collecte section Bourgogne

https://www.helloasso.com/associations/association-france-lyme/collectes/section-bourgogne

Lyme disease : 50 Frequently Asked Questions & Answers


50 Frequently Asked Questions & Answers
Lucy Barnes
1. Is Lyme disease caused by a virus, bacteria, or a parasite?

Lyme disease is caused by a spirochetal bacteria.
2. Who is the doctor that identified the spirochete that causes Lyme disease?
Dr. Willie Burgdorfer identified the spirochete responsible for Lyme disease
(Borrelia burgdorferi) in the early 1980's.
3. How long after a person is in contact with an infected source will Lyme disease symptoms appear?
Lyme disease symptoms may appear days, weeks, months or years after the initial infection.
4. How many species of ticks carry the Lyme disease spirochetes?  
At least nine species of ticks, six species of mosquitoes, 13 species of mites, 15 species
of flies, two species of fleas, and numerous wild and domestic animals (including
rabbits, rodents, and birds) have been found to carry the spirochete that causes Lyme
disease.
5. Does a "bulls-eye" rash go away without treatment?
A Lyme rash (ECM) will often disappear on its own without treatment, but it may
linger for quite some time. It may reappear later as a single rash or emerge as multiple rashes.
6. Does a Lyme rash occur at the site of the bite or elsewhere?
The ECM rash may appear at the site of the tick bite or elsewhere on the body. Not
everyone will get a rash and some will have multiple rashes.  Less than 10 percent of children get a rash.
7. If prescribing doxycycline for a tick bite, what precautions should be advised while
taking the medication?
Patients should be advised that taking doxycycline may cause sun sensitivity. 
Doxycycline should not be taken with milk or other dairy products since these
products may inhibit absorption of the antibiotic.  Doxycycline is not recommended
for children since it may cause discoloration of their teeth.  Doxycycline may also
promote yeast and fungal overgrowths which should be prevented and addressed if they occur.  Nausea,
vomiting, and diarrhea are some of the possible side effects of Doxycycline.  Birth
control pills may not be as effective while taking Doxycycline and additional
precautions to prevent pregnancy may be necessary.  Doxycycline should not be taken
with antacids or supplements that contain calcium, iron, magnesium, or sodium
bicarbonate.  Doxycycline use may cause liver problems or bruising.  People taking
Doxycycline should be advised that severe allergic reactions may occur and if there
are any problems while taking Doxycycline, they should be reported to the doctor.  For more information please check with your doctor or pharmacist.
8. What tick borne diseases have been detected in patients?
Lyme disease (Borrelia burgdorferi), Anaplasma phagocytophilum (HGA), Babesia microti, Babesia duncani, Bartonella henslea, Bartonella quintana, Bartonella elizabethae, Rocky
Mountain Spotted Fever (Rickettsia rickettsii), Rickettsia montanensis, Brucellosis, Ehrlichia chaffeensis (HME), Southern
Tick-Associated Rash Illness (STARI), Morgellons, Tularemia (rabbit fever)- and possibly
Leptospirosis are some illnesses that may be passed to animals or
humans.
9. If a patient previously had Lyme disease and is bitten by another infected tick, are they immune to Lyme disease?
No, they are not immune. Multiple bites may expose people to a number of other
tick borne diseases in addition to the same or new strains of Lyme disease.
10. Is a lumbar puncture required to confirm neuro-Lyme? Why?
No!  Lyme disease, as stated by the CDC, is a "clinical diagnosis". Research
indicates that less than 20 percent of people with Lyme disease have shown a positive
reading when testing spinal fluid.
11. What are the most common diseases that are often mistaken for Lyme disease?

