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» LymeNet Flash » Questions and Discussion » Medical Questions » Lyme Knee?

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Author Topic: Lyme Knee?
Beagle
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Does anyone know how long it takes for the effects of Lyme Knee to show up after tick bite?
I've been treating for disemenated Lyme, Babs, etc. for over a year when I recently pulled an embedded tick from 2 inches below knee. Three wks later knee joint was so painful could not sleep. Trying to figure out if new Lyme infection can cause such symptoms so quickly. I'm thinking no, and Doc said the Azithromycin I've been on should have covered it if it was a new Lyme infection. But she's not sure if one would feel the symptoms only 3 wks after the bite anyway.

Do you all agree, it would take longer? (Trying to avoid another Ortho Doc since the last one totally screwed up on a TKR to other knee) So kind of hoping it is a new Lyme infection.

Thanks,

Beagle

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marypart
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My daughter felt pain in both knees within 7 days of the bite, even though she was started right away on 400mg a day of doxy.

--------------------
Son, 26, Dx Lyme 4/10, Babs 8/10
Had serious arthritis, all gone.
Currently on Valtrex
Daughter, 26,bullseye 7/11
arthritis in knees, cured and off all meds. .
Self:Lyme, bart, sxs gone, no longer treating.

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TF
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I definitely would not go to an ortho doc for this.

You already had lyme when you got that second bite, so you can't get a "new infection" with lyme. What happened is the second bite increased your germ load (the amount of lyme germs now in your body) and your knee blew up. Each bite adds to what your already overwhelmed immune system has to cope with. Your body couldn't cope with these additional germs and obviously the meds you were on were also insufficient to cope.

"The severity of the clinical illness is directly proportional to the spirochete load." (page 3) Burrascano guidelines

I got a new lyme symptom while on lyme treatment. I got to ask Burrascano about this once at a lyme presentation. How did he explain my new symptom (trigeminal neuralgia) considering I was on high dose amoxicillin?

His reply, which I will never forget, was "If the therapy is inadequate, the disease will continue to progress."

So, if you get new lyme symptoms while in lyme treatment, your therapy is inadequate (not counting temporary herx symptoms). In the presence of inadequate treatment, the disease will continue to progress. In my case, I got trigeminal neuralgia in addition to all of my other lyme symptoms. In your case, you got fluid in your knee, the classic lyme symptom.

You don't have to look any further than lyme disease. Sounds to me like you should consider finding a better doctor.

Burrascano says that it takes combinations of antibiotics to get rid of lyme, not just one antibiotic. Here is a quote for you:

"COMBINATION THERAPY

Treatment of chronic Lyme usually requires combinations of antibiotics. There are four reasons for this:

1. TWO COMPARTMENTS- Bb can be found in both the fluid and the tissue compartments, yet no single antibiotic currently used to treat Bb infections will be effective in both compartments. This is one reason for the need to use combination therapy in the more ill patient. A logical combination might use, for example, azithromycin plus a penicillin." (page 12)

http://www.ilads.org/lyme_disease/B_guidelines_12_17_08.pdf

I suggest you read the rest of this section to see all 4 reasons antibiotic combos are necessary.

And, if you read his Guidelines, you will see the high doses that are required. You should compare your dose to what is in the Guidelines.

I was just on one antibiotic (but at appropriate high dose) when I got the trigeminal neuralgia. When I switched doctors, he put me on 2 antibiotics at a time (added flagyl to the amoxi) and I just got rid of symptoms. I didn't get any new symptoms anymore.

It is now nearly 7 years since I completed my treatment and I am still symptom free. I stick around LymeNet just to help people not waste time with docs who don't know enough to get them well. I wasted 2 years with such a doc--the one that had me on only one antibiotic.

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Lymetoo
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zith by itself won't cover lyme

--------------------
--Lymetutu--
Opinions, not medical advice!

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Beagle
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i HAVE BOTH Doxy and Omnicef here. Its been 3 -4 weeks since the tick bite near the knee. I would choose to take the Doxy, although the Doc just said the Omnicef.

One more quick question, which would you choose to take if it were up to you?

TF, thanks for the indepth info. I am desperate to be able to walk. (Other knee is already useless, have ordered a scooter chair just to walk my beagle, but this is Central MA, soon to be covered in two feet of snow!)

Beagle

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TF
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A friend of mine went to a lyme doc that I recommend. She got rid of lyme taking the following combos:

doxy and biaxin
then, doxy and ceftin
then, omnicef and flagyl

See if you can manage any of these combos. (You have to be on a combo. No one med is going to be good enough.) Let me know if you want the patient's doses.

Then, my friend was treated for babs.

That was 4 years ago and she is still fine.

You likely need babs treatment as well.

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Beagle
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TF, yes I've been on Mepron for Babs for a few months now. It was my third Lyme Doc. that suggested I have Babs and sure enough I had a lot of improvement as far as being bed ridden a lot of the time. I guess that was Babs because I have not been that sick since the Mepron. But I do have the side effect of bad depression with the Mepron, so keep stopping and starting it.

Wonder how long one must stay on Babs treatment?

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TF
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Plan on one year.

I hope you are taking zith with the Mepron and pulsing artemesinin.

This website has good instructions on taking Mepron:

http://www.lymebook.com/antibiotic-treatment-for-babesia-bartonella-ehrlichia-co-infections

Compare it to what your doc has you doing.

It is essential that you achieve a high level of Mepron in the blood or you will not get rid of babs--ever.

