Archive for the ‘Pain Management’ Category

Stomach Pain Can Be a Symptom of Lyme Disease

https://danielcameronmd.com/neurologic-lyme-disease-presenting-as-abdominal-pain-in-71-year-old-patient/

STOMACH PAIN CAN BE A SYMPTOM OF LYME DISEASE

woman with stomach pain from lyme disease

“Although abdominal pain is generally not considered a sign of LD [Lyme disease], in this case report we describe a patient with unexplained severe abdominal pain that eventually turned out to be LD due to radiculopathy,” explains Stolk from the Haga Teaching Hospital in the Netherlands. [1]

The 71-year-old woman underwent an exhaustive evaluation to determine the cause of her abdominal pain. Tests included: CT scan of the chest and abdomen; whole body emission tomography-CT scan (PET-CT); colonoscopy; gastroscopy, and an MRI of the small intestines. Initially, doctors did not consider testing for Lyme disease as a cause of the patient’s stomach pain.

The woman was admitted to the hospital for pain management and other diagnostic workups.

READ MORE: Lyme disease manifests as abdominal pain in a young child

Approximately 8 weeks prior to her hospitalization, she experienced temporary lower back pain, myalgia, fever, burning sensations and tenderness on her head and upper legs and moderate stomach pain. Several weeks later, her abdominal pain worsened.

“Going over the history again, she emphasized that she had stayed in a high endemic area for ticks and had suffered a possible tick bite without any sign of erythema migrans,” writes Stolk and colleagues.

Lyme disease associated with stomach pain

Serologic testing and a spinal tap were consistent with Neurologic Lyme disease. The spinal tap revealed an elevated IgM antibody to Borrelia burgdorferi (Bb), a lymphocytic pleocytosis, markedly elevated IgM antibody index to Bb, and markedly elevated IgG antibody to Bb.

The authors point out that “Since the incidence of LD is rising it is important to realize that severe abdominal pain could be the first clinical manifestation of early neuroborreliosis.

After a 2-week course of intravenous ceftriaxone to treat Lyme disease, the woman’s symptoms, including stomach pain, resolved completely.

This case demonstrates the importance of re-examining a patient’s history when symptoms cannot be explained, the authors point out.

“Instead of doing extensive diagnostic tests, it is important to scrutinize the patient’s medical history in the presence of unexplained clinical signs.”

The authors note: Abdominal pain in the presence of facial paralysis has been described in Europe as Bannwarth Syndrome.

Editor’s note: I often see Lyme disease patients in my practice who present with stomach pain severe enough to warrant extensive diagnostic testing before Lyme disease is suspected.

UPDATED: May 28, 2021

Severe Neuropathic Pain Due to Lyme Podcast

https://danielcameronmd.com/pain-due-to-lyme-disease/

PODCAST: SEVERE NEUROPATHIC PAIN DUE TO LYME DISEASE

man with foot pain due to lyme disease

Hello, and welcome to another Inside Lyme Podcast. I am your host Dr. Daniel Cameron. In this episode, I will be discussing the case of a 36-year-old man with severe neuropathic pain due to Lyme disease.

(Listen here or go to top link)

I first read about this case in the journal Neuromodulation by Karri and colleagues.

A 36-year-old man suffered with a chronic pain syndrome associated with post-treatment Lyme disease syndrome (PTLDS). [1] PTLDS is a complication of Lyme disease. Individuals with PTLDS remain ill with pain, cognitive impairment, and fatigue and find it difficult to function.

The patient described severe neuropathic pain in both feet and categorized the pain at a level 10 out of 10 despite treatment with methadone 5 mg every 4 hours as needed. The doctors assumed that the tick-borne infection had resolved and elected not to treat with antibiotics.

Instead, they treated the patient’s symptoms. The pain remained severe despite trials of gabapentin, duloxetine, bupropion and narcotics. “The patient was unhappy with associated adverse effects, especially drowsiness and recurrent constipation,” the authors wrote. [1]

Surgical treatments for pain due to Lyme disease

Two surgical procedures were performed, which improved the patient’s pain. First, the man had a spinal cord stimulator surgically placed in the Dorsal Root Ganglion to mask the pain signals before they reach the brain. The pain dropped to a level 3 out of 10.

A spinal cord stimulator alone does not come cheap. “The Journal of Neurosurgery: Spine published an article estimating the cost per patient of spinal cord stimulator implantation at $32,882 for Medicare patients and $57,896 for Blue Cross Blue Shield, with annual maintenance reaching $5,071 to $21,390,” wrote Laura Dyrda in Becker’s spine review. [2]

The doctors then surgically placed a pulse generator in the right paraspinal-flank area. The patient reported the pain dropping to level 0-2. Narcotics were rarely needed and the man was able to return to work as a health-care provider.