There are many different diseases or conditions that are found in patients with
Lyme disease.  All too often Borellia organisms are not considered as the
source for patients complaints and their symptoms.  For example, an
ophthalmologist may diagnose any of the following conditions: conjunctivitis, ocular
myalgias, keratitis, episcleritis, optic neuritis, pars planitis, uveitis, iritis, transient
or permanent blindness, iritis, photophobia, temporal arteritis, vitritis, Horner's
syndrome, ocular myasthenia gravis, or Argyll-Robertson pupil which may or may not be Lyme or tick borne disease related. All of the
conditions listed above have been documented in Lyme disease patients and many of these
diseases or conditions improve with proper antibiotic therapy.  
Urologists, for
example, may not realize that recurring bladder infections or swollen testicles can be caused by spirochetal organisms.  Infectious Disease specialists often dismiss
patients concerned about Lyme disease because many are under the assumption that
Lyme disease is very 'rare' and/or they are not familiar with the various signs and
symptoms of the disease due to their limited definition of the disease.

Lyme disease can be misdiagnosed as:
Chronic Fatigue Syndrome, Multiple Sclerosis, Alzheimer's, Parkinson's disease,
Lupus, Lou Gehrigs (ALS) disease, Guillian-Barre Syndrome, Polymyositis,
Hepatitis, cardiac disorders, fibromyalgia, TMJ, ringworm, Tullio phenomenon,
encephalitis, ADD, ADHD, meningitis, depression, panic disorders, Bell's palsy,
candidiasis, chronic mononucleosis, hypoglycemia, scleroderma, Epstein Barr
virus, autoimmune diseases, Bannwarth's syndrome, various cancers, 
kidney disease, Raynauds syndrome, stress-related illnesses, sleep disorders,
thyroid problems, vasculitis, anorexia, agoraphobia, cerebrovascular disorders,
arthritis, connective tissue diseases, hearing disorders, Crohn's disease, purpura,
pseudotumor, Sjogrens syndrome, stroke and respiratory insufficiency.
12. If a person has an EM rash and a negative ELISA test should they be treated for Lyme? How?
Yes.  An EM rash alone is diagnostic for Lyme disease.  Current guidelines approved by
ILADS (International Lyme and Associated Diseases Society) recommend oral
therapy for at least 6 weeks for both adults and children in the early stages or when a rash is present. 
Lyme patients who are pregnant have special recommendations to help protect themselves
and their unborn child.  According to the CDC, Lyme disease is a "clinical
diagnosis" and negative tests are not to be used to rule out the disease.
13. Are there any studies or literature on Lyme disease? 
There are over 18,000 published medical studies, abstracts, videos, websites, educational articles and brochures concerning Lyme and other tick borne illnesses.  
14. How many different strains of the spirochetes have been
identified to date in the United States and world wide?
Eight different species and over three hundred strains of spirochetes that cause
Lyme disease and Lyme-like symptoms have been identified world wide.  To date, more than 100
different strains have been identified in the United States.
15. What is STARI?
STARI or Master's Disease is thought to be caused by a strain of spirochete that was originally discovered in the southeastern sections of
the United States within the past few years.  It causes Lyme-like symptoms but is not
normally detected by the current standard Lyme tests. STARI (Southern
Tick-Associated Rash Illness).
16. What is WA-1 or Babesia ducani?
WA-1 (Babesia ducani) is a recently identified strain of Babesiosis  found in a number of
people who are also infected with Lyme disease.  There have been tests
developed to identify this specific strain in humans but the tests are not performed at
all labs.  To test for this strain of Babesiosis, physicians should have blood sent to quality labs specializing in tick borne disease detection, such as Igenex Lab in Palo Alto, CA.  A growing number of patients have been diagnosed with this strain, originally described as a "west coast" strain when it was detected in Washington state patients.
17. Approximately how many Lyme disease patients are co-infected with Babesiosis?  What is the most effective treatment for Babesiosis?
Estimates from labs, support group leaders and doctors offices indicate that
approximately 25-50 percent of patients with Lyme disease are also are
co-infected with Babesiosis.  Unfortunately, many patients are never tested so the
numbers may be even higher.
A combination of Atovaquone (Mepron-750 mg. 2x daily) and Azithromyacin
(Zithromax- 250- 500 mg day) is considered to be the best known treatment for Babesiosis at this time, with a duration of several months.  Some
patients may need extended treatment or need to be retreated if symptoms persist or return.  The Mepron/Zithromax protocol is reported to be less toxic than
the quinine sulfate and clindamycin combination that was once used and there are
fewer side effects reported with this treatment.
18. What percentage of people with Lyme disease remember having a rash or remember
being bitten by a tick?
Various studies show that anywhere from 20-80 percent of seropositive Lyme
disease patients with active symptoms do not recall a rash.  Less than 50 percent of
Lyme patients remember being bitten by a tick.  Children experience a Lyme rash less than 10% of the time.
19. After a person is bitten by a tick, how soon is it before the spirochete can be found in the spinal fluid?
Reports indicate spirochetes can disseminate quickly through the body (in as
