Do you believe in Lyme Disease?

 

Is this blog public?  I hope not, because I am genuinely afraid of who might read this information and what they might do with it.  Can I make this post only visible to people in our class?

My mother is a family practice physician, an M.D., trained at the U of M med school, formerly employed by the Mayo Clinic and currently in private practice.  She considers herself a scientist, and reads peer-reviewed medical journals daily to keep up-to-date on all of the most current research.  She prescribes antibiotics, blood-pressure medications, and even anti-depressants to her patients at times, making use of all of the principles of contemporary allopathic medicine.  However, she seems to have landed herself, as of late, on the wrong side of a raging medical controversy.

How does Descartes "inhabit" my mother?  First of all, many of the patients who come to see her have been deemed "untreatable" by the medical establishment.  Whether they have chronic fatigue, fibromyalgia, or chronic Lyme disease, these people have been told by other doctors that their symptoms are imaginary, or self-induced.  Because those doctors are unable to fit the patients' symptoms into any previously established medical diagnosis, they mark them as "not actually sick" and send them on their way, despite the patients' claims of being in too much pain to continue normal daily activities.  According to those doctors, these patients' "minds" "only" "think" that "their bodies" "are" "sick."

My mother's approach is different.  When a remarkable number of patients whom she knew personally as "honest, trustworthy people" started coming to her with the same persistent "undiagnosable" symptoms, she refused to dismiss their complaints as unreal or imaginary.  Instead, she started searching online for other doctors who had seen these symptoms, and thus began doing research into Lyme disease and its "coinfections": Bebesia, Erlichia, Bartonella.  A map published by the American Lyme Disease Foundation (http://www.aldf.com/usmap.shtml) shows the area where my mother lives as one where infected ticks (which carry Lyme disease to humans) are "abundant."  Her patients' symptoms matched other doctors' descriptions of chronic Lyme disease.  I have now been diagnosed with and treated for Lyme disease three times.

However, Lyme disease is a highly controversial disease.  According to the Columbia University Medical Center's website, doctors do not yet have a test which can definitively identify the presence or absence of Lyme disease in a patient.  Although Lyme is caused by a bacterium, Borrelia burgdorferi, this spirochete can hide in the brain and bones, and is thus not always detectable in the blood. 

What perhaps makes Lyme most controversial, however, is the fact that doctors who "believe" in chronic Lyme disease often prescribe extended (sometimes months long) courses of intravenous antibiotics as treatment.  At least one doctor, Dr. Joseph Burrascano from Ohio, has been threatened with loss of his medical license for utilizing this method of treatment.  The Infectious Disease Society of America (IDSA) has issued official guidelines stating that any prescription of antibiotics for a period of longer than three weeks is scientifically unfounded and provides reason for investigation of a medical professional.  Insurance companies base their decision of whether or not to compensate patients for treatment on these IDSA guidelines!

This controversy fits nicely into the discussion we've been having in class, in multiple ways.

Do the treatments utilized by my mother, Dr. Burrascano, and the other "believing" doctors work only as placebos, like painting a wart with purple dye and telling a kid it will heal?  Borrelia burgdorferi is a real bacteria (pictured above), which really is transmitted to humans from deer ticks (also pictured above), and really causes recognizable physiological symptoms.  The "believing" doctors believe that they have amassed evidence that long-term antibiotics greatly increase the possibility of recovery from chronic Lyme disease.  However, giving patients long-term antibiotics seems to have been stigmatized by the authorities of the medical establishment as just as "quackish" as we now consider bloodletting to be.  Are the patients crazy?  Are the doctors crazy?  Or is something else going on here?

The role of insurance companies is not to be underestimated here.  Long-term antibiotics are very costly, and require a host of supplementary treatments to maintain patient health throughout the treatment.  Insurance companies have a lot of money and want to keep as much as possible.  It is thus not unthinkable that a financial link exists between insurance company lobbyists and the decision-makers who issue the official treatment guidelines at the Infectious Disease Society of America.  How can we "reason" our way through this situation?