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January 27, 2021

1. What is Lyme disease?

 Lyme disease is an illness caused by infection with the bacterium Borrelia burgdorferi. This bacterium is carried by ticks. This infection can cause a variety of symptoms and if left untreated can become extremely severe and in rare cases, can even lead to death.

2.What is the best way to remove a tick and what if I did not get the entire tick out? 

The Centers for Disease Control provides this information about removing a tick--- Remove a tick from your skin as soon as you notice it. Use fine-tipped tweezers to firmly grasp the tick very close to your skin. With a steady motion, pull the tick's body away from your skin. Then clean your skin with soap and warm water.  Avoid crushing the tick's body. Do not be alarmed if the tick's mouth-parts remain in the skin. Once the mouthparts are removed from the rest of the tick, it can no longer transmit the Lyme disease bacteria. If you accidentally crush the tick, clean your skin with soap and warm water or alcohol. Don't use petroleum jelly, a hot match, nail polish, or other products to remove a tick. To see a diagram of how to remove a tick go to:

3. I've been bitten by a tick. Do I have Lyme disease? 

Please click HERE to see how to remove the tick.  Not all ticks carry Lyme disease. However, as a precaution to prevent the chances of Lyme disease manifesting, you should go to your doctor as soon as possible. You should ask your doctor to ask for 3-4 weeks of Doxycycline for Adults and children over 8. For children under 8, you should ask for 3-4 weeks of Amoxicillin.  For a percentage of people, you might need a longer duration of antibiotics.  You should also be on the lookout  to see If you develop any single symptom  within a few weeks of a tick bite, see your health care provider right away. 

Common symptoms of Lyme disease include a rash, fever, flu like symptoms, body aches, facial paralysis, and arthritis. Ticks can also transmit other diseases, so it's important to be alert for any symptom that follows a tick bite that may not be listed here.

4.. I have been in a tick infested area, and I am not feelling well, can I have Lyme Disease?

Possible Lyme disease, should be part of the doctors diagnostic check. It should be ruled out based on clinical diagnoses of the symptoms and testing. Please see the following question regarding testing.

5. Is testing for Lyme disease 100 percent accurate?

Unfortunately, there is no test that is 100 percent accurate for Lyme disease. Even though statistically It can take 2-4 weeks for the body to produce antibodies in the blood for Lyme Disease causing a negative result, it is still recommended to take the test right away and re test in 30 days if you had a negative test.

6. I tested negative for Lyme disease and co infections from my standard lab, Is there a more advance testing to be done.

Yes!!! Igenex and Stony brook for Lyme Disease and co-infections.  Galaxy for Bartonella, Their equipment is more sensitive to the antibodies then standard labs.

7. If I have been diagnosed with Lyme disease, do I need to get tested for other tick-borne diseases (co-infections)? 

Ticks can carry many bacteria, viruses, fungi and protozoans ( parasite) all at the same time and can transmit them in a single bite. The most common tick-borne diseases in the United States include Lyme disease, bartonella, mycoplasma, Babesiosis, anaplasmosis, ehrlichiosis, relapsing fever, tularemia, Rocky Mountain spotted fever (RMSF). There is no testing for co infections that are 100 percent accurate but you can test at regular labs. See above question for more advance testing. Some of these infections require different treatment protocol than Lyme disease. 

8. How long does it typically take between the tick bite and Lyme symptoms to appear?

In most cases, it takes from 3 to 30 days after being bitten by a tick to develop the initial symptoms of Lyme disease.  Because the risk of infection transmission also depends on the infection rate in ticks in the area where the bite occurred, not all tick bites place a person at risk of getting Lyme or other tick-borne diseases. Testing ticks to see if they are infected can be done through Lyme specialty labs test. Click Here for list of LABS. Just as everyone who is bitten does not come down with Lyme disease, not everyone who has Lyme disease recalls being bitten by a tick. This is because the tick injects anesthetics so that you don’t feel anything. They also inject antihistamines so that you don’t feel the itch when they bite. They fight your immune system so the area of the bite does not come inflamed.  

9.What percent of cases of proven Lyme disease present without erythema migrans ( Bulls Eye rash)? 

According to the Centers for Disease Control (2008), erythema migrans occurs in around 60-70% of Confirmed cases. Thus, 30-40% of confirmed cases do not present with the characteristic Lyme rash. To be considered a Confirmed cases by CDC in the absence of a rash, a person has to have laboratory evidence of infection. Not all the time will it look like an exact bulls eye rash. ILADS recommends that Lyme disease should be a clinical diagnoses and not relied only on testing bulls eye rash. 

10. What is the relationship between OCD, anxiety and Lyme disease?

OCD and anxiety is a neuropsychiatric illness that is quite common, occurring in 1 in 40 individuals.  The important point regarding infections and OCD relates to the observation that certain infectious illnesses have resulted in a higher than expected incidence of OCD.  We have seen children and young adults develop new onset OCD after getting neurologic Lyme disease. There was improvement after antibiotic treatment in some of these cases, raising the issue of whether Lyme disease causes OCD in some situations. Given that the individuals we've observed this in did not have a family history of OCD, it seems reasonable to suspect that Bb may affect a portion of the brain in some individuals and trigger OCD. 

11. I was wondering if Lyme Disease and or bartonella affects eye sight at all?

Lyme disease can affect eye sight in a number of ways. muscle weakness in the eyes may cause double vision, visual acuity appears to be less, marked sensory hyperacusis such as prominent painful light sensitivity, eye inflammation such as Uveitis or rarely visual trails

12. Why should I take supplements in addition to antibiotics?

Supplements are needed to balance out the necessary nutrients and  vitamins required by the body after the immune system gets attacked.

13. After months of treatment, I took another Western Blot and it was still positive for IgG and IgM,  does that mean the Lyme Disease is still active and further treatment is necessary?

The positive IgM or IgG Western blot indicates that your immune system is generating antibodies against some of the surface proteins that are carried by the organism that causes Lyme Disease. Your immune system however may continue to generate these antibodies long after the infection has left your body. It is not clear at this point how long the "immunologic memory" of prior infection stays active. The problem is that the Western blot does not tell you about the presence of the spirochete itself - all it tells you is indirect information about the immune system's response to the spirochete (either present or past).  Unfortunately, we do not have definitive fully reliable and sensitive laboratory markers of when the infection is no longer present and when treatment should be stopped. 

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