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

Viewpoint
September 16, 2019

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

JAMA Neurol. Published online September 16, 2019. doi:https://doi.org/10.1001/jamaneurol.2019.3043
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For more on how this very phrase is still being used against Lyme/MSIDS patients:

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.

 

 

 

 

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

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?
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.

 

 

 

 

Happy Thanksgiving!

iu-37

Thankfulness is an act of the will. It is a conscious decision to be thankful despite circumstances.

https://www.sciencedirect.com/science/article/pii/S2405939019301212

Survey on tick-borne pathogens in ticks removed from humans in Northwestern Italy

Highlights

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Ticks have a considerable importance for public health.

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Few data are present about ticks collected from humans.

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128 ticks from 92 patients were analysed.

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Almost 30% of the analysed tick pools were positive for Babesia spp.

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The zoonotic species Babesia venatorum was the most prevalent species observed.

Abstract

Ticks are able to transmit several pathogens to the host while feeding, and thus are considered the most important vectors of infectious agents together with mosquitos. The global incidence of tick-borne diseases (TBDs) is rising, due to increased interactions between pathogens, hosts and vectors, linked to global changes. Given that information about the prevalence of tick-borne pathogens in ticks removed from humans in Italy are scarce, the aim of the present study was to identify the species of ticks biting humans in Northwestern Italy and tick-borne pathogens they harbour. An overall number of 128 ticks from 92 patients were collected from April to October 2018, almost 98% of which belonging to the Ixodes ricinus species. Molecular analysis showed the presence of Babesia spp. in 29 out of 93 analysed tick pools, with a Minimum Infection Rate (MIR) of 31.18% (29/93; CI95% 22.67–41.19%), while 1 out of 93 pools tested positive for SFG Rickettsiae (MIR = 1.08%; CI95% 0.19–5.84%). No samples tested positive for A. phagocytophilum and Borrelia spp. Sequencing revealed the presence of Babesia venatorum (28 pools), Theileria buffeli/orientalis complex (1 pool) and Rickettsia monacensis. Among these, B. venatorum and R. monacensis are zoonotic pathogens able to cause from moderate to severe infections in humans. These data highlight the importance of passive surveillance to assess the epidemiology of TBDs that pose a threat to human health.

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**Comment**

Ixodes ricinus or the Castor Bean tick, sheep tick, or deer tick is considered a European hard-bodied tick; however, please note that migrating birds are transporting ticks all over the place.  https://madisonarealymesupportgroup.com/2019/03/09/danish-study-shows-migrating-birds-are-spreading-ticks-their-pathogens-including-places-without-sustainable-tick-populations/

https://madisonarealymesupportgroup.com/2018/11/07/ticks-on-the-move-due-to-migrating-birds-and-photoperiod-not-climate-change/

https://madisonarealymesupportgroup.com/2019/07/28/coinfection-of-many-types-of-borrelia-rickettsia-babesia-bartonella-anaplasma-in-french-castor-bean-ticks/Excerpt:

It transmits numerous pathogens of medical and veterinary importance including Borrelia burgdorferi s.l. causing Lyme borreliosis, tick-borne encephalitis virus, Anaplasma phagocytophilum causing human granulocytic ehrlichiosis, Francisella tularensis causing Tularaemia, Rickettsia helvetica and Rickettsia monacensis, Babesia divergens and Babesia microti responsible for Babesiosis, Louping ill virus and Tribec virus.

The fact that 30% of ticks had Babesia should cause all doctors to pause and consider.