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Lyme Disease & Deer Ticks: Symptoms, diagnosis and misdiagnosis
Last year, my mother-in-law, my father and I all got Lyme disease, this might be surprising if we all lived in the same geographic location, but as it stands we all live in different regions of the country with our greatest commonality being our love for the outdoors. When I went in with a rash at the doctor in the shape of a target sign, the doctor acted like I was crazy. We don’t have Lyme disease around here. Um… I’m a horse owner, I travel. He then said to me the following classic statement I have heard dozens of times in grad school, “ when you hear hoofbeats, think horses not zebras.” TARGET SIGN WAKE UP!! And yes, Lyme disease is plenty common in Mo. At the time (2010) the CDC had only reported 23,000 cases/year so he and other doctors believed Lyme was relatively rare. The CDC has also reported that they are lucky if 10% of cases are diagnosed and reported… leading to roughly 230,000 plus cases/year. So yes doctor, Lyme disease qualifies as a horse and not a zebra.
Lyme disease is a serious disease with extensive long-term side effects if not promptly treated. There is often a considerable delay in treatment due to 3 major issues:
1. Doctors cannot rely on the blood tests, which delivers false negatives to as many as 75% of cases (study was completed at John Hopkins University). This is likely because over 100 different Lyme disease bacteria species have been identified in the US (and over 300 worldwide)
2. The disease is misdiagnosed as of a wide variety of disease including but not limited Chronic Fatigue, Autism, MS, Parkinson’s, and Alzheimer’s.
3. Ticks can transmit a number of infections in a single feeding, multiple infections create confounding observations.
If you are lucky enough to live in a Lyme-Disease heavy state or get a bull’s eye rash, it is more likely that the doctor will be able to identify the presence of Lyme Disease. Less than half of all patients will recognize their rash. This is because it could appear on the scalp, may appear and disappear quickly, and can be difficult to see on dark, sunburned or tanned skin tones. If you see the rash, photograph immediately so that you can show your doctor in case it disappears before your appointment. Prompt treatment is imperative to limit long term side effects-this merits a trip to the emergency clinic if you find it on a Saturday. In addition, it is imperative that the antibiotic course be long enough to eradicate the disease. The standard 4-6 week long course has been shown to be too short in many patients.
Common initial symptoms are consistent with flu symptoms so they are often overlooked. They include achy muscles, fever, chills, swollen glands, and headaches. Doctors also do not receive adequate training in general medical school to make that diagnosis. They will often refer to the CDC charts on where Lyme disease is generally acquired. Because of this, be sure to know where you have travelled in the last month and be sure to bring it up with your doctor.
If left untreated, patients may end up with chronic, debilitating problems affecting all body systems, including but not limited to issues with the heart and nervous system, as well as arthritis, chronic headaches and even psychiatric problems. An acquaintance of mine carried the infection for over a decade- the result was chronic headaches. The CDC reports that only about 10% of the cases are being reported, so they lack the geographic data that would motivate doctors to make better decisions.
While ticks are the main vector, there are some documented cases of biting flies, fleas and even mosquitoes carrying Lyme. Therefore, it is advised to take adequate precautions to prevent bug bites and ticks.
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