A Letter From Dr Robert D Sax To His Patients
After having had the privilege of providing eye care to my patients for almost 40 years, I have decided to retire. As you can imagine, it is a big decision and a big change, but it will allow me to spend more time with my family.
During my years at Ophthalmic Consultants, I served as both a partner to the Practice and director of Retina services. As I looked to the future, I gave great thought about my current patients and to future patients and the need for ongoing high quality eye care. I also considered the future of Ophthalmic Consultants and the wonderful people who work there today and those who will find opportunity there in the future.
To prepare for my retirement, I joined with our management team to assure we have an experienced, compassionate, and talented team of doctors many of whom you already know. So, it is with foresight and thoughtfulness that I entrust your general eye care to:
Each of these doctors has my stamp of approval and will provide the quality of care you are used to and deserve. When it is time for your next retina eye appointment, depending on our individual needs, our office will work with you to schedule with one of these very capable physicians. You can learn more about each doctor by clicking on their names within this letter or find detailed information about all our doctors in the About Us section of our website.
Robert D. Sax, M.D., Ph.D.
Albany 438-5273 Clifton Park 383-8589 Schodack 477-2391
The Hearts Electrical System
The heart has an electrical system that determines how fast your heart beats. A danger exists because your heart can function fine even when there is a malfunction in the electrical system.
Your heart is a group of cells through which the electrical system sends signals. This allows the upper or atria, chambers, and lower ventricles, chambers of the heart to contract. The process follows specific steps: An electrical impulse is sent, the upper chambers contract, electrical signals are sent to the ventricles, the lower chambers contract or pump, a signal is sent to the atria, and the process repeats.
Sensitivities To Light And Sound
One of the pioneers in Lyme disease research is Joseph J. Burrascano Jr., MD. In the early days of the disease, he came up with a checklist that doctors could use to diagnose itand it includes all of the above signs, as well as other previously observed symptoms like sensitivities to light and sound, muscle weakness, erectile dysfunction, and dental pain.
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Systematic Approach For Lyme Carditis
To help healthcare providers consider Lyme carditis as a potential cause for heart block, our research team developed the Suspicious Index in Lyme Carditis score.
It allots points for specific risk factors. The resulting score classifies patients into low, intermediate, and high-risk categories for the likelihood that the heart block is due to Lyme carditis. The variables in the SILC score can be associated with the mnemonic CO-STAR: Constitutional symptoms, Outdoor activity/endemic area, Sex , Tick bite, Age , and Rash.
Table 1. The Suspicious Index in Lyme Carditis score evaluates the likelihood that a patients high-degree heart block is caused by Lyme carditis. The total score indicates low , intermediate , or high suspicion of Lyme carditis.
* fever, malaise, arthralgia, and dyspnea
Patients with high-degree heart block and a SILC score of three or higher should be investigated immediately for Lyme disease. They should also receive antibiotic treatment while awaiting the results of testing.
Some Chronic Lyme Disease Symptoms
As mentioned, chronic Lyme disease consists of a broad cluster of physical, cognitive, and psychiatric symptoms. Some of these symptoms are much more common, while others almost never occur, but can be deadly. But even the less severe symptoms, such as chronic fatigue and pain, can lead to drastic changes in quality of life for chronic Lyme patients.
Chronic Lyme survivors have reported experiencing the following symptoms for months to years after infection:
- Intermittent fevers, chills, and sweats
- Chronic inflammation
Chronic Lyme disease can be linked to deadly symptoms, such as Lyme carditis .
According to Lymedisease.org, studies consistently show that chronic Lyme disease patients have poorer quality of life than those with other chronic diseases. One of their own studies showed that 75% of surveyed patients reported at least one symptom as severe or very severe.
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Digestive Symptoms Related To Mast Cell Activation Syndrome
Bacterial overgrowth in the small intestine, in conjunction with the inflammation caused by leaky gut, primes the immune system that surrounds the digestive tract. Mast cells are part of the immune system and tend to be located where the outside world interfaces with the inside of the body. The skin, lungs and gastrointestinal tract are examples of these locations.
When mast cells are triggered by a variety of stimuli, they release histamine and other chemical mediators. In MCAS, mast cells are more prone to releasing their contents leading to a myriad of symptoms. The most common digestive symptoms experienced in MCAS are nausea and heartburn, but abdominal pain, diarrhea, and constipation also be present. MCAS also contributes to systemic symptoms and digestive dysfunction needs to be addressed if it is contributing to MCAS.
Early Symptoms Of Lyme Disease
The most common feature of localized Lyme disease is a slowly expanding skin lesion or rash known as erythema migrans . This rash usually develops 3 to 30 days after the disease-transmitting tick bite.
Erythema migrans is the earliest sign of the disease in about 70 percent of Lyme disease cases reported to the Centers for Disease Control and Prevention .
