What Is Post Treatment Lyme Disease
Post Treatment Lyme Disease represents a research subset of patients who remain significantly ill 6 months or more following standard antibiotic therapy for Lyme disease. PTLD is characterized by a constellation of symptoms that includes severe fatigue, musculoskeletal pain, sleep disturbance, depression, and cognitive problems such as difficulty with short-term memory, speed of thinking, or multi-tasking. In the absence of a direct diagnostic biomarker blood test, PTLD has been difficult to define by physicians, and its existence has been controversial. However, our clinical research shows that meticulous patient evaluation when used alongside appropriate diagnostic testing can reliably identify patients with a history of previously treated Lyme disease who display the typical symptom patterns of PTLD.
How Common Is Untreated Lyme Disease
Its difficult to get exact numbers when it comes to Lyme disease, in part because theres only limited accounting of the conditions frequency overall, and its often misdiagnosed or mistaken for other conditions.
Currently, its estimated that 476,000 people develop it in the United States every year, with 81% of the cases clustered in the Northeast, upper Midwest, and mid-Atlantic regions.
A significantbut shrinkingproportion of those with the disease end up progressing without treatment. Current estimates are hard to come by. In 2012, researchers estimated that about 16% of Lyme disease cases present without rashincreasing the chance that the case is missed, overall. From 1.6% to 7% of all infections have no symptoms.
Knowledge and awareness of this disease have grown over the past couple of decades, greatly improving outcomes. This improving prognosis is associated with better care and detection, leading to timelier intervention.
If you live in a hot spot area for black-legged ticks, never hesitate to reach out to your healthcare professional if youre feeling sick or have a rash.
Recurring Lyme Disease Rash Caused By Reinfection Not Relapse
Lyme disease is spread by deer ticks like this one. A study finds that some people can be reinfected many times with the bacteria that cause the disease. Lauree Feldman/Getty Creative Imageshide caption
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In recent years, a disease spread by ticks has become more common across the country.
Lyme disease causes a skin rash, and in some cases, more serious symptoms. The rash usually goes away with antibiotics, but some people say they have other symptoms that persist for months or years.
Now a study published in the latest issue of The New England Journal of Medicine suggests those with a recurring rash dont have one long illness. Instead, theyre getting new infections from fresh tick bites.
Researchers recently conducted an experiment in which they examined Lyme disease-causing bacteria in the blood of 17 patients suffering from a recurrence of the rash. Then they compared these bacteria to a sample taken from the same patients during an earlier flare-up of Lyme symptoms.
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Symptoms Of Lyme Disease
Lyme disease causes a range of symptoms that change and intensify as the Borrelia burgdorferi bacteria spreads to the rest of the body. Untreated cases can cause serious problems or lead to a fatal condition. Whats tricky, too, is that the onset of initial symptoms occurs anywhere from three to 30 days after exposure.
Clinically, there are three stages of Lyme disease: early localized disease, early disseminated disease, and late disseminated disease.
Your Pain Moves Around Your Body
Another hallmark sign of Lyme is migratory pain â that is, pain that travels from one body part to the other. You might, for example, find that your right knee is hurting one day and your left knee is hurting the next. Common kinds of pain associated with Lyme include joint paint and nerve pains that create shooting or zapping sensations, says Reihman.
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Fractional Laser Treatment For Skin
The environment is hard on our skin: from ultraviolet rays to pollution, a constant oxidative war is waged upon it, leading to loss of collagen and damage to the barrier function of the skin. A fractional laser treatment is a type of laser skin resurfacing procedure that essentially traumatizes the skin in a good way – through subjecting a small area of it to tiny amounts of laser energy. The laser penetrates the second layer of skin, the dermis, leading to skin exfoliation, which stimulates collagen and elastin production.
The treatment may help with soothing acne scarring, correcting uneven skin tone and texture, and reducing wrinkles and fine lines, sun damage and age spots. Recent research suggests the fractional laser can help with improving skin elasticity and reducing the amount and depth of wrinkles, though theres little to no evidence for any benefits for eyebags, dark circles, discolorations within the eye area and water retention.
How Do You Know If Your Lyme Disease Is Treated And Finished
Patients ask me this question all the time. We diagnose the disease, we treat with antibiotics, or herbs, or homeopathics. We feel better. We stop the treatment. And either we continue to feel better, or we relapse and have to start all over again.
Is there no way to test whether the spirochete is gone?
The Lyme disease.org website has an excellent article ondiagnosis of Lyme disease.
The National Geographic website has a good description of the deer tick, and thehistory of Lyme disease.
Standard Lyme testing includes the following:
- ELISA or IFA test
- If that test is positive, then a Western Blot test is run
- If 5 out of the 10 possible Lyme bands are positive, you are diagnosed with Lyme disease
- If fewer than 5 of the 10 possible bands are positive, you are diagnosed as negative.
