UPDATE: This project has concluded. The studies were chosen and the finished paper can be viewed by clicking HERE
Summary: Newsweek produced an article last week which I found extremely offensive and basically forced me to finish a project I had been working on for a year. Here is the article which broke the camel's back. You'll note I responded numberous times to the author and other doctors in the discussion. Nobody listened.
After they refused to listen, the idea was simple. I would put together a coherent argument that simplified, if not overwhelming demonstrated with incontrovertible evidence, that borrelia burgdorferi does persist inspite of adequate antibiotics, and given that fact, it is very possible that human beings may remain infected, and symptomatic as a result. This "possibiliy" should strike doctors hard, because it means they ought to challenge their present notions about whether it is or isn't possible.
Every time there is a political or social confrontation, the facts are never quite available to demonstrate that borrelia burgdorferi can persist despite of adequate antibiotics. And, although people have said that long term antibiotics are necessary, none on the opposing side appear to believe it, even from the most credible mouth.
Therefore, I created this document, using only objective indicators -- with one hypothesis. My hypothesis was "If abundant evidence exists that defines borrelia as a persistent infectious disease, then it increases the probability that it's at least "possible" that chronic Lyme Disease is real."
Sounds a bit silly, right? It's not, not when you read the article. It prove exactly what we've always needed. It does so without having your doctor buy a book, watch a DVD, or pay for journal access to studies that demonstrate persistence. It's free, it's instantly available.
Let them try to prove you wrong now. They might doubt the diagnosis, but they can't doubt that it's possible with this type of evidence. Therefore I have demonstrated that the IDSA has made both false statements and is advising people under false notions. We already knew this inside but couldn't find the word, .....well, now it's simple.
[ 09-04-2010, 11:47 AM: Message edited by: METALLlC BLUE ]
Posted by lymeinhell (Member # 4622) on :
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Posted by bystander (Member # 11893) on :
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Posted by lou (Member # 81) on :
Impressive. I would go with the ones by the IDSA crowd, the old ones when they were telling the truth. And also animal studies.
Posted by Rumigirl (Member # 15091) on :
MB, What are you doing with the chosen studies?
As Lou stated, there are LOTS of studies by the IDSA authors showing the persistence of Bb after IV rocephin, etc.
Posted by Elizabeth S. (Member # 22405) on :
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Posted by INEBG (Member # 27690) on :
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Posted by METALLlC BLUE (Member # 6628) on :
quote:Originally posted by Rumigirl: MB, What are you doing with the chosen studies?
As Lou stated, there are LOTS of studies by the IDSA authors showing the persistence of Bb after IV rocephin, etc.
It'll be a surprise. A helpful surprise for many I hope.
Posted by onbam (Member # 23758) on :
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Posted by sammy (Member # 13952) on :
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Posted by Need Lots of Help (Member # 18603) on :
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Posted by METALLlC BLUE (Member # 6628) on :
Keep them coming guys. Try to get others you know to read this and to help.
I need as many as possible.
Posted by ChristieL (Member # 27786) on :
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Posted by julielynne4 (Member # 20336) on :
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Posted by littlebit27 (Member # 24477) on :
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Posted by imagine2 (Member # 3136) on :
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Posted by METALLlC BLUE (Member # 6628) on :
I'm recording these as fast as you can write them. I really want to have this done by the end of today so I can present to you what I've done with this data. The finished project is for you, all of you.
Like I said, push hard to get as many people as you can to look at this and make their judgments. It will greatly assist me.
---------------------------------------------------- 1: "We now demonstrate B. burgdorferi in the brain and liver of a newborn whose mother had been treated with oral penicillin for LB [Lyme borreliosis]" - Pediatr Infect Dis J. 1988 Apr;7,4:286-9
2: The Lyme disease spirochete, can be recovered long after initial infection, even from antibiotic-treated patients, indicating that it resists eradication by host defense mechanisms and antibiotics.- 1:20 J Infect Dis. 1992 Aug;166,2:440-4
3: "Despite antibiotic therapy, there was progression to a chronic stage, with multisystem manifestations. The cultured bacteria were identified as B burgdorferi - Arthritis Rheum. 1993 Nov;36,11:1621 6.