There are certain characteristics that can help identify erythema migrans:
- It begins as a flat or slightly raised red spot at the site of the tick bite and can expand to become a round rash up to 73 centimeters across.
- It can appear on any area of the body but most frequently shows up on the lower limbs, buttocks, and groin in adults, and on the head and neck in children.
- A clear ring may appear around the center of the rash, giving it a bull’s-eye-like appearance .
- It may be warm to the touch, though rarely painful or itchy.
While the classic Lyme disease rash has a bull’s-eye shape, not all cases of erythema migrans look the same. The patient may develop a red, expanding lesion with a crusting of the skin at the center multiple red lesions red, oval-shaped plaques or a bluish rash, according to the CDC.
In addition to erythema migrans, people with localized Lyme disease may experience flu-like symptoms, including fever and chills, headache, fatigue, muscle and joint pains, a general ill feeling , and swollen lymph glands.
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Lyme Carditis: A Cant Miss Diagnosis
ABSTRACT: Lyme disease, caused by the tick-borne spirochete bacterium Borrelia spp., is becoming increasingly prevalent in Canada. Lyme carditis is a rare but important early disseminated manifestation of the disease, which can present with high-degree atrioventricular block in otherwise healthy young adults. Timely treatment of Lyme carditis with appropriate antibiotics can lead to complete resolution. However, patients with Lyme carditis often have missed or late diagnoses, which can result in unnecessary pacemaker implantations, complications, and even fatalities. Considering Lyme carditis in the differential diagnosis of young patients presenting with new atrioventricular blocks is critical to ensuring timely diagnosis and treatment.
Clinicians should consider a diagnosis of Lyme carditis, an early manifestation of Lyme disease, if nonspecific cardiac symptoms have been preceded by flu-like symptoms and erythema migrans, especially if the patient is young, has no history of cardiac disease, and has recently traveled to an endemic area for Lyme disease.
My Lyme Disease Story Starts Two Years Ago
At 27 I was fully devoted to my career and would blow off steam from a long days work at a kickboxing class 2-3 times a week. It felt good to release negative energy after a stressful day. But in April 2015, I started missing regular workouts because I just couldnt shake the flu. I had a scratchy throat, mild fever, swollen lymph nodes, muscle aches as well as sudden bouts of vertigo. This would come and go for a few days at a time but I would never actually get sick.
As the months dragged on my health did not improve and my energy was dropping. I couldnt stay late at work when my job demanded it and would limit social engagements. I felt like my body was telling me, Youre not getting enough XYZ!!. If only I could figure out what XYZ was surely Id feel better. My new family doctor, a female, thought I was being dramatic and ordered some routine blood tests and a physical exam to quell my fears. It turned out I was deficient in Vitamin D, a common ailment in our cold Canadian climate. I started taking a supplement and carried protein bars since I was also borderline hypoglycemic. Years later I would find out that reactive hypoglycemia is common in Lyme-MSIDS patients .
My bloodwork had come back with a positive Mono-spot test.
It had taken nearly two years to receive a proper diagnosis for the many symptoms that ailed me
Chelseas Symptom Breakdown:
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Advanced Lyme Disease Options
Hyperthermia utilizes your bodys temperature to fight infection. When you have fevers, that is when your body goes to work fighting off bacteria that can make you ill. Uncontrolled fevers can be risky if the temperature rises too high. However, controlled hyperthermia is medically supervised to help your body reach a high temperature slowly and boost your immune system.
Chelation is a detoxifying process that removes toxins from the body.
Oxygen therapies use extra oxygen as a medical process to treat over 100 diseases, including Lyme disease.
Apheresis can be used to replace your infected blood and plasma with clean, healthy, and usually donated blood and plasma.
Nutraceuticals are products created from foods and herbs that offer antioxidants, vitamins, and minerals that can help boost your immune system so you can fight off infections.
Biofilm eradication protocols, parasite inactivation, and immune modulation are additional treatments. You may even opt for IV therapies in which your doctor can give your immune system great strength by sending Vitamin C, Silver, and other antioxidant properties straight into your bloodstream.
The apheresis process is based on a simple theory: remove the bad, replace the bad with the good.
When treating neurologic Lyme disease, this means removing your infected blood and replacing it with donated, healthy blood that is free of infection.
Believe it or not, these processes can happen in just a few hours at your Lyme doctors office.
How Is Lyme Disease Diagnosed
Your doctor can make a preliminary diagnosis of Lyme disease based on your symptoms and history of exposure to blacklegged ticks.
It’s very likely that you have Lyme disease if you:
- Live in an area where blacklegged ticks are common
- Have a bull’s-eye-shaped erythema migrans rash
- Have other common Lyme disease symptoms, in addition to a rash
Your doctor may confirm your diagnosis with laboratory blood tests or may conduct these tests if you don’t meet all the above criteria. But these tests are often not done right away or else they are less reliable and may result in a false-negative. If a patient’s symptoms and history suggest that Lyme disease is likely, the doctor will probably begin treatment without waiting for a blood test.
