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by Stephen Petteruti
While intense controversy can surround any discussion of Lyme disease, nearly all clinicians agree that residents of New England are at high risk for acquiring an acute infection with the spirochete that causes Lyme. Early diagnosis can lead to a great outcome in the vast majority of cases when treated with appropriate antibiotics.
Lyme Disease Symptoms
The classic “Lyme rash” (known medically as erythema migrans) is a red rash, usually round, expanding over days and often with central clearing. Other symptoms of early infection can include fatigue, headache, muscle aches, joint aches and fever, so any unusual rash or flu like illness, especially during tick season, should be evaluated for possible Lyme. Early-stage Lyme disease is typically treated with 21 days of antibiotics.
If not caught early, Lyme disease can become disseminated, affecting other organs. If the heart is affected, it can result in irregular heartbeats. In the brain, it can cause paralysis of nerves that supply movement to parts of the face and eyes, for example, Bells Palsy. Even at this stage, there is broad agreement that the best treatment involves several weeks of antibiotics, in most cases with oral administration. In some cases, intravenous treatment may be recommended for all or part of the therapy.
Although the existence of chronic Lyme is not acknowledged by the mainstream medical community, thousands of patients and hundreds of clinicians have witnessed the persistence of such disabling symptoms as chronic pain, muscle weakness, profound fatigue, impaired memory and concentration. Mainstream doctors do readily acknowledge that “something is going on,” but don’t have anything to offer these patients. The conventional medical approach is to empathize with their suffering and send them to a psychiatrist.
Conversely, a few brave and thoughtful clinicians have endeavored to treat patients with symptoms of chronic Lyme. Some clinicians believe that the spirochete that causes Lyme disease can lay dormant and periodically reinvade the host. There have been reports of patients successfully treated with extended cycles of antibiotics; however, a recent Dutch study published in March in the New England Journal of Medicine indicated no clinical benefit from treating chronic Lyme beyond 28 days with antibiotics.
Since chronic Lyme can have symptoms that overlap many other conditions, it is critical to periodically re-examine the basis of the diagnosis and consider other possibilities. Cases exist where a patient labeled with chronic Lyme was subsequently discovered to have another, treatable illness.
Post Lyme Syndrome
This term is used to describe an individual who has been diagnosed and treated for Lyme disease, and no longer has any traces of ongoing infestation with spirochetes. Nevertheless, despite eradication of the causative agent, symptoms persist. The symptoms can include fatigue, weakness, poor concentration and impaired memory. In these cases, antibiotics have no value. Instead, attention must be focused on the damage done to the neuro-hormonal axis. Some cases of Lyme appear to damage the brain in a way that has a persistent negative effect on the patient. By addressing hormonal deficits, as well as addressing mitochondrial and cellular health, patients can be restored to their pre-infected state of health.
In summary, the best form of protection is to avoid high-risk environments for acquiring Lyme. Using appropriate repellents is also helpful. Most importantly, maintaining robust health with an intact immune system will provide for resistance to Lyme and other infections.
Dr. Stephen Petteruti’s concierge medical practice, The Petteruti Center, is located at 250 Centerville Rd., Bldg. E, Warwick. For more information, or to be tested or treated for Lyme disease, call 401-921-5934 or visit ThePetterutiCenter.com. See ad, page ??.