4: "A patient had chronic septic Lyme arthritis of the knee for seven years despite multiple antibiotic trials. Spirochetes were documented in synovium and synovial fluid. - Battafarano DF, Combs JA, Enzenauer RJ, Fitzpatrick JE.
5: "Antibiotics should be continued in the long term, until we achieve cure or delay the progression of the disease. - Lancet, Vol 345: 1436-37 Lopez-Andreu JA; Salcede-Vivo J
6: "Ceftriaxone, 2 g per day intravenously for 12 months, oral roxithromycin 150 mg per day for 2 months, and oral ciprofloxacin, 500 mg per 12 hours for 2 months. After ceftriaxone he has continued with oral minocycline, 100 mg per 12 hours for 7 months. His quality of life has greatly improved." Lancet, Vol 345: 1436-37 Lopez-Andreu JA; Salcede-Vivo J
7: "To conclude, we have shown that long-term treatments beginning with intraveous ceftriaxone and continuing with amoxycillin plus probenecid or with cephadroxil were useful in the treatment of late Lyme borreliosis." - Infect. 1994 Nov;29,3:255-61.
8: "Chronic infection may require chronic treatment. Borrelia are resilient." - Kenneth Liegner, MD. JSTD 1994; 1:79-81.
9: "Persistence of Borrelia burgdorferi despite antibiotic treatment. Michael A. Patmas, MD. JSTD 1994; 1:101.
10: "She was given 2 weeks of intravenous ceftriaxone 1 g daily with resolution of her symptoms. Over the next several months, however her symptoms gradually returned. she was started on ceftriaxone 2 g intravenously daily. The patient was switched to cefotaxime 3 g intravenously every 12 hours with improvement in symptoms. After 6 weeks, Clarithromycin 500mg daily for 6 more weeks. The placenta was examined at Brigham and Women's Hospital in Boston Massachusetts, where several spirochetes were noted in perivascular and intervillous spaces on modified dieterle silver stain." - Michael A. Patmas, MD. JSTD 1994; 1:101.
11: "Patient started on Ceftriaxone 2 g intravenously daily: 4 weeks. She had a significant objective response to treatment, but quickly relapsed after it was discontinued. A second 4 week course of ceftriaxone was given with only moderate improvement. A right total hip replacement was performed and a histopathologic examination revealed several spirochetes on modified dieterle silver stain of synovial tissue" - Michael A. Patmas, MD. JSTD 1994; 1:101.
12: "Despite lengthy courses of both intravenous (Ceftriaxone 2g day, 8 weeks) and oral antibiotics, Borrelia burgdorferi may persist." Michael A. Patmas, MD. JSTD 1994; 1:101.
13: "In some patients, however, it was noticed that borreliae can survive in the tissues in spite of seemingly adequate therapy." - Antimicrob Agents Chemother. 1995 May;39,5:1127-3
14: "Patients still may not do well due to failure to eradicate the spirochete." - Audrey Stein Goldings, MD. JSTD 1995; 2:59-61
15: "Neuroborreliosis in the nonhuman primate: Borrelia burgdorferi persists in the central nervous system.- Ann Neurol. 1995 Oct;38,4:667-9.
16: "We report an unusual patient with evidence of Borrelia burgdorferi infection who experienced repeated neurologic relapses despite aggressive antibiotic therapy." - Eur Neurol. 1995;35,2:113-7.
17: "The persistence of B. burgdorferi s.l. and clinical recurrences in patients despite seemingly adequate antibiotic treatment is described. The patients had clinical disease with or without diagnostic antibody titers to B. burgdorferi." - Infection. 1996 Jan-Feb;24,1:9-16.
18: "Sizeable group of patients diagnosed on clinical grounds as having chronic Lyme disease may still excrete Borrelia DNA, and may do so in spite of intensive antibiotic treatment." - Infection. 1996 Sep-Oct;24,5:347-53.
