The unfortunate truth about Lyme disease is that not a lot of doctors know exactly how it works. There is a basic understanding across the medical community, but regrettably, in-depth comprehension of this debilitating, enigmatic disorder is extremely rare. Thousands upon thousands of people across the world are diagnosed with Lyme disease every year. Increasing patient numbers coupled with unfit medical knowhow make it a serious cause for concern. The first place people turn to when they feel sick are their local doctors. There are plenty of Lyme specialists out there, like those at the BCA-clinic, who deal with Lyme disease patients on a day-to-day basis. However, Lyme knowledge must be instilled at a local level in order for patients to feel fully secure in the medical treatment they’re receiving. Here’s what all doctors across the world should know about Lyme disease.
The single biggest mistake most doctors are guilty of is not fully realising the difference between acute and chronic Lyme disease. This is not necessarily their fault; chronic Lyme has, and continues to be, the source of much confusion and suspicion in the wider medical community. Even in 2018, the CDC (Centre for Disease Control and Prevention) in the U.S. does not officially list chronic Lyme as a certified condition. This failure to legitimise the disorder has a knock-on effect throughout the medical hierarchy, with many well-meaning doctors dismissing notions of chronic Lyme on the basis that it’s a fictional disorder. This is part of the insidious nature of Lyme disease, and why it’s been able to procure a stranglehold on so many lives. To quote The Usual Suspects: ‘The greatest trick the Devil ever pulled was convincing the world he didn’t exist’.
This is obviously a melodramatic way to talk about a medical condition, but the principle holds, as the disease does have an uncanny survival instinct. It is continually able to avoid the worst of the immune system’s response while masquerading as other diseases and conditions. This is why it’s so crucial for doctors to be fully aware of the spectrum of symptoms that chronic Lyme disease produces; misdiagnoses are alarmingly common. Doctors will often immediately jump to MS or fibromyalgia, without even testing for Lyme. The symptoms these conditions produce are very similar, but the treatment plans and protocols are wildly different. In some cases, a patient can go into a consultation knowing more about Lyme disease than the doctor, just from some cursory searching on the internet. This should never be the case.
Doctors should also understand the difference between the immune system-induced symptoms of Lyme, and the infection-related symptoms. In acute Lyme, this is very easy, as symptoms are almost uniformly infection-based. They present as flu-like symptoms, sometimes accompanied by a distinctive bullseye rash. Antibiotics will usually take care of the infection, if it is caught early enough. However, if the bacteria (Borrelia burgdorferi) are allowed free reign in the body, the infection will evolve into its chronic form. Here, many of the symptoms are a product of an immune system gone haywire, as the body tries to protect itself from the long-term infection. At this stage, traces of the bacterial infection may be minimal, meaning that antibiotics will not alleviate the problem. Many doctors don’t recognise that the symptoms resulting from immune response need to be treated simultaneously, and that every patient will require a different balance.
Co-infections also need to be recognised and addressed. Lyme is not the sole vector-borne disease that poses a threat. Often, co-infections can be transmitted by a tick bite at the same time as Lyme. These can then compound the effects of the Lyme bacteria, or be a dangerous infection in their own right. We are still learning about the debilitating effects of co-infections, and what kind of concerning cocktails they can form when mixed together. However, when testing for Lyme or consulting an obvious case of chronic Lyme, doctors should be aware that co-infections may also be lurking in the body. Not eradicating these at the same time as Lyme can have devastating knock-on effects, including the resurgence of Lyme symptoms, or a set of new, apparently inexplicable, manifestations.
In order to be fully qualified to help all patients who suffer from Lyme disease, doctors need to invest in some serious research. We are still learning about Lyme as a whole, with experts like BCA-clinic paving the way with customised treatment plans and protocols. There is not even a definitive test for Lyme that can be 100% conclusive; depending on the stage of the disease, blood tests can come back negative, even when Lyme is present. If a doctor was already sceptical before, a negative result will likely mean they will never consider Lyme as a diagnosis again. Lyme disease in either form is not an easy enemy to know. However, familiarising ourselves with the intricacies and eccentricities of the disorder will benefit both doctors and patients alike as we move forward in the ongoing battle against Lyme.