Tick Borne Disease Referral Clinic
Long Island harbors a large area of beautiful, recreational parks where ticks and other insects can be found. For medical reasons, ticks are important because they are vectors of microorganisms such as bacteria, virus or parasites. Not all ticks carry these infectious organisms, thus not all tick bites are dangerous or pose a risk for acquiring an infection. Still, people can contract an infection without recognizing a recent tick bite.
Some ticks can transmit the following infectious diseases :1. Lyme Disease3. Anaplasmosis4. Babesiosis
Most of these infections are cured by a short course of antibiotics. Sometimes, these infections can cause a more severe disease in some patients. Other infectious diseases that can be transmitted by ticks in Long Island are: Rocky Mountain Spotted Fever, Tularemia, and Powassan virus.
Our highly-trained doctors will help review and manage these infections when you are seen in our outpatient facility. For treatment purposes, we follow the Infectious Diseases Society of America Guidelines .
As Tick-Borne Diseases are a topic of national research interest, we also have research projects underway to understand and provide new medical knowledge that will help other physicians to manage these infections for their patients. Our research explores how these tick borne diseases affect the health of humans. The more we understand these diseases, the better we can assign treatment modalities to patients.
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Chronic Lyme Dos And Don’ts
Chronic Lyme disease is an ongoing Borrelia burgdorferi infection that can involve any body system or tissue. The infection produces a wide range of symptoms and signs, which can be debilitating for some patients. Common symptoms include severe fatigue, migratory musculoskeletal pain, headaches, and impaired memory. Unfortunately, chronic Lyme disease is complex and often misunderstood, which means that many patients will struggle to obtain the care they need to regain their health. Every patient concerned about Lyme disease and tick-borne illness should know the following.
Health Woes Lead To Self
Oppenheimer said Freitas, once wildly independent, increasingly depends on him as she struggles with her health. The two met when she was a single mom driving a Madison Metro bus and juggling classes at the UW-Madison. Oppenheimer had overheard her speaking in Portuguese, and he tried to put together a phrase that he could speak in the same language. That led to a first date and in 2011, marriage.
But these days, Oppenheimer said, his wife is very drained.
And even friends and family members question whether the symptoms Freitas describes are real.
“When everybody is saying that it is not Lyme,” Freitas said, “you start to question yourself.”
She tried a four-week course of doxycycline, the first-line antibiotics therapy for treating Lyme disease, prescribed by another rheumatologist. She began to feel better, with less pain and less brain fog. However, the symptoms returned once she completed the treatment. She even found herself starting to stutter.
Oppenheimer himself was diagnosed with Lyme disease as a 19-year-old. At the time, he was living less than 50 miles from Lyme, Connecticut, the community for which the disease was named.
He described an “arrogant unwillingness” by the medical establishment to recognize what he believes are his wifes ongoing symptoms of Lyme disease.
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Do Your Research And Get Referrals
You can learn a lot just by researching doctors and reading patient reviews online. You can also connect with other patients through local and online support groups for various tick-borne diseases. Asking other patients to recommend or share their own experiences with different doctors can be particularly helpful when youre trying to locate and learn about physicians who specialize in various tick-borne illnesses.
The following sites can connect you to online support-group forums or help you identify different tick-borne support groups in the United States:
Chronic Lyme Disease Statistics
- 72% of Lyme patients see four or more physicians before receiving a diagnosis.
- 36% of Lyme patients are unable to receive a diagnosis before at least six years of illness. 84% of Lyme patients are not diagnosed within the first four months of illness.
- 75% of Lyme patients experience severe or very severe symptoms.
- 63% describe two or more of their symptoms as severe or very severe.
*Statistics pulled from MyLymeDatas 2019 Chart Book by LymeDisease.org
The best Lyme disease doctors are not okay with the way that these statistics read and are therefore constantly looking for ways to innovate new treatments and technologies. They dont take no for an answer and actively listen and thoughtfully when their patients describe their symptoms. If you are looking for a Lyme disease doctor, we recommend asking your physicians the following questions:
- Do you have experience treating tick-borne illnesses?
