Archive for the ‘Lyme’ Category

Increasing Burden of Lyme Carditis in United States Children’s Hospitals

https://www.ncbi.nlm.nih.gov/pubmed/31728570/

2019 Nov 14. doi: 10.1007/s00246-019-02250-9. [Epub ahead of print]

Increasing Burden of Lyme Carditis in United States Children’s Hospitals.

Beach CM1, Hart SA2, Nowalk A3, Feingold B4,5, Kurland K6, Arora G4.

Abstract

We sought to characterize the shifting epidemiology and resource utilization of Lyme disease and associated carditis in US children’s hospitals. We hypothesized that the Lyme carditis burden has increased and that hospitalizations for Lyme carditis are costlier than those for Lyme disease without carditis. The PHIS database was queried for Lyme disease encounters between January 1, 2007 and December 31, 2013. Additional diagnostic codes consistent with carditis identified Lyme carditis cases. Demographic, clinical, and resource utilization data were analyzed. All costs were adjusted to 2014 US dollars. Lyme disease was identified in 3620 encounters with 189 (5%) associated with carditis. Lyme disease (360 cases in 2007 vs. 672 in 2013, p = 0.01) and Lyme carditis (17 cases in 2007 vs. 40 in 2013, p = 0.03) both significantly increased in frequency. This is primarily accounted for by their increase within the Midwest region. Carditis frequency among cases of Lyme disease was stable (p = 0.15). Encounters for Lyme carditis are dramatically costlier than those for Lyme disease without carditis [median $9104 (3741-19,003) vs. 922 (238-4987), p < 0.001] The increase in Lyme carditis cases in US children’s hospitals is associated with an increased Lyme disease incidence, suggesting that there has not been a change in its virulence or cardiac tropism. The increasing number of serious cardiac events and costs associated with Lyme disease emphasize the need for prevention and early detection of disease and control of its spread.

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For more:  https://madisonarealymesupportgroup.com/2019/02/21/diagnosis-treatment-of-lyme-carditis/

https://madisonarealymesupportgroup.com/2019/11/04/suspect-lyme-carditis-start-empiric-antibiotics-case-report-suggest-and-lyme-carditis-is-not-rare/

https://madisonarealymesupportgroup.com/2018/07/09/with-unexpected-death-autopsies-should-look-for-lyme-carditis/

Excerpt:  “Lyme expert Dr. Daniel Cameron has done a nice job of summarizing five cases in a blog. http://danielcameronmd.com/autopsy-study-reviews-cases-due-to-sudden-cardiac-death-from-lyme-disease/
Cardiac Tropism of Borrelia burgdorferi: An Autopsy Study of Sudden Cardiac Death Associated with Lyme Carditis. (March 2016)
http://ajp.amjpathol.org/article/S0002-9440(16)00099-7/abstract
Excerpt:

“Fatal Lyme carditis caused by the spirochete Borrelia burgdorferi rarely is identified. Here, we describe the pathologic, immunohistochemical, and molecular findings of five case patients.”

https://madisonarealymesupportgroup.com/2019/05/15/lyme-carditis-presenting-as-atrial-fibrillation/

https://madisonarealymesupportgroup.com/2018/02/22/new-lyme-cme-course-available-lyme-carditis-more-than-blocked-beats/

https://madisonarealymesupportgroup.com/2019/06/04/how-vector-borne-diseases-impact-heart-health/

Category:

Heart Issues, Lyme, research

“It’s All in Your Head”- Medicine’s Silent Epidemic

https://jamanetwork.com/journals/jamaneurology/article-abstract/2751253

Viewpoint
September 16, 2019

“It’s All in Your Head”—Medicine’s Silent Epidemic

Matthew J. Burke, MD, FRCPC1,2
JAMA Neurol. Published online September 16, 2019. doi:https://doi.org/10.1001/jamaneurol.2019.3043
“It’s all in your head” is a phrase sometimes said by physicians to patients presenting with symptoms unexplained by medical disease. As a neurologist specializing in neuropsychiatry, nothing bothers me more than overhearing medical colleagues proclaim this one-liner at the bedside or snicker about these patients during rounds. Unbeknownst to them, I also hear my patients’ version of being on the other end of this phrase and find myself constantly trying to repair the damage that these words can cause. Whether physicians like to admit it or not, medically unexplained symptoms encompass a vast terrain of clinical practice. In neurology, these symptoms fall under functional neurological disorder, but every specialty has their own variants and favored terminologies (eg, chronic fatigue syndrome, fibromyalgia). The inadequate management of this segment of medicine represents a silent epidemic that is slowly eroding patient-physician relationships, perpetuating unnecessary disability, and straining health care resources.
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For more on how this very phrase is still being used against Lyme/MSIDS patients:

