I have had Lyme for over six years. I am housebound and constant dizziness has forced me to have to take online courses through Herkimer County Community College as a full-time student so that I can stay on my mom's insurance plan.
I was recently accepted into the honor's program and for three consecutive semesters I have to do a project in addition to my other courses. This semester I have chosen to make a Lyme informational pamphlet. I had a few questions that I cannot find the answers to such as why ammoxicillin has to be taken at high doses and be taken with probenicid?
I still have a lot to add to it and it not due in November. This is only what I have so far. The rest of it will be pretty easy as I will add how to properly remove a tick, and other preventative measures.
I want to make sure that my work is as accurate as possible so if anyone is bored and wants to read what I have so far , please let me know if I have anything that is wrong or worded weird.
It is kinda of long, but any input on how I can improve it would be greatly appreciated. I have tried to break up the paragraphs as much as possible to that it is easier to read.
Also is there anyone that has heard of Dr. K in Hopewell Junction, NY? He is a homeopathist that I was sent to by Dr. H in Hyde Park.
Thanks, Heather
What is Lyme disease?
Lyme disease is an infectious disease that is usually transmitted by the bite of an infected tick. The disease was first identified in Old Lyme, Connecticut in 1975 when there was a mysterious outbreak of arthritis in children who lived near Lyme, Connecticut. The bacteria that causes Lyme is a spirochete called Borrelia burgdorferi, which is named after the researcher that identified the disease, Dr. Willie Burgdorfer.
The disease is transmitted when a person is bite by an infected tick, or less commonly, by an infected mosquito, gnat, or other flying insect. In addition to Lyme disease, ticks can also transmits co-infections or associated diseases. Co-infections can include Ehrlichiosis, Babesiosis, and Bartonella. When a tick bites, its feeds on the host's blood and it can feast for 24 to 48 hours before it falls off. As it is feeding the tick transmits the infectious disease into the host's bloodstream.
The tick bite is usually painless and therefore many people do not even know that they have even been bitten. Anywhere from one day, to even in some cases years later, symptoms can appear. A ``bull's eye rash'' or erythema migrans and flu-like symptoms are possible first symptoms that some people experience. The disease affects everyone differently and can cause symptoms ranging from fatigue, to dizziness, to joint pain.
The bacteria can invade any part of the body (tissues, organs, muscles, bone, etc), and it can change in form (cystic form), which makes it more difficult for antibiotics to destroy the spirochete. The earlier that the disease is treated, the better the likelihood of a full recovery. Lyme disease can become chronic and its symptoms can be debilitating if it is left untreated, left undiagnosed, or if it is misdiagnosed.
Common Misconceptions of Lyme Disease and the Co-infections.
1.Once a person has had Lyme disease they are immune to getting it in the future.
FALSE: Lyme disease is not like the Chicken Pox that once you get it you become immune to the disease. Every time a person is bitten by an infected tick they could potentially re-contract the disease.
2. A person that has Lyme disease must have the ``bull's eye'' rash or flu-like symptoms. If they do not, then they do not have Lyme disease.
FALSE: It is estimated that only 50% of people with Lyme disease actually get a ``bull's eye'' rash or flu-like symptoms. If a person does get a rash it can be any size or shape, it does not have to resemble a ``bull's eye'', it can be anywhere on the body (not only at the site of the tick bite), and there can be multiple rashes. Studies have also shown that about 50% of people with Lyme do not even remember being bit by a tick.
So if they are not aware that they were bit and they suddenly get a rash or they seem to get they flu, they may not associate it with have Lyme disease.
3. The blood tests for Lyme disease are very accurate. FALSE: The Lyme Titer (also known as the ELISA) and the Western blot are NOT very reliable blood tests for Lyme. The Center for Disease Control (CDC) warns that, ``A negative result should not be the sole basis for excluding Borrelia Burgdorferi as the cause of illness.'' Due to the fact that there is currently no reliable blood test, the patient's symptoms and their risk factors, such as if they live in an area where Lyme disease is prevalent, should be used to make a diagnosis of Lyme.
Stated in the March 25, 1991 National Institute of Health report it says that the CDC surveillance criteria for the Lyme tests were developed to track a narrow group of cases to look for epidemiological change and were not set up to be used as diagnostic criteria or to define the full extent of Lyme disease.
