Tuesday, May 24, 2022

Do Infectious Disease Doctors Treat Lyme

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What Increases Your Risk

How Do Doctors Treat Lyme Disease?

The main risk factor for Lyme disease is exposure to ticks that are infected with Lyme disease bacteria. In areas where Lyme disease is widespread, such as the eastern and south-central areas of Canada, southern British Columbia, and northeastern United States, several factors may increase your risk, including:

  • Spending time outdoors during the warm months of the year when ticks are most active. This is usually between May and November, with peak activity in June and July.
  • Having indoor/outdoor pets. They can bring infected ticks into the house. Although dogs and cats can become infected with the Lyme disease bacteria, they cannot pass the illness to humans. But the infected ticks can drop off the animal and then bite and infect a person.
  • Having a stone fence or a bird feeder near your house. Stone fences often become homes for mice, and mice may feed on spilled seed from a bird feeder. Where there are mice, there are ticks.

Remove ticks right away, as soon as you notice them. Your risk for getting Lyme disease increases the longer a tick is attached to your body. Ticks generally cannot transmit Lyme disease until they are attached for at least 36 hours.

Call Ahead And Ask Questions

Even if you find a doctor who specializes in treating tick-borne diseases, you will want to ask some questions before making an appointment and committing your time and money. A few basic questions to consider asking upfront include the following:

  • What is your experience in treating patients with tick-borne diseases?
  • How do you diagnose diseases? Do you use any specific labs or lab tests to confirm diagnosis?
  • Do you test for coinfections?
  • Do you use traditional antibiotics and/or herbals?
  • Do you have any patient success stories you can share?
  • Do you strictly adhere to CDC test interpretation criteria or are you open to alternative criteria?

If youd like to find a LLMD and want to know more about how to vet them, read the Tick Talk blog, What Makes a Doctor Lyme Literate?

Treatment Starts With Accurate Diagnosis

The only way to get the proper treatment for your tick-borne disease is to get the right diagnosis in the first place and one of the best ways to do that is, if possible, to see a physician whos experienced with tick-borne diseases. Accurate diagnosis also requires high quality testing at a reputable lab. Learn more about why doctors and patients trust the tests offered by IGeneX.

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In General Tick Borne Disease Or Lyme Disease Should Be Treated With Antibiotics Usually These Antibiotics Should Be Pharmaceuticals Although Augmentation With Botanical Antibiotics Can Be Even More Effective Than Pharmaceutical Therapies Alone

Unfortunately in late Lyme, antibiotics alone are often not sufficient. Some patients are genetically or epigenetically predisposed to chronic Lyme disease. Often the underlying conditions must be addressed along with the infection.

Borrelia burgdorferi has been called the second great pretender, after syphilis. Like syphilis it is a spirochete , and the spirochete goes to the brain and spinal cord as fast as it can get there. In addition like syphilis it grows very slowly. Unlike syphilis it is relatively smart in the bacterial world, having the largest genome of any other bacteria. Borrelia burgdorferi is able to crawl inside of cells, thus avoiding immune detection, hide in the brain and spinal cord, where our immune system is careful not to cause too much inflammation. More recent data suggests it may, like many of its co infecting microbes be able to fool the immune system and manipulate the immune response so that the immune system thinks that there is not an infection. In 3 animal models dog, mouse and monkey, chronic persistent infectious borrelia infection has been proven after short course antibiotic. This provides evidence that the cure of chronic Lyme disease in many patients will take more than 1-3 months of antibiotics.

Stage : Early Disseminated Lyme Disease

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Early disseminated Lyme disease occurs several weeks to months after the tick bite.

Youll have a general feeling of being unwell, and a rash may appear in areas other than the tick bite.

This stage of the disease is primarily characterized by evidence of systemic infection, which means infection has spread throughout the body, including to other organs.

Symptoms can include:

  • disturbances in heart rhythm, which can be caused by Lyme carditis
  • neurologic conditions, such as numbness, tingling, facial and cranial nerve palsies, and meningitis

The symptoms of stages 1 and 2 can overlap.

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When You May Need To See A Specialist

Though a family physician or general practitioner should be able to order the diagnostic tests for Lyme disease, there are some situations in which you may need to see a specialist. For example, untreated or misdiagnosed Lyme can develop into chronic Lyme disease, which can then lead to complications such as arthritic or neurological symptoms. In these cases, patients may need to see the following types of specialists:

  • Rheumatologist Chronic joint problems from Lyme disease may need the care of a physician who specializes in rheumatology.
  • Neurologist Chronic Lyme can be associated with debilitating neurological symptoms that must be treated by a specialist.
  • Infectious disease specialist Again, even though this isnt always necessary, it can be helpful if your symptoms dont go away or become more complex.
  • Cardiologist In the event that you develop the rare but dangerous complication known as Lyme carditis, you may need to see a cardiologist and even be fitted with a temporary pacemaker.