19: "Electron microscopy adds further evidence for persistence of spirochetal antigens in the joint in chronic Lyme disease. Spirochaetes may elude host immune response and antibiotic treatment." - Hum Pathol. 1996 Oct;27,10:1025-34
20: "Treatment with ceftriaxone eradicated extracellular Borrelia burgdorferi, but spirochetes were reisolated after lysis of the synovial cells. Borrelia burgdorferi persisted inside synovial cells for at least 8 weeks.- Rheumatol Int. 1996;16,3:125-32
21: "In one of the six analysed brain tissue specimens [from a patient who had received more than six months of antibiotic treatment prior to death, including two 3-week courses of IV ceftriaxone], B. burgdorferi DNA was detected by PCR." - Brain. 1996 Dec;119, Pt 6:2143-54
22: "Two hundred seventy-seven patients with chronic Lyme disease were treated with tetracycline for 1 to 11 months, These results support the use of longer courses of treatment in the management of patients with chronic Lyme disease." - Clin Infect Dis. 1997 Jul;25 Suppl 1:S52-6.
23: "PCR positive in synovium despite previous treatment with antibiotics. " - American College of Rheumatology, Vol 40,9, Branigan P; Rao J; 1997
24: "Antibiotic treatment with amoxicillin or doxycycline for 30 days failed to eliminate persistent infection in 11 dogs. Live spirochetes, however, persisted in the tissue of at least three dogs." - Journal of Spirochetal & Tick-borne Diseases, Vol. 4, No. 1/2
25: "3-4 months of therapy indicate that prolonged courses of antibiotics may be beneficial. 90% of the patients showed excellent or good treatment response." - 1: Eur J Clin Microbiol Infect Dis. 1998 Oct;17,10:715-9
26: "This new method for culturing B. burgdorferi from patients with chronic Lyme disease certainly defines the nature of the illness and establishes that it is of chronic infectious etiology." - Infection. 1998 Nov-Dec; 26,6:364-7
27: "Despite intravenous ceftriaxon-therapy borrelia burgdorferi must have survived in the vitreous body. " - Klin Monatsbl Augenheilkd. 1998 Dec;213,6:351-4
28: "We conclude that the treatment of Borrelia burgdorferi (Lyme Disease) with appropriate antibiotics for even more than 3 months may not always eradicate the spirochete." - Ann Med. 1999 Jun; 3,3:225-32.
29: "Spirochaetes were isolated from skin cultures. The relapses she repeatedly suffered despite initially successful antibiotic treatment could be related to the observation that Borrelia may possibly be able to remain dormant in certain tissue compartments, thus escaping bactericidal antibiotic activity." - Br J Dermatol. 2001 Feb;144,2:387-92.
30: "In 18 patients with Lyme borreliosis the authors proved the persistence of Borrelia burgdorferi sensu lato by detection of the causal agent by immune electron microscopy or of its DNA by PCR in plasma or cerebrospinal fluid after an interval of 4-68 months"- Epidemiol Mikrobiol Imunol. 2001 Feb;50,1:10-6
31: "These data demonstrate that Lyme neuroborreliosis is a persistent infection."- Ann Neurol. 2001 Sep;50,3, :330-8
32: "Ponies were treated with doxycycline, ceftiofur or tetracycline for 4 weeks, 28 days. Five months after antibiotic treatment, culture positive to B. burgdorferi was found in various post-mortem tissues." - Vet Microbiol. 2005 May 20;107(3-4):285-94
33: "Spirochetes grew from the tissue samples of one-third of the mice treated with anti-TNF-alpha simultaneously or 4 weeks after ceftriaxone."- J Infect Dis. 2007 May 15;195,10:1489-96.
34: "Mice were treated with ceftriaxone or saline for one month, commencing during the early, 3 weeks, or chronic, 4 months, stages of infection with Borrelia burgdorferi. Following antibiotic treatment, mice remained infected with non-dividing but infectious spirochetes." - Emir Hodzic, Sunlian Feng, Kevin Holden, Kimberly J. Freet, and Stephen W. Barthold
35: "The results indicate that atypical extra- and intracellular pleomorphic and cystic forms of Borrelia burgdorferi and local neuroinflammation occur in the brain in chronic Lyme neuroborreliosis. The persistence of these more resistant spirochete forms, and their intracellular location in neurons and glial cells, may explain the long latent stage and persistence of Borrelia infection." - J Neuroinflammation. Sep 25;5:40.
