Nurse’s bout with MDR-TB changes her life
I am lucky to be alive’
Laura Hopkins, RN, wonders how her life might be different had the hospital where she worked followed federal guidelines for treating tuberculosis six years ago. As a new employee at the Syracuse, NY, facility, she assumed that the room where she was treating an active TB patient was under negative air pressure. It wasn’t. With only a surgical mask for protection, she was exposed to a TB strain resistant to eight drugs.
"I caught TB and about 90 people converted," she says. "After that incident the Occupational Safety and Health Administration came in and told them they were not following guidelines, and things were changed. But it was a little late for me."
And it would be later still before she was treated. When the hospital realized it had an outbreak, Hopkins was among the dozens of health care workers skin-tested. Her results were negative, however, and when she felt ill shortly afterward, she was diagnosed with the flu and later pneumonia. "They were supposed to come back because sometimes it takes longer for a reaction to build up. They never did, and so I literally walked around with active TB for about six months."
By the time Hopkins was finally diagnosed, her lungs were infiltrated with the deadly strain of TB. Not only had the patient she treated died, but so had the patient’s prison guard, who had been immunocompromised from recent chemotherapy. Fortunately, none of her children or her husband were infected.
The hospital treated Hopkins with an inadequate regimen for about six months, she says. After she reactivated, she sent her records to the National Jewish Center in Denver, and clinicians there recommended she visit. It took the removal of half her lung and three months of intensive treatment on seven drugs to stabilize her. All told, she was on anti-TB drugs for nearly three years and was unable to work for most of that time.
"I was very lucky to be alive," she says. "Fortunately, being a nurse, I knew something about multidrug-resistant TB and contacted National Jewish."
Hopkins is considered partially disabled, and has not regained the stamina she had before her infection. Nonetheless, she works as a nurse in pediatrics "I chose a safer area," she jokes and attends school. She lives with a 20% chance that her TB will return, she adds.
Not surprisingly, Hopkins is glad to see the OSHA TB standard. "Without strict guidelines and enforcement, hospitals and other facilities aren’t going to provide more efficient masks or negative-pressure rooms because it’s too expensive," she says. "My case was a workman’s compensation case, so they basically didn’t lose anything."
Hopkins says her ordeal resulted not only in the loss of her lung, but her faith in her employer. "I found I was very dispensable," she says. "They really couldn’t have cared less."