little as 6 hours in some cases) and it has been detected in the brain within 24 hours of exposure.  In addition, spirochetes are able to change forms and
remain undetected.  The old 'wait and see' if symptoms appear
before treating theory allows the organism to go unchecked, causing multiple
problems.  Late treatment also decreases the chance for a full recovery.
20. What signs and symptoms would lead a doctor to suspect a Babesia infection in a
patient?  How many strains of Babesiosis have been identified and how many are
commonly tested for in commercial labs?
The following signs/symptoms may be present in those infected with Babesiosis:
fatigue * arthralgias* myalgia* drenching sweats* headaches* emotional
lability* depression* dark urine* splenomegaly* dizziness* nausea and
vomiting * cough * dyspnea* fever* chills* hepatosplenomegaly* jaundice* 
malaise* shortness of breath* bleeding tendencies, bruising* thrombocytopenia* 
hemoglobinuria* hyperesthesia* pulmonary edema* encephalopathy* low to
normal range leukocyte counts* possible elevated levels of dehydrogenase,
bilirubin, transaminase* anorexia*
Approximately 25%- 66% of Babesia patients are known to be co-infected with
Lyme disease. The symptoms may continue for long periods of time, subside,
then return.  A low Babesiosis titer (IgG) often indicates a chronic infection.  An
acute or current infection may show a higher reading on the IgM test initially.
There are over 100 species of Babesia in the United States but only ONE or TWO
species are currently detected by most commercial labs.
21. What does the typical Lyme rash look like?
There is no "typical rash" that all patients get when infected with Lyme disease. 
Many people do not remember a rash or even a tick bite.  If a rash does appear, it
may range from a light pink color to blazing red, to blue, to purple depending
on the skin color, the type of rash and possible co-infections.  The ECM rash can be
as small as a quarter, be present in several locations, or be large enough to cover the
entire back of an adult. The rash may be mistaken for an insect bite reaction or even
ringworm.  It may be hot, it may flake or swell.  It may be well formed and
expanding or have uneven or raised edges. It may disappear and return later and it
may be slightly itchy in some individuals.
Borrelial lymphocytoma may appear on the earlobe, the scrotum, or on the nipple of
the breast. It may be bright red to a bluish color and may disappear and return
later.
The ACA rash (acrodermatitis chronica atrophicans) may have the appearance of a
scleroderma rash and is often noticed on the feet and ankles and/or the hands in the earlier stages of presentation. It
may appear elsewhere on the body and can affect underlying organs.
Photos of some Lyme and other tick borne disease rash presentations can be found at the following link:
22. Do people with babesiosis have a rash? 
Many patients infected with the Babesia organism do not present with a rash,
however, they may appear jaundiced and some may have a petechial rash.
23. Do people with Bartonella have a rash?
The rash/lesion that is typically associated with Bartonella may not be present in
patients or may not be noticed. If there is a rash/lesion, it may appear to be a small
reddish brown lesion (often mistaken for an insect bite). It may heal without
intervention. The patient exposed to Bartonella may have urticaria, vesiculopapular
lesions, or erythema nodosums. Many Bartonella patients have swollen and/or
tender lymph nodes which may become infected.
24. How do you test for and treat (which drugs) the "cyst or L-form" of Lyme
disease?
Specific tests have been developed to identify some of the various forms of
spirochetes using dark field microscopes. Tindamax, which has been shown to burst the
cell walls of the cyst form, is currently being prescribed to patients.  Normally Tindamax is
prescribed along with other antibiotics (Doxycycline), since it is not effective on the
intact spirochetes.
25. What has the CDC determined to be the proper testing procedure for confirming that
a patient does or does not have Lyme disease?
TRICK question- The CDC states emphatically that Lyme tests are NOT to be used
to exclude a diagnosis of Lyme disease.  A negative test is NOT to be considered
absolute by any means, nor is it to be used to indicate a cure.  As the CDC states,
Lyme disease is a "clinical diagnosis".  No test has been developed that can confirm
if a patient is cured.  A negative test does NOT indicate a cure.
26. What is the two tier testing procedure set up by the IDSA/CDC for testing patients
suspected of having Lyme disease and what are the most common problems with this
procedure?
The CDC and IDSA recommends an ELISA (titer) first,
which, under the best circumstances, only identifies a small percentage of infected patients.  An ELISA therefore, should NOT be used as a screening test due
to the notoriously unreliable results.  The IDSA guidelines state, if the ELISA is positive, physicians
are to perform a Western Blot test.  Under the best circumstances a Western Blot only
positively identifies 70-80 percent of those who have been exposed.  
Most labs do not report
specific bands on the Western Blot tests, hindering the experienced physician and
the diagnosis even further.  This 2-tiered method allows many cases of Lyme disease to be
missed.
The CDC also dictates which specific bands on a Western Blot are to be used
to consider a Lyme test positive. When the list was originally developed, certain bands specific for
Lyme disease were not included; however if these bands are positive it confirms
exposure even though it is incorrectly reported to the doctor and patient as a "negative test". 