The authors stressed the need for novel approaches to pain management for patients with pain associated with post-treatment Lyme disease syndrome.

Some of the following questions are addressed in the podcast:

  1. Have you seen severe pain in Lyme disease?
  2. What types of pain have you seen in Lyme disease?
  3. What is the treatment for Lyme disease pain?
  4. What is Post Treatment Lyme disease Syndrome (PTLDS)?
  5. What are the symptoms of PTLDS?
  6. What is controversial about PTLDS?
  7. What are your concerns with a surgical approach to Lyme disease pain?
  8. Would additional antibiotics have helped resolve the Lyme disease pain?

Thanks for listening to another Inside Lyme Podcast. You can read more about these cases in my show notes and on my website @DanielCameronMD.com. As always, it is your likes, comments, reviews, and shares that help spread the word about Lyme disease. Until next time on Inside Lyme.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Inside Lyme Podcast Series

This Inside Lyme case series will be discussed on my Facebook and made available on podcast and YouTube.  As always, it is your likes, comments, and shares that help spread the word about this series and our work. If you can, please leave a review on iTunes or wherever else you get your podcasts.

References:
  1. Karri J, Bruel B. Dorsal Root Ganglion Stimulation for Post-Lyme Disease Chronic Peripheral Neuropathic Pain. Neuromodulation. 2020.
  2. 5 Findings on Spinal Cord Stimulator Effectiveness for Failed Back Surgery Syndrome in Becker’s Spine,. Written by Laura Dyrda May 29, 2014. Last accesed April 22, 2020.

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**Comment**

I am happy to report that after dealing with pain of a magnitude I never knew existed before, I am PAIN FREE.  What got me here?  Antibiotics, herbs, blood ozone, and YEARS of treating this monster.  I want to offer hope that treatment can rid of you all pain or at least get you to a place you can manage it.

It’s truly unfortunate the ‘authorities’ made the decision that this man’s pain had nothing to do with a persistent infection.  The CDC/IDSA is directly behind this bad decision.  Antibiotics and other antimicrobials will not cost near as much as this surgical device, which comes with plenty of its own risks, BTW.

I had one experience where the pharmacist did not notify me they gave me 250mg tablets instead of 500mg so I was inadvertently taking half the dosage.  My pain shot through the roof.  When I finally read the bottle myself and realized the error, within ONE dose, PAIN GONE.  This little exercise taught me the importance of the right dosage.  Dr. Burrascano discusses this along with other treatment nuances: https://madisonarealymesupportgroup.com/2018/12/28/the-history-of-lyme-disease-dr-burrascano/

I highlight the video here:  https://madisonarealymesupportgroup.com/2019/02/22/why-mainstream-lyme-msids-research-remains-in-the-dark-ages/

Treatment for this takes finesse, savvy and experience.  Do not trust mainstream medicine with this or you may find yourself getting needless surgeries to mask something that appropriate treatment could resolve.  

Get to a LLMD asap:  https://madisonarealymesupportgroup.com/2020/11/25/what-makes-a-doctor-lyme-literate/

The Lyme Disease + Vagus Nerve Connection

https://rawlsmd.com/health-articles/the-lyme-disease-vagus-nerve-connection

The Lyme Disease + Vagus Nerve Connection

The Lyme Disease + Vagus Nerve Connection

by Jenny Lelwica Buttaccio
Posted 7/22/20

Take a moment to consider: How often does your intuition play a role in how you decide to treat your Lyme disease? For instance, maybe you decided not to pursue a certain healing modality despite rave reviews because you felt deep in your belly that it wasn’t right for you. Or, perhaps you were drawn to a particular therapeutic intervention (i.e. herbal therapy, detoxification, a specific healthcare provider) because something seemed “right” about the decision.

Most of us have had these types of “gut feelings” about some aspect of our lives. Although these feelings are attributed to your gut, they’re actually the interaction between your brain and the vagus nerve. The longest and most elaborate cranial nerve in your body, the vagus nerve is a primary pathway by which the sympathetic and parasympathetic nervous systems can be balanced.

So what does it have to do with Lyme disease?

People with chronic Lyme disease often report feeling hyper, irritable, and anxious from time to time — evidence of a nervous system that’s shifted into high gear. To cultivate conditions that are more conducive to healing, the overworked nervous system may need to be reset. One way to do this is by stimulating the vagus nerve so that the body can reach a greater state of tranquility.

