Sunday, August 21, 2011
Watch this!!!
You can now watch the entire documentary film about Lyme disease, Under Our Skin, on line! This film is a MUST-SEE for anyone who has (or suspects they have) Lyme disease!! (P.S. Yes, there are commercials, just be patient!)
Tuesday, August 16, 2011
Lots and lots of important info!
I want to catch you up on miscellaneous exciting news in the world of Lyme research, so this is a bit of a hodgepodge post.
1) A recent paper in the Journal of Neuroinflammation, written by Judith Miklossy, makes an excellent case for Alzheimer's being a disease caused by spirochetes! Believe it or not, Lyme and syphilis aren't the only spirochetes implicated in this....even DENTAL spirochetes are included as probable causal agents of dementia!
Here is the abstract, plus a link to the entire paper:
Alzheimer's disease - a neurospirochetosis.
It is established that chronic spirochetal infection can cause slowly progressive dementia, brain atrophy and amyloid deposition in late neurosyphilis. Recently it has been suggested that various types of spirochetes, in an analogous way to Treponema pallidum, could cause dementia and may be involved in the pathogenesis of Alzheimer's disease (AD). Here, we review all data available in the literature on the detection of spirochetes in AD and critically analyze the association and causal relationship between spirochetes and AD following established criteria of Koch and Hill. The results show a statistically significant association between spirochetes and AD (P = 1.5 x 10-17, OR = 20, 95% CI = 8-60, N = 247). When neutral techniques recognizing all types of spirochetes were used, or the highly prevalent periodontal pathogen Treponemas were analyzed, spirochetes were observed in the brain in more than 90% of AD cases. Borrelia burgdorferi was detected in the brain in 25.3% of AD cases analyzed and was 13 times more frequent in AD compared to controls. Periodontal pathogen Treponemas (T. pectinovorum, T. amylovorum, T. lecithinolyticum, T. maltophilum, T. medium, T. socranskii) and Borrelia burgdorferi were detected using species specific PCR and antibodies. Importantly, co-infection with several spirochetes occurs in AD. The pathological and biological hallmarks of AD were reproduced in vitro. The analysis of reviewed data following Koch's and Hill's postulates shows a probable causal relationship between neurospirochetosis and AD. Persisting inflammation and amyloid deposition initiated and sustained by chronic spirochetal infection form together with the various hypotheses suggested to play a role in the pathogenesis of AD a comprehensive entity. As suggested by Hill, once the probability of a causal relationship is established prompt action is needed. Support and attention should be given to this field of AD research. Spirochetal infection occurs years or decades before the manifestation of dementia. As adequate antibiotic and anti-inflammatory therapies are available, as in syphilis, one might prevent and eradicate dementia.
Please read and re-read that last sentence in the abstract!! With proper antibiotic treatment "...one might prevent and eradicate dementia"! That is FANTASTIC news indeed!
If only the medical world as a whole will pay attention to this paper.....? That is the $64,000.00 question, unfortunately. I hope the IDSA won't try to stand in the way of treating dementia with long-term antibiotics!!
2) Everything you thought you knew about cyst busters is wrong!! This is the title of a post by LymeMD, a fellow blogger who is a LLMD in Germantown, MD. He discusses a new study by Eva Sapi that shows that Tigecycline and Tindamax reduce both spirochetal and round body (cystic) forms of Lyme by ~90%! WOO-HOO!! I don't know about you, but I'm so jazzed by this! I will be talking to my doctor for sure!
Of course this is not the end of the story.....biofilms remain a big issue. It is very very difficult to kill bacteria that are protected by a biofilm and Lyme definitely uses biofilms to avoid antibiotics and preserve itself. Still, the results of the Sapi study are extremely interesting, showing exactly which antibiotics are (or are not) effective against the spirochetal and cystic forms of Lyme.
3) Tracking Lyme disease in dogs may help prevent Lyme in humans. This is from a news article in HealthDay: a recent study by a team led by Dr. Paul Mead reveals that when 1% or fewer dogs test positive for Lyme, the risk for human infection is relatively low. But when 5% or more dogs in an area have Lyme, the risk for humans to contract Lyme disease is high.
4) This same news article also discussed another study from researchers in Germany which says that pastures with domestic livestock such as cows and goats have fewer ticks in general and fewer ticks with Lyme disease! Let's go get us some cows!! :)
Friday, July 22, 2011
The untruths told by the CDC are getting WORSE, not better!
From an email I received from a Lyme Warrior and friend:
For those who think we are making progress with the establishment regarding Lyme disease, this will likely cause you to rethink that idea. In my eleven years of Lyme advocacy I've watched the CDC steadily retreat from a more balanced presentation of Lyme to one where they walk in lockstep with the IDSA, spewing the same myths and misinformation. Sadly rather than progress with regards to understanding Lyme, it seems the CDC is choosing to move farther and farther from the truth.
Below is just a sample of lies from the CDC (bold text indicates the most egregious ones):
Full text of CDC answers to Frequently Asked Questions about Lyme located here:
CDC states:
"Finally, blacklegged ticks need to be attached for at least 24 hours before they can transmit Lyme disease."
"This means that if your blood tests positive, then it will likely continue to test positive for months or even years even though the bacteria are no longer present."
My serologic (blood) test for Lyme disease is still positive even though I finished 3 weeks of antibiotics. Does this mean I am still infected?
No. The tests for Lyme disease detect antibodies made by the immune system to fight off the bacteria, Borrelia burgdorferi. Your immune system continues to make the antibodies for months or years after the infection is gone. This means that once your blood tests positive, it will continue to test positive for months to years even though the bacteria are no longer present.
I heard that if I get Lyme disease I will always have it. Is that true?
No. Patients treated with antibiotics in the early stages of the infection usually recover rapidly and completely. Most patients who are treated in later stages of the disease also respond well to antibiotics, although some may have suffered long-term damage to the nervous system or joints. Approximately 10-20% of patients experience fatigue, muscle aches, sleep disturbance, or difficulty thinking even after completing a recommended course of antibiotic treatment. These symptoms cannot be cured by longer courses of antibiotics, but they generally improve on their own, over time.
Can you recommend a doctor who is familiar with diagnosing and treating Lyme disease?
The American Lyme Disease Foundation (ALDF) keeps a national list of doctors who are familiar with the diagnosis and treatment of Lyme disease and other tickborne infections. You can access this list by:
- Visiting the ALDF website
- Sending the ALDF an e-mail and asking for doctors in your area, physref@aldf.com
Please note that CDC cannot evaluate the professional qualifications and competence of individual doctors. The inclusion of a doctor on the ALDF list should not be seen as an endorsement by CDC. You could also choose to see a doctor in your area who specializes in infectious diseases. Often these doctors are affiliated with a university."
Why does CDC only link to one set of treatment guidelines?
CDC believes that the Infectious DiseaseSociety of America (IDSA) guidelinescurrently represent the best available synthesis of the medical literature on the diagnosis and treatment of Lyme disease. The IDSA, with input from CDC expert and other doctors, has developed and published Lyme disease treatment guidelines."
"In contrast, Lyme disease in North America is caused by a specific type of bacteria,Borrelia burgdorferi, which is transmitted by two species of blacklegged ticks, Ixodes scapularis and Ixodes pacificus. While blacklegged ticks exist in the southern U.S., their feeding habits in this region make them much less likely to maintain, sustain, and transmit Lyme disease."
Of course, WE know better....we know that:
(1) if you've had Lyme longer than a few weeks, you will likely need a LONG course of antibiotics to recover (months or even years of antibiotics).
