How To Diagnose Chronic Lyme Disease

Who’s At Risk Of Lyme Disease

How to Diagnose Lyme Disease – More Than A Test

The risk of getting Lyme disease is higher:

for people who spend time in woodland or moorland areas
from March to October because more people take part in outdoor activities

It’s thought only a small proportion of ticks carry the bacteria that cause Lyme disease. Being bitten doesn’t mean you’ll definitely be infected. However, it’s important to be aware of the risk and speak to a GP if you start to feel unwell.

Bartonella Causes A Lot Of Problems That Look Like Other Illnesses

Symptoms and signs of Bartonella are: day sweats, ongoing anxiety, pain on the soles of the feet, a rash that looks like stretch marks, a large number of swollen lymph nodes, severe thinking problems, seizures or seizure like disorder, neurologic symptoms of numbness or sharp, shooting, stabbing or burning pain, loss of nerve function in a body part, abdominal pain for which there is not an identifiable cause, bladder symptoms of pain, and urgency or burning and severe psychiatric problems.

Severe psychiatric problems in someone with Lyme is a reason to consider Bartonella – especially if there are other Bartonella symptoms like those I mention above. These psych symptoms can include depersonalization, depression, marked anxiety, bipolar illness, hallucinations, mania, obsessive compulsions, and even rage and anger.

Lyme Disease Nursing Care Plan 4

Nursing Diagnosis: Acute Pain related to peripheral neuropathy secondary to Lyme disease as evidenced by verbalization of tingling sensations and numbness.

Desired Outcomes:

The patient will be able to adapt skills to manage the sensory disturbances with the long-term treatment of Lyme disease.
The patient will be able to resume activities of daily living with minimal supervision and assistance.

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Disclaimer: The above material is provided for information purposes only. The material is not nor should be considered, or used as a substitute for, medical advice, diagnosis, or treatment, nor does it necessarily represent endorsement by or an official position of Global Lyme Alliance, Inc. or any of its directors, officers, advisors or volunteers. Advice on the testing, treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patients medical history. Global Lyme Alliance, Inc. makes no warranties of any kind regarding this Website, including as to the accuracy, completeness, currency or reliability of any information contained herein, and all such warranties are expressly disclaimed.

Risk Factors For Lyme Disease

Several factors increase the risk of acquiring and the spread of Lyme disease. These include

Age and sex. Men between the ages of 15 to 60 are most likely to play outside and go on outdoor activities such as camping, hunting, and hiking.
Socioeconomic factors. Those people who live and work outdoors, in construction, landscaping, near the farm, park, wildlife, or forest.
Geographic location. Ticks that carry Lyme disease are widespread but are mostly found in the northeast, upper midwest, and mid-Atlantic states and south-central and southeast Canada.
Weather conditions. Tick bites are common during summer when people spend more time outdoors but it is also possible during early fall and late winter with extremes of temperatures.
Environmental factors. Spending time in moorland and woodland areas with deep or overgrown plants with animals to feed the ticks and an increase in deer population where the ticks thrive.
Pet. Taking care of a pet, especially a dog, increase the risk for Lyme disease.

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Lyme Disease Nursing Care Plan 3

Nursing Diagnosis: Fatigue related to prolonged infection secondary to Lyme disease as evidenced by general body discomfort and muscle weakness.

Desired Outcomes:

The patient will verbalize improvements in fatigue after 72 hours of nursing interventions.
The patient will be actively engaged with the daily activities independently.

Early Localized Lyme Disease Symptoms

The most telltale sign of Lyme is a rash , which occurs at the site of the tick bite. This rash occurs in 70 to 80% of patients.

On average, the rash shows up one week after the tick bite. But it can appear as early as 3 days or as late as 30 days after the bite.

The rash may feel warm but is usually not itchy or painful. The red patch will expand over several days and can grow as big as 12 inches across. The classic Lyme rash eventually takes on a bulls-eye shape with a red circle in the middle and an outer red ring.

Since the bulls-eye shape doesnt always appear, watch out for any circular or oval rash that gradually expands.

The 20% to 30% of people who dont develop a rash may notice other symptoms in the first month. These include chills, headache, low energy, sore muscles and joints, and swollen lymph nodes.

These initial symptoms and rash are the bodys first immune response to a foreign bacteria. This is why, beyond the typical rash, the symptoms are non-specific and can resemble any flu-like illness.

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Bartonella Diagnosis Approach In Chronic Lyme Disease

Figuring out if a person has Bartonella as part of Lyme disease involves putting together the pieces of the puzzle. If there are a large number of signs or symptoms of this coinfection, then in my opinion it is appropriate to treat without testing. This is because a negative Bartonella test does not exclude or rule out the diagnosis.

