FWIW Lyme is prevalent in all of the US but many urban/suburban MD's don't even put it on the radar unless they are "woods dwellers" themselves.
Cheers,
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Very true! Although named for Lyme, Connecticut, it is all over the US; there are a couple pockets that don't have Lyme, Dallas being one of them, but you don't have to go far to East Texas or north to Oklahoma to find it. Lyme has occurred in every state in the US. The "classic" rash of ECM is great when you see it, but too often is missed or doesn't occur altogether. My hunch is that there is a lot of misdiagnosed "arthritis" and "fibromyalgia" people walking around, and 152 you are correct the blood tests aren't great, esp. for the latent forms of the disease. There isn't even an absolute test for neuroborreliosis - when the Lyme invades the brain and CSF and the findings will even look identical to multiple sclerosis on T2-weighted MRI's and EMG's!
The really sad thing is that the treatment of early Lymes is SO easy - 3 weeks of a relatively cheap mild antibiotic - as in one of the $4 Walmart ones (only contraindications are pregnant women and kids whose adult teeth haven't come through yet - but there are alternatives for them too), when it doubt please get treated. The advanced form of Lyme is very difficult to treat and there isn't even consensus about duration and type of antibiotics for cases as mentioned above with neuroborreliosis.
IMHO - Lyme should be treated based on 1) exposure history and 2) clinical symptoms. Some sources say a single dose of antibiotic the day the tick is found is sufficient, I'd lean toward the 3 weeks course if it was my family member. In complicated cases such as no known/definitive tick exposure, multiple potential diagnoses, then its appropriate to do the labs, and especially if considering the longer or more complicated treatments such as IV antibiotics. High risk areas to me should be a no-brainer with a definitive exposure and especially with ECM.
edit: Rolling Thunder, I see the comment about getting treated only if the blood tests are positive. Doctors can, and should treat based on probability - exposure and symptoms, esp. if ECM present IMHO the labs are a waste of money unless patient does not respond to the oral antibiotics. Do you have any idea how much those tests costs? A lot. Add in the blood draw, multiple doc visits...with money being tight enough that people are hunting to put food on the table I would hope that docs are being "easy" on the requirements and leaning toward empiric therapy, which has I mentioned for primary Lyme is relatively inexpensive. I know doctors need to protect themselves from malpractice/over-prescribing antibiotics but I've got a personal bias on this issue...
I wouldn't hesitate to mention a little more about failure to treat early - facial paralysis (Bell's Palsy), chronic nerve pain = neuropathy, meningitis, confusion, inflammation of the heart leading to irregular heart rhythm and heart failure, disabling arthritis.
Great PSA regardless RT.
