Chronic Lyme Disease
By Sue Peck PhD, GNP-BC, APNP, and Gail Corse BS, BA
Lyme is a spiral-shaped bacterial (spirochete) infection of animals transmitted to humans by a tiny tick; most commonly by the deer tick. It is more likely to occur in areas where existing forest is broken up for suburban development, allowing the white-footed mouse to flourish because of a decrease in the number of its predators. Climate change has contributed to the spread of the disease. According to the Environmental Protection Agency (EPA), warmer temperatures and shorter winters have increased the prevalence and active period of the deer tick. The deer population, migration of birds, and number of other host animals also affects the prevalence of the disease.
The EPA reports that in the United States the incidence of Lyme disease has doubled since 1991. It is the most common vector-born disease in the United States. The Wisconsin Department of Health Services reports that Lyme disease is more prevalent in the Northeast, the Midwest, and on the West Coast. In Wisconsin, the western and northern regions have reported the highest number of infections, but the number of cases in the central and eastern regions has increased recently. Lyme has been recorded in almost every state in the nation, and abroad.
An individual infected with Lyme disease may see symptoms appear anywhere from three to thirty days after a tick bite. Lyme disease affects multiple systems in the body. Only 15 to 50 percent of persons with the disease recall being bitten by a tick. The early symptoms include fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes. A rash may occur in less than 50 percent of persons infected, and is not a reliable measure of having Lyme. When the rash occurs, it expands over several days in a “bull’s-eye appearance” and may have a diameter as large as 12 inches. Later symptoms occur when the bacteria has “set up shop” in the soft tissues of the body and may include severe headaches and neck stiffness; additional rashes; arthritis; Bell’s palsy; intermittent and roving pain in tendons, muscles, joints, and bones; an irregular heart beat; episodes of dizziness or shortness of breath; inflammation of the brain and spinal cord; nerve pain; shooting pains, numbness, or tingling in the hands or feet; and problems with short-term memory. Testing for Lyme and related co-infections is done in several ways. The most commonly used test in the mainstream medical system is the ELISA lab test. The ELISA screening test is unreliable, missing 35 percent of culture proven Lyme disease (only 65 percent sensitivity) and is unacceptable as the first step of a two-step screening protocol. By definition, a screening test should have at least 95 percent sensitivity. A second test with somewhat improved reliability is the Western blot. This test is positive in 70 to 80 percent of people who have active Lyme; it may remain positive for some time after. Some providers use a Lyme Survey that asks the patient input on severity and frequency of a multitude of symptoms known to be associated with Lyme. Other tests can be obtained, including CD57, iGenex, and others. Testing for Babesia, Anaplasma, Ehrlichia and Bartonella (other tick-transmitted organisms) should be performed. There is however, no accurate test available at this time to show that the organism is eradicated or that the patient is cured.
Most of the time early Lyme can be treated effectively with oral antibiotics. The provider needs to be aware of how the symptoms mimic other diseases and in tune with how the patient feels treatments are working. One short course of a single antibiotic has never been shown to cure or prevent Chronic Lyme Disease.
Later stages can be difficult to treat. Sometimes people have persistent or recurrent symptoms, which is referred to as post-treatment Lyme disease syndrome or Chronic Lyme Disease. There is currently controversy among the medical community as to whether or not Chronic Lyme Disease exists. Providers who manage care according to the Centers for Disease Control (CDC) believe those symptoms are from another cause. The CDC website states the surveillance criteria were never intended to be used as diagnostic criteria, nor were they meant to define the entire scope of Lyme disease. Providers who manage patient care according to the International Lyme and Associated Diseases Society (ILADS) use antibiotics and additional methods to treat Chronic Lyme Disease.
The ILADS organization teaches that Chronic Lyme Disease is an autoimmune disease caused by dysregulation of the immune system. Lyme bacteria can become immune to the antibiotics and seal itself off from treatment, creating an autoimmune disease. First, Lyme bacteria don’t really reside in the bloodstream. The bacteria set up housekeeping in joints and the soft tissues of the body. The bacteria wall themselves off, so antibiotics aren’t always effective. Several different antibiotics might be required over a course of time to destroy the wall they build, and the varying stages of life of the eggs, cysts, and bacteria. The human body often has difficulty tolerating several antibiotics, and requires pre- and probiotics and solid nutritional support to avoid or minimize the side effects of the antibiotics. The person usually requires treatments to support the body’s immune system, their nutrition, and hormone regulation. Nutrition is key. Avoidance of sugar and artificial sweeteners promotes best function of the immune system. One teaspoon of sugar suppresses the immune system for hours. While the immune system is suppressed, the bacteria increase their activity. Herbal therapies play a crucial role in treatment as well. Support of the adrenal gland and the hormonal levels improve the body’s ability to handle the work. A treatment available that is used in conjunction with those listed above is Major Auto-Hemolytic (MAH) therapy. The MAH therapy assists your body to produce its own hydrogen peroxide; a process that occurs in the body normally to fight infections. An IV will be started in your arm. You donate one half a unit of blood for yourself. Pure medical grade ozone is added to the bag and mixed in with your donated blood. The blood is returned into your vein after passing through ultraviolet light to assist ridding the bacteria. The procedure takes approximately ninety minutes. Prolozone Therapy can be used to treat painful joints, soft tissue injuries, and the spine when it is suspected the bacteria have sealed into a space. The skin of that joint or area will be cleaned and topical numbing spray applied. A very small needle is used to first inject a mixture of vitamins, minerals, numbing medicine, and homeopathic solutions. The needle is stabilized while the syringe is changed, then ozone is injected, and the needle is removed. The prolozone solution helps remove walled off bacterial biofilm buildup; the ozone supersaturates the area to promote healing. Insurance (most companies) and Medicare/Medicaid usually cover the appointment visit but will not cover the ozone therapy costs. Costs for MAH and prolozone vary depending on what you have done. A single injection with prolozone is currently $125–$175 per site injected. The IV treatment (MAH) with ultraviolet light is currently $150 per treatment. These costs are in addition to the office visit (costs may change without notice). If you are concerned that you or someone close to you has new or Chronic Lyme Disease, make an appointment to see one of us. We’ll evaluate your symptoms, the progress you’ve made with treatments to date, and determine a plan to best meet your needs. Call 715-832-1953. References: International Lyme and Associated Diseases Society, www.ilads.org. Centers for Disease Control, www.cdc.gov/lyme. Evidence Assessments and Guideline Recommendations in Lyme disease: The Clinical Management of Known Tick Bites, Erythema Migrans Rashes and Persistent Disease. The International Lyme and Associated Disease Society (ILADS). www.ilads.org/lyme/treatmentguideline.php#sthash.IhA2SBSO.dpuf. These guidelines are part of the National Guidelines Clearinghouse, www.guideline.gov. Cameron, D. (ed). Top Ten Tips to Prevent Chronic Lyme Disease: Recognize the Signs, www.ilads.org/lyme/Prevent_chronic_lyme