(2) Lyme-infected ticks have been found in 49 out of the 50 states. You can catch it literally anywhere! Lyme is also becoming a very serious problem in Europe and Asia.
(3) If you have Lyme disease, or have ever had it, you should NEVER donate blood. There's too great a risk of passing the disease on to others.
Saturday, July 9, 2011
You know you have Lyme when....
Retrieved from the "Truth About Lyme Disease Forums" on 5/6/2011 (and slightly edited)
YOU KNOW YOU HAVE LYME WHEN:
1) You don't care where your spouse goes, just as long as you don't have to go along.
2) You are cautioned to slow down by the doctor instead of by the police.
3) "Getting lucky" means finding your car in the parking lot.
4) Your sweetie says, "Let's go upstairs and make love" and you answer, "Honey, I can't do both!"
5) Everything hurts; but you don't know when or where it will hurt.
6) You're asleep, but others worry that you're dead.
7) You get exhausted from just waking up.
8) Your children can do math better than you can.
9) People call at 7 pm, and ask, "Did I wake you?"
10) You know all the answers, but nobody asks you the questions [if for once you don't have brain fog].
11) You look forward to your IV infusion of antibiotics [or oral antibiotics].
12) You turn down the lights because of photosensitivity rather than romance.
13) You sit in a rocking chair and get motion sickness. even when the rocking chair isn't moving.
14) Your GPS becomes your best friend when driving.
15) You get motion sickness when you drive. Forget about trying to be the passenger!
16) You burn the midnight oil until 9:00 PM or 1 AM or 6 AM depending on your internal clock's daily computations. Everyday is different.
17) You put the margarine in the toaster oven and try to butter your bread. You put the margarine in the cupboard, the knife in the refrigerator, and the toast in the sink. Then you walk around in circles trying to find the toast.
18) You get exercise by going to the bathroom 10 or more times a day.
19) One shelf of the refrigerator is filled with abx (or supplements, herbs, etc)
20) You can't remember how to turn the shower off.
21) You can't figure out how to get the key out of the ignition [you forgot
about the little black button you push in].
22) You can't find your way home and you only took a walk around the block.
23) When your little black book contains only names ending in M.D.
24) You get winded playing chess.
25) You look forward to a dull evening.
26) The best part of your day is over when your alarm clock goes off.
27) You have too much room in the house and not enough room in the medicine cabinet.
28) When you wake up with that morning-after feeling and you didn't do anything the night before.
29) When it takes longer to rest than to get tired.
30) There are three signs of Lyme Disease. The first is your loss of memory, the other two I forget.
31) The only part of your body that gets a "workout" are your thumbs - from clicking on that remote or mousepad all day.
32) When your idea of cleaning the house is sweeping the floor with a glance.
33) You know you have Lyme when you stop to think and forget to start again
34) When you wake up screaming and stressed - then you realize you haven't fallen asleep yet.
35) When your day was a total waste of makeup.
36) When you think to yourself: "This ain't no party...this ain't no disco..."
37) When all the pharmacists and lab workers in town know you on a first name basis.
YOU KNOW YOU HAVE LYME WHEN:
1) You don't care where your spouse goes, just as long as you don't have to go along.
2) You are cautioned to slow down by the doctor instead of by the police.
3) "Getting lucky" means finding your car in the parking lot.
4) Your sweetie says, "Let's go upstairs and make love" and you answer, "Honey, I can't do both!"
5) Everything hurts; but you don't know when or where it will hurt.
6) You're asleep, but others worry that you're dead.
7) You get exhausted from just waking up.
8) Your children can do math better than you can.
9) People call at 7 pm, and ask, "Did I wake you?"
10) You know all the answers, but nobody asks you the questions [if for once you don't have brain fog].
11) You look forward to your IV infusion of antibiotics [or oral antibiotics].
12) You turn down the lights because of photosensitivity rather than romance.
13) You sit in a rocking chair and get motion sickness. even when the rocking chair isn't moving.
14) Your GPS becomes your best friend when driving.
15) You get motion sickness when you drive. Forget about trying to be the passenger!
16) You burn the midnight oil until 9:00 PM or 1 AM or 6 AM depending on your internal clock's daily computations. Everyday is different.
17) You put the margarine in the toaster oven and try to butter your bread. You put the margarine in the cupboard, the knife in the refrigerator, and the toast in the sink. Then you walk around in circles trying to find the toast.
18) You get exercise by going to the bathroom 10 or more times a day.
19) One shelf of the refrigerator is filled with abx (or supplements, herbs, etc)
20) You can't remember how to turn the shower off.
21) You can't figure out how to get the key out of the ignition [you forgot
about the little black button you push in].
22) You can't find your way home and you only took a walk around the block.
23) When your little black book contains only names ending in M.D.
24) You get winded playing chess.
25) You look forward to a dull evening.
26) The best part of your day is over when your alarm clock goes off.
27) You have too much room in the house and not enough room in the medicine cabinet.
28) When you wake up with that morning-after feeling and you didn't do anything the night before.
29) When it takes longer to rest than to get tired.
30) There are three signs of Lyme Disease. The first is your loss of memory, the other two I forget.
31) The only part of your body that gets a "workout" are your thumbs - from clicking on that remote or mousepad all day.
32) When your idea of cleaning the house is sweeping the floor with a glance.
33) You know you have Lyme when you stop to think and forget to start again
34) When you wake up screaming and stressed - then you realize you haven't fallen asleep yet.
35) When your day was a total waste of makeup.
36) When you think to yourself: "This ain't no party...this ain't no disco..."
37) When all the pharmacists and lab workers in town know you on a first name basis.
Monday, June 13, 2011
Nine Reasons for False Negative Lyme Blood Test Results
From the Lyme Disease Foundation brochure: Frequently Asked Questions About Lyme Disease
1. Antibodies against Borrelia burgdorferi (Bb) are present, but the laboratory is unable to detect them.
2. Antibodies against Bb may not be present in detectable levels in a patient with Lyme disease because the patient is currently on, or has recently taken, antibiotics. The antibacterial effect of antibiotics can reduce the body's production of antibodies.
3. Antibodies against Bb may not be present in detectable levels in a patient with Lyme disease because the patient is currently on or has previously taken anti-inflammatory steroidal drugs. These can suppress a person's immune system, thus reducing or preventing an antibody response.
4. Antibodies against Bb may not be present in detectable levels in a patient with Lyme disease because the patient's antibodies may be bound with the bacteria with not enough free antibodies available for testing.
For this reason, some of the worst cases of Lyme disease test negative -- too much bacteria for the immune system to handle.
5. Antibodies against Bb may not be present in detectable levels in a patient with Lyme disease because the patient could be immunosuppressed for a number of other reasons, and the immune system is not reacting to the bacteria.
6. Antibodies against Bb may not be present in detectable levels in a patient with Lyme disease because the bacteria has changed its makeup (antigenic shift) limiting recognition by the patient's immune system.
7. Antibodies against Bb may not be present in detectable levels in a patient with Lyme disease because the patient's immune response has not been stimulated to produce antibodies, i.e., the blood test is taken too soon after the tick-bite (8-6 weeks).
Please do not interpret this statement as implying that you should wait for a positive test to begin treatment.
8. Antibodies against Bb may not be present in detectable levels in a patient with Lyme disease because the laboratory has raised its cutoff too high.
9. Antibodies against Bb may not be present in detectable levels in a patient with Lyme disease because the patient is reacting to the Lyme bacteria, but is not producing the "right" bands to be considered positive.