 

Category:

Activism, Lyme, research

Gratitude For The Long Game

https://globallymealliance.org/gratitude-for-the-long-game/

Pic of notebook and pen and its says today I am grateful for.

by Jennifer Crystal

In the current political climate, one is often reminded of Martin Luther King’s quote, a paraphrase of abolitionist minister Theodore Parker, that “The arc of the moral universe is long, but it bends towards justice.” The lesson is, though we may spiral through difficult times, we must remember that we are still moving forward, if slowly.

The same lesson is true for patients with Lyme and other tick-borne illnesses, especially those battling late-stage infections that take months or years to treat. Sometimes it can be hard to keep this long game in mind, particularly if you’re feeling worse today than you did yesterday, or worse, more sick this month than you did last month. It’s easy to feel stuck, or even to believe that you’re moving backward instead of forward.

In my worst days of suffering from Lyme and two of its co-infections babesia and Ehrlichia, I was without hope. Bedridden with migraines and insomnia, I wanted to pull my hair out. Some days I’d start to feel a little better, maybe gaining the ability to run an errand or type an email, and then I’d crash and spend the next three days in bed. I felt that I couldn’t take the suffering another second. I didn’t want to die, but I didn’t want to go on living like that, either.

Thankfully, I survived because my health got so much better than I ever thought it possibly could. Someone recently asked me, “What got you through those dark times?”

I thought for a minute and said, “faith.” “Where,” she asked, “did you get your faith?” “Friends,” I quickly said. “They believed in the long game even when I did not. They kept the faith for me.”

Friends who had gone through their own adversity, medical or otherwise, trusted in the possibility of my recovery. They reminded me of the gains I had made. “You drove to the post office today! Last week you walked to the mailbox!” These accomplishments felt insignificant and silly then. I couldn’t see how I could ever move from such baby steps to working or exercising again, especially when I couldn’t lift my head off the pillow, let alone walk to the mailbox.

But within a year of treatment, including intravenous antibiotics, my brain fog lifted and I started tutoring students. My friends had been right. I wrote an article for a local magazine. I traveled to Florida. After another year of treatment, I felt well enough to move out on my own (I’d been with my parents) and started an editorial assistant job. I did physical therapy and was working towards skiing.

Then, I relapsed. Despondent, I thought I’d lost years of gains and that I would have to start all over again. I envisioned another two years in bed, if not more. But a friend pointed out, “Before this relapse, you had six months of good health. You haven’t lost that ground. You’re not back to ground zero.”

She was right. In reality, it only took a few months for me to restabilize. My arc had bent towards wellness before, and it did again, but this time more rapidly. Though the relapse felt devastating at the time, I can now see that it was really just a big hiccup in my long game of Lyme recovery. Since then I’ve been in remission, with smaller hiccups, for more than a decade. I’m able to teach, write, ski, paddleboard, and live a happy life within the context of chronic illness.

I now teach a creative writing course called “Writing to Heal.” On the first day of class, I draw a spiraling arc on the board. The line starts in the lower left corner and moves upward to the right. Then it circles back on itself. Then it moves upward and forward again, then circles back again until there’s an extended helix. It continues to spiral like a staircase until it reaches the top right hand corner of the board. When I finish, I tell my students to look closely at the long, looping arc.

“This is the healing process,” I say.

I’m grateful I held on through my spirals, because the long game has been more rewarding than I could have ever imagined. Hard as it’s been, it has always bent towards wellness, and I have faith that it will continue to do so.

jennifer crystal_2

Opinions expressed by contributors are their own.

Jennifer Crystal is a writer and educator in Boston. Her memoir about her medical journey is forthcoming. Contact her at lymewarriorjennifercrystal@gmail.com.

 

 

 

 

Category:

Lyme, Psychological Aspects

Could Advanced Imaging Reveal Cognitive Impairment in Lyme Patients?

https://danielcameronmd.com/advanced-imaging-cognitive-impairment-lyme-patients/

COULD ADVANCED IMAGING REVEAL COGNITIVE IMPAIRMENT IN LYME PATIENTS?

