by rich insolation; it is characterized by pronounced ionization of the air, low (compared to the plain) atmospheric pressure, sharp daily temperature fluctuations and moderate winds, has a pronounced tonic effect on the body, has a beneficial effect on the nervous, circulatory and respiratory system, as well as on metabolic processes.

Mountainous areas have a good effect on patients with tuberculosis outside the acute stage, with moderate severe symptoms intoxication. Patients with an acute course of the tuberculosis process, especially with cardiovascular disorders, mountain climate is contraindicated.

The flat climate has a mild and even gentle effect on patients due to moderate insolation, relatively high atmospheric pressure, and mild ionization.

Treatment in these conditions, which are familiar to patients, does not contribute to obtaining tonic and hardening effects. As a rule, it is used for after-treatment of various forms pulmonary tuberculosis.

Heliotherapy(solar healing) is also one of the components of climatotherapy. The presence of direct or diffuse sunlight is a strong irritant for the body.

As a rule, heliotherapy is used to treat extrapulmonary localizations of tuberculosis (osseous-articular, lymph nodes, skin).

The therapeutic effect of this method is provided by ultraviolet rays of the solar spectrum. Due to its high intensity, heliotherapy should only be used by an experienced physician with strict control over the radiation dose. In case of active pulmonary tuberculosis, sunbathing is absolutely contraindicated.

When performing heliotherapy, certain techniques must be followed. There is a scheme that provides for irradiation of only the front surfaces of the legs for 10 minutes on the first day.

On the second day, the entire front surface of the legs is irradiated, but the irradiation of the legs is already 20 minutes, and the thighs - 10. On the third day, the entire front surface of the body is irradiated, while the irradiation of the legs is already 30 minutes, the thighs - 20, and the abdomen, chest and arms - 10.

The next 3 days, irradiation is carried out in the same sequence. back surface bodies. Then they very gradually move on to sunbathing for the whole body, monitoring the appearance of any complaints and negative sensations in the patient.

Children and adolescents are allowed sunbathing only in the morning at an air temperature of 20-25° C after adaptation to aerotherapy.

Heliotherapy helps increase the body's natural resistance to tuberculosis.

Can also be used hydrotherapy(hydrotherapy) how component climate therapy, or in local and even home conditions as a method of hardening and training the body, increasing resistance not only to tuberculosis, but also to other respiratory infections.

At home or in a local sanatorium, you can use douches and other water procedures, which are first performed at a water temperature of 30-35 ° C (warm), followed by a gradual decrease (down to the temperature of tap water).

After water procedures, the skin should be rubbed with a rough terry towel. Water treatments, carried out daily, have a tonic effect on the nervous system, improve well-being, sleep and appetite.

Sea bathing in climatic sanatoriums combines the healing effects of various natural factors - sea ​​water, solar radiation and sea winds.

Koumiss therapy is currently one of unconventional methods treatment of tuberculosis. Previously, treatment with kumis was widespread. Fresh air of the steppes, good nutrition and kumiss were in great demand among the sick.

The healing factors of kumis treatment should be recognized as fresh steppe air, which in itself is necessary for patients with tuberculosis, as well as alcohol and lactic acid, complete protein and vitamins of mare's milk.

In addition, taking 3 to 5 liters of kumis daily added 1,500 to 2,000 calories to the diet. On modern stage There is a tendency towards the revival of kumiss therapy.

The question of why you can’t sunbathe if you have pulmonary tuberculosis interests many people. Experts have different opinions. On the one hand, they argue that sunlight promotes the development of the infectious process.

On the other hand, it is known that in order to more effectively get rid of tuberculosis, patients are prescribed sanitary-resort treatment in a warm southern climate. Why is it believed that you can’t sunbathe if you have tuberculosis?

Tuberculosis is one of the oldest diseases of mankind. Its first researchers were famous ancient healers - Hippocrates and Avicenna, who lived in warm countries, the climate of which should be favorable to people's health. However, neither mild conditions, not adequate for those times health care could not prevent the spread of the disease.