The CDC recommends a two-step process for testing blood for the antibodies against Lyme disease: the enzyme immunoassay or indirect immunofluorescence assay , followed by an immunoblot test if the first test is positive.
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Diagnosing And Treating Lyme Carditis
The initial symptoms of Lyme disease can be mistaken for other common infections or allergic reactions. Delayed diagnosis and delayed initiation of proper treatment can lead to serious Lyme disease presentations including Lyme carditis in all its forms.
We need ongoing education at all levels to close the gap in knowledge and ensure all participants in the health-care system aware of this preventable condition.
The good news is that prompt diagnosis and appropriate antibiotic therapy leads to a much better prognosis. Lyme carditis responds very effectively to treatment, completely eliminating the cardiac manifestations, with a very favourable prognosis in both short- and long-term followup. We now know that when antibiotics are used according to guidelines, the prognosis two years after the infection reveals no residual disease in the heart.
It is important to remember that most heart conduction abnormalities caused by Lyme carditis resolve with appropriate antibiotic therapy without requiring the implantation of permanent pacemakers. As most patients presenting with Lyme carditis are young and otherwise healthy, any medical strategy that could prevent the need to implant a pacemaker for the rest of their lives is welcomed.
Lyme Disease And Heart Health: What To Know
Lyme disease occurs when an infected deer tick transmits the Borrelia burgdorferi bacteria into your bloodstream. The infection travels through your bloodstream to all parts of your body, including the heart.
When Lyme infection enters the tissues and lining of the heart, it is called Lyme Carditis, which occurs in one to five percent of persons diagnosed with Lyme disease.
That number is likely much higher because Lyme is commonly misdiagnosed by general practitioners. Lyme disease symptoms mimic those of other disorders, including medical and psychological conditions. Also, the only two Lyme disease tests used by doctors are less than 50% accurate. The ELISA and the Western Block tests, even when used together, only test for the active antibodies of Lyme bacteria.
The problem? Lyme bacteria are intelligent and can quickly go inactive and hide in the lining of your blood cells. They also create biofilms that serve as an armor of protection around the bacteria.
For these reasons, Lyme disease symptoms progress and can eventually affect the heart.
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Is Lyme Carditis Curable
Lyme-related heart disease is usually diagnosed with a blood test which tests for antibodies of Lyme disease and an electrocardiogram to identify AV block. Once diagnosed, the condition can usually be treated with oral or intravenous antibiotics. While some patients may need a temporary pacemaker, according to the CDC, patients generally recover within 1-6 weeks with the correct treatment .
What Are The Signs & Symptoms Of Lyme Disease
Lyme disease can affect different body systems, such as the nervous system, joints, skin, and heart. The symptoms of Lyme disease are often described as happening in three stages. Not everyone with Lyme has all of these, though:
The rash sometimes has a “bull’s-eye” appearance, with a central red spot surrounded by clear skin that is ringed by an expanding red rash. It also can appear as an growing ring of solid redness. It’s usually flat and painless, but sometimes can be warm to the touch, itchy, scaly, burning, or prickling. The rash may look and feel very different from one person to the next. It can be harder to see on people with darker skin tones, where it can look like a bruise. It gets bigger for a few days to weeks, then goes away on its own. A person also may have flu-like symptoms such as fever, tiredness, headache, and muscle aches.
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How Common Are Lyme Disease And Lyme Carditis
Lyme disease is the most commonly reported vector-borne disease in North America, with an annual incidence of approximately 25, 000 confirmed cases in the United States. However, estimates suggest that the true incidence is closer to 300, 000 cases annually. Lyme disease affects the heart in 0.3-10% of cases.
Treatment For Lyme Carditis
Antibiotic treatment for three weeks or longer is usually what doctors will prescribe for Lyme carditis. One of the best things you can do for your heart is work with a Lyme literate doctor, a specialist in Lyme disease.
Lyme literate doctors know to ask patients about cardiac symptoms. They follow antibiotics with the most advanced treatments available. And they have the equipment to complete the treatment in their office.
Depending on the severity of the symptoms, a temporary pacemaker may be needed to regulate heartbeats. Lyme literate doctors may also provide treatments like therapeutic apheresis, intravenous infusions, anti-parasitic, anti-microbial, and anti-viral protocols are also beneficial in treating Lyme-related heart disorders.
Lyme carditis is very treatable once accurately diagnosed. If you think you may have symptoms of Lyme carditis or Lyme disease, dont wait to seek help. Days and weeks count when treating any stage of Lyme disease. Reach out to a Lyme literate doctor today to share your symptoms and develop a plan of action.
If you do not have Lyme disease, take the following prevention steps to avoid getting it and risk your heart health.
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