Sputum Test submissions and outcome results

I have a question for everyone about taking sputum samples to the lab. I recently had three lab orders from my doctor to submit sputum samples as we're checking for MAC since I'm in watchful waiting mode. I produced what I thought was a good sample on one day and I refrigerated it. The next day, I got what I thought was another good sample so I took them both to the lab a couple of hours later. I did the third sample two days later and also took that to the lab a couple hours later. The same day samples were not refrigerated.

I got an email notification that my lab results were in a few days later which I thought was weird since testing for MAC takes a long time. But when I looked, it said that the test could not be done because the sample was not refrigerated. As mentioned, one was and one wasn't on the first trip because I produced the second one a few hours before my trip to the lab. I've submitted a sample in the past to another lab that was a same day sample and there was no problem with running the test which came back ultimately showing my MAC had returned after treatment was stopped. I don't know how I can get these samples to the new lab my insurance uses any faster than I did. It's located about 20 minutes away from my home. So now I'm going to have to start all over again to get new lab orders from my doctor and submit 3 new samples. How does everyone else work the timing of submitting samples?

@linda1334 What you have described I am sorry to say we have heard happen to others also. I believe there are factors of who knows what and who believes what as one possibility. It can be so frustrating due to our time factors in life and how we look forward to knowing the results.
I am in OKC and I send mine to Texas via Fed Ex and then sputum for testing, at different times, goes to NJH, Denver via my doctor in OK. That means that I may have refrigerated them for a few hours before sending them to Tyler or taking it to the lab in OK that is 30 minutes away. They have accepted all samples so far. When I took the one to the lab in OK I had a foldable ice back that I wrapped it in to hopefully avoid someone saying what you were told and also did it because I thought it would be best. As we know, I can't keep that Tyler sample cold while in the hands of FeEx!!!
I try to make my sputum samples in the morning, refrigerate them until I leave the house to get them to either the lab in OK or Fed Ex. When I take them to FeEx I make sure I take it to the main location who will be sending it out on the plane within an hour or so from the time I deposited it. So that means it gets to Tyler, via FeEx in approximatley two days from the day I sent it. Have no idea the journey and timing of the OK sputum samples full journey being it goes to the OK lab and then onto NJH, Denver.
Sounds like you need a good discussion with a lab manager, if that is possible.
You are lucky it is just 20 minutes away, but minutes add up. Time is precious.
Does your doctor have the ability to send your samples to NJH? However again, I believe it depends upon the person receiving it and their understandings. Don't know???
Barbara

@blm1007blm1007 Thanks for your reply, Barbara. Obviously different labs must have different requirements. As mentioned, I did the same thing with another sample I took to a different lab and it was fine. But I did submit one to this lab that was refrigerated so who knows? I think if this lab is that picky, I'm going to have to keep them all in the fridge before I leave and then put them in a small ice chest in transit until I bring them in so they can see that they were refrigerated. I'm actually wondering if the lab itself didn't refrigerate them where I dropped them off because I know they're sent out from there to do the actual analysis. I don't trust that the techs actually know what they're doing at the drop off location where they do blood tests, and take urine specimens, etc. But this is the lab my insurance chooses to use now so I'm stuck with it for a while. I may request to speak with the manager as you suggested as well.

@linda1334 Well, I had a similar experience, my clinic lab, after accepting refrigerated samples from 3 consecutive days for 7 years, suddenly insisted that samples had to be refrigerated immediately and submitted within 24 hours of being expectorated or the test would be "null." I knew that couldn't be right because my samples had been working fine for years, even when they had to ship them to NJH for colony counts and drug-sensitivity testing. It took a call to my pulmonologist - apparently they were using a "new protocol" and didn't bother to clear it with her department, so they had to rewrite the protocol and get it out to all 15+ of their lab locations.

So in addition to getting a new order, you might want the doc to write special directions on them for how to handle the specimens.

Keep in mind that many doctors' offices and clinics now out-source their lab work (or certain tests) to what one of my docs calls "factory" labs. They may not have the same rules as previously used. And they may not have specific rules for rare tests like our cultures.

@linda1334 . I can’t remember where I read this or heard it on a mac podcast… so I will stand corrected, but I remember hearing that mac is pretty tough and sputum samples can be out and about for a cross country trip to njh with out any problems.

Yes. I have had a series of doing 3 in a row of 3 weeks and some were positive and some were not. My ID doctor said they call it smooths when they’re different and it’s probably due to contaminated slides or testing equipment. She said ignore it.
I can’t say , considering my condition now a year later, that that was the prudent thing to do. I now have pseudomonas and various other bacteria which I have gotten completely different ways to deal with. I’m hoping to get into NJH so I can get some clarification and proper treatment

@crepass Yes, that was my understanding. And if they can make it okay to NJH cross country, my lab 20 minutes away should be able to handle mine. I'll be talking with them and my doctor on Monday.

@toni4501 I believe that what you have said and due to my own experience with the local pulmonologist in OKC and the lab used by the local pulmonologist causes me to believe, that in the big picture it would be best for all who are told they have BE, they should be sure the lab that the pulmonologist sends the sputum to is as good as the NJH or Tyler labs. I am not familiar with the Mayo lab in terms of it compared to NJH or Tyler.
Glad you are going to try and get into NJH. I should have gone sooner to NJH but I had put off making the appointment with NJH for approximately 1 year from the time the local PCP ordered the CScan to say 'You have BE." It was at NJH that I found out I was walking around with an infection in my lungs, MAI. Thankfully is was found to be at a low load and only one bacteria in me.
Barbara

@crepass
Same thing I was told by my doctor

@blm1007blm1007 I absolutely agree with you! When I first started this journey in 2017, I was told that my sputum cultures were gonna take at least six weeks because that’s how long it took to properly culture them and watch them grow. Now they send them to some lab downtown and they’re back the next day! What is that?! I believe my infectious disease doctor has gotten very sloppy and I do not appreciate her lackadaisical attitude. And then the opposition between her and the pulmonologists, it’s just ridiculous that we as patients are supposed to figure this out as to who knows what’s right? I personally have had enough and this is why I’m going to NJH.
Initially, my PCP was absolutely wonderful! He was on top of it every minute of the day. He had me do a culture at least every three months, a CT scan every three months come to see him every two months, he was on top of it. Since then I’ve had to really advocate for myself.
Thank you so much for reaching out! I wish you all the luck in the world and I’m so glad at NJH. Which campus are you going to?