1. Antibodies against Borrelia burgdorferi (Bb) are present, but the laboratory is unable to detect them.
2. Antibodies against Bb may not be present in detectable levels in a patient with Lyme disease because the patient is currently on, or has recently taken, antibiotics. The antibacterial effect of antibiotics can reduce the body's production of antibodies.
3. Antibodies against Bb may not be present in detectable levels in a patient with Lyme disease because the patient is currently on or has previously taken anti-inflammatory steroidal drugs. These can suppress a person's immune system, thus reducing or preventing an antibody response.
4. Antibodies against Bb may not be present in detectable levels in a patient with Lyme disease because the patient's antibodies may be bound with the bacteria with not enough free antibodies available for testing.
For this reason, some of the worst cases of Lyme disease test negative -- too much bacteria for the immune system to handle.
5. Antibodies against Bb may not be present in detectable levels in a patient with Lyme disease because the patient could be immunosuppressed for a number of other reasons, and the immune system is not reacting to the bacteria.
6. Antibodies against Bb may not be present in detectable levels in a patient with Lyme disease because the bacteria has changed its makeup (antigenic shift) limiting recognition by the patient's immune system.
7. Antibodies against Bb may not be present in detectable levels in a patient with Lyme disease because the patient's immune response has not been stimulated to produce antibodies, i.e., the blood test is taken too soon after the tick-bite (8-6 weeks).
Please do not interpret this statement as implying that you should wait for a positive test to begin treatment.
8. Antibodies against Bb may not be present in detectable levels in a patient with Lyme disease because the laboratory has raised its cutoff too high.
9. Antibodies against Bb may not be present in detectable levels in a patient with Lyme disease because the patient is reacting to the Lyme bacteria, but is not producing the "right" bands to be considered positive.
Tuesday, May 3, 2011
May is Lyme Awareness Month!
....and certain members of the IDSA are trying to keep the populace ignorant, as usual!!
Keep fighting, everyone! We're in a battle not just with the spirochetes that have invaded our bodies, but also with certain self-centered, heartless factions in the medical community. The IDSA group in question literally has the power of life and death over Lyme patients in this country, because they call the shots regarding Lyme diagnosis and treatment protocols. And they are trying to suppress the truth about THEMSELVES, of course.
I saw the following brief article posted in one of my Lyme groups, so am re-posting it here.
IDSA aims to censor UNDER OUR SKIN TV broadcasts
Posted: 28 Apr 2011 04:10 PM PDT
Open Eye Pictures has recently learned that the Infectious Diseases Society of America (IDSA) has been trying to stop the television broadcast of its award-winning documentary on Lyme disease, UNDER OUR SKIN. Working behind the scenes, IDSA officers and members have been contacting the Public Broadcasting Service (PBS), the National Educational Telecommunications Association (NETA), and local PBS stations, calling our film "dangerous for viewers" and full of "conspiracies. "
The Public Broadcasting Service (PBS) was created in 1967 to "provide a voice for groups in the community that may otherwise be unheard," and serve as "a forum for controversy and debate" by broadcasting programs that "help us see America whole, in all its diversity."
We are heartened that no PBS affiliate station has folded under the pressure. UNDER OUR SKIN is the first televised documentary dedicated to educating the public about the plight of Lyme disease patients, who have been abandoned by the medical establishment, in part, because of the IDSA's flawed Lyme guidelines development process.
While the primary focus of UNDER OUR SKIN is to inform viewers about Lyme disease through the eyes of patients, it also includes interviews with several authors of the IDSA Lyme disease treatment guidelines. These authors were briefed by the IDSA vice president of communications before the filming began, and we believe these interviews accurately represent the IDSA viewpoint on Lyme disease.
UNDER OUR SKIN also shows the unfolding of the investigation into the IDSA Lyme disease guidelines by former Attorney General Richard Blumenthal of Connecticut. His final investigative report found that there was:
. Significant conflicts of interest among the original IDSA guidelines authors,
. Suppression of scientific evidence by authors, and,
. Exclusion of panel members with opposing viewpoints.
The IDSA's suppression of dissenting views continues. This time the target is UNDER OUR SKIN. (More examples of IDSA censorship are listed at the end of this article.)
Recently, the importance of transparency and open dialogue in medical guidelines development were underscored in a report by the Institute of Medicine (IOM), "Clinical Practice Guidelines We Can Trust." In this mandate for guidelines reform, the IDSA Lyme guidelines were called out as an example of a process gone awry:
"This case highlights the need for standardization and transparency in all aspects of systemic data collection and review, committee administration, and guideline development, so that questions about these issues do not detract from the science. [Guideline developers]. must be aware of the many, varied observers who will consider their development processes, particularly when their recommendations are likely to be controversial. "
And in a recent study in Archives of Internal Medicine, researchers found that out of 4,200 IDSA guideline recommendations, more than half were based on no more than expert opinion and anecdote, not hard evidence, reinforcing points made in our film. (See references below.)
So, as investigative news organizations and documentary film producers - with the help of the Physicians Sunshine Act - begin to shine the light on endemic commercial influences on "evidence-based medicine," it's a wake up call to the medical establishment to clean up their own act before attacking outside organizations dedicated to protecting the public.
In other words, don't shoot the messenger.
____________ _________ _________ ______
To read more about past IDSA efforts to censor dissenting opinions:
Poses, R. (2006) "The Conflicted Defending the Conflicted: Infectious Disease Specialists' Attack on the LA Times Goes Awry."
Henderson CW, DeNoon, DJ. (1997) "Strange Bedfellows Damage CDC and NIH Credibility" AIDSWEEKLY Plus. Feb 3 1997.
Oransky, I. "Transparency needed in drug researchers' finances." Boston Globe. Oct. 7, 2006.
To read more about the flawed IDSA guidelines development process:
Johnson, L. and R. B. Stricker (2010). "The Infectious Diseases Society of America Lyme guidelines: a cautionary tale about the development of clinical practice guidelines." Philos Ethics Humanit Med 5: 9.
IOM. (2011) "Clinical Practice Guidelines We Can Trust." Washington D.C. National Academies Press.
Lee, D. H. and O. Vielemeyer (2011). "Analysis of Overall Level of Evidence Behind Infectious Diseases Society of America Practice Guidelines." Arch Intern Med 171(1): 18-22.
Frederik Joelving, Medical "best practice" often no more than opinion".
--
Vickie Travis
Former Caregiver, Eldest Child and Daughter of Adam Wesley Arnold
Keep fighting, everyone! We're in a battle not just with the spirochetes that have invaded our bodies, but also with certain self-centered, heartless factions in the medical community. The IDSA group in question literally has the power of life and death over Lyme patients in this country, because they call the shots regarding Lyme diagnosis and treatment protocols. And they are trying to suppress the truth about THEMSELVES, of course.
I saw the following brief article posted in one of my Lyme groups, so am re-posting it here.
IDSA aims to censor UNDER OUR SKIN TV broadcasts
Posted: 28 Apr 2011 04:10 PM PDT
Open Eye Pictures has recently learned that the Infectious Diseases Society of America (IDSA) has been trying to stop the television broadcast of its award-winning documentary on Lyme disease, UNDER OUR SKIN. Working behind the scenes, IDSA officers and members have been contacting the Public Broadcasting Service (PBS), the National Educational Telecommunications Association (NETA), and local PBS stations, calling our film "dangerous for viewers" and full of "conspiracies.
The Public Broadcasting Service (PBS) was created in 1967 to "provide a voice for groups in the community that may otherwise be unheard," and serve as "a forum for controversy and debate" by broadcasting programs that "help us see America whole, in all its diversity."
