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  #1  
Old 12-15-2011, 08:16 PM
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Default Rapid Transmission of Lyme Disease

For many years now, doctors advised patients not to worry if an embedded tick has been on them less than "x" hours. I'd like to share some knowledge from my discussions (and interviews) with patients and doctors:

- be wary of blood tests, but at the same time consider this: a good doc will employ tests that use regionalized assays (for different geographies and 300+ Borrelia strains);
- Lyme disease is a clinical diagnosis;
- Borrelia can live inside human cells, outside human cells, create biofilm communities and easily avoid most diagnostic detection;
- docs don't like to prescribe antibiotics more than a few weeks, and usually only prescribe doxycycline;
- docs will (generally) not perform blood tests on co-infections or the other microbes that most ticks carry (mycoplasma, viruses, microfilaria, etc.).

Lots to know, unfortunately. At least this abstract below shows that some doctors are committed to patients' health and getting answers on "chronic lyme disease," something that, is for some reason, still controversial.

Look at ticks this way: they are the perfect, mobile, biofilm-making machine. They are a roving septic tank with sophisticated hydraulic & pumping systems...

Refer to my interview with Dr. Eva Sapi, here:

Dr. Eva Sapi - Geneticist, Microbiologist (Two Videos Available)

__________________________________________________ ______

Diagn Microbiol Infect Dis. 2011 Nov 18. [Epub ahead of print]
Clinical evidence for rapid transmission of Lyme disease following a tickbite.

Hynote ED, Mervine PC, Stricker RB.
Abstract

Lyme disease transmission to humans by Ixodes ticks is thought to require at least 36-48 h of tick attachment. We describe 3 cases in which transmission of Borrelia burgdorferi, the spirochetal agent of Lyme disease, appears to have occurred in less than 24 h based on the degree of tick engorgement, clinical signs of acute infection, and immunologic evidence of acute Lyme disease.

Health care providers and individuals exposed to ticks should be aware that transmission of Lyme disease may occur more rapidly than animal models suggest. A diagnosis of Lyme disease should not be ruled out based on a short tick attachment time in a subject with clinical evidence of B. burgdorferi infection.

PMID: 22104184 [PubMed - as supplied by publisher]
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  #2  
Old 12-16-2011, 10:16 PM
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laid up doc laid up doc is offline
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Harrison, just like a lot of diseases... there are a lot of people who have the dx of chronic lyme (based on what, i am not sure) and use it as a free pass for all kinds of crap (narcs, home IV antibiotics for months, disability, admission to the hospital whenever they wish). they insist on treatments that have no rational basis, find wacko docs who will give it to them, and then end up w/ complications that are worse than the disease with which they started.

that is why there is still consternation about chronic lyme... that and there aren't great diagnostic criteria... it's very frustrating as a healthcare professional, i can tell you that much.
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The content herein represents my professional thought and opinions in a general sense only; they do not constitute professional advice or services. if you need medical advice, please consult a licensed physician.
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Old 12-16-2011, 10:44 PM
annapurna annapurna is offline
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Laid up doc, I appreciate the frustration you have with people looking for treatments that will ultimately not help them but you're a little aggressive in your labeling. Before your back went bad, I suspect that you would have called anyone looking for an overseas surgeon more than a little wacko. Many of the "wacko cures" you just attacked have been shown to help in some cases. There's really no justification in attacking them across the board unless there's clear double-blind studies refuting them; just like the medical community demands those same studies to support their use.
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Old 12-17-2011, 12:35 AM
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i'm talking about docs that will do whatever a patient wants, regardless of what is proven to work or right... just b/c they'll get paid.

i'd say that about any doc anywhere in the world... it's irresponsible and only leads to more problems b/c then those patients think all docs work that way.

and you are right - until i did my homework, i thought it was kinda crazy to go to another country for surgery. once i heard the logic and looked into why US alternatives aren't ok.... it made sense.

but i'm telling you - dealing w/ certain sorts of patients in my practice setting is beyond frustrating. let's just say i'm not the definitive specialist for a lot of things, but people come to me a lot wanting quick fixes.
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US non-spine MD - laid up no more!!!
had recurrent annular tear L5/S1, failed everything
M6L done 10/19/11 w/ Dr Clavel getting back to my old self more and more every week!
laidupdoc@gmail.com if my PM box is full

The content herein represents my professional thought and opinions in a general sense only; they do not constitute professional advice or services. if you need medical advice, please consult a licensed physician.
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  #5  
Old 12-17-2011, 03:51 PM
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LUD,

I am sorry to hear that some of the patients get you frustrated, but this is something I care very deeply about; hence, my post. I would like to find out more (if you are amenable) about which tests other than culture you might use to screen for acute or chronic bacterial infections, especially Lyme. We should probably move to this private messaging, but whatever works for you is fine with me.