Even outstanding researchers of subsequent centuries failed to determine the cause of the disease and methods of preventive hygiene. Only at the end of the 19th century was the causative agent of the disease identified, named after its discoverer - Koch's bacillus. The most favorable conditions for the development of bacteria are dampness, warmth and temperatures from 30 to 40°C. The bacterium has high viability. It is resistant to influence of factors external environment, tolerates heat, cold and exposure to chemicals without any harm.

Recent studies have revealed that Koch's bacillus quickly dies from ultraviolet radiation. It would seem that this is good news for those who like to lie on the beach. Unfortunately, for ultraviolet light to have a destructive effect on a bacterium, it must directly hit the pathogen within 3-5 minutes. The bacteria that live in the human body are completely safe.

Moreover, solar heat, being a biogenic stimulant, increases the activity of the inflammatory process in general and bacteria in particular. As a result of heating the body, a natural improvement in blood circulation occurs, which facilitates the spread of bacteria from the source of infection. So, is it possible to sunbathe with pulmonary tuberculosis and, if so, which categories of patients?

Process of influence sunlight and heat on Koch's stick forms the basis of contraindications for sunbathing for certain categories of people with tuberculosis.

You can't sunbathe in the sun:

• sick active form pulmonary tuberculosis or its progressive form;
• patients during an exacerbation or in the acute stage;
• people with tuberculosis who experience bleeding (including menstruation), exhaustion, malignant and benign tumors;
• people in whom pulmonary tuberculosis is combined with severe atherosclerosis, angina pectoris, circulatory failure of II-III degree, bronchial asthma with frequent and severe attacks, severe dysfunction of the nervous system, severe organic lesions central nervous system (syringomyelia, multiple sclerosis and etc.);
• patients with any blood diseases, lupus erythematosus, thyrotoxicosis and increased sensitivity to sunlight (hematoporphyria, etc.).
• patients taking medications, increasing the risk of getting sunburn(for example, fluoroquinolone antibiotics);
• people with an inactive form of tuberculosis who feel weakened, overwhelmed, and depressed;
• patients who have recently completed a course of treatment (they need to consult with their doctor about rest, recommendations and contraindications).

Among other things, you must remember that you should sunbathe in a dry climate (dampness is a favorable condition for the development of bacteria), constantly monitoring the time spent in the sun and the quality of the tan. Excess solar radiation (hyperinsolation) can lead to exacerbation of quiescent processes.

They have a positive effect and increase immunity in cases of extrapulmonary tuberculosis and inactive form of pulmonary tuberculosis. There is a method of treatment using sunlight - heliotherapy (suntherapy). Heliotherapy is prescribed to accelerate the resorption of infiltration, increase immunity, normalize the function of external respiration and the cardiovascular system.

What should you consider when relaxing on the beach?

Patients whose sun exposure has been approved by their physician should remember some aspects of sunbathing:

1. The climate for relaxation and sunbathing should be dry (a damp climate is one of the favorable conditions for the development of bacteria).
2. Sunbathing is necessary in diffuse shade and during the hours of least sun activity (9 - 11 am, 16 - 19 pm). The time spent in the sun should be increased gradually, starting from 10-15 minutes on the first day.
3. People suffering from pulmonary tuberculosis should avoid exposure and prolonged exposure to direct sunlight on the chest.
4. You need to pay enough attention to your physical and morale with a sharp change in climate, increased load and disruption of the regime. This is especially true for those who have a thin physique or are suffering from significant weight loss. Before going to the beach, it is recommended to get used to the climate.
5. You must use sunscreen.
6. Don't overheat in the sun.
7. Sunbathing is not allowed on an empty stomach or immediately after eating.
8. On hot days, it is better to lie on trestle beds or sun loungers.

The best results in treatment are achieved by patients who impeccably follow the doctor’s advice on personal hygiene, nutrition and improving immunity. This also applies to relaxing in the sun.

Judging by your diet, you don’t care about your immune system or your body at all. You are very susceptible to diseases of the lungs and other organs! It's time to love yourself and start improving. It is urgent to adjust your diet, to minimize fatty, starchy, sweet and alcoholic foods. Eat more vegetables and fruits, dairy products. Feed the body by taking vitamins, drink more water (precisely purified, mineral). Strengthen your body and reduce the amount of stress in your life.

