Lyme Disease is a well studied infectious and autoimmune disease.  It begins from the bite of an infected tick.  It then becomes an infection.  Once treated the infection resolves.  If treated early enough (usually in the first 3-6 months of infection), there is very little risk of any further problems.   If, however the infection is not treated or treated too late, our immune system will continue to fight our own tissues at the site of the infection.  This is a problem of "autoimmune disease" or self-immunity (our immune system fighting our own tissues).  This can result in after-the infection (post-infectious) symptoms.  There are many autoimmnue diseases.  Such things as thyroid disease, rheumatoid arthritis, lupus, and diabetes are autoimmune disorders. 

The first hurdle to Lyme Disease is making the diagnosis clear.  This is sometimes difficult.  Laboratory testing is dependent on interpretation and correlation with signs and symptoms.  Strict criteria for interpretation of testing and extended testing are available.  Many times the diagnosis does not rely on one test.  An ELISA or EIA test measuring a Lyme IgM (early immune response) and IgG (later immune response) is the first step in testing.  If either of these are suscipious, a Western blot measuring both the Lyme IgM and IgG should be done.  The Western blot measrues our immune response to multiple proteins of the organism.  Some of these proteins will be reactive on the Western Blot because they look like proteins of other organisms.  For this reason, a positive Western blot will require several of the proteins to be reatctive to actually indicate a response to Lyme is present.  Theses tests measure our response to the organism.  They do not predict the disease is present unless the matching signs and symptoms are present.  If the initial testing is negative, but suscipion is still high, repeating the testing in 3-4 weeks is reasonable. 

There are other diseases with similar symptoms, so clarifying the diagnosis can result in your best chance for improvement.  This may require us all to keep an open mind during the work-up of your complaints.  Treating the wrong diagnosis rarely results in any improvememt!  There are several syndromes presenting as Lyme Disease.  Some of these include, but are not limited to;  aseptic meningitis, arthritis, myalgias and fatigue, erythema chronicum migrans, Bell's palsy and carditis.

Lyme Disease may be treated by several antibiotics.  Usually, a tetracycline or penicillin is used.   If nervous system involvement is present, Lyme is usually treated using Rocephin (ceftriaxone), an intravenous or intramuscular injection.  The usual course of therapy is 2-4 weeks.  Longer courses of therapy have not proven any clear benefit.  Specifically, patients who continue on prolonged courses of antibiotics have the same functional status and complaints as do those without prolonged antibiotics.   Despite this clear evidence based information, some patients and doctors will insist on continuing antibiotics long term for Lyme Disease.  It is the opinion of Dr. Rebecca Shadowen that this should be strongly discouraged.  The cost, complications, and debilitation of prolonged antibiotics is significant where there has NOT been shown any clear benefit.

You should know that there are clinical guidelines drafted from the literature and science behind Lyme Disease by the Infectious Disease Society of America.  Although there is much discord among those using long term antibiotics to treat late Lyme disease, this practitioner is in agreement with the current guidelines published.  The evidence is overwhelming to support these guidelines.  If the scientific evidence (not opinion, feeling, or individual experience) should change, I will keep an open mind to this change also.