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View Diary: Lyme: How I told the doctor what to do (226 comments)

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  •  This is totally naive. (9+ / 0-)

    Tick species that carry lyme are present in most of the country. Also, the prime feeding time for ticks is spring and fall, not summer, although you can certainly get bitten by a tick in any season, and with global warming ticks remain active later into the winter and come out earlier in the spring.
    I found a deer tick in my chest hair in late November, in Vermont.

    For whatever reason, many in the medical field seem to think that they are also entomologists, and seem to believe that ticks somehow have great respect for borders and maps, rather than understanding how ticks move or are carried by their hosts, and how their range is expanding. Here in Southern VT, I've had doctors tell me "we don't have a lot of lyme up here." But just over the border in Massachusetts they do, so what, the ticks turn back at the Welcome to Vermont sign?

    "'club America salutes you' says the girl on the door/we accept all major lies, we love any kind of fraud"--The Cure, "Club America"

    by Wheever on Thu May 19, 2011 at 12:28:04 PM PDT

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    •  Speaking from the perspective of epidemiology (1+ / 0-)
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      The clinical evidence indicates that Lyme disease is rare outside of the Northeast, California, and the Great Lakes region.  Even the map you link to (which concerns canine, not human cases, btw) demonstrates this, and the article notes:

      Nearly every state in the United States has reported cases of Lymes disease, but the disease is concentrated in the east coastal states, the north central states, and northern California. Connecticut, Rhode Island, New York, New Jersey, Delaware, Pennsylvania, Maryland, and Wisconsin reports for about 90% of all Lymes cases.
      It's not that it could never happen outside these areas, just that it's far more likely there.  Similarly, although ticks are active in from spring to fall, children are still more likely to present with Lyme in the summer.  And location/time are just two of many factors to consider in evaluating the risk of isolated Bell's Palsy being attributable to Lyme disease.  All I'm saying is that the doctor's hesitance to prescribe dangerous antibiotics with limited clinical evidence is understandable, and would be moreso if it happened outside the Northeast, or perhaps, say in the winter.  

      I don't think it is naive to have a healthy sense of evidence-based skepticism.  

      •  respectfully disagree (6+ / 0-)

        Virginia State Health Commissioner --Karen Remley, MD, MBA, FAAP -- was so concerned that she sent this email alert out to all health practitioners and pharmacists in Virginia on May 17, 2011:

        Many of you learned about Lyme disease during your training, but thought cases in Virginia would be rare. However, since 2007 Virginia has experienced significant increases in the number of reported Lyme disease cases and other tick-borne infections. The risk of acquiring Lyme disease is no longer confined to northern Virginia. These significant increases are one reason Governor Bob McDonnell has declared May as Lyme Disease Awareness month in Virginia.


        Disease Trends
         As you can see in the graphs below, Virginia has seen a steady increase in the annual number of newly identified Lyme disease cases and other tick-borne infections since 2000. This increase is likely to be due to multiple factors, including increased diagnosis and reporting by clinicians like you.

        In 2007, Lyme disease increased dramatically and has remained high. From 2009 to 2010, there was a 37% increase. The recent increase in Lyme disease has coincided with a progressive geographic spread of activity southward and westward from northern regions of the Commonwealth as part of an overall expansion in the eastern United States.

        This is in Virginia. I doubt the ticks come to an abrupt halt at the NC and TN borders.

        •  and a Virginia anectdote (6+ / 0-)

          told to me by a Army reserve PA servicing the soldiers doing maneuvers in Virginia countryside, 2009:

          The soldiers are told to do a self body search for ticks after coming in from the field. They drop the ticks in a container. At a later briefing the PA is told that 95% of the ticks carry lyme.

          That sounded really high to me. This PA had neuroborreliosis, so maybe he got the number wrong,,, but nonetheless, it was a very high infection rate of Virginia ticks.

      •  My use of canine data was deliberate. (7+ / 0-)

        See other comments in this dairy that cite the greater accuracy in testing and more frequent correct diagnosis of lyme in canines by DVMs.

