Tuesday, August 12, 2008
To treat or not to treat that is the ?
A 46 year old male looks well, the picture of health. His wife has Lyme disease. His IgeneX WB for Lyme shows a 41 band and an indeterminate 31 band. He feels tired. He feels somewhat forgetful. He forgets names, numbers and generally has difficulty with word retrieval. It has progressive over several years. Perhaps he has other vague cognitive symptoms. He functions well at work as an engineer, but has to "push himself harder" to do well there. He has no pain. He has no neurological symptoms other than than the "subjective" cognitive complaints. A brain MRI is normal. A spect scan has not been performed, but I suspect it will negative as well. Of further interest, he has taken a course of antibiotics for several months in the past and felt he was improving. His symptoms seemed to worsen off treatment. It is clear to me that other doctors would say his symptoms are compatible with aging, depression or something else. I don't even know if most LLDS would treat him. My gut tells me spriochetes are busy multiplying in his brain. I feel compelled to treat. I don't know if its the right thing to do. This is where the "art" of medicine supersedes the "science." Comments welcome.