4. If I am bitten by a tick then a single dose of doxycycline will cure the disease and prevent symptoms.
FALSE: It takes AT LEAST a four to six week course of antibiotics to treat Lyme disease in its early stages. If symptoms persist additional treatment may be needed until all symptoms are eradicated. If the disease is in its late or chronic stage it may take months to years to treat.
People that have been misdiagnosed with another disease that find out that they really have Lyme many also need years of treatment. Lyme disease not only invades the blood stream but also the tissues, muscles, and organ.
5. If a person is bit by a tick and they get a rash but they get a negative blood test for Lyme, then they do not have Lyme disease.
FALSE: Getting a rash after being bite by a tick is diagnostic for Lyme despite the negative blood results. As previously mentioned the Lyme disease blood tests are very inaccurate. There is a very high incidence of false-negatives. A person that has Lyme can get a negative blood test for numerous reasons.
For example, due to the fact that the Western blot looks for antibodies that attack the Lyme bacteria, if a person was on antibiotics prior to the test, steroid, or cancer drugs, then the test may have a false-negative because these medicines hindered the development of antibodies to begin forming.
6. If I am bite by a tick and it is attached to my body for less than 24-48 hours than I cannot get Lyme disease.
FALSE: Once a tick bites it begins to feed on the host's blood and in the process it transmits the Lyme bacteria and the co-infections. There is no minimum amount of time that the tick must be attached for a person to become infected.
7. My doctor told me that Lyme disease or the co-infections (Ehrlichia, Babesia, and Bartonella) do not exist in the state that I live.
FALSE: Lyme disease and the associated diseases have been identified in every one of the fifty United States as well as in every other continent, with the exception of Antarctica. Some doctors use the amount of reported cases to the CDC as a way to determine the amount of people infected with Lyme disease.
The problem with that is that it is not required for doctors to report to the CDC when a patient contracts Lyme disease. It is estimated that the number of people with Lyme disease is at least double that which is reported. Also ticks do not know geographic boundaries so they are not confined to a single area.
8. If a person has or may have Lyme disease or associated diseases it is okay for them to take prednizone to alleviate their symptoms.
FALSE: Prednizone is a prescription steroid that is used to treat inflammation and numerous other ailments. Since steroids suppress the immune system it would give the spirochetes an unchallenged environment to multiple. Steroids should not be given to a Lyme disease patient.
9. There currently is a vaccine for Lyme disease.
FALSE: There was a vaccine for Lyme disease but it was taken off of the market for numerous reasons. First, there is evidence that suggests that there are people with a certain gene that could develop an autoimmune disease from the vaccine.
About one-third of the population has this gene and if they received the vaccine they could develop severe arthritis, for which there is no known cure. Second, when some people that were previously cured of the disease got the Lyme vaccine the Lyme was reactivated.
10. I have been diagnosed with Lyme disease, Ehrlichia, and Babesia and one antibiotic will cure all three.
FALSE: Lyme disease and Ehrlichia are both caused by a bacteria, and usually, if caught early, a round of one antibiotic with cure both. Babesia on the other hand is caused by a protozoal parasite. Therefore an antiprotozoal medication in conjunction with an antibiotic will be prescribed, such as mepron and zithromax (SEE POSSIBLE TREATMENTS).
11. There is no controversy surrounding Lyme disease.
FALSE: There is a major controversy surrounding Lyme disease. There are many doctors that believe that Lyme can be cured with a few days or with three weeks of oral antibiotics, and they do not believe that Lyme disease can become chronic or that long-term treatment is helpful.
They may believe this because they might be disregarding new updated evidence that says that Lyme disease can be a very serious and debilitating disease if it is not properly treated or if it goes undiagnosed, and it may need long-term aggressive treatment. (SEE HELPFUL WEBSITES).
12. I do not go camping or hiking, and I do not go in the woods, so I am not at risk for getting bit by a tick or getting Lyme disease.
FALSE. Ticks get Lyme from feeding on mice and rats, which carry the Lyme disease spirochete. A single tick can lay as many as 1000 larva, and if the original tick was infected with Lyme that means that now for every one tick there are 1000 ticks carrying the bacteria. Some of the animals that ticks feed on include mice, squirrels, chipmunks, rabbits, deer, and birds.
Since all of the animals can move around easily to any area, they take with them the infected ticks that they carry. Ticks can be found in woods, brushy areas, seashores, parks, and even in your backyard. Whenever you are outdoors, tick checks should always be performed.