Many "borderline" tests are reported to patients as being negative
and many positive tests are incorrectly reported to be "false-positive" because physicians are
not familiar with reading the test results, nor with the multiple symptoms that can occur
in a person with Lyme disease.  Many
patients with chronic Lyme disease have low titers or seronegative results.
27. Which bands normally show up first on a Western Blot test?  Which bands are
specific for Lyme disease?  Which bands normally appear after the patient has had
Lyme for at least one year?
The first Western Blot band to show positive is normally the 41KD band followed
intermittently by the 23KD band.  Bands 18KD, 23-25KD, 31KD, 34KD, 37KD,
39KD, 83KD and 93KD are specific for indicating Bb exposure.  The problem is they
may not show up early in the infection, may not appear for a year or more,
or may not show up at all.  The presence
of the 41KD band along with one of the specific bands listed above indicates a person
has been exposed to Lyme disease and appropriate treatment should be initiated.
28. Why would a Lyme test not be accurate?
1. Antibiotic use prior to testing 
2. Patient has been on steroids or cancer drugs
 3. Antibodies are bound by bacteria
 4. Immunosuppression
 5. The bacteria has shifted forms
 6. Lab standards for cut off are too high
 7. The test was performed too soon, before antibodies have a chance to develop
 8. Bands are for reporting purposes, not for clinical diagnosis and are being misunderstood
 9. Poor labs that do not specialize in tick borne illnesses
 10. Contamination of specimen
 11. Various strains or the organism are not identified using standard tests
29. Can bismuth be used for Lyme patients?
Studies have shown that bismuth will penetrate Borellia cyst walls.  Intestinal
problems are especially common in children with Lyme disease and bismuth
compounds may eventually prove to be effective in treating the cyst form of the
bacteria in the intestines.  Check with your doctor for updated information concerning bismuth and other cyst busters (Tindamax).
30. What are the symptoms of Bartonella? What is the standard treatment for Bartonella
and how long should a person be treated?
Common symptoms of Bartonella include fatigue, swollen lymph nodes,
encephalopathy, headaches, cognitive dysfunction, rash/lesions, vision problems,
numbness, and tingling.  Reports indicate Doxycycline may be effective in treating
Bartonella.  Rifampin has also been used in combination with Doxy, but is not as
successful when used alone.  Several other antibiotics have been reported to be successful in
Bartonella treatment and new discoveries are being reported.  Antibiotics have occasionally been used for over a year to
attempt to eradicate the persistent Bartonella bacteria.
31. If a patient is infected with Lyme, Babesiosis, and/or Ehrlichiosis, which infection should be treated first?
In co-infected patients experts have noted that treating Babesia first has been proven to be more effective,
however, in acute situations, treatment for all infections should be considered.
32. Where would you send blood and tissue samples to have the best available tests performed
on Lyme patients?
IGeneX Lab in California performs a variety of tests for tick borne diseases (PCR,
urine tests- DOT, RWB- Reverse Western Blots, Lyme, Babesia, Erhiclia, and
Bartonella).  Igenex reports all WB bands, providing more factual results in the
clinical setting.  
33. What is a "Lyme Dot"?
Lyme Dot is a urine test performed by Igenex Lab which detects spirochete residue
in urine samples.
34. What is an ACA?
ACA (acrodermatitis chronica atrophicans) is a skin rash normally seen in patients
with late stage Lyme disease. The ACA rash indicates ongoing chronic
infection.
35. What is a Herxheimer reaction?
Jarisch-Herxheimer's reactions (herx) often occur during antibiotic therapy for spirochetal 
infections and may be fatal in some cases.  A 'herx' occurs when the spirochetes die
off and produce toxins which can overwhelm the system.  Patient's symptoms may become much worse during the reaction. 
Due to the replication cycle of the spirochete, treatment for Lyme should continue
for several months after all Jarisch-Herxheimer reactions have ceased and all symptoms have cleared, or the patient is likely to relapse.
36. How does prednizone help the Lyme patient?
Trick question- Do not take steroids if Lyme disease is even suspected, unless it is a life threatening emergency.  Steroids
suppress the immune system and allow the spirochetes a non-challenged environment in which to
multiply.  Many people who now suffer with chronic cases of Lyme disease were
given steroids and are now chronically ill, disabled or have died.  If you must take steroids it is recommended to take antibiotics during that time.
37. Approximately how many Lyme cases are reported?
In 2008 there were 28,921 confirmed cases of Lyme disease reported to the CDC.  The CDC has estimated the total number of cases is at least ten times
higher than what is being reported, therefore approximately 289,210 new cases of Lyme occurred in 2008.  For information on reported cases please visit the national Lyme Disease Association website (under Resources, cases, stats, maps and graphs) at www.LymeDiseaseAssociation.org  
38. What are the signs or symptoms of Lyme disease?
Lyme is a multi-systemic disease that can cause multiple signs and symptoms.
Lyme disease can have a wide range of symptoms, which can go dormant (sometimes
for years), can migrate, return, disappear, or change day by day. Symptoms can be
aggravated by stress, medications, weather, and other outside influences. Symptoms
may tend to worsen on a four week peaking cycle. SOME of the symptoms that may
be found in those with Lyme disease include:

Flu-like symptoms, headaches (mild to severe), recurring low grade fevers or
fevers up to 104.5 degrees. Usually in the first few weeks of Lyme disease fevers
tend to be higher. (Patients with Lyme disease often tend to have a "normal
temperature" below 98.6 degrees, therefore, a slight rise in temperature may be all
that is noted.) 
Often patients exhibit fatigue (mild to extreme), joint pain (with or
without swelling), muscle pain, connective tissue pain, recurring sore throat
(sometimes only on one side of the throat), swollen glands (come and go), varying
shades of red on ear lobes and pinna, malar rash, cold hands and feet in a warm
environment, weakness, lightheadedness, eczema and psoriasis, painful or itching
skin, flushing, night or day sweats, inordinate amounts of sweating, anhydrosis
(inability to sweat), or dermatitis (acrodermatitis chronica).

There may be a rash, but it isn't noticed or does not appear in all cases. The rash
may be basically circular with outward spreading, however, other varieties are seen. 
The rash may be singular or multiple, at the site of a bug bite, or in another location,
warm to touch, or slightly raised with distinct borders. 
In dark skinned individuals
the rash may appear to be a bruise.

Numbness, sleep disturbances, vertigo, hearing loss, feelings of being off-balance,
unexplained weight gain or loss, and feeling "infected" are also problems associated
with Lyme disease. 
Symptoms may develop that include: panic attacks, anxiety,
depression, mild to severe cognitive difficulties, mood swings, coma, seizures,
dementia, mania, biploar disorders, vivid nightmares, stammering speech, confusion,
memory loss (short or long term), "brain fog", vibrating feeling in head,
topographical disorientation, and environmental agnosia.