Climatic resorts treatment of pulmonary tuberculosis

A significant network has been deployed in our country sanatorium institutions in different geographical and climatic conditions for treating patients of all ages with different localizations and clinical forms pulmonary and extrapulmonary tuberculosis.

The largest number of these institutions are local sanatoriums, located in almost all regions, territories and republics. These resorts are located in favorable conditions, often in forested areas, and are characterized by clean air, without sharp temperature fluctuations, protected from strong winds and excessive insolation. Climatic factors of forest, especially coniferous areas have a beneficial effect on the overall patient status, his autonomic nervous system, improve appetite and sleep. Local sanatoriums have their advantages in that they are indicated for most patients with pulmonary tuberculosis and do not require the body to adapt to other unusual climatic conditions and are not associated with long trips to resorts remote from the patient’s place of residence. Local sanatoriums operate throughout the year and are used for modern long-term treatment in various seasons of the year.

Naturally, for the middle zone, the Urals and Siberia, the most favorable for tuberculosis patients are the summer and winter months, when stable weather factors make it possible to better organize the use of climatic conditions in complex treatment patients with tuberculosis. All patients with fresh forms of pulmonary tuberculosis, without destruction and with destruction, when at the previous stage (in the hospital) complex antibacterial treatment symptoms of intoxication have been relieved, resorption has been achieved, and there has been a tendency to reduce the progression of the tuberculosis process.

For the majority of newly identified patients with pulmonary tuberculosis, regardless of the prevalence and phase of the process, staying in a sanatorium is the second stage in their treatment. However, in sanatoriums where the sanatorium-hygienic regime is well organized with extensive use of natural factors, round-the-clock stay on the verandas, balanced nutrition, physiotherapy, labor processes and qualified medical care, it is possible to refer patients with an active form of tuberculosis, bypassing the first stage of hospital treatment.

Treatment in local sanatoriums is indicated for patients with cavernous tuberculosis outside the acute phase in order to heal the cavity or prepare the patient for surgery (for a period of 4-6 months), as well as for patients with fibrous-cavernous pulmonary tuberculosis without progression for a long course of chemotherapy, prevention of exacerbation and how preoperative preparation(within 3-8 months). Prevention of relapse is also indicated for persons who were under the supervision of a dispensary for active tuberculosis and in whom, as a result of treatment, it was possible to achieve a clinical cure (i.e., transfer to the inactive group), but with the presence of pronounced residual tuberculous changes (during the first two years after completion of the main course of treatment). Persons with newly discovered inactive changes in the lungs (X-ray positive), who were not registered at the dispensary, should not be sent to sanatoriums. To prevent exacerbation, patients with pulmonary cirrhosis of tuberculous etiology can be sent to local sanatoriums in the absence of signs of pulmonary heart failure (II - III degrees), but for a limited period of time - 1% - 2 months. For exudative pleurisy of tuberculous etiology in the resorption phase and in the presence of residual changes after exudative pleurisy (if the disease is no more than one year old), a sanatorium course of treatment is carried out for 2-4 months. Patients after effective surgical interventions(resection and collapse surgery) during the first 2-3 years after surgery are also indicated for treatment in local sanatoriums in order to consolidate the results obtained and prevent relapses (for a period of 2-3 months).

With regard to extrapulmonary localizations, it should be noted that patients with tuberculous mesadenitis and peritonitis in the resorption and convalescent phase after tuberculous meningitis as a result of long-term treatment in hospitals can also be sent to local sanatoriums with an individual stay of 2-6 months.

Resort treatment is contraindicated: a) for acute forms of pulmonary tuberculosis (such as acute miliary tuberculosis, extensive infiltrative-pneumonic and hematogenously disseminated processes, caseous pneumonia and other forms prone to rapid progression and decay); b) when effusion pleurisy in the acute phase; c) with frequently recurring hemoptysis; d) in complicated forms of pulmonary tuberculosis with damage to bones and joints, genitourinary organs, skin, etc. Such patients are subject to treatment in tuberculosis hospitals.