Clinicians can now measure neurotransmitter levels in the brains of patients with mild cognitive impairment using magnetic resonance spectroscopy (MRS) with advanced 7 Tesla technology. MRS, also referred to as Nuclear Magnetic Resonance (NMR), shows the “levels of gamma-aminobutyric acid (GABA), glutathione and other neurotransmitters in brain regions of interest with greater precision than previous, lower-strength imaging systems,” explains Oeltzschner and colleagues. ¹

By

Multiple studies indicate that neurotransmitter levels can be “related to measures of behavioral outcomes, such as memory, reaction timing,” writes Oeltzschner in the journal Neurobiology of Aging.“These relationships can be region-specific.”

Measuring these levels, he adds, “could be a promising way to find out more about the inner workings of the disease and how it proceeds.”

Tognarelli agrees, writing, “Magnetic resonance spectroscopy (MRS) provides a non-invasive ‘window’ on biochemical processes within the body.”²

“The clinical use of in vivo magnetic resonance spectroscopy (MRS) has been limited for a long time, mainly due to its low sensitivity,” explains Marinette van der Graaf.³

“However,” she points out, “with the advent of clinical MR systems with higher magnetic field strengths such as 3 Tesla, the development of better coils, and the design of optimized radio-frequency pulses, sensitivity has been considerably improved.”

A study by Oeltzschner and colleagues looked at 13 people with mild cognitive impairment and found significant differences in several neurotransmitter levels relative to total creatine (tCr) when compared to healthy controls.

Results indicated patients with mild cognitive impairment had:

  • Decreased levels of g-aminobutyricacid (GABA);
  • Decreased levels of glutamate (Glu);
  • Decreased levels of N-acetylaspartate (NAA);
  • Increased levels of inosito (mI).

Oeltzschner from The Johns Hopkins University School of Medicine recommended additional studies “to improve the understanding of the regional specificity of brain metabolite changes and their effects on different domains of cognitive function.”

Editor’s Note: How about measuring the neurotransmitter levels in the brain of Lyme disease patients?
Related Articles:

Oppositional behavior in children with Lyme disease

Can we measure the brains exaggerated response to pain and sensory input?

What happens to the brain during acute Lyme neuroborreliosis?

References:
  1. Oeltzschner, G. et al. Neurometabolites and associations with cognitive deficits in mild cognitive impairment: a magnetic resonance spectroscopy study at 7 Tesla. Neurobiol Aging. 2019 Jan;73:211-218.
  2. Joshua M. Tognarelli. Magnetic Resonance Spectroscopy: Principles and Techniques: Lessons for Clinicians. J Clin Exp Hepatol. 2015 Dec; 5(4): 320–328.
  3. Marinette van der Graaf. In vivo magnetic resonance spectroscopy: basic methodology and clinical applications. Eur Biophys J. 2010 Mar; 39(4): 527–540.

 

 

 

 

Category:

Lyme, Testing

What Happens if Lyme Disease Goes Untreated?

https://www.bca-clinic.de/en/what-happens-lyme-disease-goes-untreated/

What Happens If Lyme Disease Goes Untreated?

21. November 2019in BCA-clinic
BCA-clinic - late stage Lyme disease

Much of the attention given to Lyme disease currently centres around the diagnosis and treatment of the condition in an acute stage. But what happens if Lyme disease goes untreated? The symptoms of the condition, in its later stage, can be much more severe and debilitating, which means that recovery can be more challenging – even with appropriate treatment. Here’s some information on questions you might have about untreated or chronic Lyme disease.

What is Lyme disease?

Lyme disease is an infectious condition caused by the bacterium Borrelia burgdorferi, which was named after an American scientist named Willy Burgdorferi who researched the disease in the early 1980s). The condition is named after a town called Lyme, Connecticut in the US, where numerous people fell ill with similar symptoms of rashes and fatigue.

Lyme disease is most commonly contracted if you’re bitten by a tick that is a Lyme carrier. Common symptoms of acute Lyme disease include:

  • Skin rash (often a red, bullseye rash)
  • Flu-like symptoms (such as fever, chills, malaise, etc.)
  • Fatigue
  • Headache and stiff neck
  • Muscle soreness
  • Joint pain
  • Swollen lymph nodes
  • Sore throat

If the infection starts to spread throughout the body (without antibiotic intervention), you might start to experience additional symptoms, such as vision changes, heart problems like palpitations or chest pain, multiple rashes, or facial paralysis (also known as Bell’s palsy). Typically, early stages of Lyme disease are treated with antibiotics; more significant treatment is needed if the condition is not caught early on and has progressed to chronic Lyme disease.