Some patients have problems with numbers and sequencing, disorganization of
thoughts, rambling on in great detail while talking, frequent errors in word selection
or pronunciation, changes in personality, short attention span, Tourette
manifestations, OCD (obsessive compulsive disorder), raging emotions, and cranial
nerve palsies.


Patients have reported bladder disfunction (neurogenic bladder with either
hesitancy, frequency, loss of bladder awareness, urinary retention, incontinence or
symptoms of UTI, and chronic pyelonephritis). Intersitial cystitis, irregular or
severe menstrual cycles with decreased or increased bleeding, early menopause, a
new onset of P.M.S. symptoms, or disturbed estrogen and progesterone levels are
documented in many cases. 
Other problems include altered pregnancy outcomes,
severe symptoms during pregnancy, abdominal bloating, irritable bowel syndrome,
abdominal pain and cramping (may appear to be ulcers), loss of sex drive, testicular
or pelvic pain, breast pain, and fibrocystic breast disease.

Diarrhea (which can come and go or last for months with no explanation),
constipation (which can be severe enough to cause blockage), irritable bowel
syndrome, spastic colon, nausea, stomach acid reflux, gastritis, abdominal myositis,
and indigestion are some of the gasto-intestinal disorders reported. 
In addition, patients demonstrate a higher occurrence of various types of cysts (liver, breast, bone, ovary, skin, pineal gland and kidney). 
Some Lyme patients are diagnosed by
their eye care professionals and have been documented as suffering from one or
more of the following disorders: conjunctivitis, ocular myalgias, keratitis,
episcleritis, optic neuritis, pars planitis, uveitis, iritis, transient or permanent
blindness, iritis, photophobia, temporal arteritis, vitritis, Horner's syndrome, ocular
myasthenia gravis, and Argyll-Robertson pupil. 
Often eye problems require a
changing of prescription glasses more often than normal. 

Heart-related problems are associated with Lyme disease and can include: mitral
valve prolapse, irregular heart beat, myocarditis, pericarditis, enlarged heart,
inflammation of muscle or membrane, shortness of breath, strokes, and chest pain. 
Twitching of facial muscles, Bell's palsy, tingling of the nose, cheek or face are
reported. 
In addition, there may be chest pain or soreness, enlarged spleen, liver
function disorders, tremors, extreme sensitivity to being touched or bumped,
burning sensations, stiff neck, meningitis, and encephalitis. Patients may experience continual or recurring infections (sinus, kidney and urinary tract are most common).


Patients may suffer from a weakened immune system, the development of new
allergies, recurring upper respiratory tract infections (causing, or worsening of
pre-existing sinusitis, asthma, bronchitis, otitis, mastoiditis), and allergic or chemical
hypersensitivity's. 
Other noted problems include: T.M.J., difficulty swallowing or
chewing, tooth grinding, arthritis (in small joints of fingers and larger, weight
bearing joints), Osgood-Schlatter's Syndrome (water on the knee), bone pain,
gout-like pain in toe, muscle spasms to the point of dislocating joints and tearing
muscle tissue, leg and hip pain, "drawing up" of arms, "growing pains" in children,
tendonitis, heel pain, carpal tunnel syndrome, and paravertebral lumbosacral
muscle strain/spasm.


Some patients tend to suffer from a monthly "flare-up" of symptoms as the
spirochetes reproduce and/or die off.
39. When testing by EEG and MRI, what are the results that may indicate Lyme disease
could potentially be a problem?
Some EEG's have been abnormal showing bilateral sharp waves and some slowing.
 CAT Scans are usually normal.  A number of MRI's have shown evidence of increased signal in the white matter, which may resemble what
is seen in patients with MS.
40. What are the symptoms and signs in a patient with Ehrlichiosis?
Symptoms of Ehrlichiosis may include: high fever, chills, muscle pain, headaches,
confusion, nausea and vomiting.  A few patients may develop a rash similar to Rocky Mountain Spotted Fever.  If Ehrlichiosis is suspected, as is the case with Rocky Mountain Spotted Fever, treatment should begin immediately.