When it is not clear enough based on a lack of a tick bite history and the symptoms that Bartonella is present, then I suggest doing the Galaxy Diagnositics enhanced PCR for Bartonella. If it comes back positive, then definitely treat for Bartonella.

One special situation occurs with the person who has severe psychiatric illness and Lyme. In this situation, even if there are not many other Bartonella symptoms, I found it very helpful to treat for Bartonella in my Seattle practice. So based on my clinical experience, people with Lyme and severe psych symptoms also require Bartonella treatment without getting Bartonella testing first.

Lyme Disease Nursing Care Plans Diagnosis And Interventions

Understanding the Persistent Symptoms in Lyme Disease | Johns Hopkins Medicine

Lyme Disease Nursing Care Plans Diagnosis and Interventions

Lyme disease, also known as Lyme borreliosis, is a vector-borne disease passed to humans by infected ticks causing a bacterial infection. The disease was originally thought to be juvenile rheumatoid arthritis and was first recognized when a cluster of cases was identified in the towns of Lyme and Old Lyme in Connecticut, giving its name Lyme disease.

It is most common in spring and early summer with an estimated 476,000 cases yearly in the United States and 200,000 yearly in Western Europe. Currently, there are no available human vaccines for Lyme disease but multiple vaccines to prevent Lyme disease are available for dogs.

Signs And Symptoms Of Lyme Disease

Lyme disease can produce a wide range of symptoms if left untreated. The symptoms depend on the stage of infection, such as:

Stage 1. This stage is called early localized disease, which happens within 3 to 30 days after a tick bite. It starts with a single-circle rash that spreads around the site with a clear center which is not painful or itchy but warm to the touch also called erythema migrans . Other symptoms include fever, headache, fatigue, muscle pains, joint stiffness, nausea, upper respiratory problems, and swollen lymph nodes.
Stage 2. This stage is called early disseminated disease, with more serious and widespread symptoms often showing within 3 to 10 weeks after a tick bite. Symptoms include rashes on different parts of the body, severe headache, neck pain or stiffness, facial muscle weakness, Bannwarth syndrome, dysrhythmias, fainting, shortness of breath, paresthesia, back pain radiating to the hips and legs, eye pain, swelling, or vision loss.
Stage 3. This stage is called late disseminated disease and usually begins 2 to 12 months after a tick bite. Symptoms include long-lasting pain and swelling, arthritis in large joints, peripheral neuropathy, acrodermatitis chronic atrophicans, heart problems, insomnia, memory or concentration problems, and swelling/discoloration of the hands, feet, elbows, and knees.

How Long Does It Take To Show Signs Of Lyme Disease

Lyme disease is characterized by various symptoms. The discomforts are very varied and affect many organs. If a person becomes infected with the Borrelia burgdorferi bacterium by means of a tick bite, a reddish and annular lesion on the skin may appear after several days or weeks this would be the first manifestation.

In the first month of exposure to the tick, which in most cases the patient does not remember, early localized infection occurs, which is usually manifested by nonspecific flu-like symptoms and the appearance of migratory erythema, which is a papule or macula that extends painlessly to take the form of a target with the clearer center. Since a quarter of patients do not have migratory erythema, it is not uncommon for this first stage to go unnoticed and doctors receive a patient with symptoms of an early disseminated infection , after weeks or months of exposure. This stage could be initiated, for example, as a general condition with intense discomfort, diffuse pains, headache, asthenia or new cutaneous symptoms: annular lesions smaller than migratory erythema, or the rare presence of lymphocytoma cutis .

Considering the inconstancy and clinical variability of borreliosis in this phase, it has been called the great imitator.

In any case, and if we exclude the almost constant fatigue/lethargy, it seems that the most relevant and frequent presentation symptoms are neurological, followed by the musculoskeletal and dermatological signs.

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How Much Do At

Generally, at-home Lyme disease tests cost around $100, while others may cost closer to $500. The difference comes down to how many pathogens you are hoping to test for. On average, the test will look for two or three, but more expensive tests may screen for 10 to 15.

Depending on your insurance and which test you select, it may be covered. Another option is to pay for the Lyme disease test with your HSA/FSA, since some companies will accept that as a payment form.

How Is Lyme Disease Diagnosed

10 Signs You May Have Chronic Lyme DiseaseAnd Not Even Know It

A healthcare provider will diagnose Lyme disease based on symptoms, physical findings and whether or not you’ve been in an area populated by infected ticks.

Many people dont remember or know that theyve been bitten by a tick. This is because the tick is tiny, and its bite is usually painless.

Your provider will confirm the diagnosis using a blood test. If your first blood test is negative for Lyme disease, you won’t need another test. If the first test is positive or equivocal, your provider will conduct the test again. You have to have two positive results to be diagnosed with Lyme disease.

