Yesterday was bring your child to work day. So my 17 year old sat in on a visit. The patient recapitulated her story. She contracted Lyme 15 years ago, and over the past two years things had really gone down hill. A one-time physically active/fit brilliant CEO became disabled with profound fatigue, cognitive dysfunction and other constitutional symptoms. At this point I had treated her for over one year. I heard things I had never heard before.
Let me first say this is a happy patient. Six months of oral therapy prescribed by me, superimposed on previous, intermittent oral therapy prescribed by others had been largely unhelpful.
Intravenous therapy - now into the forth month has made a magical difference. Cognitively she is almost back to normal, weakness and endurance are improving weekly.
Not wanting to share an exact recipe, because I have found some patients have taken it as gospel, I limit my comments here. I will say very aggressive, somewhat outside the box antibiotic "cocktails" are frequently required. And in difficult cases I have found a combination of three drugs works best.
A common problem is that most Lyme patients look a lot better than they feel. This patient naturally has a sunny disposition and has never suffered with depression.
I really cannot imagine how horrible it feels to have tertiary neuroborrelios. (I also can't imagine what's like to have never felt depressed).
But she told my daughter she had set a date.
If she was not better by a certain date she planned to commit suicide.
I never knew such as a date existed and I glad I didn't.
How many Lyme sufferers have contemplated suicide? I hear the number is great. Recently a patient told me if he couldn't afford the needed care he would just let the disease progress and die.
I don't know what the message here is. That is for the reader to decide. Just comments from the trench.