- How do you diagnose Lyme disease? Which specific lab tests do you use to confirm diagnosis?
- Do you test for co-infections?
- Do you prescribe antibiotics or herbal remedies?
- Do you have any Lyme-specific success stories you can share with me?
- Do you strictly adhere to CDC testing criteria or are you open to alternate methodology?
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Who Treats Lyme Disease
Lyme disease is a bacterial infection spread to people by deer ticks. Lyme disease can cause different symptoms, depending on how long youve had the infection. And symptoms of Lyme disease can come and go, making it seem like youre betterand making it harder to figure out when you were first infected.
All of this can make Lyme disease complex for healthcare providers to diagnose and treat. If you think you have Lyme disease, look for providers who have experience treating the condition, especially in areas where Lyme disease is more common. In the United States, this includes the northeastern coast and the upper Midwest.
Healthcare providers who treat Lyme disease include:
Late Manifestations Of Lyme Disease
- Arthritis: this is uncommon in the UK but may be present if infection is acquired in the USA. There are usually recurrent attacks in one or more large joints, particularly the knee. It often presents as a large knee effusion, or a Baker’s cyst. There is occasional progression to a chronic arthritic condition.
- Acrodermatitis chronica atrophicans: this is a rare skin condition that can occur years after the infection. Extensor surfaces of the limbs develop blue-red discolouration and swelling. There can be associated peripheral neuropathy.
- Late neurological disorders: these include polyneuropathy, chronic encephalomyelitis, vertigo and psychosis.
- Chronic Lyme disease and ‘post-Lyme syndrome’ , both very controversial areas.
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What Kinds Of Neurological Problems Are Caused By Lyme Disease
Typically, three main neurological complications develop in people with untreated Lyme disease.
- Cranial neuropathy: If the infection affects nerves of the face, some patients might experience cranial neuropathyor dysfunction of the peripheral nervescausing drooping or swelling. The most common form of cranial neuropathy is Bells palsy, which is muscle drooping on one side of the face.
- Meningitis: If the bacterial infection reaches the meninges, or the tissue lining the brain and spinal column, it may cause inflammation and tissue damage. Patients with meningitis are likely to experience fevers, headache, fatigue, and stiff neck.
- Radiculoneuritis: If the bacterial infection reaches the nerve root, or the part of the nerve cells that attaches to the central nervous system , it can cause severe pain, numbness, and other abnormal sensations.
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Lyme Disease Prevention And Treatment
The summer is prime time for deer ticks to spread Lyme disease across Connecticut and most of the northeast. A warmer fall due to climate change means ticks will continue to pose a threat well into September and October.
Lyme disease is a bacterial infection discovered by two Yale physicians in 1975. When a group of children developed knee pain around Lyme, Connecticut, they suspected they were dealing with a new illness.
Joint or muscle pain is now recognized as one of the common symptoms of Lyme disease. Other symptoms can include fever, chills, swollen glands, heart palpitations, facial weakness and the classic bullseye rash. However, Yale New Haven Health infectious disease specialist , said that rash only looks like a bullseye in about one out of 10 patients. It can be a long time before some people develop any symptoms at all.
Lyme is typically broken down into three stages of infection and the last stage is called late or late disseminated Lyme and that can actually show up years after you get the initial tick bite, Dr. Grant said.
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Use Of Disulfiram For Lyme Disease
Disulfiram was initially marketed in the U.S. as Antabuse as an alcohol sobriety aid which deters alcohol consumption by eliciting physical discomforts . Its use as a possible treatment for Lyme disease has been described in several recent studies. Borrelia burgdorferi, the bacteria responsible for Lyme disease, possesses survival strategies in humans. Current antibiotic therapies for early Lyme disease have been shown to be less
Treating A Pinched Nerve
Mild cases of a pinched nerve may go away on their own after your body adjusts to naturally remove pressure off of the affected nerve. However, in moderate to severe cases of pinched nerves, you may experience an increase in the severity of symptoms over the course of days of weeks, leading you to seek treatment from a doctor. Orthopedic doctors and surgeons treat pinched nerves in a variety of ways depending on the location and severity of the pinched nerve. Orthopedic doctors and surgeons frequently utilize a combination of a physical exam and diagnostic imaging tools to identify the affected nerves and develop a treatment plan accordingly.