Signs Of Lyme Disease That Appear On Your Skin

Signs of Lyme disease

If you see a rash or another sign of Lyme disease on your skin, see your primary doctor right away. When caught early and treated, Lyme disease can be cured with antibiotics and most people recover fully.

Lyme disease is caused by a bite from a black-legged tick. If you are bitten by this tick and develop Lyme disease, you may see a bulls-eye rash. Its a common sign of Lyme disease, but its not the only sign.

Lyme disease occurs in stages. Heres what you may see on your skin during each stage.

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How Is It Diagnosed

If youâve been outside in an area where ticks are known to live, you should tell your doctor. Theyâll also want to know about the symptoms youâre having. These details are crucial to making a diagnosis of Lyme disease.

Early symptoms that usually occur within the first month after a tick bite can include:

Rash at the site of the tick bite that may look like a âbullâs-eyeâ

Problems with your short-term memory

Symptoms that come and go are common with Lyme disease. They will also depend on the stage of the disease.

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Living With Lyme Disease

Most people treated in the early stages of Lyme disease make a quick and complete recovery. Some may experience symptoms for a few weeks after treatment. If you were treated for Lyme disease but you still dont feel well, call your family doctor. He or she can make sure there isnt something else wrong. They can help you find ways to ease your symptoms. Some patients have found relief with treatments typically used for chronic fatigue syndrome or fibromyalgia.

Other things you can do to help manage Lyme disease include:

Educate yourself.There is a lot of inaccurate information to be sorted through, especially on the internet. Ask your doctor if you have questions.
Track your symptoms.Keep a diary of your sleep patterns, eating habits, exercise routines, and how youre feeling. You or your doctor may be able to make connections between them.
Take care of yourself.Eat a healthy diet. Exercise as regularly as you can. Get plenty of rest.

Find support. It can be hard to not feel well and not know why. Some people may think your symptoms arent real. Talk to friends and family. If they cant offer support, talk with a counselor who can help you.

What Is The Most Reliable Lyme Disease Test

More research needed to understand Chronic Lyme disease

There is no one answer when it comes to determining which Lyme disease test is the most reliable. This is because each test looks for a different thing at a different stage of the infection. When investigating a long-term infection, tests that look for the bodys response to the infection are the most reliable, whereas for an active infection, a test that identifies the bacteria itself will be the most effective. Some tests only show up on an active infection and fail to indicate chronic Lyme, so the most reliable test option depends on which stage a persons infection is currently at.

Featured image by Emin Baycan on Unsplash

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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:

A circular rash at the site of the tick bite, typically within 12 weeks of infection, often is the first sign of infection. Its considered typical of Lyme disease, but many people never get one.

The rash sometimes has a bulls-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. Its 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.

The last stage of Lyme disease happens if the early stages werent found or treated. Symptoms can begin anytime from weeks to years after an infectious tick bite. In kids and teens, this is almost always in the form of arthritis, with swelling and tenderness, particularly in the knees or other large joints.

The Chronic Lyme Disease Controversy

Chronic Lyme disease is a poorly defined term that describes the attribution of various atypical syndromes to protracted Borrelia burgdorferi infection. These syndromes are atypical for Lyme disease in their lack of the objective clinical abnormalities that are well-recognized in Lyme disease and, in many cases, the absence of serologic evidence of Lyme disease as well as the absence of plausible exposure to the infection. The syndromes usually diagnosed as CLD include chronic pain, fatigue, neurocognitive, and behavioral symptoms, as well as various alternative medical diagnosesmost commonly neurologic and rheumatologic diseases. Perhaps the most recognized and contentious facet of this debate is whether it is effective, appropriate, or even acceptable to treat patients with protracted antibiotic courses based on a clinical diagnosis of CLD.

Is There A Blood Test For Lyme Disease

If your doctor suspects that you have Lyme disease, they may order two blood tests. These will look for signs that your body is trying to fight it off. The results are most precise a few weeks after youâve been infected.

These tests are:

ELISA test. This test canât check for the bacteria that causes Lyme disease. It can only look for your immune systemâs response to it.

Once Borrelia burgdorferi gets into your blood, your body begins to make special proteins called antibodies to fight it off. The ELISA test checks for those antibodies.

Although itâs the most common way to check for Lyme disease, the ELISA test isnât perfect. It can sometimes give false âpositiveâ results. On the other hand, if you have it done too soon after youâve been infected, your body may not have developed enough antibodies for the test to detect them. This will give you a ânegativeâ result even though you do have Lyme disease.

Western blot test. Whether your ELISA test comes back positive or negative, your doctor will need to do this blood test, too.

A Western blot uses electricity to split certain proteins in your blood into patterns. This is then compared to the pattern of people known to have Lyme disease.

At least five band matches means that you have Lyme disease. Still, not all labs have the same standards. Thereâs a chance that you could get a âpositiveâ result from one and a ânegativeâ result from another.

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