When is the medical profession going to wake up and treat SYMPTOMS like MS, fibromyalgia and RA as a possibility of being Lyme disease? Simply stated, treat the cause, not the symptom.

DEAR READER: I have never known Lyme to be spread by sources other than a tick. It is caused by a bacteria called Borrelia burgdorferi and spread by deer ticks that carry the contaminant. Animals that commonly transport these insects include the white-footed field mouse, deer, foxes, moles, chipmunks, squirrels, raccoons, opossums, and horses.

The U. S. National Library of Medicine, the Centers for Disease Control and Prevention, Mayo Clinic, the Lyme Disease Foundation, National Institutes of Health and even WebMD all agree with my view.

Lyme was first diagnosed in 1975 following an unusually large number of children being diagnosed with juvenile rheumatoid arthritis in Lyme, Connecticut, a town in the very state in which I live. An investigation resulted in the discovery of tiny deer ticks infected with a bacterium, later named Borrelia burgdorferi. I find it hard to understand how Lyme can now be spread by flies, gnats and the like. Were that truly the case, Lyme would be epidemic or perhaps even pandemic!

Multiple sclerosis (MS) is an autoimmune disease that affects the central nervous system. It is caused by damage to the myelin sheath, the covering surrounding nerve cells.

The cause of fibromyalgia is unknown but may be related to a viral infection, although none has been identified.

Rheumatoid arthritis is also an autoimmune disease. Infection may be linked to the disorder.

I must admit I was unaware of Dr. Singleton and his book — despite the fact he lectures frequently on the topic of Lyme disease. I’m sorry to say I cannot agree with your views but don’t choose to deprive you of believing anything you read.

Readers who would like information on related subjects can order my Health Report “Fibromyalgia” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order made payable to Dr. Peter Gott, PO Box 433, Lakeville, CT 06039-0433. Be sure to mention the title when writing or print out an order form from my website’s direct link www.AskDrGottMD.com/order_form.pdf. I must warn you, though, that the report does not connect the disorder with Lyme disease.

I happened to get information through a friend that there are actually two types of Lyme tests and that one is much more accurate than the other. I then went to a specialist who ordered the more sensitive test and discovered that I do, indeed, have Lyme.

I am shocked because I haven’t been hiking much in recent years, although I did a fair amount when I was younger — and I don’t live in a particularly high-risk area. I have been freaking out for the past few months thinking I had MS or God knows what else.

I am very concerned about others out there who could have Lyme disease and come up with a negative test because it was not the right test. I am confused about why the less accurate test hasn’t been discontinued, as it is so misleading. (This is the test currently being ordered by most MDs). Please tell your readers about the two types of test as well as Lyme symptoms. It could literally save someone’s life! Sign me … GLAD TO BE DIAGNOSED FROM THE CENTRAL COAST OF CALIFORNIA

DEAR READER: Lyme disease is the most common tick-borne illness in North America. It is caused by a bacterium known as Borrelia burgdorferi. The bacterium is spread by deer ticks that feed on the blood of humans, mice, deer, birds, cats and dogs. They are brown and approximately the size of the head of a pin, making them very difficult to spot. In order for a person to develop Lyme disease, he or she must be bitten by an infected deer tick. Before any bacteria can be transmitted, however, the tick typically has to be attached for at least 48 hours.

Symptoms vary from person to person, with various areas of the body affected. Common signs may include a rash or bull’s-eye ring in one location or over the body, joint pain, headache, body aches, fever and chills. Less common symptoms are neurological in nature — such as Bell’s palsy, weakness of the limbs, irregular heartbeat, impaired memory, hepatitis and overwhelming fatigue. These are typically associated with advanced disease.

Some symptoms of Lyme disease (without the telltale bull’s-eye ring or rash) are also found in disorders such as fibromyalgia, depression, joint pain and chronic fatigue. Therefore, if your physician has any question at all, he or she might choose to order lab testing such as an ELISA (enzyme-linked immunosorbent assay) test, a Western blot to detect antibodies to several proteins of B. burgdorferi, or a PCR (polymerase chain reaction) that detects bacterial DNA through fluid drawn from an infected joint or spinal fluid.

