Pakistan: Follow-up medical tests + Issues with IOM MHD

[51747]

I know this is an old thread, but hoping someone can help me out. I'm giving my whole situation below so bear with the long post.

I'm applying from Pakistan. Here we have an assigned IOM Medical Assessment Center (They call it IOM MHD) that does medical assessments for us. My wife, son and I gave our medical tests and x-rays on January 31st 2013. After the x-rays and the tests they told us to wait in the waiting area to tell us if our x-rays were fine or not. After about 10 minutes they told us that our tests were clear and we could leave.

IOM MHD called me on February 8th 2013 saying that my wife's x-ray wasn't clear so she had to come in again. When I inquired over the phone what the issue was they told me that they could not discuss it over the phone. Worried and distressed about the possibility of my pregnant wife having TB we rushed to the medical center. Over there we were told that the x-ray was not clear and we hence had to get follow-up sputum tests done; for which we would have to pay extra. When we insisted to talk to the radiologist and see the x-ray, we were taken to another room where (who I'm assuming to be) a doctor explained to us that there was a very small and minute scar on the lung which he was 99% wasn't TB or any other disease but had to file it because the Canadians had very specific guidelines on this matter. I sneaked a peek at the medical form while he was talking and under the section where it said something like "threat of TB" the doctor had ticked "No". I didn't question it at that point and took my distraught wife home. Should point out here that my wife is a hypochondriac and was extremely freaked out by this time.

My wife's sputum tests were scheduled for February 11, 12 and 13th at a separate facility hosting IOM's laboratory in a shady part of the city. When we got there (at about 8 am) the first thing I noticed was that the only patients waiting there were women. Not a single male. I left my wife in the waiting room because they only allowed patients inside the facility. I waited in my car. When my wife came back she explained how they asked her to cough hard to get the sputum. Despite the fact that she told them she was pregnant AND had had fetal hemorrhaging before, they kept on asking her to cough harder. The same happened for the next 2 days. At the end when she asked them when we'd get the results, they said it would take 6 weeks!

On February 19th, I emailed them asking them to inform the Candian Medical Officer about our results and my wife's delay, but they refused to do so. They said that "as following our protocal [sic] we donot [sic] act on behalf of our clients." I informed the CHC myself.

I waited till April 2nd to email them and ask them for an update on my wife's medical exams. They did not respond.

Today (April 23rd 2013) I received a call from IOM MHD stating that my wife had a follow-up x-ray on May 3rd! The guy said it was standard procedure to do a follow-up x-ray 90 days following the sputum tests. I asked him for the results of the sputum tests and he said they did not have them right now - that's 10 weeks after the tests! I also asked him why we were never told of these x-rays before and the person had no answer.

So my questions:
1. What does the follow-up x-ray mean? Did they find something in the tests and are not informing us?
2. Doesn't this all look fishy to you? Telling us at the initial tests that everything was fine and then calling us later to tell us that there was a problem. Still sending my wife for further testing despite the doctor thinking there is no threat for TB. Only female patients at the testing lab. Not informing us of the follow-up x-ray. Charging money each time. Not having the results of the sputum tests even though 10 weeks had passed since the tests.

I want to know if someone else has had an experience with IOM MHD and if they found something strange about them as well. I'm thinking of approaching the Country Director for IOM on this because there are definitely a lot of things in my scenario that raise doubts about the transparency (and efficiency) of their system.

 

[sunasir]

I know this is an old thread, but hoping someone can help me out. I'm giving my whole situation below so bear with the long post.

I'm applying from Pakistan. Here we have an assigned IOM Medical Assessment Center (They call it IOM MHD) that does medical assessments for us. My wife, son and I gave our medical tests and x-rays on January 31st 2013. After the x-rays and the tests they told us to wait in the waiting area to tell us if our x-rays were fine or not. After about 10 minutes they told us that our tests were clear and we could leave.

IOM MHD called me on February 8th 2013 saying that my wife's x-ray wasn't clear so she had to come in again. When I inquired over the phone what the issue was they told me that they could not discuss it over the phone. Worried and distressed about the possibility of my pregnant wife having TB we rushed to the medical center. Over there we were told that the x-ray was not clear and we hence had to get follow-up sputum tests done; for which we would have to pay extra. When we insisted to talk to the radiologist and see the x-ray, we were taken to another room where (who I'm assuming to be) a doctor explained to us that there was a very small and minute scar on the lung which he was 99% wasn't TB or any other disease but had to file it because the Canadians had very specific guidelines on this matter. I sneaked a peek at the medical form while he was talking and under the section where it said something like "threat of TB" the doctor had ticked "No". I didn't question it at that point and took my distraught wife home. Should point out here that my wife is a hypochondriac and was extremely freaked out by this time.

My wife's sputum tests were scheduled for February 11, 12 and 13th at a separate facility hosting IOM's laboratory in a shady part of the city. When we got there (at about 8 am) the first thing I noticed was that the only patients waiting there were women. Not a single male. I left my wife in the waiting room because they only allowed patients inside the facility. I waited in my car. When my wife came back she explained how they asked her to cough hard to get the sputum. Despite the fact that she told them she was pregnant AND had had fetal hemorrhaging before, they kept on asking her to cough harder. The same happened for the next 2 days. At the end when she asked them when we'd get the results, they said it would take 6 weeks!

On February 19th, I emailed them asking them to inform the Candian Medical Officer about our results and my wife's delay, but they refused to do so. They said that "as following our protocal [sic] we donot [sic] act on behalf of our clients." I informed the CHC myself.

I waited till April 2nd to email them and ask them for an update on my wife's medical exams. They did not respond.

Today (April 23rd 2013) I received a call from IOM MHD stating that my wife had a follow-up x-ray on May 3rd! The guy said it was standard procedure to do a follow-up x-ray 90 days following the sputum tests. I asked him for the results of the sputum tests and he said they did not have them right now - that's 10 weeks after the tests! I also asked him why we were never told of these x-rays before and the person had no answer.

So my questions:
1. What does the follow-up x-ray mean? Did they find something in the tests and are not informing us?
2. Doesn't this all look fishy to you? Telling us at the initial tests that everything was fine and then calling us later to tell us that there was a problem. Still sending my wife for further testing despite the doctor thinking there is no threat for TB. Only female patients at the testing lab. Not informing us of the follow-up x-ray. Charging money each time. Not having the results of the sputum tests even though 10 weeks had passed since the tests.

I want to know if someone else has had an experience with IOM MHD and if they found something strange about them as well. I'm thinking of approaching the Country Director for IOM on this because there are definitely a lot of things in my scenario that raise doubts about the transparency (and efficiency) of their system.

Dont worry dear ,everything was according to protocol of any suspicious finding of x-ray.Sputum for AFB or culture is taken in the same way as your's spouse did .It seem's fine sofar soforth .I could guess that you AFB and cultured proved Negative (Normal) that's why they asked for last protocol of the followup x-ray after 90 days .If it would be negative then you medical would become OK straight away,So relax and think positive .Good Luck

 

[Avadava]

The only thing that worries me about all this is that your pregnant wife did X-rays. Did the doctors know your wife was pregnant? Under no circumstances X-Rays are performed on pregnant women, since the radiation can severely affect the fetus. Unless the woman insists and all the dangers and complications were explained beforehand.

Either way, what you wrote here is all according to protocol. They ask for a second X-ray so they can compare the two. Usually in patients with active PTB the X-Ray will change as the illness progresses. So the standard protocol for any suspicion of TB is sputum culture and 2 chest X-Rays at least 3 months apart . This is also the protocol for anybody that has a TB history.