Climatic seaside resorts of the southern coast of Crimea and the Caucasian coast of the Black Sea for the treatment of tuberculosis.

For these resorts, located in particularly favorable conditions for the treatment of patients tuberculosis conditions, the following general climatic features are characteristic: uniformity and small annual and daily temperature amplitude, relative low humidity on the southern coast of Crimea, warm winter and sunny autumn (warmer than spring), abundance sunny days even in the winter months, the presence of breezes, the presence of sea salts in the air. The beauty of nature is of great importance, which has a beneficial effect on patients.

The climatic conditions of mid-mountain regions (400-700 m above sea level) differ from the climatic stations of the coastal zone, i.e. the average temperature in winter is about 0°, the winter is humid, there is often fog, there is less wind, the summer is not hot and is well tolerated by tuberculosis patients.

The Caucasian coast of the Black Sea is characterized by lower annual and daily temperature fluctuations than on the southern coast of Crimea, an abundance of precipitation, higher humidity in the summer season, warmer winters, relatively low windiness throughout the year, and the rarity of cold winds breaking through. The northern part of the Caucasian coast (Kabardinka, Gelendzhik region, etc.) is approaching in its climatic conditions the southern coast of Crimea.

Features of climatic conditions in different coastal zones should be taken into account when selecting patients with various forms pulmonary tuberculosis when they are sent at the most favorable time of year for them. The widespread use of antibacterial drugs is very important for clarifying and expanding the indications for treatment at seaside resorts for patients with fibrous-cavernous and disseminated pulmonary tuberculosis with disintegration in the summer season.

The sanatoriums of the Southern Coast of Crimea are specialized for the treatment of children, adolescents and adults with various forms and localizations of tuberculosis.

There are sanatoriums for the treatment of patients with osteoarticular tuberculosis (in the Alupka area), sanatoriums for adolescents suffering from pulmonary forms, lymphadenitis (Pioneer sanatorium in Simeiz), sanatorium for children 7-14 years old (Moscow sanatorium in Simeiz). For patients with genitourinary tuberculosis, sanatoriums have been organized in Alupka and other places. The Dolossy sanatorium has a department for tuberculosis patients and diabetics. To provide for the sick surgical assistance special departments have been allocated in sanatoriums located in Simeiz, Yalta, etc.

IN last years attention is paid to organizing treatment in the sanatoriums of the southern coast of Crimea for patients with metatuberculous changes - tuberculous bronchitis, pneumosclerosis, bronchiectasis, as well as for patients with severe residual changes in the lungs after clinical cure according to place of residence (metatuberculous cirrhosis, large focal formations and etc.).

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Love asks:

Good afternoon, Vera Alexandrovna!
I would like to receive consultation (advice) on the timing and rules of referral to VTEC for tuberculosis.
First things first.
- I was diagnosed with tuberculosis relatively recently (since September 8 this year). Open form (in washings and sputum +++). The lesion is ~ 1/2 of the left lung. Now I am in a hospital at the National Hospital. and those phthisiology and pulmonology named after. Yanovsky.
- In the anamnesis - serious problems with kidneys (in the past disability) + xr. hepatitis + allergies to many antibacterial drugs. I have suffered several anathemas in the past. shocks.
- The course of treatment was selected (with difficulty and a reduced dosage). Now 3 drugs are prescribed: isoniazid, imbutol, levoflox. Everything is in/drip. I couldn’t take the pills, my liver was rebelling. But I’m not talking about treatment, which, I suspect, will not be very simple, given the characteristics of my health.
- My problem is that I’m not working at the moment. Or rather, I quit my previous job at the beginning of August (I’m 53 years old and I was looking for a job with a white salary). From 1.09 I had to go to new job. And here it is! So it turns out that I am not entitled to sick leave, and there is simply nothing to live on. Moreover, I was the only one “working” in our family. Of course, I have small savings, but treatment also requires certain funds. In general, there is a dilemma. On the one side - long-term treatment. On the other hand, it is impossible to get a job if there is an open form.. Can you advise what to do in such a situation?
With uv. Lyubov Anatolyevna

Answers Strizh Vera Alexandrovna:

Dear Lyubov Anatolyevna! Discuss this problem with your doctor and your local phthisiatrician. VTEK issues are dealt with by doctors in clinics and tuberculosis dispensaries at the place of residence on the basis of an extract from the medical history. For clarification, you can contact the VTEK of your clinic and social services at your place of residence. Solve disability issues now not with tuberculosis, but with kidney and liver diseases. Referrals to VTEC are usually given by medical consultation commissions after a certain period (4-5 months) of the patient’s stay on sick leave or a shorter period in case of permanent disability. You have just started treatment for tuberculosis, which may end full recovery. Order dated 04/07/2004 N 183 On the approval of the Instructions on the establishment of disability groups: “Another disability group 4.2.1. The presence of one leg and chronic respiratory failure stage II following pathological changes in another leg. 4.3. Third group of disability 4.3.1. The existence of one legend."

Anastasia asks:

Hello! I would like to tell my story - My parents never knew about problems related to lung disease, and my dad decided to take a fluorography because of a cough, my mother also took a picture for the company, he is doing well, although his cough is pronounced, because... He probably smokes a lot, but my mother was diagnosed with an outbreak. In the end, she took an extensive X-ray and the doctor said that she had tuberculoma on the right light solution up to 1 cm. How dangerous is this for life, is it curable and what are the consequences? We have two children in the family, the youngest is only 4 years old... this is very scary for us. We are very worried. Thanks in advance for your answer.

Answers Selyuk Maryana Nikolaevna:

Good afternoon, Anastasia! Tuberculoma is often a stable formation that can persist for many years. But sometimes tuberculomas (although this is more typical of large tuberculomas) soften, destruction forms and bronchogenic foci appear in various parts of the lungs. Your mother requires observation by a TB specialist. For now, you should just be attentive to your health and follow all preventive measures.

Answers Gordeev Nikolay Pavlovich:

Hello, Anastasia. Firstly, up to 1 cm this is not a tuberculoma, but a lesion. Secondly, it is immediately necessary to further examine the mother and find out whether it is tuberculosis (take up old radiographs, conduct a laboratory examination) and, if so, how active the process is. It is the active tuberculosis process that poses an epidemic danger. You all also need to be examined both x-ray and laboratory. It is unknown how long ago the outbreak formed. In the arsenal of phthisiatricians there are almost all ways to carry out both diagnosis and treatment. You just need to listen and follow all the TB specialists’ instructions. Good health to you.

Askar asks:

Hello. On next examination in honey The institution discovered multiple foci after suffering from a tuberculosis process, after which he took sputum tests. and other tests are all negative. Could it be that I suffered from tuberculosis on my legs, without the use of drug intervention. What are my actions after this? I did not take any medications in hospitals in this direction. Best regards, Askar.

Answers:

Hello! Yes, such cases are not uncommon. In individuals with a sufficient immune response, the symptoms of tuberculosis may appear inactive, resulting in the disease not being detected. It should be borne in mind that the symptoms of pulmonary tuberculosis are not strictly specific; the disease can occur under the guise of banal bronchitis, acute respiratory infections, and pneumonia. If, during the examination, no foci of active tuberculosis were detected, but only multiple calcifications, which was also confirmed by laboratory signs of the absence of active inflammation, you do not need to undergo special treatment. However, despite the past self-healing, unfortunately, Mycobacterium tuberculosis cannot be completely destroyed in the body, so in the future, under any conditions that contribute to a decrease in the immune response, the tuberculosis process may be activated. In connection with the above, you should be examined by a phthisiatrician at least 2 times a year, and fluorography of the lungs in the absence of signs of the disease at least once a year. Be healthy!

Sergey asks:

Hello, I have a sick brother who is in prison. I got infected about a year ago. After 10 days he is released, but with open form, with three holes and an ESR of 57, according to him, he bleeds every night, despite the fact that his weight is 45 kg. at the age of 24 years. I took the first series of medications to no avail, plus there was the issue of transportation from another region. Tell me how to behave with him, I’m afraid of offending him, is it possible to touch his clothes, hug him, because I have two children? And the main thing is where to start treatment.
Thank you in advance

Answers Gordeev Nikolay Pavlovich:

Hello, Sergey. I don’t recommend taking your brother to your children or to your home upon arrival. You need to solve organizational issues of transportation (preferably by car - van, like an ambulance), hygiene procedures at the hotel and immediately to the hospital. Before you go to get it, go to the TB dispensary at your place of residence and notify the local TB doctor who is in charge of your area. Then there should be no delay in hospitalization. And the treatment will continue in the hospital and only there. Good health to you.