However, its important to remember that seeing a specialist for symptoms related to Lyme disease without treating Lyme disease is costly and dangerous. In other words, a rheumatologist or neurologist will not be able to treat your Lyme if no diagnosis has been made. They can simply help treat symptoms that result from chronic or untreated Lyme.

To treat Lyme disease, you must get an accurate diagnosis and be prescribed antibiotics.

Why Lyme Disease Can Be So Hard To Diagnose And Treat

QUESTION: After feeling really miserable for many months, my doctor finally concluded I had Lyme disease. He put me on antibiotics for a month and my symptoms went away. But now that Ive stopped taking the antibiotics, Im feeling horrible again. Is this typical for Lyme disease?

ANSWER: Lyme disease can be difficult to treat especially when it is not identified right away.

It is caused by a bacterium called Borrelia burgdorferi, which is spread through the bites of tiny blood-sucking ticks that hide out in grassy meadows and wooded areas. The ticks originally pick up the bacteria from infected mice and deer.

Before the 1980s, Lyme disease was unknown in Canada and very few physicians have actually seen a case first-hand, says Dr. Gregory Taylor, Canadas Chief Public Health Officer.

The early symptoms are flu-like and can include fatigue, fever, chills, headaches and muscle pain. That could be virtually anything, says Dr. Taylor.

Some patients will get a distinctive bulls-eye rash around the site of the bite, but others do not.

The rather vague and varied symptoms add to the difficulty of making an accurate diagnosis. To make matters worse, the laboratory tests that check for the bodys production of antibodies to the infection can be difficult to interpret.

They are losing their jobs, their homes, their life savings everything, says Mr. Wilson, who was sick for three years before a doctor identified his symptoms as Lyme disease.

Also Check: How To Know If I Have Lyme Disease

Should You Use Antibiotics

Different antibiotics may be used to treat children and adults. The decision to take medicines for Lyme disease may be based on one or more of these factors:

  • You have symptoms of Lyme disease, especially the red, circular rash, and a history of exposure to ticks in geographic regions where Lyme disease is known to occur.
  • Blood tests show that you have antibodies to the Lyme disease bacteria in your blood, spinal fluid, or joint fluid.
  • You are pregnant or breastfeeding and are bitten by a tick.

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Stage : Early Localized Disease

Symptoms of Lyme disease usually start 1 to 2 weeks after the tick bite. One of the earliest signs of the disease is a bulls-eye rash.

The rash occurs at the site of the tick bite, usually, but not always, as a central red spot surrounded by a clear spot with an area of redness at the edge. It may be warm to the touch, but it isnt painful and doesnt itch. This rash will gradually fade in most people.

The formal name for this rash is erythema migrans. Erythema migrans is said to be characteristic of Lyme disease. However, many people dont have this symptom.

Some people have a rash thats solid red, while people with dark complexions may have a rash that resembles a bruise.

The rash can occur with or without systemic viral or flu-like symptoms.

Other symptoms commonly seen in this stage of Lyme disease include:

When Should Someone Seek Medical Care For Lyme Disease

Seek immediate medical attention if you live in or have visited an area where Lyme disease is common and you experience a flu-like illness or develop a red or target-like rash anytime from late spring to early fall. Prompt treatment at this early stage reduces the risk of further symptoms of Lyme disease.

  • Remove any attached ticks by pulling them off your body. The CDC recommends the following tick-removal process:
  • Grasp the tick with fine-tipped tweezers as close to the skin’s surface as possible.
  • Pull upward with steady, even pressure. Don’t twist or jerk the tick or mouth-parts may break off and remain in the skin. If this happens, remove the mouth-parts with tweezers. If you are cannot remove the mouth easily with tweezers, leave it alone and let the skin heal.
  • After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water.
  • If the tick is still alive, dispose of it by submersing it in alcohol, placing it in a sealed bag/container, wrapping it tightly in tape, or flushing it down the toilet. Never crush a tick with your fingers.
  • However, removing ticks promptly is more important than how you remove them. If you cannot remove an attached tick, see a doctor, who will remove it.
  • Following tick removal, see a doctor if any flu-like symptoms or rash develop within the next three weeks. If a rash develops, draw a line around it with ink that does not wash off each day to see if it is growing.
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    What Are Signs And Symptoms Of Lyme Disease

    Early signs and symptoms of Lyme disease occur from three to 30 days after a tick bite and include the following:

    The initial infection can occur with minimal or no signs or symptoms. But many people experience a flu-like primary illness or a characteristic rash several days to a few weeks following a tick bite. This rash may feel warm to the touch but is rarely itchy or painful.

    The flu-like illness usually occurs in the warm weather months when flu does not occur.

    The rash is a red rash that grows in size daily. It is called erythema migrans and occurs in about 70%-80% of infected individuals.

