Sometimes you only get a 31 band, like a patient I saw today. She has an IND 41 band with a +31 band. This is on the IgM side. Her IgG showed +++41, IND 31,34,39. IgeneX calls it negative. Her previous Labcorp WB showed no reactive bands. After antibiotics she had a typical Herx and was getting better. She still wanted more proof that she has LD. I spent 40 minutes explaining the nuances. She didn't get it. It is difficult to treat patients when the concepts seem so foreign. (This is not to disparage the patient since I would get the same response from mainstream doctors in the community). I could not get through even though I drew diagrams and did my best to simplify the issues. She, like many patients told me that she would no longer read things on the Internet. She would not see "Under Our Skin." She would not read this blog or books on Lyme disease. She is already incredibly anxious and the thought of doing more research throws her into panic mode.
So I ordered the $100.00 31 band confirmation test through IgeneX. This test uses an additional antigen which confirms exposure to Bb with 98% specificity. I still couldn't explain that a positive result would only confirm exposure to Bb. It does not mean you have Lyme disease. I am starting to understand why LLMDs charge $1000.00 per visit. It screens out patients who cannot grasp the concepts. By the time patients are willing to cough up that kind of money they know more about tick borne illness than their physicians.
It is frustrating when second opinions from ID specialists present only the IDSA point of view. There is no acknowledgment that another perspective exists at all.
I hope that other physicians in the community can become versed in the issues.
This will be a long and difficult process.