36: "Results suggest that the joint or a tissue adjacent to the joint is the niche of persisting B. burgdorferi in ceftriaxone-treated mice." - Departments of Medical Microbiology and Immunology, Heta Yrj�n�inen, University of Turku
[ 09-04-2010, 11:41 AM: Message edited by: METALLlC BLUE ]
Posted by LightAtTheEnd (Member # 24065) on :
I would pick ones involving people, not animals, and with multiple patients, not single case studies (because those are objections that can be raised). If they're also by IDSA authors, so much the better (assuming you are presenting it to a skeptic, which they must be if they need evidence that Bb can persist after antibiotics).
Posted by lou (Member # 81) on :
Well Light, I understand your reasoning, but some of the animal studies in the last five years or so have been very convincing, and I would not leave them out. Animal models are used in a lot of diseases and have been accepted.
Posted by MichaelTampa (Member # 24868) on :
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Posted by springshowers (Member # 19863) on :
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Posted by METALLlC BLUE (Member # 6628) on :
Ok, I've finished. I'm proud to present, "The Case For Chronic Infection: Evidential persistence of Borrelia species post antibiotic exposure in vivo and in vitro."
It can be linked quickly and is Published by adobe. This article can now be accessed anywhere in the world by anyone without constraint.
Use it to educate who ever you wish. I am confident that it is incontrovertible. If anyone finds fault in my argument, grammar, or anything else, please provide me with your constructive criticism at [email protected]
WOW This is a terrific resource!
Posted by timaca (Member # 6911) on :
Impressive. Thanks. I sent it along to one of my doctors.
Timaca
Posted by hope_29 (Member # 22363) on :
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Posted by TF (Member # 14183) on :
Metallic Blue, I'm confused. From what I see at the end of the document, this article was published in March 2010.
So, what study did you do with the input you just collected here from people?
Posted by Pinelady (Member # 18524) on :
OK I get it.....Great Job.
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Posted by METALLlC BLUE (Member # 6628) on :
quote:Originally posted by TF: Metallic Blue, I'm confused. From what I see at the end of the document, this article was published in March 2010.
So, what study did you do with the input you just collected here from people?
You would have to read the linked document to understand.
What you saw regarding March 2010 was just the last abstract I used to support my argument. The first three pages are what matter most, the rest are abstracts -- over 100 -- supporting what I've said. Think of them as references, except you can actually read the "bold" portions to get a firm grasp of what was significant in each study.
thank you for all your hard work putting this together!
Posted by seekhelp (Member # 15067) on :
Now please send this directly to our friends Mr. Wormser and Steere.
Posted by Paul Mall (Member # 27581) on :
@Metallic Blue great article... this is for all those who say there is no evidence. I love it.
can this be shared freely?
Paul
[ 09-05-2010, 12:47 AM: Message edited by: Paul Mall ]
Posted by METALLlC BLUE (Member # 6628) on :
Share it all you wish to your hearts content. Get it out into the world. It's your jobs to make sure it's now spread.
Posted by springshowers (Member # 19863) on :
Amazing work you do with such detail and love the notes and links etc.
MB - Can you share your overall goal of the paper and what you feel it will accomplish.
I will reply after as I have some thoughts that may not apply if I am not on the mark exactly with your thoughts.
You will see why after you answer. I do not mean to be asking you to repeat yourself or to pull a dah moment.
But if you would not mind just answering so I can find out if I am on the same train of thought.
Thanks
Posted by METALLlC BLUE (Member # 6628) on :
Read the first post for your answer Spring.
Posted by springshowers (Member # 19863) on :
Has everyone read this presentation?
Posted by METALLlC BLUE (Member # 6628) on :
Yeah, I watched the hearing. I've read all of Dr. Phillips papers as well.