Because a pinched nerve in one area can cause pain and discomfort in multiple areas of the body, it is important to receive treatment from a highly experienced and knowledgeable orthopedic doctor to receive the comprehensive care you deserve. Your particular situation may call for more conservative treatment to reduce inflammation in the area or nerve-related testing before it leads to anything chronic. From herniated discs to rheumatoid arthritis, AICA orthopedic surgeons develop an individualized treatment plan that works for you and your body so you can experience pain relief and healing.
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How Do I Know Whether I Have Received A Sufficiently Long Course Of Antibiotic Therapy
Taken together, these study results suggest that repeated antibiotic therapy may be beneficial for a subgroup of patients. However all of these studies also reported troubling adverse effects associated with the IV antibiotic therapy. Given these potentially dangerous risks, it is clear that other safer and more durable treatments are needed for patients with persistent symptoms.
Ilads Campaign Highlights Importance Of Doctor
Bethesda, MD, December 9, 2021 The International Lyme and Associated Diseases Society is running a powerful public awareness campaign to highlight the importance of doctor-patient relationships in the treatment of Lyme and other chronic diseases. The campaign debuted this week on a jumbotron in New York Citys Times Square.
The jumbotron video highlights the challenges doctors face from bureaucratic institutions when trying to treat patients. The video sends viewers to the ILADS.ORG website for more information. .
ILADS supports a doctors freedom to treat and a patients right to choose the best treatment options available, without bureaucratic interference. A doctors primary duty is to put the patient first. Outside interference restricts a physicians ability to provide optimum care.
We want to restore real healthcare for our patients and allow doctors to prescribe the best possible treatments without interference from insurance companies and other bureaucracies, said Dr. Steven J. Bock, president of the ILADS Board of Directors.
The jumbotron is anything but invisible. The giant video screen is 29 feet tall and 56 feet across and is strategically positioned at 1500 Broadway on the corner of 44th Street and 7th Avenue in New York City. The spot will run 5 times per hour for 36 days. It is estimated that 1.6 million people pass through Times Square each day. The spot will remain in place during the December holidays and New Years Eve celebration for bonus exposure.
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Lyme Disease Treatment And Management
How to manage a tick bite
- If the tick is still attached, remove it. Grip the tick with fine-tipped or precision tweezers and pull upwards without twisting.
- Clean the skin afterwards with soap and water or an antiseptic preparation.
- The tick may be disposed of in normal household rubbish.
- Do NOT use petroleum jelly, alcohol, or nail varnish remover, or burn the tick off.
- For those regularly exposed to ticks, removal devices are available from veterinary surgeries or pet shops.
- Antibiotic prophylaxis is NOT recommended routinely in the UK following a tick bite.
How to manage a patient with erythema migrans and a history of tick bite or likely exposureBlood tests are NOT necessary the diagnosis can be made clinically.
Treat with an oral antibiotic for 2-3 weeks:
- Doxycycline 100 mg bd or amoxicillin 500 mg tds.
- Cefuroxime 500 mg bd if both are contra-indicated and there is no history of anaphylaxis with penicillins.
- For children aged under 12, use amoxicillin in age-dependent doses as per the British National Formulary or cefuroxime 5 mg/kg twice per day .
- For breast-feeding women, use amoxicillin or cefuroxime.
- For pregnant women, use amoxicillin or cefuroxime and inform an obstetrician. Lyme disease carries little direct risk to the pregnancy however, there is a possible risk of uterine contraction following a reaction to treatment.