The ELISA test is the current standard of care and is ordered first. It can take several week following the initial bite for the body to develop sufficient antibodies for the test to be positive. Testing too early may produce a negative result when in fact, infection is present. If the ELISA is positive, it is followed up with a Western blot; in patients with “chronic” Lyme or Lyme arthritis, the PCR may also be ordered.

It is important for both physician and patient to realize that testing may not indicate Lyme disease. And, once an individual has been diagnosed, a portion of the report known as the IgG may remain positive for months or years after the initial infection. This doesn’t require treatment, but remains an indication that the patient had Lyme at one stage.

Treatment is commonly initiated with oral antibiotics such as doxycycline for adults and children over the age of 8, or amoxicillin or cefuroxime for those younger, pregnant women or women who breast-feed. A two- to four-week course is the norm. However, some research studies now indicate that between 10 and 14 days might be sufficient.

With progression of Lyme disease that fails to respond to traditional methods, treatment with intravenous antibiotics may be appropriate and can last anywhere from two to four weeks. This method is extremely effective in eradicating infection; however, it may cause a low white blood cell count, diarrhea, or infection with other antibiotic-resistant organisms unrelated to Lyme.

The Food and Drug Administration has warned consumers and health care providers to avoid Bismacine. This injectable compound contains high levels of a metal known as bismuth. It has been prescribed by some alternative medicine practitioners. While safe in some oral medications, in its injectable form it can cause poisoning that can lead to heart and kidney failure and is not approved.

DEAR READER: You failed to mention which ticks you are talking about, so I am unsure which tick to discuss.

Colorado tick fever is an acute viral infection that is transmitted through the bite of an infected wood tick and should not be confused with the bacteria tick-borne Rocky Mountain spotted fever. There is also the possibility of dogs picking up infected wood ticks and transmitting the disease. Symptoms are similar to those of a cold: fever, chills, aches and pains. A vaccine was created for Colorado tick fever but was never manufactured.

If you are referring to the tick-borne Lyme disease, this was discovered only about 35 years ago, in 1975, and was named after a small town in Connecticut. This infectious disease is caused by a spirochete that thrives in deer ticks. It is spread to humans by a tick bite. Your childhood state of Maryland is one of the top 10 in the United States for ticks, preceded by Delaware, Connecticut, New Jersey, Massachusetts, Pennsylvania, New York and Wisconsin, and followed by New Hampshire and Maine. Therefore, I can appreciate that people in Virginia might not know about this disorder, but I would think they might know about tick fever from wood ticks. I am from Connecticut, and Lyme disease is extremely prevalent in my area. I have treated more cases than I can remember.

In any event, the disease usually presents with a fever, muscle and joint pain, rash or rashes, or a bull’s-eye ring or rings anywhere from three days to several weeks following the bite of an infected tick. A vaccine to treat Lyme was developed, but production stopped in 2002 due to low demand, so it is no longer available to humans. The three-dose vaccine was geared toward people between the ages of 15 and 70 who resided in endemic areas of the northeastern and north central United States. This translated to the duration of immunity and need for any booster shots beyond the third dose to remain unknown. For a time several years ago, I immunized patients who insisted on receiving the course of treatment. Some experienced such unpleasant side effects following the first or second dose that they finally (and thankfully) refused to continue.

Blood testing can be ordered by a physician and may help to diagnose or rule out the disorder. However, a visual examination by a physician familiar with Lyme might be all that is necessary to make a diagnosis. Treatment for early-stage Lyme is commonly two to three weeks of an oral antibiotic.

In addition to alpha-lipoic acid, my doctor put me on Levaquin. Amazingly, the shoulder pain, chronic gall-bladder infection, swallowing problems, ankle swelling and chronic stomach ulcer went away. The numbness in my feet and fibromyalgia did not disappear but got better.

My point is that one of the symptoms of bartonella is numbness of the feet. It is rarely looked at as the cause of peripheral neuropathy. I had none of the diabetic or circulatory problems that normally cause it. I am still scratching my head as to why my now-retired doctor did not diagnose it earlier. It would have made my recovery from Lyme disease so much easier.