We are heartened that no PBS affiliate station has folded under the pressure. UNDER OUR SKIN is the first televised documentary dedicated to educating the public about the plight of Lyme disease patients, who have been abandoned by the medical establishment, in part, because of the IDSA's flawed Lyme guidelines development process.
While the primary focus of UNDER OUR SKIN is to inform viewers about Lyme disease through the eyes of patients, it also includes interviews with several authors of the IDSA Lyme disease treatment guidelines. These authors were briefed by the IDSA vice president of communications before the filming began, and we believe these interviews accurately represent the IDSA viewpoint on Lyme disease.
UNDER OUR SKIN also shows the unfolding of the investigation into the IDSA Lyme disease guidelines by former Attorney General Richard Blumenthal of Connecticut. His final investigative report found that there was:
. Significant conflicts of interest among the original IDSA guidelines authors,
. Suppression of scientific evidence by authors, and,
. Exclusion of panel members with opposing viewpoints.
The IDSA's suppression of dissenting views continues. This time the target is UNDER OUR SKIN. (More examples of IDSA censorship are listed at the end of this article.)
Recently, the importance of transparency and open dialogue in medical guidelines development were underscored in a report by the Institute of Medicine (IOM), "Clinical Practice Guidelines We Can Trust." In this mandate for guidelines reform, the IDSA Lyme guidelines were called out as an example of a process gone awry:
"This case highlights the need for standardization and transparency in all aspects of systemic data collection and review, committee administration, and guideline development, so that questions about these issues do not detract from the science. [Guideline developers]. must be aware of the many, varied observers who will consider their development processes, particularly when their recommendations are likely to be controversial.
And in a recent study in Archives of Internal Medicine, researchers found that out of 4,200 IDSA guideline recommendations, more than half were based on no more than expert opinion and anecdote, not hard evidence, reinforcing points made in our film. (See references below.)
So, as investigative news organizations and documentary film producers - with the help of the Physicians Sunshine Act - begin to shine the light on endemic commercial influences on "evidence-based medicine," it's a wake up call to the medical establishment to clean up their own act before attacking outside organizations dedicated to protecting the public.
In other words, don't shoot the messenger.
____________
To read more about past IDSA efforts to censor dissenting opinions:
Poses, R. (2006) "The Conflicted Defending the Conflicted: Infectious Disease Specialists' Attack on the LA Times Goes Awry."
Henderson CW, DeNoon, DJ. (1997) "Strange Bedfellows Damage CDC and NIH Credibility" AIDSWEEKLY Plus. Feb 3 1997.
Oransky, I. "Transparency needed in drug researchers' finances." Boston Globe. Oct. 7, 2006.
To read more about the flawed IDSA guidelines development process:
Johnson, L. and R. B. Stricker (2010). "The Infectious Diseases Society of America Lyme guidelines: a cautionary tale about the development of clinical practice guidelines." Philos Ethics Humanit Med 5: 9.
IOM. (2011) "Clinical Practice Guidelines We Can Trust." Washington D.C. National Academies Press.
Lee, D. H. and O. Vielemeyer (2011). "Analysis of Overall Level of Evidence Behind Infectious Diseases Society of America Practice Guidelines." Arch Intern Med 171(1): 18-22.
Frederik Joelving, Medical "best practice" often no more than opinion".
--
Vickie Travis
Former Caregiver, Eldest Child and Daughter of Adam Wesley Arnold
Thursday, February 24, 2011
A Lyme Obituary - and a Message to the Living
I received this obituary in email and felt I had to share it with you. No, I didn't know the gentleman in question. Unfortunately, this is what can happen if you have Lyme disease and you're forced to rely on conventional medicine and doctors who follow the IDSA guidelines for treating Lyme:
Vernon Dale Kyle, 55, Kansas
Vernon Dale Kyle liked a good story. Mostly about catfishing on a long-forgotten Kansas lake. He was born Sept 24, 1955 in Garnett, Kansas. He had one best friend in those early days, and it was Don. They roamed the Kansas prairie like the buffalo, wild and free! He was raised by Chester and Edna Kyle with one brother and one sister, Jim and Aletha.
Vernon Dale Kyle liked a good story. Mostly about catfishing on a long-forgotten Kansas lake. He was born Sept 24, 1955 in Garnett, Kansas. He had one best friend in those early days, and it was Don. They roamed the Kansas prairie like the buffalo, wild and free! He was raised by Chester and Edna Kyle with one brother and one sister, Jim and Aletha.
Vernon went into the US Army 82nd Airborne division and it wasn’t long before he took his turn in Vietnam in 1974, then on to Germany. He re-enlisted into the US Army Veterinary Corps stationed at Ft. Ord, then to an outpost in San Diego, California. He met Peggy Miller and they married at Cabrillo National Monument at the Lighthouse overlooking the ocean.
After discharge, he moved to Tulsa, OK where his two awesome kids were born, Jamie Lynn in 1985 and Jesse Dale in 1988. Vernon went to college and became a journeyman welder and stationary engineer. He specialized in boilers and high pressure systems, and stainless steel welding. He loved coin collecting, nature, and decorative engraving. He returned to Garnett, Kansas in the early 1990’s to support his mother when his father was ill.
After discharge, he moved to Tulsa, OK where his two awesome kids were born, Jamie Lynn in 1985 and Jesse Dale in 1988. Vernon went to college and became a journeyman welder and stationary engineer. He specialized in boilers and high pressure systems, and stainless steel welding. He loved coin collecting, nature, and decorative engraving. He returned to Garnett, Kansas in the early 1990’s to support his mother when his father was ill.
He was employed at the Anderson County School District in the maintainence department until suddenly he became too ill to work in October 2007. He was life-flighted twice to the KC hospitals and in ICU and on a rehabilitation unit for five months.
Vernon’s illness was bacterial in origin, his family was told by the doctors in Kansas City. When he received IV antibiotics, he thrived. When the doctors took away the antibiotics, he began to fail. The doctors would never identify the name of the bacteria that was trying to take Vernon’s life.
He had symptoms like abcesses in his abdomen and near his lung and kidney, foot pain, rashes similar to a bartonella rash, and little red dots on his body, memory loss, dizziness, joint pain, loss of feeling in his hands, feet, loss of use of fine motor skills, difficulty processing any information, body jerks (myoclonus and severe muscle cramps) and seizures.
As time went on he experienced intense bone pain from a collapsing spinal cord, and lost about 6 inches in height. One doctor his family consulted said that Lyme disease and bartonella can cause the bone to not have blood supply and oxygen due to excessive fibrin production in the blood. As time progressed, Vernon needed oxygen, had an intermittent low heart rate of 40, would pass out. He became a diabetic and experienced hepatitis and kidney failure.
By the way, his cat died of tick-borne illness.
He could never understand the “controversy" over Lyme disease. Even though other family members were eventually diagnosed with Lyme disease, he was never tested by his doctors, simply because they refused.
Additionally, after numerous hospitalizations, he was denied long term antibiotics by infectious disease doctors in the hospital and his physicians in the community, and was denied testing when his family directly asked for Lyme testing using specialty laboratories. More than three years of advocacy efforts failed on his behalf.
During one hospitalization, his family asked the infectious disease doctor, “Can you help him? His family has Lyme disease, will you test him?” That Infectious Disease doctor said, “No,” firmly, immediately turned his back and walked out of the room. The doctor discharged Vernon the next morning.