How to manage a patient with an isolated facial nerve palsy and a history of recent erythema migrans or exposure to tick bites
Can A Tick Be Tested For Lyme Disease
Researchers examined the prevalence of ticks in the Quebec region, along with the frequency of engorged ticks carrying Borrelia burgdorferi , the causative agent of Lyme disease. Their findings suggest that tick testing may not always be an effective tool in determining the risk of infection.
Ticks can be tested for the Lyme disease bacteria and other tick-borne pathogens. But the accuracy of test results may depend on whether the tick is engorged.
A study by Gasmi et al. found that results may not be accurate when testing ticks which are engorged. The authors examined 4,596 I. scapularis ticks removed from individuals living in Quebec.
They found that 24.9% of the non-engorged blacklegged tickswere infected with Borrelia burgdorferi , the causative agent of Lyme disease.
Engorged ticks were expected to have an even higher rate of infection with the Lyme disease bacteria. But the prevalence was much lower with only 8.9% of engorged ticks testing positive for the Lyme disease agent. These findings are consistent with those from another Canadian study.
Engorged ticks were expected to have an even higher rate of infection with the Lyme disease bacteria. But the prevalence was much lower.
It is still unclear why testing of engorged ticks is not accurately revealing the higher prevalence of Bb infection. The authors suggest that it could be due to the presence of inhibitors in the blood meal or problems with the collection and transportation of engorged ticks.
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Do I Need To See An Infectious Disease Specialist To Get Tested For Lyme Disease
No, you do not need to see an infectious disease specialist.
As noted above, any type of physician should be able to order the correct diagnostic tests, interpret your test results, and provide antibiotics to treat Lyme disease. This is especially true the earlier the disease is caught.
In fact, American Lyme Disease Foundation points out that waiting for an appointment with an infectious disease or other type of specialist can actually delay your diagnosis and treatment. If you were bitten by a tick, notice symptoms of Lyme disease, or believe youre at risk for Lyme or another tick-borne disease, its important that you make an appointment with a doctor immediately even if its your primary care physician.
That said, there are plenty of reasons why you may want to consult with, or get a second opinion from, someone with specific experience with Lyme disease. In other words, you may want to make an appointment with a Lyme-literate doctor . Read on to learn more.
Laboratory Tests That Are Not Recommended
Some laboratories offer Lyme disease testing using assays whose accuracy and clinical usefulness have not been adequately established. Examples of unvalidated tests include:
- Capture assays for antigens in urine
- Culture, immunofluorescence staining, or cell sorting of cell wall-deficient or cystic forms of B. burgdorferi
- Lymphocyte transformation tests
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What Are The Symptoms Of Lyme Disease
Symptoms of Lyme disease have a wide range and depend on how far the disease progresses. Symptoms can occur anywhere from three to thirty days post infected tick bite. Early symptoms of Lyme disease include a rash that develops on the area surrounding a tick bite. This rash can spread over the course of a few days and may have a noticeable bullseye pattern in its center. In some cases, a rash never develops. Not all tick bites carry infection.
Early signs of Lyme disease include:
If left untreated, Lyme disease can progress to more serious complications. Later stage symptoms include:
- Severe headache and neck stiffness
- Arthritis with severe joint pain and swelling
- Inflammation of the brain or spinal cord
- Heart-related complications
If you think youre experiencing some of the symptoms of Lyme disease, schedule a consultation at Advanced Infectious Disease Medical.
Lyme Disease Antibiotic Treatment Research
For early Lyme disease, a short course of oral antibiotics, such as doxycycline or amoxicillin, cures the majority of cases. In more complicated cases, Lyme disease can usually be successfully treated with three to four weeks of antibiotic therapy.
After being treated for Lyme disease, a minority of patients may still report non-specific symptoms, including persistent pain, joint and muscle aches, fatigue, impaired cognitive function, or unexplained numbness. These patients often show no evidence of active infection and may be diagnosed with post-treatment Lyme disease syndrome .
Multiple clinical trials, funded by NIH and others, have shown no benefit to additional IV antibiotic treatment in patients with Lyme disease, although the interpretation of those results have been challenged by some.
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