DEAR READER: Bartonella henselae, also known as cat-scratch disease, is a bacterium that enters the body at the site of the scratch. Adult cats can spread the disease, but it more commonly comes from kittens. Lymph nodes, primarily those around the arms, head and neck, become swollen. Lack of normal appetite, fever, headache, fatigue and transient peripheral neuropathy may result. Those commonly infected are people with a compromised immune system.

Lyme disease presents with the same symptoms, so it is no wonder your physician would have zeroed in on that possibility. You can perhaps understand why some diseases and disorders are discovered following a process of exclusion. The symptoms are the same, and, at times, the treatment is the same.

The Levaquin you were prescribed is a broad-spectrum antibiotic used to treat bronchitis, pneumonia, skin infections, the sinuses, UTIs, ears, chlamydia and more.

You are correct that peripheral neuropathy is not commonly linked to cat-scratch disease. It is not one of the more common symptoms, but there is a definite link that should not be overlooked when making a diagnosis. Thank you for writing and sharing your interesting case.

The place he lives in has ticks. Also, a friend of his who lives in the neighborhood has had Lyme disease. What are the symptoms of the disease, therapy, cure and duration?

DEAR READER:
Lyme disease was first recognized in 1975 following an excessive outbreak of arthritis near Lyme, CT. Lyme infection is spread by the bite of a black-legged deer tick (Ixodes scapularis) in the northeast and north-central United States. On the Pacific coast, the culprit is the western black-legged tick (Ixodes pacificus).

Most individuals are infected through bites of immature ticks known as nymphs that are tiny and difficult to see. For the most part, they feed during spring and summer. Adult ticks can also transmit Lyme disease bacteria, but because they are so much larger than nymphs, they are easier for an individual to see and remove from clothing or skin before they have had time to feed. The complete life cycle of an Ixodes is two years; a complete meal can take several days and the tick’s body enlarges as it feeds. The general consensus is that a tick must feed for two days before it can transmit bacteria. However, some physicians take the position that if a tick feeds at all, it can transmit the “disease”.

Ticks attach to animals or humans as they brush against them. They can neither jump nor fly. The risk of exposure is greatest in wooded areas, but keep in mind that animals can carry ticks from a wooded area into your backyard. Hosts such mice and deer can provide food for ticks throughout their stages of life.

Lyme disease is most frequently identified by a characteristic skin rash or rashes, bull’s eye ring or rings, fatigue, muscle and joint pain, headache, chills and fever. The difficulty here is that the symptoms mimic those of the flu. Physicians outside an endemic area will often lean toward a virus or arthritis, rather than Lyme disease during the initial stages. Without a characteristic rash or bull’s eye ring, the most important thing a suspecting individual can present to his or her physician is a complete history of possible exposure to ticks and any classic symptoms. Not all rashes that occur at the site of a bite are Lyme disease. This is because when a tick bites an individual, an allergic reaction to the tick’s saliva results. This reaction ordinarily appears within a few hours to a few days following the bite. It does not enlarge, often itches excessively, and should disappear within a few days to a few weeks.

Some physicians will choose to treat an individual simply by history and symptoms. Others might choose to order laboratory testing to confirm the diagnosis. Unfortunately, testing takes several days, during which a patient can be quite uncomfortable.

Several antibiotics are available for treating Lyme disease. They are given orally during early stages and recovery is often rapid and complete. For those with late-stage Lyme, intravenous antibiotics might be preferred. Some individuals suffer recurrent symptoms and may require a second course of treatment. There is some question on the length of time an individual should remain on antibiotic therapy. Your own physician can best guide you.

Following a walk in the woods or in areas where deer and mice traverse, a complete body check should be made for any ticks that might have attached to skin or clothing. Should a tick be found, there is no need to panic. Remove it with tweezers placed nearest the skin and as close to the head of the tick as possible. Carefully pull the tick away from the skin and dispose of the body. Do not become alarmed if the mouthparts remain in the skin.