13. I was bit by a dog tick so I cannot get Lyme disease.
FALSE: It was once believed that only deer ticks could transmit the bacteria, but new research has proven than other species of ticks carry the disease. Numerous species of ticks have been found to carry the disease including dog ticks and wood ticks.
14. I suspect that I may have Lyme disease, so it is okay if I go to any type of doctor, because they should all have a general knowledge of the disease.
FALSE: The best type of doctor to see when Lyme disease is suspected is a Lyme disease specialist, or a ``Lyme Literate Medical Doctor'' (LLMD). They will have the most up to date knowledge of the disease and effective treatments (SEE HELPFUL WEBSITES).
***Are there any other important misconceptions that I have missed?
Common Diagnostic Testing:
When a person is suspected of having Lyme disease their doctor may recommend certain diagnostic tests to help confirm a Lyme diagnosis, or to rule out closely related diseases.
1. CBC (Complete Blood Count), LFT (Liver function Tests), and Complete Metabolic Panel: These are general routine blood tests that are usually taken when a person is suspected of having any illness.
These tests check various things such as the number of white and red blood cells as well as how well the liver, kidneys, and gallbladder are functioning. When a person is on antibiotics, especially intravenous antibiotics, CBS's and LFT's will be periodically monitored to check the function of the liver and gallbladder.
2. ELISA (also known as the Lyme Titer): This test measures the level of antibodies in the blood that fight Lyme. This test is very inaccurate and is rarely used in making a definitive Lyme diagnosis.
3. Western blot: This is a blood test that looks for antibodies in the blood that fight the Lyme bacteria. Antibodies (or immunoglobulins) are proteins that are produced by the immune system in the response to a foreign substance such as a bacteria or virus. The test measures the two main classes of immunoglobulins, the IgG and the IgM. By having a certain number of positive antibody ``bands'' for each class of immunoglobulins it would indicate a positive test.
This test is more accurate than the ELISA, but the results should still not be the sole basis for diagnosing Lyme. Many doctors have realized the inaccuracy of this test and they will commonly send the Western blot to a lab in California called Igenex.
This lab tends to have more accurate results than other labs and it makes the Western blot a more reliable diagnostic tool.
4. PCR (Polymer Chain Reaction): The PCR is a blood test that looks for the actual DNA of the Lyme spirochete or the co-infections. A positive test signifies that the person does have Lyme disease or the co-infections, and it has been clearly identified in the blood.
The problem with this test is that there are often many false-negatives due to the difficulty of detecting the bacteria with such a small sample. The PCR is routinely sent to MDL Labs in New Jersey.
*** I will also be adding info about the SPECT SCAN...I did not forget about it.
Common Treatments For Lyme and Associated Diseases & Precautions to Medications:
The medications that a doctor prescribes depend on a number of factors. The longer that a person has had Lyme the more aggressive treatments they may need. Certain medications seem to be better for targeting certain symptoms, and some may be more accommodating to a person's lifestyle or other health factors.
Often a worsening of symptoms will occur as the bacteria dies off when it is being overcome by the antibiotics. This is known as a Herxheimer's reaction (herx) or flaring.
Whatever antibiotics or medications your doctor prescribes you should take the supplement acidophilus. Our stomach and intestines have natural ``good'' bacteria that protect our body from harmful bacteria.
Taking antibiotics or medications for extended periods of time can decrease the amount of acidophilus in the digestive tract, which can lead to upset stomach, nausea, and candida (yeast overgrowth). Acidophilus should be taken on an empty stomach preferably 30 minute to an hour before taking medications.
ORAL ANTIBIOTICS:
TETRACYCLINES:
Doxycycline: This is the most common antibiotic prescribed during the early stages of Lyme, or when a person has recently been bit by a tick. This antibiotic is good for hitting Lyme as well as Ehrlichia.
Tetracycline: This antibiotic is in the same family as doxycycline. Some studies show that is may good to treat neurological symptoms in early stages of Lyme.
PRECAUTIONS: Antibiotics in the tetracycline family should be taken with food because it can cause an upset stomach. Dairy products, multi-mineral supplements, and antacids should not be taken within 1 hour before or after the antibiotic because it can decrease the effectiveness of the drug.