Vernon’s illness was bacterial in origin, his family was told by the doctors in Kansas City. When he received IV antibiotics, he thrived. When the doctors took away the antibiotics, he began to fail. The doctors would never identify the name of the bacteria that was trying to take Vernon’s life.
He had symptoms like abcesses in his abdomen and near his lung and kidney, foot pain, rashes similar to a bartonella rash, and little red dots on his body, memory loss, dizziness, joint pain, loss of feeling in his hands, feet, loss of use of fine motor skills, difficulty processing any information, body jerks (myoclonus and severe muscle cramps) and seizures.
As time went on he experienced intense bone pain from a collapsing spinal cord, and lost about 6 inches in height. One doctor his family consulted said that Lyme disease and bartonella can cause the bone to not have blood supply and oxygen due to excessive fibrin production in the blood. As time progressed, Vernon needed oxygen, had an intermittent low heart rate of 40, would pass out. He became a diabetic and experienced hepatitis and kidney failure.
By the way, his cat died of tick-borne illness.
He could never understand the “controversy" over Lyme disease. Even though other family members were eventually diagnosed with Lyme disease, he was never tested by his doctors, simply because they refused.
Additionally, after numerous hospitalizations, he was denied long term antibiotics by infectious disease doctors in the hospital and his physicians in the community, and was denied testing when his family directly asked for Lyme testing using specialty laboratories. More than three years of advocacy efforts failed on his behalf.
During one hospitalization, his family asked the infectious disease doctor, “Can you help him? His family has Lyme disease, will you test him?” That Infectious Disease doctor said, “No,” firmly, immediately turned his back and walked out of the room. The doctor discharged Vernon the next morning.
But Vernon had to laugh when this same, bright, Infectious Disease doctor actually said, “There are no ticks in Kansas.”
Several times Vernon was too sick to leave the hospital and care for himself. Even in his weakened condition, once the hospital sent him home in a taxi without any home nursing! His insurance wouldn’t pay any more for his care. Not even Adult Protective Services would intervene, even after many calls.
Vernon learned NOT to mention Lyme disease to anyone. No one was willing to test and treat him for Lyme disease and bartonella. Not the Veteran’s Administration hospital, not the big medical centers in Kansas City, nor his local doctor. But they were all perfectly willing to let him suffer and die from tick-borne illnesses. Ultimately, he lost the war.
Vernon was left by his doctors to debilitate, and after losing balance, he had repeated traumatic brain injuries from falling. He later was able to get assistance through the TBI waiver program, but after many calls for a higher level of care, even this system failed him.
His family later discovered that he had gone a month without a bath, and often didn’t have food or water, and went to the hospital on his birthday after he collapsed from carbon monoxide poisoning from his furnace. Thankfully, he was with family that day and he was admitted for another time in the ICU.
Several times Vernon was too sick to leave the hospital and care for himself. Even in his weakened condition, once the hospital sent him home in a taxi without any home nursing! His insurance wouldn’t pay any more for his care. Not even Adult Protective Services would intervene, even after many calls.
Vernon learned NOT to mention Lyme disease to anyone. No one was willing to test and treat him for Lyme disease and bartonella. Not the Veteran’s Administration hospital, not the big medical centers in Kansas City, nor his local doctor. But they were all perfectly willing to let him suffer and die from tick-borne illnesses. Ultimately, he lost the war.
Vernon was left by his doctors to debilitate, and after losing balance, he had repeated traumatic brain injuries from falling. He later was able to get assistance through the TBI waiver program, but after many calls for a higher level of care, even this system failed him.
His family later discovered that he had gone a month without a bath, and often didn’t have food or water, and went to the hospital on his birthday after he collapsed from carbon monoxide poisoning from his furnace. Thankfully, he was with family that day and he was admitted for another time in the ICU.
Yet those medical professionals who were suppose to care for him, didn’t. Every time his family would try to get help for him, those in charge would fight his family. They even refused to help him to apply for full Veteran’s benefits as a Vietnam veteran, and he often suffered from not having enough money to live. He took it well. He kept his doctors laughing even when he knew they were going to let him die.
He lived with the courage of a warrior, and endured and persevered through unrelenting pain to the end, which came on Sunday, October 3, 2010. He left a good example of courage under fire, and joy in the midst of sorrow. At his memorial service, his son-in-law recited “Invictus,”
The more his body was crushed by Lyme disease and bartonella, the sweeter and more loving he became. He had given his heart to his Savior, Jesus Christ, rather late in life, and it was evident that his life had changed.
He lived with the courage of a warrior, and endured and persevered through unrelenting pain to the end, which came on Sunday, October 3, 2010. He left a good example of courage under fire, and joy in the midst of sorrow. At his memorial service, his son-in-law recited “Invictus,”
The more his body was crushed by Lyme disease and bartonella, the sweeter and more loving he became. He had given his heart to his Savior, Jesus Christ, rather late in life, and it was evident that his life had changed.
He is already greatly missed by the love of his life, Peggy, and his children, siblings, and neighbors and friends. Now he is truly free, and we are sure he is fishing in heaven and that he caught the biggest fish this time!
Now, please understand, I'm not sharing the story of Mr. Kyle to be morbid; I'm sharing it because I feel that it's important for the Lyme community to have ALL the facts. There is some very important information in this obituary. For example:
1. You can DIE from Lyme disease. Yes, it is possible.
2. If you have Lyme, you should be tested immediately for hypercoagulation syndrome; it's a very common condition for Lymies and that's why poor Vernon lost 6 inches in height when his spine crumbled. It can also lead to a stroke and prevent your medications from being effective.
3. There are parts of this country (USA) which have few or even NO Lyme-Literate doctors (aka LLMDs). And most of the "regular" doctors will not treat Lyme. Some of them live in denial of the very existence of Lyme disease, at least in their part of the country.
If you live in one of those places, you should probably move. Seriously. Otherwise be prepared to fly to New York or Seattle or San Francisco every six months or so to see someone who is willing to give you long-term antibiotics (in defiance of the IDSA edict that no one should receive more than 4 weeks of antibiotics for Lyme even if they are DYING).
Because that's the reason Vernon Kyle was not diagnosed with Lyme, why he never got proper treatment. His doctors had already treated him with antibiotics ... the obituary doesn't say for how long, but I assume it was at least 10 days, maybe longer.
All of those short-sighted, IDSA-believing doctors Vernon trusted merely said to themselves, "He's already been treated for Lyme, this must be something else!". They really do believe that a short course of antibiotics takes care of 100% of Lyme cases ... always ... end of story.
All of those short-sighted, IDSA-believing doctors Vernon trusted merely said to themselves, "He's already been treated for Lyme, this must be something else!". They really do believe that a short course of antibiotics takes care of 100% of Lyme cases ... always ... end of story.
R.I.P., Vernon ... and catch a lot of fish!
Monday, January 17, 2011
Go Directly to Jail, Do Not Pass "Go"
It's so hard to explain this to people who are not chronically ill...but it's just like being in prison. I can't go out, I have Lyme and lupus and twenty other diagnoses, and I'm extremely sun-sensitive....to the point where I break out in a horrible rash if I'm in the sun for more than a few minutes. I get severely nauseated, sometimes even end up in the ER with chest pains after sun exposure. I have to wear dark glasses, even indoors.
Besides, my driver's license is suspended for medical reasons (vertigo, narcoleptic episodes, etc.). I'm working with my neurologist on getting it back, and I'm hoping that I will get it back very soon, but at the moment I can't go anywhere unless someone takes me there. That "someone" is usually my husband, but lately he's been sick and in a lot of pain. We found out recently that he has Lyme too, probably caught it from me. He doesn't feel like going anywhere, so even if I wanted to go somewhere (which doesn't happen very often), I can't because he won't take me.