Prevention includes avoiding walking in known tick-infested areas, using insect repellent with DEET and wearing protective clothing. Avoid shorts. Tuck long pants inside socks or boots and shirts into pants. And most important of all, remember daily tick checks.

I do not feel your friend’s loss of memory and nervousness are related to Lyme disease. If he is that concerned, a simple blood test will assist. He should visit his primary care physician, explain his concerns and be referred to the appropriate specialists if his doctor cannot pinpoint the problems.

To give you related information, I am sending you a copy of my Health Report “Alzheimer’s Disease”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

DEAR READER:
Lyme disease was first recognized in the United States more than 30 years ago, and has been diagnosed from coast to coast. In the east, the black legged deer tick known as the Ixodes scapularis spreads the disease, while a different species of the black-legged tick known as the Ixodes pacificus is the culprit on the west coast. Ticks are usually found in wooded areas; however, it is common to have one crawl up a pant leg while walking across your own back yard. Dogs, cats, deer and mice are common carriers.

Most humans are infected through the bites of immature ticks known as nymphs. They are tiny, feed during the spring and summer months and are extremely difficult to see. Adult ticks tend to feed during the summer and fall. They, too, can easily transmit Lyme bacteria, but are substantially larger and are often picked off the skin faster because they are easier to see.

Contrary to popular belief, ticks cannot jump or fly. They crawl onto people or animals as the recipients brush against them. They feed on blood by inserting their mouth parts only into the skin and because they are slow feeders, a complete meal can take several days. During that time, the body of the tick swells.

Early stage Lyme disease can be marked by a characteristic skin rash or multiple rashes, bulls-eye ring, chills, fever, headache, muscle and joint pain, and swollen lymph nodes. The rash is a red circular patch that ordinarily appears within three to thirty days after the bite of an infected tick. The rash can be warm, but ordinarily isn’t painful. Other symptoms of Lyme disease may also develop during this time frame. However, some unfortunate individuals may not develop symptoms for weeks, months or even years after the initial tick bite. Additional symptoms include arthritis, numbness, pain, nerve paralysis, meningitis, abnormal heart rhythm, fatigue, headache, sleep disturbances and/or memory and cognition difficulties. Fortunately, today most doctors recognize the symptoms of Lyme (regardless of what part of the country they are in), test and successfully treat it.

When feeding, an allergy to the tick’s saliva often occurs. This results in the initial bite area that is surrounded by a dark pink or red ring, surrounded by the normal color of the flesh. This is not a bulls-eye ring, but a common reaction to the saliva itself. A true bulls-eye is exactly that — ring surrounded by ring, surrounded by ring.

The fever, fatigue and muscle aches and pains of Lyme are often mistaken for infections such as influenza, arthritis and other conditions. Diagnosis is relatively simple when the typical rash is present and an individual gives a history of tick bite. When no known tick bite has occurred and a physician is uncertain, he or she might order laboratory blood testing. Herein a problem could surface. Take, for example, an individual who presents in a physician’s office because of flu-like symptoms present for three days. In an endemic area, the physician might be suspicious enough to obtain blood work for Lyme disease. However, blood tests do not detect infection until the body starts to produce measurable levels of antibodies to the Lyme bacterium which often occurs from two to four weeks after a bite. The tests will be negative, the patient will feel miserable, and the doctor is back to square one. Timing is extremely important in this case.

When a patient presents to his or her physician with a history of removing a tick within the prior three days, the physician might choose to prescribe two doxycycline to be taken as a means of boosting the immune system. When a patient presents with flu-like symptoms, aches and pains, and more but doesn’t remember when the tick bite occurred, then a full course of antibiotics might be more appropriate.

In summary, before walking in the woods, use an insect repellent with a 20-30% concentration of DEET. Spray it on shoes, pant legs, and exposed skin. Wear protective clothing such as long pants and long sleeves. Tuck pant legs into socks while in wooded areas. Perform tick checks regularly. They ordinarily must be attached for at least 24 hours before bacteria can be transmitted. Simply remove them before then and you will substantially reduce the risks of acquiring Lyme disease.