Not all the bands which appear on a Western blot are specific to Lyme disease even though one ofthose non-specific bands is required by the CDC for diagnosis.
Two of the bands which are specific to Lyme disease are not on the CDC list of bands required to be positive.
How much sense does that make?
For more detailed information about the IFA and Western blot testing, check out theIGeneX website.
There is another test that can give us an idea whether the Lyme disease is actually gone out of our systems. This is an inflammatory marker, so it tells us whether there is continued inflammation or whether that inflammation is no longer present.
Bottom line:
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Dont Be Fooled By The Repeat Test
People with Lyme want to know if treatment is working especially if they are not feeling better. The truth is, there are no biologic markers or immune system tests that show if you have recovered or are recovering from Lyme and coinfections. Repeating elispot tests like those offered by Armin Labs, or western blot tests and immunoblot tests offered by IGenex do not have any scientific proof to show they can predict the end of treatment or where you are in your treatment.
Simply put, retesting is not scientifically valid.
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Stage : Early Localized Lyme Disease
Stage 1 or early localized Lyme disease occurs 128 days following a tick bite.
Some people with stage one Lyme disease do not experience any symptoms. If symptoms do occur, they may include the following:
- a skin rash that may or may not resemble a bulls-eye
- flu-like illness, including chills and a fever
- swollen lymph nodes
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Synovial Fluid Pcr For B Burgdorferi
Although reported in a few patients,30 it is exceedingly difficult to culture B. burgdorferi from synovial fluid in patients with Lyme arthritis. This is presumably due to the fact that joint fluid, with its many inflammatory mediators, is an extremely hostile environment. In spiked cultures, adding small amounts of joint fluid results in rapid killing of spirochetes.13 In contrast, polymerase chain reaction testing of synovial fluid for B. burgdorferi DNA often yields positive results before antibiotic therapy ,13,31 and usually becomes negative following antibiotic treatment.12 However, spirochetal DNA may persist after spirochetal killing, which limits its use as a test for active infection. Moreover, PCR testing has not been standardized for routine clinical use. Therefore, in most cases, the appropriate clinical picture and a positive serologic result are sufficient for diagnosis of Lyme arthritis, and PCR testing serves as an optional test to further support the diagnosis.
Why Are Antibiotics The First Line Of Treatment For Lyme Disease
The use of antibiotics is critical for treating Lyme disease. Without antibiotic treatment, the Lyme disease causing bacteria can evade the host immune system, disseminate through the blood stream, and persist in the body. Antibiotics go into the bacteria preferentially and either stop the multiplication of the bacteria or disrupt the cell wall of the bacteria and kill the bacteria . By stopping the growth or killing the bacteria the human host immune response is given a leg up to eradicate the residual infection. Without antibiotics, the infection in Lyme disease can evade the host immune system and more readily persist.
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Youve Been Diagnosed With Another Condition Without A Known Cause
Like its cousin Syphilis, which is also caused by a spirochete bacterium, Lyme is called the great imitator because it can impact any organ system or tissue of the body, says Reihman. So, when someone is diagnosed with a condition that has no known cause, the cause is sometimes Lyme. Conditions that can stem from Lyme include Fibromyalgia, Multiple Sclerosis, Irritable Bowel Syndrome, Chronic Fatigue Syndrome, Interstitial Cystitis, Autism, ADHD, Alzheimers, chronic pelvic pain, Rheumatoid Arthritis, chronic migraines, hyperthyroidism, hypothyroidism, and Amyotrophic Lateral Sclerosis, as well as a number of mental health conditions.
If the diagnosis doesnt have a known cause or cure and youre not satisfied with that as an answer, its worth it to look into getting treatment for Lyme and seeing if that makes a dent in your symptoms, says Reihman.
How Is Lyme Disease Treated
Antibiotics, usually doxycycline or amoxicillin, are effective treatments for Lyme disease. How long your treatment lasts depends on the stage of infection. In general, its true that the sooner youre treated, the quicker and more complete the recovery.
Pregnant people should receive treatment for Lyme disease as well. There is, however, no evidence that a fetus can get the infection from its parent. Theres also no strong evidence that miscarriages are more likely after Lyme disease.
What should I do if a tick bites me?
If a tick bites you, the best way to remove it is by taking the following steps:
- Tug gently but firmly with blunt tweezers near the “head” of the tick at the level of your skin until it releases its hold on your skin.
- Avoid crushing the tick’s body or handling the tick with bare fingers because you could expose yourself to the bacteria in the tick.
- Wash the bite area thoroughly with soap and water.
- Don’t use kerosene, petroleum jelly or hot cigarette butts to remove the tick.
- Don’t squeeze the tick’s body with your fingers or tweezers.
