Monday, June 9, 2008

What does the Montgomery County Health Department say about Lyme disease?

I saw a patient today that had two deer tick bites. She went to the emergency room to have one tick removed. She had a rash at the site of the bite and then developed a red 8cm bulls eye type rash in an adjacent area. When she was treated at the emergency room she was given a single dose of Doxycyline for 200mgs. She developed a host of symptoms. She had fatigue, fever, chills, muscle and joint aches. She had painful swollen glands.She had a severe headache and stiff neck. She went to her primary physician. He didn't know what was wrong with her. He ordered a test for Lyme disease which was negative (after three weeks of persistent symptoms) and told her she did not have Lyme disease.

Doctors are programmed that Lyme is not real by IDSA propaganda topical New England Journal editorials. This has caused an unfortunate backlash.

The following information does not come from ILADS. It comes from the County Health Department. Most Lyme infections are caused by nymph forms of the tick, the size of a pin head. Early symptoms include skin rash which may be multiple. Fatigue. Chills and fever. Headache. Muscle and Joint pain. Swollen lymph nodes. The County website/bulletin goes on to say that some people never develop a skin rash and that the symptoms vary. It also states: "Some signs ans symptoms of Lyme disease may not appear until weeks or years after a tick bite. It list symptoms in late Lyme as including numbness, arthritis, memory problems, fatigue which persist after treatment. It states that: "If Lyme is detected and treated early, symptoms are usually mild and easily treated." It skirts around the issue of chronic or Post-Lyme symptoms, but does not take a stance on the issue (chronic Lyme vs Post-Lyme).

This patient had classic sign and symptom of acute Lyme disease, but it was missed. Perhaps headlines in the Washington Post which state that chronic Lyme doesn't exist per the New England Journal get truncated to, "Lyme disease doesn't exist" in the minds of clinicians.

The CDC has made it clear that Lyme is not to be diagnosed based on their laboratory test which was set up for surveillance purposes only. And even the IDSA admits that the antibody tests for Lyme will not turn positive for 4 to 6 weeks after infection. In this patient the negative blood test was completely meaningless.

Forget about the Lyme controversies. Physicians should be adequately informed so that acute Lyme can be diagnosed and treated properly. Early treatment will prevent most patients from subsequently developing chronic Lyme disease.

1 comment:

lymebytes said...

Its good the Montgomery County posted something on their web site but it seems that some of the most important people within the County system continue to stay ignorant. I contracted Lymes while at work and won a Workman Compensation Case. You know. Your my doctor and have been struggling to understand why all my treatment is denied and the County continues to send me to IME after IME. I finally found out why.

Here is an unbelievable document written to me by the person who oversees the entire Workman Compensation program for the County. I just got it even though it was written a month ago. It is absolutely stunning in its ignorance and we taxpayers are paying this guy a 6 figure salary. Here it is:

Dear Ms. Hamilton,
I received your voice mail in The County Executive has asked me to respond to your comments about your workers' compensation claim. Since you indicated in the message you left me that you have referred the matter to your attorney, I decided to send you this correspondence rather than call you directly.
With respect to the Workers' Compensation Commission Order mentioned in your emails, the finding is that you contracted Lyme Disease at work. Further, the Order “reserved as to temporary total disability,” which means that you are not eligible for Disability Leave until medical documentation has been received from your treating provider indicating you are disabled from work and providing a history, diagnosis, treatment plan and prognosis. Satisfactory medical information has not been provided. The Order grants that you have contracted an occupational disease but there has been no medical information received that diagnoses you with this condition. You have been paid for your disability up to the current time notwithstanding the fact that medical information has not been provided that relates your lost time from work to Lyme Disease. In fact, none of the tests that have been reported to the claims service confirms that you actually have the condition.
The provision of timely medical documentation is required before benefits can be paid. Further, the medical condition for which you are treating must be causally connected to the finding of the Workers' Compensation Commission.
Consequently, there will be changes to the benefits you have been receiving. Beginning immediately, Disability Leave will be suspended pending the receipt of medical information as mentioned above (that you are disabled from work as a result of the condition identified in the Workers' Compensation Commission Order).

The guy, Terry Fleming, blatently questions the judges decision after denying my case and dragging me through a trial. He is clearly bias against me. He obviously does not believe I have Lymes disease but it seems he has not checked his facts.

So what the County has on its web site and what they believe internally are two very different things. The web site is a political thing. The letter I received indicates their real belief.