Sun exposure should be avoided because it causes photosensitivity and can result in a rash. Sunscreen greater than or equal to 35 SPF should be worn on all exposed areas.
PENICILLINS:
Amoxicillin: This antibiotics is often given when the tetracyclines cannot be taken to avoid the side effect of photosensitivity. Amoxicillin can be taken with or without food. It is not given as often as other treatments because it needs to be taken at higher dosages because Amoxicillin****. This treats Lyme and Ehrlichia.
Penicillin: This antibiotic gets into the blood better than Amoxicillin so it can be given in lower doses. It is also used to treat Lyme and Ehrlichia.
PRECAUTIONS: Penicillins can be taken with or without food. If upset stomach does occur take with food.
MACROLIDES:
Zithromax: This is an antibiotic that is used in combination with mepron to treat Babesia.
Biaxin: This is an antibiotic that is used in combination with plaquenil to treat Babesia.
Dynabac: This is an antibiotic that is usually used in combination with plaquenil to treat Babesia.
PRECAUTIONS: Do not take antacids or multi-mineral supplements within 1 hour before or after macrolides as it will decrease the effectiveness of the drug.
Macrolides may cause an abnormal taste in the mouth, which is a normal side effect. Drinking a small amount of cranberry juice when taking the antibiotic can help to minimize the taste.
ANTIPROTOZOALS:
Mepron: This medication should be taken with a high fat meal because it is fat-soluble. Take this liquid with foods and drinks such as milk, cheese, or meats. This is usually taken in combination with zithromax to treat Babesia.
Plaquenil (or hydroxychloroquine): This is an antimalarial medication that is used to treat Lupus and rheumatoid arthritis. It is often used by LLMDs in combination with an antibiotic to treat cystic forms of Lyme disease.
Plaquenil also works as an anti-inflammatory and it is therefore beneficial for a person who has an overactive immune system caused by the Lyme disease.
PRECAUTIONS: Do not take any supplements that contain the enzyme CoQ10 because it may interfere with mepron.
When being on plaquenil there is a very slight chance of getting visual field problems. Let your doctor know if you have a history of visual field to color vision problems.
Have your eyes checked before starting plaquenil and every six months while being on the medication.
INTRAMUSCULAR ANTIBIOTICS:
Bicillin LA injections: Bicillin injections or intramuscular shots (IM shots) are usually prescribed to Lyme patients that are in later stages of the disease. IM shots are given in the buttock to kill the spirochetes that are hiding in the muscles and tissues.
Often an oral antibiotic will be given in conjunction with the shots to target bacteria in the muscles as well as the blood stream. Bicillin shots are usually either given in one 2.4 million unit injection per week, or two 1.2 million unit injection twice per week.
PRECAUTIONS: To reduce the discomfort of the IM injection your doctor may prescribe Ela cream, which is a local anesthetic that is put on the injection site and covered with a clear bandage one hour before the shot is given (Tegaderm bandages work well).
Also applying ice to the site will additionally help to numb the area. After the IM shot rub the injection site to ensure the antibiotic disperses.
INTRAVENOUS ANTIBIOTICS:
IV Rocephin: This intravenous antibiotic is prescribed for people with late stage or chronic Lyme disease. It is a powerful medication and the flares while being on it can be severe. The antibiotics are usually given via a Peripherally Inserted Central Catheter or PICC line, which is very thin tube that is inserted into a vein in the upper arm that runs just above the heart.
There is a chance that rocephin can cause gallbladder problems so it is usually given for three-four days a week and then you are given a break for three-four days.
PRECAUTIONS: Rocephin can cause gallbladder problems so CBC and LFT's are usually checked every two weeks. The dressing on the IV site must be changed every 7-10 days.
Posts: 66 | From Dutchess County, NY | Registered: Aug 2002
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livinlyme
Frequent Contributor (1K+ posts)
Member # 3773
posted
0947, I think you have a really good start there... keep going and share it when you are finished..
-------------------- "Hatred paralyzes life; love releases it. Hatred confuses life; love harmonizes it. Hatred darkens life; love illuminates it." Posts: 1389 | From who knows, who cares, but somewhere over the rainbow | Registered: Mar 2003
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posted
Looks good! As for your question about high dose amox and probenecid, I think all abx are in high dose because the spirochetes are so hard to target and kill. The probenecid, as I recall, keeps the amox in the system longer. Keep up the good work.