I only get out of the house to go to doctor's appointments.
But it's worse than that, really....it's not just that I don't leave the house, I spend most of my time in one room with the blinds closed and the lights dimmed, with my laptop as my only link to the outside world.
Because most of the time I don't feel well enough to leave my bedroom. My feet hurt and burn because of the erythromyalgia, so it's very difficult to walk. I hurt all over anyway because of Lyme and RA and fibromyalgia and God-knows-what-else.
I make it to the kitchen sometimes to cook dinner. Occasionally I bake something. That's about it.
I suppose this is coming up now because I will not be able to work much longer. I still work part-time over the Internet for my employer, even though I've been too sick to go in to the office since early April 2010. But while I've been sick for quite some time, as long as I knew that I could still do my job, I felt as though I might have a future.
Now the future seems curiously empty, as if I have been traveling in a ship over a Flat-Earth ocean and suddenly I reach the end of the world where the ocean spills off into the abyss. The emptiness ahead is terrifying.
I feel so alone, which is silly because there are plenty of people in this world who are going through similar phases in their lives, who are losing their careers because of illness. But that doesn't help me feel any less alone.
Sorry for the negative tone of this post, but today I needed to talk about where I'm at and what I'm going through and how Lyme (and lupus, and RA, and autoimmune hepatitis, and Babesiosis, and Bartonella, and HME, and celiac disease, and etc.....) is/are affecting me TODAY.
I will post something more helpful next time, no doubt.
Thursday, January 13, 2011
The pain that Lyme can cause: Erythromelalgia, or "Man-On-Fire Syndrome"
I have recently been diagnosed with erythromelalgia (aka EM), a painful neurovascular disorder that is believed to be rare....in fact, Kate Conklin's video above states that fewer than 400 people in the United States have actually been diagnosed with EM.
NORD (National Organization of Rare Disorders) defines defines erythromelalgia thusly:
Erythromelalgia is a rare condition that primarily affects the feet and, less commonly, the hands (extremities). It is characterized by intense, burning pain of affected extremities, severe redness (erythema), and increased skin temperature that may be episodic or almost continuous in nature. (The prefix "erythro-" denotes redness, "mel-" is a combining form meaning limb or limbs, and the suffix "-algia" indicates pain.) Although erythromelalgia typically affects both sides of the body (bilateral), it may sometimes involve only one side (unilateral). In addition, the disease course may be extremely variable from case to case. For example, in some individuals, symptom onset may be gradual (insidious), with the condition potentially remaining relatively mild for years. However, in others, it may have a sudden (acute) onset, possibly spreading and becoming severe over weeks.
The specific underlying cause of erythromelalgia remains unknown. However, the condition is thought to result from vasomotor abnormalities or dysfunction in the normal narrowing (constriction) and widening (dilation) of the diameter (caliber) of certain blood vessels, leading to abnormalities of blood flow to the extremities. Erythromelalgia may be an isolated, primary condition or occur secondary to various underlying disorders. Primary erythromelalgia may appear to occur randomly for unknown reasons (sporadically) or may be familial, suggesting autosomal dominant inheritance.
My symptoms began suddenly, just as Kate's did in the video. Fortunately my erythromelalgia has not been as severe as hers, but it IS painful! That first day my toes suddenly swelled up and became hot and red and excruciatingly painful. The soles of my feet were painful too. The really odd thing is that my Raynaud's syndrome had been very active just before this, so I had the startling experience of seeing my toes turn from a cold ice blue to a hot beet red in just a few minutes!
EM makes it VERY painful to walk when it's flaring. EM has also affected my face and ears on occasion, causing them to feel very hot, turn bright red and practically glow, but my feet seem to be the main targets of the erythromelalgia.....they are nearly always red and painful these days.
I suspect that EM is not as rare as most doctors believe; there are likely MANY people have EM who remain undiagnosed. I myself recently encountered two people online who apparently have undiagnosed erythromelalgia....they reported their symptoms to me and when I told them of erythromelalgia and they looked it up online, they were able to confirm from the descriptions and pictures that's exactly what they do have! Of course, the reason they didn't know they had erythromelalgia in the first place is because their doctors had never heard of it.
So you've read this far and are now wondering, "what does erythromelalgia have to do with Lyme?"
When I first started to research EM, I found information that indicated in many cases there is no known cause. Erythromelalgia can be primary, that is a disease in and of itself, or it can be secondary to another illness or syndrome. One of the illnesses associated with EM in the literature is SLE (systemic lupus erythematosus), or lupus for short.
In my case, I think Lyme has everything to do with my erythromelalgia! After all, I blame Lyme for triggering my lupus anyway (see my previous post on lupus). I know that I was born with a familial predisposition to developing lupus, but I didn't actually develop the disease until AFTER I contracted Lyme.
Since EM can be secondary to lupus, and Lyme often mimics or triggers lupus, Lyme has very probably triggered the EM (directly or indirectly) in many of those poor souls out there who have it.
And I found at least one Lymie who agrees with me, Kris who writes the Lyme blog called Lyme Lights Utah. She too suffers from erythromelalgia and has numerous posts on this topic on her blog. I confess I have not read them all...yet. Please see her very well written and interesting initial post on erythromelalgia from November 2009.
Of course, since I'm a scientist, I've continued to dig into this topic. I have actually come up with another reason for believing that Lyme and erythromelalgia are linked somehow, based on data in a recent medical paper I read: Incidence of Erythromelalgia: A Population-Based Study in Olmstead County, Minnesota.
The authors of this article have discovered that the incidence rate of EM is increasing over time. So erythromelalgia is becoming more and more common every year in Olmstead County, MN.
Guess what else is becoming more common every year in Minnesota? Yep!! Lyme!
I decided to compare the data for EM from the paper with the data on the Minnesota State website regarding the incidence rate of Lyme disease as a function of time.
From http://www.health.state.mn.us/divs/idepc/diseases/lyme/casesyear.html |
In order to actually compare the incidence of Lyme properly to the incidence of EM in Olmstead County, I need the Lyme numbers from Olmstead County only. But those data were unavailable on the state website, so I used the Lyme numbers for Minnesota as a whole for comparison.
I summed up the numbers in each "bin" to calculate the 10 year incidence rate; unfortunately, since Lyme came to national attention in the late '70s in Connecticut, the numbers for Lyme disease in Minnesota began in 1986, at least on that particular website. So I was only able to calculate numbers for two of the bins: '86-'95 and '96-'05. Statistically this is not "good enough" to prove anything, of course.
The results are interesting nonetheless....I ended up scaling the Minnesota Lyme numbers by dividing them by 200, and then was amazed at how similar the two graphs looked, at least from 1986 - 2005!
So the scaled (divided by 200) Minnesota Lyme numbers (red bars) look very much like the Olmstead County erythromelalgia numbers (blue bars)....even though this does not suffice to prove anything, it is suggestive. It is enough, at least in my mind, for doctors to tell patients who present with EM that they ought to be tested for Lyme.
Thursday, January 6, 2011
Human-to-human transmission
This is a post I hoped that I would NEVER have to write. Yesterday I accompanied my husband to the doctor (my LLND); he gave us the results of my husband's recent IGeneX Western Blot tests:
IgM: bands 31, 41, and 83-93 positive
IgG: bands 28, 30, 41, and 66 positive
The IgM test is IGeneX positive, although both of them are CDC negative, of course.