From Burrascano:

"Treatment failures usually are related to inadequate atovaquone levels. Therefore, patients who are not cured with this regimen can be retreated with higher doses (and atovaquone blood levels can be checked), as this has proven effective in many of my patients. Artemesia (a nonprescription herb) should be added in all cases. Metronidazole or Bactrim can also be added to increase efficacy..." (page 24)

Your doctor can test Mepron levels in your blood to determine if your levels are adequate. If you don't eat enough fatty foods with it, you will not absorb it and so the money you spent on the Mepron will be wasted.

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Brussels
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New infected bite on top of chronic lyme was the worse thing that happened to me.

My health went fast downwards despite being on treatment. I suspect new bites add so many coinfections again, and meet a body that was already weak due to chronic lyme, and they just do a feast...

Just treat as much as you can. I would load myself with astragalus for the new bite. Buhner suggested me so. Plus the other treatments you may be on.

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Beagle
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Has anyone cured a case of Babesia with Bactrim or anything other than atovaquone?

It helped me immensely but I'm already depressed and the Mepron I fear is going to put me over the edge.
I think my doctor is Ok, because she was the only one of three that did anything to help...she diagnosed the Babs and once beginning treatment with Mepron allowed me to at least leave the couch! So, not sure I should look again for new doctor.

Bussels,
It's so hard to be sure if the new bite infected me or not. The tick was attached to my leg but only for less than a full day. This time I had no bullseye but after 2 - 3 wks that knee just went out for no known reason. Anyway I will start astragalus right away, that sounds good.

thks again

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TF
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My doc got rid of babs for me using Bactrim DS and pulsed artemesinin.

This is an alternative for those who cannot take mepron/zith. In my case, I could not take zith or any of its substitutes.

My doc said Bactrim will do the trick, but it takes twice as long as Mepron to do the job.

I had a top notch doctor. I have found that lesser lyme doctors do not know that Bactrim will get rid of babs, or do not believe it will.

It was about 8 years ago that I did this treatment for 1 year. It is now nearly 7 years since I completed treatment and I am still symptom free, enjoying my life.

However, I must say that I also did the exercise requirement in Burrascano. My doc said it was absolutely necessary if I was ever to get well. I did one continuous hour of weight lifting every other day. I did a full body workout each time.

I also did not drink or smoke.

One knowledgeable long-timer on this board believes that the babs people are dealing with now is more difficult to get rid of than when I was in treatment. Don't know if that is correct or not.

The website I gave you above discusses using Bactrim for babs. Also, Burrascano says the following regarding bactrim for babs:

"Therefore, patients who are not cured with this regimen can be retreated with higher doses (and atovaquone blood levels can be checked), as this has proven effective in many of my patients. Artemesia (a nonprescription herb) should be added in all cases. Metronidazole or Bactrim can also be added to increase efficacy, but there is minimal clinical data on how much more effective this will be." (page 24)

I understand that when Burrascano was practicing, he sometimes sent his babs patients to Dr. H. in NY when he could not clear their babs. So, here are the notes I took from Dr. H's talk at the recent lyme conference in Toronto. Some alternatives for you to consider from a real expert.

2011 ILADS Conference, Toronto, Canada

Lyme & Babesiosis: Updates on Treatment & Diagnosis 2011

Dr. H 10/28/11

He has 20 years of experience treating lyme; >12,000 chronic patients
He was in France and China discussing babesiosis. Talked with Chinese CDC regarding parasites

Some of his patients get better with glutathione alone. It opens up the detox pathways (is an anti-oxidant)

Borrelia miyamotoi is showing up in ticks in Hyde Park, NY. This strain is in Japan. We can�t test for it.

There is a new ehrlichia species also found.

Indicators of bad outcome with babesiosis:

male sex, extremely high WBC

We see blood transfusion babesiosis in California. WA-1 is now in the Northeast U.S.. It is found along the entire eastern seaboard. It is difficult to get a positive test for it. LabCorp has a WA-1 test. The FISH through Igenex is also very useful.

He treats with clindamycin with azithromycin, also Mepron, then malarone. There is lots of Mepron resistance. So, he adds Septra (Bactrim). This works well. Also, he uses much higher doses of Mepron due to the Mepron resistance.

He uses coartem (which has Artemisinin in it) Dosage is 4 twice per day. Take at 7 a.m. and 3 p.m.; then switch to 7 a.m. and 7 p.m. It can be pulsed once per month.

You can�t combine this with any med that affects the QT interval.

Babs is spreading world-wide. Babs also suppresses the immune system (based on a study of b. microti)

Artemisinin is not as effective now as it was in the past. Use art when coartem doesn�t cure the person. He no longer uses ketek.

Beta blockers (blood pressure medicines) control these types of parasites. So, use them as an antagonist. We need a study on this. Heparin may also inhibit babs. Need a large study on this.

Curcumin (a herb)--he is now using it to treat babs. Published studies show it is useful for malaria.

Cryptolepis has been used in Africa for malaria. There is a published study in Ghana. It had a 93% cure rate (a 50% cure rate in 3 days; 90% cure rate in 7 days) You can get it at: www.woodlandessence.com

If adrenal function is low (patient has a low cortisol), they will not respond to antibiotics.

He told of a patient with intractable babs. They were treated for babs for 5 years and were not cured. Then, he gave them 1 teaspoon of cryptolepis 3 times per day with Byron White herbs. This is making the patient feel well. He hasn�t found any side effects with the cryptolepis. It may not be curative. It lowers the parasite load and strengthens the patient�s immune system.

Brucellosis also causes night sweats, so check for this in a patient with night sweats.

Use malarone for the patient who can�t clear babs. Low dose to maintain them.

We need new treatment options for babs.

[end of notes]

I hope this gives you some ideas. I have a friend who can't take Mepron for the same reason.

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