Many people receive misdiagnoses when they first report their symptoms to their doctor because Lyme disease can mimic symptoms of other conditions like arthritis, depression, chronic fatigue syndrome and others.

BCA-clinic - Lyme symptoms
Image by Carolina Heza on Unsplash: Leaving Lyme disease untreated can mean you experience more severe symptoms.

What are the symptoms of late-stage Lyme disease?

Late-stage Lyme disease is one of the terms used when the condition has become chronic. This is generally after months (or sometimes even years) of the condition going untreated, where the Lyme bacteria has spread throughout the body.

Many patients develop chronic arthritis, as well as additional neurological and cardiac symptoms. These symptoms can also include:

  • Arthritis in the joints (sometimes near the point of infection)
  • Severe headaches or migraines
  • Vertigo or dizziness
  • Migrating pains that come and go in joints and tendons
  • Stiff, aching neck
  • Sleep disturbances (including insomnia)
  • Disturbances in heart rhythm
  • Mental fogginess and concentration issues
  • Numbness in limbs, hands, or feet
  • Severe fatigue

Because the infection has spread over time, antibiotics can be less effective; sometimes patients are required to enter hospital for stronger intravenous (IV) antibiotics. There are also cases where people are treated in the early stages of the condition but still do not respond to treatment for some reason. This is also known as post-treatment Lyme disease syndrome (or PTLDS). Researchers don’t have a definitive answer as to why some people develop PTLDS. People suffering from chronic Lyme disease often have significantly worse symptoms that can negatively impact their day-to-day lives.

Can Lyme disease go away on its own?

At this time, there is no research that supports the idea that Lyme disease will just go away on its own if left untreated. In fact, it seems like quite the opposite is true. Without proper intervention and treatment, the infection can spread throughout the body and the brain, causing severe symptoms.

BCA-clinic - IV
Image by Olga Kononenko on Unsplash: Chronic Lyme disease often needs to be treated with intravenous antibiotics in hospital.

Is Lyme disease fatal?

Unfortunately, in some cases, Lyme disease can indeed be life-threatening. In late-stage Lyme disease, the infection can wreak serious havoc on the body as a whole, but can be especially damaging to the nervous system. In some cases, patients have died of respiratory failure because of the long-term effects the infection has on the nervous system. The infection can also affect other parts of the body (such as the kidneys), which can also turn out to be fatal.

Another serious complication that people can experience is called Lyme carditis. When Lyme bacteria enter the tissues of the heart, carditis can occur; this interferes with the normal movement of electrical signals from the heart’s upper to lower chambers (a process that coordinates the heart’s beating). This results in what doctors call ‘heart block’, which can vary in severity from patient to patient and can progress rapidly. Lyme carditis can be treated with oral or IV antibiotics, and patients sometimes require a temporary pacemaker. There have been some recorded deaths from Lyme carditis as well.

There’s also one other cause of death that can be related to Lyme disease. Because the condition causes emotional issues and can lead to some significant psychological symptoms, Lyme disease patients are at an increased risk of suicide.

When should you get tested for Lyme disease?

In order to make sure that your Lyme disease doesn’t progress, it’s a good idea to get tested as quickly as possible if you think that you may have been bitten by a tick or if you notice some of the above-mentioned symptoms. There are blood tests to test for Lyme disease, and some labs (like BCA-clinic) can help give you an accurate diagnosis. Make sure to bring your concerns to your doctor right away so that they can test for Lyme disease. Getting an accurate diagnosis and then starting with effective treatments right away can mean that you can possibly avoid Lyme disease progressing into a chronic stage.

Leaving Lyme disease untreated can have a serious negative effect on your health, both physically and emotionally. Be sure to pay attention to any symptoms you might be having, as well as making sure to check for ticks on your body if you’ve spent time outdoors. Extra vigilance and taking steps to stay protected from ticks can mean you’re less at risk of contracting Lyme disease and less likely to suffer from the effects of letting the condition go untreated.

Featured image by Yohann LIBOT on Unsplash

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For more:  https://madisonarealymesupportgroup.com/category/lyme-disease-treatment/

Category:

Lyme, Treatment