I was so afraid of this, after he suddenly developed TWO autoimmune diseases overnight (celiac disease and psoriasis) a couple of years ago.....then he started complaining of headaches, extreme fatigue, pain in his feet, knees, neck, etc. My husband's health has really gone downhill recently.
We were married in 2004, in February. My first symptoms of severe illness occurred in March 2004. But his health was good for the most part until early 2009. That's when he was dx with celiac and psoriasis.
I've been telling him for over a year that he needed to get a Western Blot done, but he always insisted that he couldn't possibly have Lyme and that it was a big waste of money. He fought tooth and nail against getting this test done and then going to see my LLND.
I believe that this is a case of sexual transmission....I gave it to him. :(
I think this is an important issue, because spouses out there may be passing Lyme back and forth to each other and preventing each other from getting well.
Luckily my husband had symptoms, which is how I finally persuaded him to be tested, but some people might not be symptomatic even if they are infected. Lyme can lie dormant for years until triggered by stress or something else.
We're not SURE who got bitten by the tick, but I think that logically it had to be me, since I have so many tick-borne illnesses . My husband doesn't have symptoms of Bartonella or Babesiosis or HME. He's not nearly as sick as I am (thank goodness!), and he doesn't seem to have any neurological involvement, which is VERY good news!
Also, I recently remembered having a bulls-eye rash, which at the time I thought was ringworm. So again, that points to me as the one who first contracted Lyme. He has no memory of any tick bite or rash.
It is always possible that we were each bitten separately, but I believe that's less likely than the human-to-human transmission scenario, for the simple reason that Lyme is related to syphilis.
I am so depressed now....
Monday, January 3, 2011
Letter To People who are NOT struggling with Chronic Pain
From http://www.painexhibit.com/ag213_Collen |
But this brought to mind a letter that has been circulating in email and posted various forums for some time; the author is unknown. I'm posting it here because it really tells it like it is; it is truly worth reading:
Having chronic pain means many things change, and a lot of them are invisible. Unlike having cancer or being hurt in an accident, most people do not understand even a little bit about chronic pain and its effects, and of those that think they know something, many are actually misinformed.
In the spirit of informing those of you who wish to understand...these are the things that I would like you to understand about me before you judge me.
Please understand that being sick does not mean that I’m not still a human being. I have to spend most of my day in considerable pain and exhaustion, and if you visit, sometimes I don’t seem like much fun to be with, but I’m still me — stuck inside this body. I still worry about school, my family, my friends, and most of the time, I’d still like to hear you talk about yours.
Please understand the difference between “happy” and “healthy”. When you’ve got the flu, you probably feel miserable with it, but I’ve been sick for years. I can’t be miserable all the time. In fact I work hard at not being miserable. So, if you’re talking to me and I sound happy, it means I’m happy, that’s all. It doesn't mean I’m not in a lot of pain, or not extremely tired, or that I’m getting better, or any of those things. Please don’t say, “Oh, you’re sounding better!” or “But your looking so healthy!”... I am merely coping. I am sounding happy and trying to look normal. If you want to comment on that, you’re welcome.
Please understand that being able to stand up for ten minutes doesn't necessarily mean that I can stand up for twenty minutes, or an hour. Just because I managed to stand up for thirty minutes yesterday doesn't mean that I can do the same today. With a lot of diseases you’re either flat on your back or you can move. With this one, it gets more confusing everyday. It can be like a yo-yo. I never know from day to day, how I am going to feel when I wake up. In most cases, I never know from minute to minute. That is one of the hardest, most frustrating, components of chronic pain.
Please repeat the above paragraph substituting, “sit up”, “walk”, “think”, “concentrate”, “be sociable”, and so on, for the phrase "stand up"...it applies to everything. That is what chronic pain does to you.
Please understand that chronic pain is variable. It’s quite possible (for many it’s common) that one day I am able to walk to the park and back, while the next day I’ll have trouble getting to the next room. Please don’t attack me when I’m ill by saying, “But you did it before!” or “Oh come on, I know you can do this!” If you want me to do something, then ask if I can. In a similar vein, I may need to cancel a previous commitment at the last minute. If it happens, please do not take it personally. If you are able, please try to remember how very lucky you are--to be physically able to do all the things you can do.
Please understand that “getting out and doing things” does not make me feel better, and can often make me seriously worse. You don’t know what I go through or how I suffer in my own private time. Telling me that I need to exercise, or do some things to get my mind off it may frustrate me to tears, and is not correct and if I was capable of doing some things any or all the time, don’t you think I would? I am working with my doctor and am doing what I am supposed to do.
Another statement that hurts is, “You just need to push yourself more, try harder…” Obviously, chronic pain can deal with the whole body, or be localized to specific areas. Sometimes participating in a single activity for a short period of time can cause more damage and physical pain that you can imagine. Not to mention the recovery time, which can be intense. You can’t always read it on my face or in my body language. Also, chronic pain may cause secondary depression (wouldn’t you get depressed and down if you were hurting constantly for months or years?), but it is not created by depression.
Please understand that if I say I have to sit down/lie down/stay in/take these pills *now*, that probably means that I have to do it right NOW - it can’t be put off or forgotten just because I’m somewhere, or I’m even in the middle of doing something. Chronic pain does not forgive, nor does it wait for anyone.
If you want to suggest a cure for me, please don’t. It’s not because I don’t appreciate the thought, and it’s not because I don’t want to get well. Lord knows that isn’t true. In all likelihood, if you’ve heard of it or tried it, so have I. In some cases, I may have been made sicker, not better. This can involve side effects or allergic reactions. It also includes failure, which in and of it self can make me feel even lower. If there were something that cured, or even helped people with my form of chronic pain, then we would know about it. There is worldwide networking (both on and off the Internet) between people with chronic pain. If something worked we would KNOW.
It’s definitely not for lack of trying. If, after reading this, you still feel the need to cure, then so be it. I may or may not take what you said and discuss it with my doctor.
If I seem touchy, it’s probably because I am. It’s not how I try to be. A matter of fact, I try very hard to be normal. I hope you will try to understand. I have been, and am still, going through a lot. Chronic pain is hard for you to understand unless you have had it. It wreaks havoc on the body and the mind. It is exhausting and exasperating. Almost all the time, I know that I am doing my best to cope with this, so accept me as I am. I know that you literally can not understand my situation unless you have been in my shoes, but as much as is possible, I am asking you to try and be understanding.
In many ways I depend on you – on people who are not sick. I need you to visit me when I’m too sick to go out. Sometimes I need you to help with the shopping, cooking or cleaning. I may need you to take me to the doctor, or to the store. You are my link to the normalcy of life. You can help me to keep in touch with the parts of life that I miss and fully intend to undertake again, just as soon as I am able.
I know I've asked a lot of you, and I do thank you for listening. It really does mean a lot to me.
AUTHOR UNKNOWN
Saturday, January 1, 2011
Western Blots - what do all of those darn bands MEAN???
Diagram of basic steps to a Western Blot result |
OK, this is an important issue; you should know what your medical tests mean. And always, always get copies of all blood work (or any other type of test for that matter)!
Some of these antibodies are made to attack specific proteins on the outer surface of the bacteria, others to attack the flagellum (the tail), etc. Each band in the Western Blot corresponds to a certain antibody that your body might make to fight the Lyme spirochetes.
I should also point out that which of these bands are important and specific for Lyme and which are not is still a bit controversial (depends on which researcher you talk to); the list below is a synthesis of a couple of different lists that I found online.