41. Is Babesia a bacteria, protozoan, virus, or parasite?
Babesiosis is caused by a protozal parasite which should be treated with antiviral medications
and an antibiotic. Antibiotics alone are not effective for treating Babesiosis.
42. Is Ehrlichiosis or Anaplasmosis more common in humans?
Both HGE and HME have been responsible for infecting animals and humans.  Serology tests for both should be performed if Ehrlichosis or Anaplasmosis is suspected.
43. Approximately how many late cases of sero-negative Lyme patients will become
sero-positive after successful treatment?
It has been reported that increasing numbers of seronegative patients who were
diagnosed clinically and treated for Lyme disease, converted to seropositive after
the completion of antibiotic therapy. Unfortunately, physicians unfamiliar with
Lyme disease often refuse treatment to seronegative patients even when they have
active symptoms.  The CDC states Lyme disease is a clinical diagnosis and negative
tests should not be used to rule out the diagnosis.
44. Why do some patients respond to certain antibiotics and others do not respond?
Certain gene-types, spirochetal loads, various strains, co-infections, previous health
issues, delays in treatment, immune system activity, and many other factors
contribute to the success or failure of antibiotic therapy. One size does not fit all.  Each patient's history and clinical picture should be considered by experienced
physicians prior to and throughout treatment.
45. What dose of doxycycline is needed for adults to allow the
medications to be bactericidal instead of bacteriostatic?
The typical doses (100 mg 2 X day) of Doxycycline that were prescribed by many
doctors were not high enough to be considered bacteriostatic (killing action) for Lyme disease.  To
enhance antibiotic action several other agents are now being prescribed along with
the antibiotics in order to increase effectiveness.  Additionally, the recommendations for Doxycycline doses now range from 300-600 mg a day unless contraindicated.  If necessary, Doxycycline can be administered by IV to keep blood levels high or in combination with other antibiotics (such as cyst busters).
46. What medications are prescribed to remove Lyme disease
neurotoxins from the body?
Welchol and Questran are sometimes prescribed to remove toxins.  Other methods are also used to remove toxins.  Patients should check with their doctors for more in-depth information. 
47. Should a patient with Lyme disease be restricted from donating blood?
Anyone who has Lyme disease or any of the tick borne co-infections should not donate blood or organs.  It has been determined blood bank conditions do not kill spirochetes and some of the other tick borne organisms have been passed on to recipients of the blood donation causing a worsening of the condition, disability and even death.
48. What special precautions should be taken with pregnant women who contract Lyme
disease?
There are special recommendations for treating pregnant women infected with Lyme and
other tick borne illnesses.  All pregnant patients should be tested for co-infections and should be
aware that breast milk may also pass infections to children.  Cord samples, blood and tissue can be sent for PCR testing to check for Lyme and other tick borne diseases, although a negative test would not indicate a newborn has not been infected. 
49. What are the symptoms of Brucellosis?
Fever, chills, headaches, excessive sweating, fatigue, back pain and joint pain are
some of the symptoms that may be present in a person infected with Brucellosis.
50. How do you properly remove a tick?  Where can the tick be sent for testing and what
are the costs? How do you package the tick for shipment?  Does the tick need to be alive
for testing?
To remove an attached tick- Do not touch the tick with your fingers or squeeze the 
tick. Use fine point tweezers to grasp the tick as close to the skin as possible. Pull
the tick out in the opposite direction from the way it entered with a smooth motion. 
Do not twist or crush the tick. Clean the wound with soap and water, and alcohol to help prevent a
secondary infection.  Place the tick, dead or alive, in a plastic baggy with a cotton
ball that is slightly damp.  Contact a lab that
performs tick testing, such as IGeneX Lab, to determine the current shipping methods
and prices for tick testing.  The current cost to test an individual tick (or up to 20
ticks together) is approximately $50.00- $65.00 for each tick borne disease test ordered.

Please feel free to share this information with others.  Thank you!