Here, we’ll examine the vagus nerve, its role in chronic illness, and what you can do to improve its function and restore your health.

Vagus Nerve Basics

There are 12 pairs of cranial nerves in the body. Each originates from the brain and has a specific set of tasks to perform that affect sensory and motor function. Each nerve has a Roman numeral from I through XII assigned to it. The vagus nerve, for example, is the 10th cranial nerve and corresponds to the Roman numeral X.

Vagus is a Latin word that means “wandering,” and indeed, this intricate cranial nerve lives up to its name because it wanders throughout the body. It acts as an information superhighway from your brain, through the neck and thorax, and stops in the abdomen.

While some nerves influence only the senses or only movement, the vagus nerve is unique in that it has an impact on both. The primary functions of the vagus nerve include:

  • Providing sensory input to the throat, lungs, heart, and digestive tract
  • Having a minor role in the sensation of taste in the back mouth
  • Supplying movement information to neck muscles for speech and swallowing
  • Regulating mechanical functions of the respiratory tract, heart rate, and gastrointestinal tract
  • Modulating the response of the immune system
  • Influencing mood

Additionally, the vagus nerve is a crucial component of your parasympathetic nervous system, the relaxing side of the nervous system, which helps bring your body back to a state of calm after a stressful period or event. However, the challenges of living life with Lyme or Lyme coinfections like Babesia and Bartonella can disrupt the communication to and from your vagus nerve, activating your sympathetic nervous system.

Sick woman sitting on the sofa in the living room

“The stress associated with being chronically ill sends the sympathetic nervous system, the part of the nervous system associated with the ‘fight-or-flight’ response, into overdrive,” says Dr. Bill Rawls, Medical Director of RawlsMD and Vital Plan. “Sympathetic overactivity releases stimulating chemicals like norepinephrine and dopamine, which can leave you feeling wired, tired, and anxious.”

The flight-or-fight response is critical when our circumstances demand a high state of alertness. But prolonged periods of stress can hinder sleep, recovery, repair of tissues, and more — the exact opposite of the resting state brought on by the vagus nerve.

“If you feel revved up all the time, you’ve got adrenaline surging through your system, and it makes your system very fragile,” says Dr. Rawls. So how do we best support the function of our parasympathetic nervous system and vagus nerve? The answer lies in the biological process carried out by the vagus nerve called vagal tone.

Vagal Tone and 4 Ways to Bolster It

The concept of vagal tone has seen a recent surge in interest among integrative health and wellness professionals, but some of the first-known research on the subject dates back to the early 1900s. By increasing vagal tone, your body is better equipped to tap into the calming and reparative mechanisms of the parasympathetic nervous system when stress ensues.

Your vagus nerve is involved in many different bodily processes, so it’s essential to understand how to get out of the chronic flight-or-fight mode. Let’s take a closer look at some options.

1. Get a Daily Dose of Cold.

When you think about experiencing cold temperatures, vagus nerve stimulation probably doesn’t come to the forefront of your mind (heavy layers, coats, and thick blankets are more like it). However, research indicates exposure to cold may indeed improve vagal tone.

Upon initial introduction to cold weather, study participants demonstrated an increase in activity of the sympathetic nervous system, as measured by their cardiovascular function. However, once the participants acclimated to the temperature, their parasympathetic activity rose, suggesting that adapting to the cold may balance the response of the vagus nerve.

Cold shower interval improve vagal tone

To get your daily dose of cold and stimulate the vagus nerve, consider alternating 60-second intervals of hot water, directly followed by cold water when taking a shower. Then, repeat the process two or three times. If you need to calm down in a pinch, try splashing some cool water from the sink on your face. The quick rush of cold may be just enough to produce a desired calming result.

2. Improve the Health of Your Microbiome.

The microbiome is the sum of all the microbes that inhabit the body, including normal flora that typically causes no harm as well as potential disease-causing pathogens,” says Dr. Rawls. “The microbiome is vast and more complex than anyone could have ever imagined.” Though the science of this expansive micro-ecosystem continues to advance, research — like that found in the Journal of Medicinal Food — suggests a sea of possibilities for how the gut and brain interact with one another.

The main mode of communication? It’s the vagus nerve, which gives and receives information from your gut, via a two-way, or bidirectional, throughway called the gut-brain axis. Additionally, the vagus nerve facilitates the production of relaxing chemicals like serotonin and GABA in the brain, slows breathing, reduces heart rate and blood pressure, decreases inflammation, and promotes healing.