Posts: 422 | From Herndon, Virginia | Registered: Oct 2005
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It really looks good, I am going to copy and save it if you don't mind. Its something that I show to people who don't understand the disease.
One thing I do not agree with is this statement:
quote: The longer that a person has had Lyme the more aggressive treatments they may need.
I have had LD for 38 years undiagnosed, and I cannot tolerate high doses of ABX. My mother was just diagnosed a few months ago and she was bit in the early 1960's. She can only tolerate 25mgs of Minocycline a week. So from what I have learned from my LLMD is that if you have had it for many years you are overloaded with spirochetes and can die from herxing. I think maybe they may have to be treated LONGER.
Maybe something about Mino....
quote: TETRACYCLINES:
Doxycycline: This is the most common antibiotic prescribed during the early stages of Lyme, or when a person has recently been bit by a tick. This antibiotic is good for hitting Lyme as well as Ehrlichia.
Tetracycline: This antibiotic is in the same family as doxycycline. Some studies show that is may good to treat neurological symptoms in early stages of Lyme.
Minocycline hits the co-infections(Bart, Erlichia) but has less side effects then Doxy. It dosesn't cause stomach upset or sun sensitivity.
Not sure about this one...
quote: Acidophilus should be taken on an empty stomach preferably 30 minute to an hour before taking medications.
My LLMD says to take acidophilus 2 hours after ABX to replenish what was killed off by the ABX.
But you write really well. I hope you get a good grade on it, and you inform alot of people.
SForsgren
Frequent Contributor (1K+ posts)
Member # 7686
posted
Minor but prednizone s/b with an "s".
-------------------- Be well, Scott Posts: 4617 | From San Jose, CA | Registered: Jul 2005
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CaliforniaLyme
Frequent Contributor (5K+ posts)
Member # 7136
posted
GREAT JOB!*)*!)! Just a few picky picky comments!
AMOxicillin has to be taken at high doses to get good tissue penetration, for the level to be high enough in your system to affect the bacterial load.
QUOTE: which is named after the researcher that identified the disease, Dr. Willie Burgdorfer.
ME: His name is spelled Willy with a y not ie. Technically the disease was identified before the organism - it was called ertheyma migrans disease- he identified the causative bacteria.
QUOTE: The disease is transmitted when a person is bite by an infected tick, or less commonly, by an infected mosquito, gnat, or other flying insect.
ME: STop at tick if you want to be accurate. Otherwise it is mere speculation- and it is bitten by not bite by!!
QUOTE: In addition to Lyme disease, ticks can also transmits co-infections or associated diseases.
ME: transmit!!!
QUOTE: 4. If I am bitten by a tick then a single dose of doxycycline will cure the disease and prevent symptoms.
FALSE: It takes AT LEAST a four to six week course of antibiotics to treat Lyme disease in its early stages. If symptoms persist additional treatment may be needed until all symptoms are eradicated. If the disease is in its late or chronic stage it may take months to years to treat.
People that have been misdiagnosed with another disease that find out that they really have Lyme many also need years of treatment. Lyme disease not only invades the blood stream but also the tissues, muscles, and organ. UNQUOTE
ME: OKAY!! I personally ***believe*** all that and thank god got myself to a doctor who does too HOWEVER that is all speculative as far as being backed up scientifically. Our wonderful doctors have been too busy treating their desperately ill patients instead of doing what the Steerites do- publish publish publish!!!!!!!!!! When our doctors do publish more of their work I am sure we will be able to say the above are facts- but as of now- they are opinion. UNSUBSTANTIATED by ANY scientific or medical data other than anecdotal reports.
QUOTE: 5. If a person is bit by a tick and they get a rash but they get a negative blood test for Lyme, then they do not have Lyme disease.
FALSE: Getting a rash after being bite by a tick
ME: bitten!!!
is diagnostic for Lyme despite the negative blood results.
ME: no it's not- not any old rash- some people DO get a small rash at bite site that is an allergic reaction to the tick saliva!!! a rash over 3cm at the bite site or a bulls-eye rash is diagnostic however!!! clarify!!!
QUOTE: 6. If I am bite by a tick and it is attached to my body for less than 24-48 hours than I cannot get Lyme disease.
ME: bitten!!!