Western Blot Bands description (note: cross-reactive means it could indicate other spirochetes, specific means it ONLY happens when Lyme disease is present. Borrellia or Bb is Lyme disease.):
Western Blot Bands description (note: cross-reactive means it could indicate other spirochetes, specific means it ONLY happens when Lyme disease is present. Borrellia or Bb is Lyme disease.):
18 p18 flagellin fragment
20 cross-reactive for Borrellia
21 unknown
22 specific for Bb, probably really the 23/25 band
23-25 outer surface protein C (OspC), specific for Bb
28 outer surface protein D (OspD); Oms28; specific for Bb
30 OspA substrate binding protein; common in European and one California strain
31 outer surface protein A (OspA), specific for Bb
34 outer surface protein B (OspB); specific for Bb
35 specific for Bb
37 specific for Bb
38 cross-reactive for Bb
39 is a major protein of Bb flagellin; specific for Bb
41 flagellin protein of all spirochetes; this is usually the first to appear after a Bb infection
45 cross-reactive for all Borellia (sometimes people with Lyme who have this band positive also have the co-infection Ehrlichiosis)
50 cross-reactive for all Borrellia
55 cross-reactive for all Borrellia
57 cross-reactive for all Borrellia
58 unknown but may be a heat-shock Bb protein
60 cross reactive for all Borrellia
66 cross-reactive for all Borrelia, common in all bacteria
83 specific antigen for the Lyme bacterium, probably a cytoplasmic membrane
93 unknown, probably the same protein in band 83, just migrates differently in some patients
The numbers are actually the molecular weights in kilo-Daltons (kDa). I've highlighted the antibodies in red which (many people agree) are very specific for Lyme disease.
IgM versus IgG is usually interpreted this way: if you have a positive IgM Western Blot, but negative IgG, it may mean that you just became infected fairly recently, because the IgM reaction to infection generally happens before the IgG. If you have a positive IgG it may mean an established, chronic infection.
OK, finally we need to talk about what POSITIVE means!
How does one decide what constitutes a positive Western Blot test? In some ways this seems like it would be a fairly easy question to answer, but when you realize that every person's body reacts differently to infection, and one immune system may not make the same antibodies that another immune system might make, then it becomes highly complicated.
In addition, to follow this discussion on all levels, you must realize that most doctors in the United States are NOT well-educated about Lyme disease. They generally believe that:
(a) The CDC and the Infectious Disease Society of America (IDSA) are the ultimate authorities and that anyone who disagrees with them is a crackpot.
(b) Lyme disease is rare, hard to catch and easy to cure (this is the IDSA official "line" and it is WRONG!!!!!!).
(c) Lyme disease should be treated with 2 - 4 weeks of doxycycline and THAT'S IT! (IDSA guidelines again. This makes NO sense...there are many illnesses out there that have to be treated very aggressively for months and months.)
Please understand that there is a political and economic battle being waged in this country with the health insurance companies and the IDSA on one side and many, many Lyme patients who are desperately ill on the other side.
If you don't believe me, you need to watch Under Our Skin ASAP!!
OK, here are three sets of Western Blot criteria for determining whether or not someone has Lyme disease; let's compare them:
1. The current CDC criteria (used by the IDSA and health insurance companies) for a positive Western Blot are as follows:
(a) For IgM, 2 of the following three bands have to be positive: OspC
(22-25), 39 and 41.
(b) For IgG, 5 of the following ten bands have to be positive: 18, OspC
(22-25), 28, 30, 39, 41, 45, 58, 66 and 93.
I will not go into the ins and outs of how they came up with these criteria. You can look at the CDC website for that. Suffice it to say that when the CDC criteria were first created, they were not recommended for diagnostic purposes. In fact, there used to be a statement on the CDC website that said so. I think that statement has now been taken down in an attempt to appease the IDSA.
2. The criteria used by IGeneX, one of the top Lyme laboratories in the country: IGeneX considers a Western Blot (IgM or IgG) to be positive if just two or more of the following bands are positive: OspC (23-25), 31, 34, 39, 41, and 83-93.
3. Possible future criteria in China: I recently read an article about Lyme disease testing in China, where Lyme is spreading rapidly through the country. The researchers quoted by the article recommended considering a Western Blot positive if just ONE single Lyme-specific band was positive.
So the IDSA and the health insurance companies are in cahoots, but ILADS (the International Lyme and Associated Diseases Society) is opposed to their anti-patient agenda and their highly restrictive and ridiculous diagnostic criteria for Lyme disease. Our heroes, the Lyme Literate doctors (aka LLMDs in the online Lyme communities) are generally member of ILADS and believe that the using the CDC WB criteria for diagnosis of Lyme disease is incorrect.
So what's so terrible about the CDC WB criteria anyway? For one thing they don't mention some of the bands which are the most highly specific for Lyme disease, namely bands 31 and 34, aka OspA and OspB. Your body can only produce these antibodies if you have been exposed to Lyme spirochetes!
The main reason these were left out is that several of the doctors who originally decided on the criteria were involved in an effort (at that time) to create a Lyme vaccine, and those two bands were part of the vaccine, so anyone who had been vaccinated against Lyme would test positive for 31 and 34 even if they did not have Lyme. So they deleted those two bands from the list.
However, the Lyme vaccine is no longer being used because it caused terrible autoimmune reactions in a number of people who received it. But (oops!!) the CDC forgot to put those two bands back into the criteria after they stopped using the vaccine!
And requiring FIVE bands for an IgG to be positive? How do you know that everyone will produce a minimum of 5 different IgG antibodies? And why include bands 45, 58, and 66, which are not specific for Lyme disease? Why not include bands that are SPECIFIC for Lyme??? Clearly these criteria are too restrictive.
It has been said that the current CDC testing misses at least half of those who truly have Lyme disease.
As to the IGeneX criteria, these make a lot more sense, as the only band in their set that is NOT Lyme-specific is band 41. Band 41 is usually the first band to show up for Lyme but also is frequently positive for people with other spirochetal infections such as syphilis and certain dental infections.
However, in my humble opinion, the proposed Chinese criteria make the most sense, since your body should not be able to produce even one single antibody to a Lyme spirochete unless you have been exposed to Lyme!
In the opinion of many LLMDs, IGeneX is one of the best places to get a Western Blot done, as their testing is more sensitive and they also report the "indeterminate" results, which means that there was some sort of reaction there, but not a strong enough response to be considered positive. The indeterminate results can be considered clinically significant if a doctor wishes to include those.
My own IGeneX Western Blots were both positive by IGeneX criteria but negative by CDC criteria.
The positive bands from both my first and second IgM tests were 18, 30, 31, 34, and 41. Bands 23-25 and 39 were reported as indeterminate in the first IgM WB but only band 39 showed up as indeterminate in the second IgM WB.
The positive bands from my first IgG WB were 30, 31, 34, 41, and 58, and in the second IgG WB bands 31, 34, 41, and 58 were positive. In the first IgG WB, band 23-25 was indeterminate, and in the second band 39 was indeterminate.
Attention, all doctors employed by (health insurance company which shall remain nameless) who have denied my various insurance claims, and who use the CDC criteria to tell me that I don't have Lyme disease: note that many of the positive and indeterminate bands in my IgM and IgG WB results are VERY VERY specific for Lyme disease: 23-25, 30, 31, 34, and 39.
THERE IS NO WAY IN H-E-DOUBLE-HOCKEY-STICKS THAT MY IMMUNE SYSTEM IS "RANDOMLY" PRODUCING THESE PUPPIES!!!!!