Monday, May 18, 2009

Lyme Disease

There's a very sad story on MSNBC about a woman with Lyme disease. In the late stages of the disease, she finally killed herself to get away from its misery.

From a medical standpoint, one of the problems with Lyme is the difficulty of diagnosis. The positive cases that are reported to me (Lyme is a reportable condition) generally place onset at a year or more ago. Sometimes many years ago. Unfortunately, they have missed the window of opportunity in which treatment is most effective. For many patients, the diagnosis was not considered until late in the illness. I had a doc tell me recently that we don't have Lyme disease in this part of the country. Well, A) that's not true, and even if it were, B) people do travel outside of this area.

When doing a case history, I have found that most people with Lyme disease do not remember ever having a tick attachment. Some do. Some clearly had the bull's eye rash. But a lot of them didn't.

Sometimes laboratories will report positive results which the physician will contest. It's a false positive, the doc will say, even though all the markers are there. Certainly that is a possibility, but these scare me, because the patient will not receive treatment.

It is important to review your lab work with your doctor. Ask to see it, and ask what it means. Laboratories flag values that are out of normal so the doctor can easily see it. If you see a flag, ask about it. If your doctor says it is a false positive, ask why she or he thinks that, and ask to be retested.

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