Sick for a long time this patient had already been to many doctors. Previous treatments included 9 months of Rocephin. She first saw me two months ago. Prominent symptoms included: cognitive dysfunction,depression, weakness, seizures, "TIA", headaches, tingling, joint pain, palpitations, neuropathic pains and gastrointestinal issues. The depression was profound, associated with suicidal ideation at times.
She had a history of sporadic abnormal liver test with marked abdominal pain. Belly symptoms including bloating, nausea, anorexia and difficulty eating which was chronic.
She had dysautonomia and POTS.
There is much more to the story.Of course.
Lyme has been confirmed by IgeneX and Stony Brook. A recent Western Blot showed IgM bands: 41,18,20,30,31,37,38,58,60, The test showed 5 IgG bands.
Physical examination showed tenderness over the gallbladder.
The abdominal sonogram was negative for gall stones (it always is).
The HIDA scan was entirely normal. Here's the catch. The injection of CCK which makes the gallbladder contract reproduced her severe pain.
A surgeon friend has found this sign may be associated with gallbladder disease even with normal studies.
Her gallbladder was removed.
Then - something remarkable happened: she felt great, even off antibiotics.
Weakness,cognitive dysfunction,neuropathic pains were all better. Orthostatic tachycardia had improved significantly.
No longer using a cane, she was playing the piano - first time in over a year.
She sent a piece of gallbladder to Clongen for PCR testing for "everything."
The result was surprising: Mycoplasma species. I have no idea what to make of this unexpected finding.
Mycoplasma is an intracellular bacteria. You can never get rid of it.