Monday, September 14, 2020

"I haven't felt well since..." Post-recovery Syndromes: Tales of Lyme and COVID

When a person gets an infectious illness under normal circumstances their immune system will assure a full recovery. However some diseases leave what seems like a more or less permanent mark on those who suffer from them.

Many times I have talked with patients who tell me, "I've never felt quite well since…" And this could be anything from a parasite infection to a sexually transmitted disease to Lyme or any of a host of other conditions. More often than not these people have been treated with the appropriate antibiotics or other drugs, perhaps by another medical provider. Nevertheless, they have constellations of symptoms that troubled them for months or years to come.

I have not been terribly surprised to learn that COVID-19 has caused this problem for some people recovering from it. Broadly speaking we observe two categories of this post recovery syndrome. The first is persisting symptoms after the disease itself is resolved, and the second is persisting symptoms in patients who required hospitalization, or even treatment in an intensive care unit, for very severe disease: basically, treating the side effects or after-effects of the regular medical treatment.

Lyme disease is an example of this. Many people who present to me with complaints of long-standing Lyme have been treated with antibiotics, often on more than one occasion, and sometimes they've been practically bathed in antibiotics, often administered intravenously. One common interpretation of this failure to improve after treatment is that the germ is still being harbored somewhere in the body. This is true in selected circumstances, but a number of research studies have shown that it's not generally true. Indeed the high levels of antibiotic treatment that some of these patients receive should barely leave any bacteria in the body alive, including the microbiome! That's all those good bacteria in the gut that not only help us digest our food, but also play a significant role in our overall health and well-being.

After all those antibiotics it's no wonder people feel terrible, ever afterward!

There is an interesting line of research, and I've written about this in my blog elsewhere, that suggests that a number of infectious diseases can cause derangements in immunity, and it may be these derangements that are responsible for the wide variety and persistent nature of symptoms in people who never quite get over certain infections. In Lyme disease, I and many others call this post Lyme treatment syndrome. Recently we've begun to see a similar phenomenon with COVID-19. 

How does one begin to treat something like this? Well in classical homeopathy we would approach this like we would approach any case: interview the patient, examine him, and tried to determine which homeopathic remedy would cause this particular set of symptoms in a healthy test subject. "Like cures like." I have written elsewhere about the homeopathic treatment of COVID-19 during the acute illness, and noted that because of the potency of this infectious agent, most people will be treatable with one of a handful of remedies. However in post treatment syndromes or post recovery syndromes we universally find that the individual experience of these events leads us to great individuality in remedy selection.

So while treating an acute case of coronavirus might involve Sulfur, or Gelsemium, or Eupatorium, or one of a few other remedies, treating a chronic post recovery case could lead us to almost any remedy. This is also true in Lyme disease, and in any of a number of other infectious events such as food poisoning, pneumonia, STDs, and others. It usually is not true of the flu, or the common cold. The thing that ties these together is that post recovery syndrome is often the result of something that can have severe consequences, cause lasting inflammation, and is often in need of treatment from antibiotics or other drugs.

And they tend to be diseases that are potentially deadly.

I expect at some point I will be seeing some of these cases of people who had COVID-19 and have never been right since. In the meantime I've had the opportunity to treat some acute cases, and the nice thing about that is that people seem to recover without any further problem. The key is reaching people early in the course of the disease.

But in the event I don't see them when they're early in the course of things, I'm glad I have a tool that I can use to help them when the troubles just won't go away.

Be well!