Friday, June 13, 2008
Who are the Lyme specialists?
There is no such thing as a Lyme specialists. There are infectious disease specialists. These physicians believe they are the ultimate authority regarding all infections, including Lyme disease. Nearly 100% f ollow a strict IDSA interpretation. They don't believe in chronic Lyme disease. If you make an appointment at Johns Hopkins, Harvard or the Mayo Clinic to see a "Lyme" specialist, you will see a doctor who doesn't believe in chronic Lyme disease. You will see a doctor who doesn't order Lyme Western blots, Lyme C6 peptide antibody index scores, complement levels, vitamin D levels, CD57 counts or co-infection panels. Physicians who have established themselves as "Lyme literate MDs" are a diverse group of practitioners scattered about the country. They all operate out of paradigms which vary with one another. They generally believe in chronic Lyme, but in other ways disagree. Some use IV antibiotics, others will not. Some use herbs and alternative medicines, others do not. Some focus on co-infections. Some believe that Bartonella is the key to chronic Lyme morbidity, while others emphasize Babesiosis. Others look for a host of other infections including Epstein Barr virus, Herpes virus 6, parasites and others. Some are focused on Chlamydia and Mycoplasma yet others think its all about Lyme, stupid. One thing can be said for IDSA doctors. They all agree; even though they are all wrong! So I am sorry to report; there are no true Lyme specialists. There are doctors out there in the community doing the best they can to treat this vexing disease or disease complex. Patients vary tremendously in their responses to different approaches. For now medicine will remain an art more than a science. Eventually, as there is a consensus and a broader understanding of Lyme a specialty of Lyme medicine will be developed. At this moment this dream is far off.