Posted by ukcarry (Member # 18147) on :
Well done, Metallic Blue: you've done a brilliant job here,
Carry
Posted by Tincup (Member # 5829) on :
Excellent. Again, thank you! I am sharing it within the community. Much appreciated MB. A lot of work for you... and much needed for us all.
Posted by METALLlC BLUE (Member # 6628) on :
Thank you, I just want it to get out so it'll help people and be accessible.
Posted by sammy (Member # 13952) on :
Thank you Metallic Blue!
Your hard work is going to help so many people. Thank you so much!
Posted by Sophie1234 (Member # 26412) on :
Wonderful and impressive. And right, and true. Thanks for all the hard work.
Posted by METALLlC BLUE (Member # 6628) on :
Pass this along to those who have strong contacts.
Posted by Rumigirl (Member # 15091) on :
MB,
I haven't checked all the studies yet. Do you have the packet that your LLMD's office has, which is usually used for insurance denials?
They have a HUGE packet of studies showing persistence of LD that they send for $25 to cover xeroxing and mailing (or you can pick it up at the office). Maybe you already have all those studies?
Yeah, Dr. P's presentation also clearly shows all the many studies by the IDSA guideline authors that clearly shows Bb persistence (and also problems with testing, etc). The authors published plenty of these articles earlier!
Posted by METALLlC BLUE (Member # 6628) on :
No, I did not get a packet Rumi. The studies and information are already available online though and so I read all of those. I've read the studies on all the other subjects as well, including seronegativity, seroconversion, test relability, and a long list of other issues.
Persistence was the only one I wished to focus on primarily, since it seems to be the only one being opposed vehemently.
Posted by Dawn in VA (Member # 9693) on :
MB, you ROCK!! I haven't yet read it all the way through, but what a tremendous amount of effort you have put into this. Thank you so very much.
Posted by METALLlC BLUE (Member # 6628) on :
Tell me what you think when each of you have finished reading it.
Posted by migs (Member # 16496) on :
That is great.
I 100% agree that persistent infection should be the focus. That is the fact that the "experts" of the IDSA spend so much time trying to erase.
Posted by METALLlC BLUE (Member # 6628) on :
My reason for supporting this one specific part of the debate is because it is the key. All other factors, including poor testing, and PLS are not crucial.
Antibiotic therapy is "also" not the key, because it usually doesn't work. It works partially for most, pretty well for a select few.
So, the argument is, persistence takes place inspite of adequate antibiotics. If that is true, why would I focus on antibiotics as the solution when I've already shown persistence?
Hopefully everyone can see here why I've moved onto focusing on other therapies. I'm looking for a clear cut, firm method -- but arriving there will take work. I'm working on it right now.
I'm buying all my equipment, and seeking solutions in a laboratory setting.
Posted by Abxnomore (Member # 18936) on :
Great job Mike. Amazing you can do this while you are battling this illness. Thank you!!
Posted by METALLlC BLUE (Member # 6628) on :
Trust me AB, it's a massive burden -- I'm surprised that I can do it. Hunching over and typing for hours, researching, trying to find the words -- it's like.....torture.
It's torture trying to accomplish goals while sick, but if I can do it, somehow, and it's meaningful, then it's worth it. Most projects are just too big.
The Lyme Disease Treatment Guide was a project that has become too much for me. It's about a hundred pages and still incomplete. The majority of the work is done, and yet I still can't seem to finish.
The guide was originally pieced together by BettyG, as a packet that many of us received upon arrival. It was a blessing and a curse -- as most remember. It had so much to say and yet it was brutally painful to read through.
I've streamlined it, organized it, and re-written about 95% of it. I've actually added twice the content that it originally had, yet shortered it by half of what it originally was.
I need help finishing it, but I just don't know if I can. The biggest issue is that it's still in a word Document. I didn't really want to do it that way since I wanted the document to be accessible to everyone -- and quickly, so of course I'm considered moving it into an Adobe file.
One of the biggest problems is that I've been working on it for two years and so I haven't updated the content to include 2009 and 2010. I just don't think I'll ever get it done.
![[Big Grin]](biggrin.gif)