You may recall that I suffered greatly for years with a “sub-clinical” bacterial infection (mycoplasma pneumonia). I saw more than 20 different types of doctors in a 2 year period. I finally learned about chronic bacterial infections and PCR (1st generation molecular diagnostics), which my PCP used to confirm the infection --which at that point was systemic. Why did I have to beg my doctor to consider PCR? If I didn’t, I’d probably be dead now. Or wish that I was. There's no way to describe the agony that affected every part of my body; cardiovascular, neuromuscular, skeletal, etc.

Unfortunately, I can relate to most Lyme patients and their suffering because of the constraints in the system – there’s a big reluctance to use PCR (and even more advanced) diagnostics on very sick patients. There’s even more of a problem recognizing chronic bacterial infections (primarily biofilms). I hope and pray that doctors move away from cultures into the “modern” world so that fewer patients fall through the cracks.

Lastly, there’s no question that many microbes can and do effect the nervous system -- including the brain. Some actually have a proclivity for neural tissue, as I learned in my research & interviews. Think about how Treponema pallidum causes syphilis, even neurosyphilis; which is similar to how Borrelia invades the human brain. This has since been well documented by Dr. Alan McDonald et al.

Hope these links are of interest or value to members:
- Why Lyme becomes hard to treat or “chronic:” Evaluation of in-vitro antibiotic suscept... [Infect Drug Resist. 2011] - PubMed - NCBI

- Off topic, but related: Tuesday’s Wall Street Journal, there’s an article that proposes a link between Strep throat and behavioral issues: Does Strep Throat Trigger Serious Ills? - WSJ.com

- Solid documentary on Lyme disease: Under our Skin | An Infectious New Film
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"Harrison" - info (at) adrsupport.org
Fell on my ***winter 2003, Canceled fusion April 6 2004
Reborn June 25th, 2004, L5-S1 ADR Charite in Boston
Founder & moderator of ADRSupport - 2004
Founder Arthroplasty Patient Foundation a 501(c)(3) - 2006
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  #6  
Old 12-17-2011, 05:35 PM
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Harrison -

PCR for anything but gonorrhea and chlamydia is not in the scope of my practice at all... but i have to deal with the worst of any patient population.

i think that there are a lot of diseases that we don't understand well - but when the treatment is worse than the disease, i get mad.

example: long term IV antibiotics for chronic lyme. patient gets an invasive catheter, and get septic/blood clot/other issues from the line. no good proof that months of ceftriaxone does anything, but there are docs who will do it b/c they can bill for it.

that's what i'm talking about...
__________________
US non-spine MD - laid up no more!!!
had recurrent annular tear L5/S1, failed everything
M6L done 10/19/11 w/ Dr Clavel getting back to my old self more and more every week!
laidupdoc@gmail.com if my PM box is full

The content herein represents my professional thought and opinions in a general sense only; they do not constitute professional advice or services. if you need medical advice, please consult a licensed physician.
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  #7  
Old 12-17-2011, 08:55 PM
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Harrison Harrison is offline
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I understand better now. That said, consider that (most) antibiotic studies don’t take into account what I mentioned earlier – what we have learned from experts. Also, studies are sometimes sponsored by pharmaceutical companies, like this one, which was supported by a grant from Hoffmann–La Roche. It is still on PubMed and the NEJM:

Ceftriaxone Compared with Doxycycline for the Treatment of Acute Disseminated Lyme Disease

http://www.nejm.org/doi/full/10.1056...0501#t=article

Also note the word "acute" in the title. Using "chronic" is a big no-no and so problematic for some people. if untreated, most bacteria create chronic biofilm infections -- get over it!

Many antibiotics are not effective against bugs that have the ability to form biofilms, change into cysts, blebs or corkscrew into human blood cells and become intracellular. So we actually share similar concerns. See the Sapi study that explains this adaptive response bugs have to antbx.

This amazing evolutionary capability for bacteria -- and their complex communities -- to adapt and exploit the immune response has been known for many decades, so it's very sad that we (caring patients) have dropped the ball on educating patients and doctors on how to help people heal.

But the game continues: pharma companies have made substantial investments in very sophisticated biofilm diagnostic companies. There are several layers to this story that I wish had the time to explain; but it's very serious and bad news for patients with chronic bacterial conditions. Bottom line: if big pharma owns the "best" and most sophisticated diagnostics, we are really screwed as a society.

That's the direction we are headed. Every night, I pray that people will wake up and at least pay attention to this kind of news. That's why I am doing this film.
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"Harrison" - info (at) adrsupport.org
Fell on my ***winter 2003, Canceled fusion April 6 2004
Reborn June 25th, 2004, L5-S1 ADR Charite in Boston
Founder & moderator of ADRSupport - 2004
Founder Arthroplasty Patient Foundation a 501(c)(3) - 2006
Creator & producer, Why Am I Still Sick? - 2012
Donate www.arthropatient.org/about/donate
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