        There is little controversy surrounding diagnosing lyme in canines, mostly because the testing is better, and vets are never tempted to tell a dog it's "all in your head."

        Please keep in mind that, concerning humans, a case of lyme can only be reported if it is properly diagnosed. I would assume a 100% overlap in actual incidence of human lyme and canine lyme.

        "'club America salutes you' says the girl on the door/we accept all major lies, we love any kind of fraud"--The Cure, "Club America"

        by Wheever on Thu May 19, 2011 at 02:37:18 PM PDT

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      •  cases not being reported in Midwest (8+ / 0-)

        The maps and reports of cases are not accurate if patients are not getting a diagnosis. Just for example, here in Nebraska there is not one doctor who specializes in treating Lyme. People like me have to travel outside of the state for treatment. Since my 'test' wasn't CDC positive anyway, my case isn't reported anywhere, I'm guessing.

        Over the past three years, just in my limited circle of acquaintances, I have learned of nearly a dozen full-blown cases of Lyme among people living in a TWENTY MILE RADIUS of my home! Each of these people were treated (or are being treated) out of state.

        When one of these people came back home and reported her diagnosis to her PCP, he laughed! He still insisted in spite of her positive Western blot and clinical diagnosis by a Lyme specialist, that it's "unlikely" she has Lyme! WTF???!!!!!!

        My point is that there is no accurate way to say how many cases of Lyme or other tick-borne disease there are here. It's being ignored.

        ~On, Wisconsin! On, Wisconsin! Raise her glowing flame!~

        by sillia on Thu May 19, 2011 at 03:07:06 PM PDT

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        •  Check out maps that show the range of (4+ / 0-)

          Never meddle in the affairs of cats, for they are subtle and will piss on your computer.--Bruce Graham

          by Ice Blue on Thu May 19, 2011 at 03:47:10 PM PDT

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        •  I got it in Princeton, NJ at an outdoor opera (5+ / 0-)

          I was lucky: picked the tick off of myself, had the bulls-eye rash, and had a doctor that was too afraid of me to not put me on antibiotics.  About 60% of my neighborhood in New Jersey had Lyme so I knew the symptoms.

          Unfortunately, I soon went to Michigan on vacation and got hives from the antibiotics(too much sunshine) so the doctor in Michigan took me off the strong stuff(Tetracycline) and put me on Amoxicillin saying he didn't know anything about Lyme disease, but he thought Amoxicillin would work the same as the tetracycline.

           About two months later, I got seriously ill and thought I had a virus.  I became so lethargic, I could hardly function. My doc in NJ administered  a Western blot test and found that I was positive.  The Amoxicillin had not knocked the Lyme out of my system, and it had regrouped and flourished.  I went back on the Tetracycline(and stayed out of the sun) and have been fine ever since(about 20 years).

          When I moved to northern IL, a friend got Bell's Palsy.  No one could figure out why until his wife-- who was a biology teacher-- started insisting he get a Western Blot test for Lyme.  Voila!  He had been bitten by a tick on a hunting trip in Wisconsin. If it's in Wisconsin, it's probably all over the Midwest!

          If Liberals Hated America, We'd Vote Republican

          by QuarterHorseDem on Thu May 19, 2011 at 03:54:31 PM PDT

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      •  You've been flooded with IDSA propoganda (3+ / 0-)
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        MsGrin, churchylafemme, Wheever

        The IDSA disseminates misinformation to doctor's who are far too busy to research themselves.

        The IDSA's own research from the 80's and 90's shows lyme is a systemic, chronic infection which is very difficult to treat and can continually relapse. Today, the IDSA states that very short courses of antibiotics completely wipes it out.

        Here's a link to a 1988 New England Journal of Medicine article where the IDSA states...................

        "We studied 17 patients who had presented with acute Lyme disease and received prompt treatment with oral antibiotics, but in whom chronic lyme disease subsequently developed.

      •  Tautological explanation... (1+ / 0-)
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