Monday, March 21, 2016

Spring has Sprung...and so has Lyme Disease

I have a student this semester who is working on her senior project. The subject is Lyme disease.  Part of the assignment is to study community resources that are available for people who suffer from the health problem the student is investigating. As one can see from the map, Lyme is a common concern here in the northeast, although it does occur everywhere.
Lyme Disease in Northeast U.S. (Courtesy CDC 2014)
My student has been exploring the world of medicine that operates behind the scenes of what we commonly think of as "medicine" and medical practice.Just Google "Lyme Disease" and you'll get a lot of hits. Many are mainstream pages, like WebMD, the Centers for Disease Control, and Mayo Clinic. But there are also dozens of alternative sites such as My Chronic Lyme Disease Journey, Lymeinfo, and many discussion boards in which sufferers, clinicians, and healers talk about the condition and its effects and its cure. I recently read my student's midterm journal report, and indeed she has found herself deep in the middle of this complicated, confusing world. I think it must be even more strange for professionals, like my student, an RN getting advanced degree, who are used to living in the world of "legitimate" medicine, a world run by doctors and hospitals, a world with an accepted view of biomedicine, a world that tends to marginalize those who advocate alternative viewpoints.

Two Stories of Lyme

The first story has to do with what Lyme disease is and what it does. The second story is about our response to Lyme. My student's experience this semester touches on both.

What Lyme Is and Does

For a long time we thought that Lyme, like other bacterial diseases, would respond simply to antibiotic treatment. That is, you get bitten by a deer tick. You get the rash, maybe a fever or some joint pains. We give you doxycycline or something, and you get better. However, Lyme, like syphilis, comes from a family of bacteria that tend to stick around. Like syphilis, there are "tertiary" or late-stage Lyme cases. Any disease can be beaten by the human immune system, but there are some against which the immune system doesn't always do so well. Examples include syphilis, Lyme, HIV, hepatitis C, hepatitis B, and others. Yes, there are cases in which all of the foregoing diseases have been cleared or cured by the genetics and immunity of certain individuals (how about that!)--but in general, this group of infections requires a bit of help from antibiotics or antivirals.

So Lyme--Borrelia burgdorferi--is a little corkscrew shaped bug that gets into a variety of tissues, especially joints, and if untreated and uncleared by a person's immune system, becomes a source of chronic, low level inflammation, which can eventually cause really serious problems: arthritis, weakness, brain fog, and even heart problems. The treatment for every stage of Lyme is antibiotics, usually a course lasting anywhere from 10 days to 4 weeks, depending on the duration, and on which authority's recommendations are used. Late-stage Lyme can last decades to a lifetime.

Next installment: Our Response to Lyme

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