Natalya asks:

Hello!
Eight years ago she suffered from closed infiltrative pulmonary tuberculosis. In December 2013, I went to Thailand for a week (lots of time in the sun), immediately upon returning home to a cold climate, I got sick (bronchitis, sinusitis), after which I still have a low-grade fever for the fifth month.
In mid-February, they took pictures at another tuberculosis clinic at my new place of residence, they said that I had post-tuberculosis changes, there were no new lesions, mantu and diaskin were 7mm each. A prophylactic course of rifampicin and isoniazid was prescribed for a month and a control scan in August.
At the same time they discovered erosive gastritis(after a trip and two courses of antibiotics for bronchitis). Due to the urgent need to treat the stomach, I decided to postpone the course of anti-tuberculosis therapy.
From the first days of May (i.e., two months after visiting the TB clinic), I started taking rifampicin and isoniazid tablets. At the moment I have been drinking for 10 days, the last 4 days I have been feeling constant dizziness, slight confusion, despite the fact that I take B6 three times a day.
I would really like to know the opinion of a specialist: could tuberculosis develop so sharply that low-grade fever began immediately after the trip and illness?
It is absolutely not clear what the diagnosis “post-tuberculosis changes” means; after suffering tuberculosis, I still have dense foci, does this mean that painful processes have begun to occur in them again?
How critical is it that I postponed the preventive course of treatment for two months, and what should I do after I felt the effect of the pills on the nervous system? I’m worried that if the disease is discovered, I will already develop resistance to the drugs.
Another unpleasant moment: I have neither registration nor residence permit. At the Moscow dispensary they accept me, but they insist that I register, they don’t give me medicine for free and they say that treatment in the hospital is only possible at the place of registration, in my case - in another city. What should I do if the situation develops badly? Is it worth insisting on treatment in a Moscow hospital (in terms of quality compared to the Krasnodar Territory)?

I would like to know the opinion of the site’s specialists on the current situation. I understand that I need to go to an appointment with a TB doctor, which is what I’m going to do, but the doctors at the dispensary are very stingy and reluctant to answer some questions, so I’m forced to look for help here.
I apologize for the lengthy question and overly detailed presentation. Thanks in advance.

Answers Veremeenko Ruslan Anatolievich:

The tuberculosis process begins to progress sharply after a holiday at sea, even in as soon as possible(sunbathing with tuberculosis is contraindicated). But in your case, considering that 8 years ago you had tuberculosis, you took an x-ray 2 months later (after rest) and the x-ray showed post-tuberculosis changes, i.e. “old” lesions or, as they are called, calcifications. They do not contain the tuberculosis bacillus and are not a source of relapse of the tuberculosis process. The main thing is that there are no fresh outbreaks. You were correctly prescribed a preventive course; what you postponed for 2 months is not critical. And you don't need to worry about stability. There are many anti-tuberculosis drugs side effects, B6 alone is not enough. Take Neurovitan or Neurorubin 1 tablet 3 times, Hepabene 1 drop 3 times. If the condition does not improve, take a break for 3 days (do not take rifampicin and isoniazid). Unfortunately, today's ministerial orders are such that the patient must receive medications at his place of registration. If in another city, treatment is at your own expense.

Simon asks:

Hello!!! I would like to ask the following question: is tuberculosis hereditary in nature if one of the parents had this disease in childhood, but then this disease did not bother him, thank God, that is, the fluorography images are normal. Can the disease recur in the parent? Or in him I already have immunity, what can I do to avoid getting sick? Thank you!!! Good luck in your business!!!

