Q: I am 29 years old. Two years back, I was detected to have Pott's (TB) spine after suffering for a long time, because the diagnosis was not correct. During this time considerable damage had been done to my 3 vertebrae viz. D11, D12, D13 and subsequently after diagnosis I was asked to take complete rest. I was completely bedridden for 6 months after which I started moving a bit. The recovery was fine. I continued the treatment for 10 months. During this period, my weight had grown to 65 kg from 50 kg. The vertebrae were completely healed as per the doctor and the MRI scans. After 10 months, I stopped combination drugs and started living normal life. Now I feel very tired. How can I be 100% sure that there is no remnant of the disease? What are the tests? I feel weak since I' have been lying for such a long time and without any activity. What care should I take and what kind of exercises should I do so that I don't face any problems? What are the long term effects of such a treatment and rest? I am a software engineer and have to go abroad, which I am required to do a test for TB.

A:Knowing your details and the exact treatment prescribed, your treating doctor is ideally placed to answer your queries satisfactorily. I can only make general points since I lack many vital details. Your doctor is right in stating that prolonged bed rest does lead to a host of problems, a sense of weakness being one of them. The considerable increase in weight may also contribute to a sense of lassitude. As you resume your routine and start gentle but progressive physical training, taking care not to strain your spine, this malaise should fade. There is no certain test to ensure that the last trace of disease had disappeared from your body. As your doctor has pointed out, evidence of healing of bones on x-ray films or scans and return of findings on examination of the blood are pointers to disappearance of disease. Almost all of us in India have, at some time or another, suffered from tuberculosis without knowing it. Our healthy immune status conquers the tuberculosis germs but scars may be left behind that may be seen on x-ray films of the lungs. This is well known internationally and causes no concern. Immigration authorities are worried only when they see evidence of active tuberculosis on the x-ray film of the lungs. The principle evidence that you suffered tuberculosis of the spine will be seen on x-ray films or CT/MR scans of the affected portion of the spine.