Gut bacteria can impact the vagus nerve because the microbes stimulate nerve impulses that send signals to the brain, affecting such functions as sleep, reactivity to stress, cognition, and more. When the gut flora is healthy, there’s a more harmonious relationship among the types of signals being sent along the lengthy cranial nerve. However, the persistent symptoms of Lyme disease can fuel chronic stress, altering your body’s normal microbial load and, along with it, the signals they send.

Stealth microbes inflammation body brain

Additionally, “Stealth microbes that are deeply embedded in tissues generate low-grade inflammation throughout the body and the brain,” says Dr. Rawls. The shift in the body’s terrain may trigger an overproduction of excitatory chemicals like adrenaline, norephinepherine, and dopamine.

But there is hope to strengthen the microbiome and improve communication through the vagus nerve. Dr. Rawls suggests herbs as an efficient, natural solution: “Taking the appropriate herbs provides phytochemicals that work to restore the microbiome and support vagus nerve function.” His top recommendations for gut-balancing herbs include:

  • Berberine: An herb with substantial anti-microbial properties, berberine helps manage the gut microflora.
  • Slippery elm: Due to its ability to form a protective film in the gut, slippery elm soothes irritation in the mucosal lining and keeps foreign substances out of the bloodstream.
  • Dandelion root: Known as a bitter herb, dandelion root activates bitter receptors throughout our GI tract, releasing the saliva, enzymes, and bile we need to break down our food.
  • Andrographis: Originating from India, andrographis has antiviral, antibacterial, and antiparasitic qualities. It helps to restore the GI tract and is a powerful anti-inflammatory herb.

3. Practice Calming Breathing Exercises.

Since the vagus nerve assists in regulating your respiration and heart rate, one way to improve vagal tone is by engaging in breathing exercises. Research has shown that practicing slow breaths lessens the activity of the sympathetic nervous system and boosts parasympathetic functions. In contrast, rapid breathing — something we tend to do when we’re on edge — doesn’t provide the same benefits.

Activities like meditation, yoga, tai chi, and qigong can facilitate a slow breathing practice.

Wide angle view at modern young woman enjoying breathing exercises while meditating at home, copy space

But if you can’t get to a class, belly breathing is an excellent alternative, and it’s easy to do. Here’s how to get started:

  1. Sit or lie in a comfortable position.
  2. Place one hand on your belly and the other hand over your heart.
  3. Breathe in deeply through your nose to the count of 4, allowing your belly to move your hand out or up. Note that your chest shouldn’t move with the breath.
  4. Exhale for 4 counts. Notice how your belly lowers back to the starting position.
  5. Repeat until you feel an increased sense of calm.

4. Hum a Tune.

Did you know that humming to yourself may be a healthy habit? That’s because the vagus nerve runs through your throat and provides sensory input to the ear. The act of humming offers a mechanical way to stimulate the vagus nerve and lessen heart rate and respirations, which may be the reason why many people find humming to be soothing to them.

Humming singing mantra improve vagal tone

Other vocal activities such as repeating a mantra or singing may improve vagal tone and promote a more peaceful state of wellbeing as well. So, go ahead — pick your favorite tune and start humming, or just wing it!

The Bottom Line

The key to improving vagal tone is to be on the lookout for factors that raise adrenaline during the day and, when levels are rising in the absence of a true emergency, introduce activities that curb the excessive fight-or-flight response, says Dr. Rawls. Though not a cure-all, when combined with a comprehensive natural protocol and a nutrient-dense diet, increasing vagal tone is a low-cost and simple tool to maximize healing and restoration.

Dr. Rawls is a physician who overcame Lyme disease through natural herbal therapy. You can learn more about Lyme disease in Dr. Rawls’ new best selling book, Unlocking Lyme.
You can also learn about Dr. Rawls’ personal journey in overcoming Lyme disease and fibromyalgia in his popular blog post, My Chronic Lyme Journey.

REFERENCES
1. Bonaz B, Bazin T, Pellissier S. The Vagus Nerve at the Interface of the Microbiota-Gut-Brain Axis. Front Neurosci. 2018;12:49. Published 2018 Feb 7. doi: 10.3389/fnins.2018.00049
2. Breit S, Kupferberg A, Rogler G, Hasler G. Vagus Nerve as Modulator of the Brain-Gut Axis in Psychiatric and Inflammatory Disorders. Front Psychiatry. 2018;9:44. Published 2018 Mar 13. doi: 10.3389/fpsyt.2018.00044
3. Clancy JA, Deuchars SA, Deuchars J. The wonders of the Wanderer. Exp Physiol. 2013;98(1):38-45. doi: 10.1113/expphysiol.2012.064543
4. Mäkinen TM, Mäntysaari M, Pääkkönen T, et al. Autonomic nervous function during whole-body cold exposure before and after cold acclimation. Aviat Space Environ Med. 2008;79(9):875-882. doi: 10.3357/asem.2235.2008
5. Pal GK, Velkumary S, Madanmohan. Effect of short-term practice of breathing exercises on autonomic functions in normal human volunteers. Indian J Med Res. 2004;120(2):115-121
6. Vickhoff B, Malmgren H, Aström R, et al. Music structure determines heart rate variability of singers [published correction appears in Front Psychol. 2013 Sep 05;4:599]. Front Psychol. 2013;4:334. Published 2013 Jul 9. doi: 10.3389/fpsyg.2013.00334