Answers Medical consultant of the website portal:

Hello! Tuberculosis is not caused by genetic inheritance received from parents. A child can become infected in utero if the mother had tuberculosis during pregnancy; or after birth. After suffering from tuberculosis, there is no sufficiently strong immunity left to prevent the recurrence of the disease, because Mycobacterium always remains in the human body, just in an insufficient quantity to activate the inflammatory process. In case of exposure to unfavorable factors (hypothermia, overwork, prolonged stress, previous trauma, surgery, acute infectious process, immunodeficiency states) fertile soil may arise for the growth and reproduction of mycobacteria, which leads to relapse of the disease. To avoid similar phenomena maintenance required healthy way life, abandonment bad habits, good nutrition and rest, Spa treatment, which helps prevent the recurrence of tuberculosis. Be healthy!

Yuri asks:

Hello!
I have a question about the length of incapacity for work due to tuberculosis. Namely. I completed a course of treatment for six months, and all that was left of the infiltration was a lesion. The attending physician said - we will prescribe her, despite the fact that antibacterial therapy had to be continued. The regional association "Phthisiology", which makes the final decision on this matter, was allowed to extend the sick leave for another two months. After their completion, x-rays showed subtle fibrosis. Am I eligible for an extension? sick leave? I’m interested in this because I didn’t stop working, but did everything at home (so as not to lose my skills and generally, so to speak, “not fall out of life”) and at the same time provided sick leave to management. And it’s very far for me to get to work - from a peripheral town to the regional center is two hours one way, plus it’s summer, it’s hot on the trains, etc.
Thanks for the answer.

Answers Gordeev Nikolay Pavlovich:

Hello, Yuri. Your case is twofold. On the one hand, you should be happy, because... This option for healing infiltrative tuberculosis is very rare nowadays and you are simply lucky. But from the point of view of the question you are asking, you have a reason to be sad, because... The doctors, based on the dynamics of the course of tuberculosis, have officially chosen the entire limit of the certificate of incapacity for work. And problems associated with traveling to work are usually not taken into account when deciding on permission to work. Good health to you.

Veronica asks:

For about five months I treated acute (then subacute, then chronic...) otitis media with varying success. A month after the course of treatment, all the symptoms of otitis began again. Today, thanks to the doctor’s intuition, I did fluorography... Diagnosis: disseminated pulmonary tuberculosis, small focal shadows are observed in the upper lobes on both sides. What can I expect from treatment? What should I do for diagnosis and prevention in my husband and 1.5 year old son?

Answers Strizh Vera Alexandrovna:

The prognosis of tuberculosis is determined by the duration of the disease (first discovered, chronic), the prevalence of inflammatory and destructive changes in the lungs, and the sensitivity of the office to anti-tuberculosis drugs. For my husband, an X-ray and sputum culture for tuberculosis bacilli (TBB), for my son, a Mantoux test and an X-ray. Give both of them chemoprophylaxis with isoniazid along with hepatoprotectors and vitamins for 3 months. The baby can be given an additional 20 days a month beneficial bacteria(bifido- and lactic acid)

Sergey asks:

After 4 months of treatment for tuberculosis, Koch bacillus was detected during sputum testing. Is it possible to infect other people? Before this, cultures were taken 2 times, the result was negative. Are these Koch sticks alive?

Answers Medical consultant of the website portal:

Hello, Sergey! About nothing re-infection there is no question. Bacilli found in sputum indicate the activation and progression of your existing tuberculosis. During previous examinations you were not a bacteria excretor, but now you are. The rods found in sputum are alive and pose a considerable danger to the people around you. An urgent review of treatment tactics and a change in treatment regimen are necessary. Be sure to contact your doctor with your test results. Take care of your health!

LYUBA asks:

Is it possible to go to the seaside if you have tuberculosis in the summer?