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How Can I Tell If Treatment Is Working
If joint lameness is the presenting sign, improvement may be noted after 3-5 days starting antibiotics. A dogs response to therapy can be assessed by repeating the QC6 test six months after treatment is complete. Dogs that start with a moderate to high QC6 value typically show a 50% reduction or more in the QC6 at six months, indicating that treatment has been successful. Dogs that have a lower initial QC6 value may not show such dramatic reductions in the QC6 at six months, although the value should still be lower than the starting point if treatment has been successful.
A persistently high QC6 suggests treatment may not have been complete or that the dog became reinfected after treatment was stopped.
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What Is The Outlook For Someone With Lyme Disease
Most of the people who get Lyme disease and receive treatment early will be fine. Treatment can cure Lyme disease but you might still have some long-term effects. Untreated Lyme disease may contribute to other serious problems but its rarely fatal.
Post-treatment Lyme disease syndrome
Even after proper treatment, some people may experience lingering fatigue, achiness or headaches. This is known as post-treatment Lyme disease syndrome or PTLDS. The symptoms dont mean that you still have an infection. PTLDS probably wont respond to additional antibiotics. The majority of people in this group will have symptoms that resolve at some point over the next six months.
Chronic Lyme disease
Chronic Lyme disease is a term used by some for a condition in a person who had Lyme disease and the symptoms of PTLDS. Some people consider chronic Lyme disease to be the same as PTLDS. However, some people receive a chronic Lyme disease diagnosis without a Lyme disease diagnosis. Sometimes, extended treatment with antibiotics helps.
This term may be why some people think a Lyme disease infection can occur without being bitten by a tick. There isn’t enough proof that mosquitoes can transmit Lyme disease. Many researchers dislike using the term chronic Lyme disease.
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Lyme Disease: Resolving The Lyme Wars
- By , Contributor
Its finally getting warm here in New England, and most of us have plans to enjoy the beautiful weather. And thats why the Centers for Disease Control and Prevention recently released a report raising awareness about how to prevent the tickborne infections that typically occur during this time of the year. Lyme disease is probably the most well-known, and the one for which diagnosis and treatment are most controversial.
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
- Numbness and tingling in the limbs
- Dizziness and shortness of breath
- Heart palpitations and irregular heartbeat
- Anxiety and paranoia
- Multiple-chemical sensitivities
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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Six Years After Tick Bite Its Markand The Illnessstill Show
You see that little spot on my calf? You wouldnt think that a small bite like this would change someones life, turn it upside down, crush their goals and dreams, shake them to their core, causing immense pain and profound fatigue along with a multitude of other symptoms and issues.
That bite also caused a secondary neurological disorder which affects my heart and all body systems , as well as a brain lesion. That bite is from a tick. Yes thats a tick bite from six years ago! Out of the hundreds of people with Lyme disease that I have met, only one other had a re-appearing bite years after she was bitten. This is not very common, but it does show how resilient and chronic this bacteria can be.
I remember the day as if it were yesterday. We were at a local creek, and the tick was only attached for a few hours. My husband saw the tick, as well as my parents, and my father removed the tick for me.
A few weeks later I developed flu-like symptoms and a rash . Because my case was not a textbook diagnosis, I was sent away without even being prescribed precautionary antibiotics.
Also, I was told that we did not have Lyme disease in Georgia so the doctor refused to order a Lyme disease test. Pretty tragic that the urgent care doctors decision and lack of knowledge has affected my entire life six years later.
We need recognition, we need accurate testing, we need Lyme-literate doctors, we need understanding, we need awareness, we need a cure!
Common Misconceptions About Lyme Disease:
1. If a dog tests positive for Lyme disease, it means she has it.
2. Dogs are much more likely than people to become ill from Lyme disease.
3. A dog infected with Lyme disease will tend to start showing symptoms within a month, and sometimes within the first 18 hours.
4. Dogs can transmit Lyme disease to people.
5. Lyme disease strikes only in warm weather.
A lot of times, a dog will test positive for Lyme disease, and her owners get nervous that their pet is sick and needs treatment, but the dog is fine. How can that be?
Its because testing positive for Lyme simply means that antibodies to the illness have been detected in the dogs blood. It does not mean that the animals body is actually being affected by the disease. How can that be?
The fact that a dog can test positive for Lyme disease yet not actually have it in a way that matters has led to a lot of nervous owners, and sometimes, even veterinarians who have over-treated. To clear up the misconceptions, heres what you need to know.
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Can We Test Fluids Other Than Serum
Yes, CSF samples can be submitted from horses with neurological signs. The CSF sample needs to be submitted together with a serum sample from the same animal and taken at the same time. The relative increase of antibodies in CSF can indicate local production of antibodies in the CNS. Typically, one or two antibody values are increased more than 2-fold if B. burgdorferi contributes to the neurologic condition.
For other samples, contact the lab first .