FALSE: Once a tick bites it begins to feed on the host’s blood and in the process it transmits the Lyme bacteria and the co-infections. There is no minimum amount of time that the tick must be attached for a person to become infected.
ME: Well, yes and no. In the vast majority of ticks there IS a minimum amount of time, over 24 hours or whatever it is- however in 2-3% of ticks it Bb is in their salivary glands and can be transmitted at bite!!! OR if the tick is removed IMPROPERLY a tick can transmit at that time because the squeezing or whatever causes regurgitation at that time instead of at the normal time- disengagement-
QUOTE: 7. My doctor told me that Lyme disease or the co-infections (Ehrlichia, Babesia, and Bartonella) do not exist in the state that I live.
FALSE: Lyme disease and the associated diseases have been identified in every one of the fifty United States as well as in every other continent, with the exception of Antarctica.
ME: Not true!!!
QUOTE: 8. If a person has or may have Lyme disease or associated diseases it is okay for them to take prednizone to alleviate their symptoms.
FALSE: Prednizone is a prescription steroid that is used to treat inflammation and numerous other ailments. Since steroids suppress the immune system it would give the spirochetes an unchallenged environment to multiple. Steroids should not be given to a Lyme disease patient.
ME: to multiply!! FALSE!!! There are some Lyme-induced conditions like pseudotumor cerebri or some optical conditions which threaten vision in which even Lyme sufferers MUST be treated with steroids to prevent serious sequelae- sometimes even Lyme patients must have steroids- rare- but sometimes VERY necessary!!!!!!!
QUOTE: 2. ELISA (also known as the Lyme Titer): This test measures the level of antibodies in the blood that fight Lyme. This test is very inaccurate and is rarely used in making a definitive Lyme diagnosis.
ME: It is used all the time (unfortunately). It is inaccurate to say it is rarely used.
QUOTE: Often a worsening of symptoms will occur as the bacteria dies off when it is being overcome by the antibiotics. This is known as a Herxheimer’s reaction (herx) or flaring.
ME: Herxheimer Reaction
QUOTE: Amoxicillin: This antibiotics is often given
ME: antibiotic!!!
QUOTE: ela cream
ME: EMLA cream, not ela unless there is something new called ela I don't know about (which is possible!!!)
QUOTE: There is a chance that rocephin can cause gallbladder problems so it is usually given for three-four days a week and then you are given a break for three-four days.
ME: Most LLMDs give only a two day break I believe!!! And some none at all!!!!!
Great work mostly- really great job!!! Best wishes, Sarah
-------------------- There is no wealth but life. -John Ruskin
All truth goes through 3 stages: first it is ridiculed: then it is violently opposed: finally it is accepted as self evident. - Schopenhauer Posts: 5639 | From Aptos CA USA | Registered: Apr 2005
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Thanks for the suggestions. It is not due for about a month, so this is not my final project yet. All of the litte spelling and grammar mistakes I am not worring about until I do final touches. I just want to make sure that I get the facts as accurate as possible, but thanks for the corrections.
Thanks Lymeout for the info about amox.
Lisianthus, you are right about the longer you've had Lyme the more aggressive treatment you will need may not apply to everyone. For me, everytime I am on an antibiotic all I do is flare. I've been on many oral combo's, IM shots, IV rocephin, IVIG, and lots of natural stuff, and all I do if flare. Also the thing about acidophilus, I have been told different things from different doctors as to when to take it. I will word both of the things that you suggested differently. Thanks
CaliforniaLyme thanks for the suggestions, but right now I just want to make sure the facts are accurate, I am not worried about spelling mistakes yet, as they will all be corrected as I go. You wrote:
QUOTE: 2. ELISA (also known as the Lyme Titer): This test measures the level of antibodies in the blood that fight Lyme. This test is very inaccurate and is rarely used in making a definitive Lyme diagnosis.
ME: It is used all the time (unfortunately). It is inaccurate to say it is rarely used.
I meant to say that LLMD's rarely use it in making a definitive Lyme diagnosis, and will alter it.
Also you said: ME: EMLA cream, not ela unless there is something new called ela I don't know about (which is possible!!!)
Emla cream was taken off the market a few years ago. Ela is basically the same thing that is used as it's replacement. I think it was taken off of the market because it was not in the proper type of tube.
Thanks for the comments and suggestions Heather
Posts: 66 | From Dutchess County, NY | Registered: Aug 2002
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