Answers Strizh Vera Alexandrovna:

Hello, LYUBA! IN modern conditions climatic treatment(a sanatorium, and not just a trip to the sea!!!) is used mainly in the rehabilitation of patients with tuberculosis, and also as a method to preserve the ability to work in those recovering and sick during the period of remission of a chronic process. In case of exacerbation of the disease and bacterial excretion, contacts of patients should be limited to the hospital at the place of residence. You can go to the sea in summer if you have mild and moderate severity. It is not allowed for milliary tuberculosis and open forms of pulmonary tuberculosis. The main purpose of a trip to the sea is not only climatic benefits (dosed sun, moon and air baths, sea bathing, health paths), but also a certain hygienic, dietary and work regime, psycho-emotional relief, breathing exercises, Fresh air 24 hours a day. Perfect fit juniper grove, in which the air is sterile, pine forest, seaside resorts of the southern coast of Crimea and the Caucasian coast of the Black Sea.

Alexandra asks:

My mother was diagnosed with tuberculosis (initial stage), sick leave was opened, how long will the sick leave last? After all, treatment lasts 6-12 months. She works as a janitor in a children's room. kindergarten, will this diagnosis become a barrier to further work?

Answers Strizh Vera Alexandrovna:

Answers Gordeev Nikolay Pavlovich:

Hello, Alexandra.
The duration of sick leave for tuberculosis is up to 4 months. Then the documents are submitted to MSEC (formerly VTEC) and the issue of either extending it for 2-3 months is decided. or about registration of 2nd disability group for 1 year. In any case, she will not work in kindergarten. A disability pension is given as compensation for the period of incapacity for work.
Thank you.

Lyudmila asks:

Hello!!! In September 2007, I was diagnosed with tuberculosis. I underwent a course of treatment with tubazit drugs, I don’t remember the names of the others. In August 2008, I was transferred to group 3 (taking medications in the spring and autumn and x-ray control 2 times a year. In January 2009, I became pregnant, I don’t know what to do. I’m afraid to leave the child in case it somehow affects him. Maybe it’s better not to risk it and have an abortion?

Answers Medical consultant of the website portal:

Hello! Yes, sensitivity to antibiotics must be determined during sputum culture. However, as a rule, treatment is prescribed immediately with first-line drugs, before receiving the study results, because The earlier treatment for tuberculosis is started, the higher its effectiveness, and the lower the risk of complications and progression of the disease. A large number of adverse reactions are due to the hepatotoxicity of anti-tuberculosis drugs, which necessitates the need to follow a gentle diet, stop smoking and drinking alcohol during the course of treatment, and the use of hepatoprotectors (Karsil, Hepabene) during the treatment period is also effective. The development of adverse reactions is not a generally predictable event, because it is necessary to have an individual predisposition to the development of these, which is due to the presence of dysfunctions of the relevant organs. Refusing treatment in your case is unreasonable and is fraught with adverse consequences. Be healthy!

Natalya asks:

Hello! Half a year ago, it turned out that we had an employee with an open form of tuberculosis (who refused to undergo treatment), our entire team was sent to undergo a tuberculosis examination. dispensary. They did a diaskintest, a manta test, took a picture, etc. The picture is good, other tests also seem to be normal, but the Diaskintest and the manta ray were positive. I was prescribed to take Fenazid tablets. But I refused, because... I developed a terrible allergy to Diaskintest (since I myself am very allergic) and therefore I was afraid to take these pills, given that the reviews from our employees were far from good. They told me to take a picture every six months for 2 years. I haven’t tried it yet, I’m afraid. How is this drug tolerated by people with an allergic reaction? And what is the likelihood of getting sick if you don’t take these pills?

Answers Gordeev Nikolay Pavlovich:

Hello, Natalia. All in your hands. Positive tuberculin tests mean that you are already infected (infected) with Mycobacterium tuberculosis. How quickly you get sick and whether you get sick at all depends on several factors: the state of your immunity (it is reduced because you are allergic), the massiveness of mycobacteria entering your body, the duration of contact, the virulence of the invading mycobacteria (their ability to cause disease). You, and even then very relatively, can only control the state of your immunity. All other factors are beyond your control. Phthisiatricians are trying to prescribe anti-tuberculosis drugs to slow down the proliferation of mycobacteria in your body and prevent the disease itself. You are actively resisting this. You know, you can’t help a person if he doesn’t want it himself. As long as it’s simple and cheap (prevention), it’s in your hands. When it becomes difficult and expensive (treatment), it will already be in the hands of the Lord. Here's your choice. Good health to you.