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For more:  https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Vagus-Nerve-Stimulation

https://www.psychologytoday.com/us/blog/the-athletes-way/201607/vagus-nerve-stimulation-dramatically-reduces-inflammation

https://www.mayoclinic.org/tests-procedures/vagus-nerve-stimulation/about

Act Now! FDA Shuts Down Natural Pain Options

https://healthimpactnews.com/2020/fda-shuts-down-natural-pain-options/

FDA Shuts Down Natural Pain Options

Dec. 12, 2020

by Alliance for Natural Health

FDA-approved pain medicines are dangerous, but the government is systematically attacking safer, non-addictive natural treatments. Action Alert!

A recent study in Switzerland found that acetaminophen poisoning increased by 40% following the approval of 1,000mg doses. This is just the latest data to indicate the public health problems caused by this commonly used pain drug, which is the active ingredient in Tylenol.

Despite the dangers of FDA-approved pain drugs, the federal government aggressively attacks and censors natural pain medicines like homeopathic treatments, CBD, medical foods, and supplements. This needless suffering must end.

We’ve written for years about the dangers of acetaminophen. It is the most commonly prescribed class of drugs despite causing 50 percent of all liver failure in the US. According to the FDA’s adverse event database, acetaminophen has caused more than 100,000 adverse events and more than 78,000 serious adverse events, including 24,000 deaths. It has also been linked to asthma and hearing loss.

Overdoses involving opioids killed nearly 47,000 people in 2018 alone.

Now consider the federal government’s approach to natural pain medicines. The FDA essentially banned all injectable homeopathic medicines, which includes Traumeel, a prescription-only homeopathic medicine for pain with an extremely robust safety profile.

Previously, the FDA went after Limbrel, a medical food for the treatment of osteoarthritis. In a letter to Primus, the FDA stated that 194 adverse event reports for Limbrel were received between 2007 and 2017—about 20 a year.

Then, of course, there’s CBD. The federal government’s approach to CBD right now is frankly a mess, and we’ve sifted through the details in previous coverage. In short, hemp and its derivatives have been legalized at the federal level, but FDA laws still apply to products containing hemp, such as supplements, lotions, cosmetics, etc. Since 2018, the FDA has been trying to figure out how it will treat these products. Recall, too, that the agency has approved a CBD drug, and according to FDA rules, this means that CBD cannot legally be sold as a supplement.

We ultimately don’t know how the FDA will treat CBD supplements. If history provides any clues, the FDA will protect the drug-approval process and ban CBD supplements. To add to the confusion, Congress is directing the FDA to release an interim policy (called a policy of enforcement discretion) explaining how it will treat CBD products in the marketplace as the agency develops its final regulatory framework. Will the FDA release an interim policy that allows CBD supplements for the time being before banning them outright when a final policy is released? We just don’t know, but we should assume that the FDA will not do the right thing, especially when Big Pharma profits are at stake.

It is unconscionable, but unsurprising, that the FDA would reduce access to safe, non-addictive alternatives to dangerous opioid drugs that killed 30,000 people in 2018 alone. We’ve also seen basic information on natural health censored to protect drug industry profits during the COVID-19 pandemic. This cronyism has to stop.

Action Alert! Write to Congress and the FDA, telling them to issue a policy of enforcement discretion that protects consumer access to hemp-derived CBD supplements at therapeutic levels and full-spectrum hemp oil. Please send your message immediately. By sending this message, you will also be supporting our petition to ungag doctors so that they can share with patients the benefits of supplements and natural treatments for COVID.


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**Comment**

Our government shuts down anything that competes with its own lucrative products.

For more:

Looking Back on Her Teen Years of Lyme-Related Pain. (Life’s Better Now!)

https://www.lymedisease.org/teen-lyme-pain-lifes-better-now/

Looking back on her teen years of Lyme-related pain. (Life’s better now!)