    The U.S. Centers for Disease Control and Prevention defines this rash as a skin lesion that typically begins as a red spot and expands over a period of days to weeks to form a large round lesion, at least 5 cm across, and up to 30 cm . A red circular spot that begins within hours and is smaller is usually a reaction to the tick bite.

    When the rash occurs at the site of the tick bite, it is called a primary lesion. Multiple secondary lesions can occur that are a reaction to the infection and are not due to multiple tick bites. All of these lesions can enlarge to the size of a football. This growth in size of the red spots on the skin is characteristic of Lyme disease.

    The red spots may be circular or oval.

    Symptoms and signs in children are similar, though younger children are more likely to have skin lesions occur on the head or neck and older children on the extremities.

    What Is A Lyme

    Lyme Disease Quick Facts  Abounding in Hope with Lyme

    A LLMD is a physician whose experience with Lyme disease patients makes them familiar with the vast range of symptoms, co-infections, and complications associated with the disease at various stages. Because of this knowledge and expertise, many patients also find LLMDs more open-minded and understanding of their experiences, especially if theyre having a hard time getting an accurate diagnosis from another physician.

    But how do you know if you need to see a LLMD? Below are some common reasons, any or all of which may apply to you.

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    How To Approach Your Non

    For various reasons, you may choose to consult with a doctor who doesnt specialize in Lyme disease or other tick-borne diseases.

    If so, be sure to be as proactive as possible in providing information that could help in diagnosing your disease, and always feel free to share resources that you find in your own research to prompt discussions about any aspect of your diagnosis or treatment, including more advanced testing options.

    If your doctor does not believe Lyme disease exists, reach out to another doctor for a second opinion.

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    Finding A Good Lyme Doctor

    I was one of the lucky ones.

    After over a year of my general doctor running tests and sending me to different specialists, I tentatively questioned if Lyme disease might be worth investigating.

    My doctor agreed: it was a good idea. But he also admitted that he knew the tests were terribly unreliable and Id need a good Lyme doctor to help me figure out if this was indeed causing all of my mysterious symptoms.

    He referred me to a colleague who helped guide me through the early stages of Lyme testing and getting my diagnosis.

    Ill forever be grateful for my doctors honesty. He knew he didnt understand Lyme well enough. He knew certain tests were sadly unreliable. And he was gracious enough to help me search for answers when most doctors would have scoffed.

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    What Is Lyme Disease

    Lyme disease is a bacterial infection transmitted to humans by an infected blacklegged or deer tick. Lyme disease is more common than you might think, affecting more than 300,000 people a year, although experts suspect the real number is higher since it is often misdiagnosed. Its important to see a specialist like Dr. Choudhary for an accurate diagnosis and early treatment so the disease does not progress.

    Identify Doctors Trained In The Diagnosis And Treatment Of Tick

    The Signs & Symptoms of Lyme Disease. A Doctor Explains

    You can access a variety of online resources and directories to locate doctors who are specifically trained in identifying and treating tick-borne illnesses. These do not have to be infectious disease specialists they can be physicians from any practice area who simply have extensive experience with tick-borne diseases.

    It is particularly important to find a Lyme expert if you suspect that you may have Lyme disease, since it is the most frequently misdiagnosed of all tick-borne diseases. Finding a Lyme-literate medical doctor a physician who is familiar with the vast range of symptoms that may indicate infection at various stages of the disease, as well as potential coinfections and other complexitiescan help ensure that you get the right treatment, right away.

    To find a doctor who is also a Lyme expert, you may want to explore the following resources:

    Note: Some of these organizations may require you to submit a form or create a login to access their databases.

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    Few Conn Physicians Treat Chronic Lyme Disease

    Only a very small number of physicians in Connecticut — the epicenter of Lyme disease — diagnose and treat patients with the controversial chronic form of this tick-borne infection, a survey found.

    Among 285 primary care physicians surveyed, only about 2% treat chronic Lyme disease, and almost 50% don’t believe that chronic infection with the spirochete Borrelia burgdorferi exists, Michael Johnson, MD, and Henry M. Feder, Jr., MD, of the University of Connecticut in Farmington, reported online in the Journal of Pediatrics.

    The remaining 48% were uncertain as to whether chronic Lyme disease is a valid condition.

    Advocates of chronic Lyme disease believe that the infection can persist for months and even years, requiring long-term treatment with oral or intravenous antibiotics — a stance counter to the recommendations of the American College of Rheumatology, the American Academy of Pediatrics, the American College of Neurology, and the Infectious Diseases Society of America .

    They have formed their own society, the International Lyme and Associated Diseases Society , publishing their own guidelines, and refer to themselves as “Lyme literate.”

    To see how widespread acceptance of chronic Lyme disease is among clinicians in Connecticut, which has the highest incidence of B. burgdorferi infection in the country, Johnson and Feder sent a survey to a random sample of more than 1,000 physicians. The survey had a 39.1% response rate.

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