Lyme Disease Research Database Independent reporting on all aspects of Lyme Disease

IDSA treatment guidelines

Listen to Tina Garcia's experience at the IDSA hearing

Patient advocate Tina Garcia is passionate about justice and fairness.

Disabled by Lyme in 2004, she soon discovered the injustices in Lyme treatment. Particularly, she was outraged to learn that patients in her position were frequently turned down for medical insurance coverage for the treatment of Lyme disease. Her own insurance requests for coverage were rejected as well, and like so many Lyme patients she had to pay for treatment out of pocket.

When Connecticut Attorney General Richard Blumenthal began the investigation into the IDSA standard of Lyme treatment, Tina submitted her rejected insurance claims to his office. However, her concern wasn't simply about her own welfare. Desire to help others inspired her to found the organization, LEAP Arizona, a Lyme Education Awareness Program. She began a dialog with the Assistant AG, which lead to her invitation to testify on July 30 at the historical IDSA hearing in Washington, DC.

Tina, who is still healing from Lyme, traveled to DC where she delivered her eloquent testimony to the hearing panel. On her website, you will find a link to listen to the IDSA hearing, and a copy of her testimony.

Tina spoke with me on Thursday, August 20, about her experience at the hearing. She describes the day's emotional highlights, in particular the presentations of Drs Ken Liegner and Steven Phillips. She also talks about her faith in the IDSA panel, who, in a matter of months, will be deciding whether or not to recommend changing the standard Lyme protocol.

I invite you to listen to our conversation by joining.

Comments

Watch the IDSA hearing live online

If you have ever had trouble getting treated for Lyme disease, or you are interested in long-term antibiotic treatment of Lyme, you probably already know about this Thursday's hearing. If you don't, then you may want to tune in.

The long-awaited IDSA hearing on Lyme treatment is finally happening, Thursday, July 30, '09. You can follow the entire broadcast live online.

Panel member Raphael Stricker, MD, an ILADS physician, is one of the doctors included in our experts interview series. Several of the healthy Lyme survivors included in our Success Stories series have included his patients. Tune in to listen to what Dr Stricker has to say.

We plan to interview many more members of the panel soon, starting with Tina Garcia, a dedicated Lyme patient advocate.

Click the link below for important information about the IDSA hearing:
http://www.idsociety.org/WorkArea/showcontent.aspx?id=14974
Comments

IDSA announces presenters for hearing

IDSA Announces presenters for its July 30, 2009 Hearing of the Lyme Disease Review Panel
Posted June 22, 2009 on the IDSA website

On July 30, 2009 (8:00 AM – 5:00 PM EASTERN), IDSA will hold an all-day hearing of its Lyme Disease Review Panel to hear testimony from patients, physicians and scientists on its 2006 Lyme Disease Guidelines. Individuals presenting and the order in which they will present follows:


* Tina Garcia, Lyme Education Awareness Program Arizona (L.E.A.P. Arizona, Inc.), Mesa, Arizona
* Lorraine Johnson, California Lyme Disease Association (CALDA), Ukiah, California
* Daniel Cameron, MD, International Lyme and Assoiciated Diseases Society (ILADS), California
* Phillip Baker, PhD, American Lyme Disease Foundation (ALDF), Bethesda, MD
* Ben Luft, MD, The State University of New York, Stony Brook, NY
* Allison Delong, ILADS, Providence, RI
* Barbara Johnson, PhD, Centers for Disease Control and Prevention, Fort Collins, CO
* David Volkman, MD, Nissequogue, NY
* Sam Donta, MD, Falmouth, MA
* Eugene Shapiro, MD, IDSA & Yale University School of Medicine, New Haven CT
* Brian Fallon, MD, Columbia University Medical Center, New York, NY
* Sunil Sood, MD, Schneider Children's Hospital at North Shore, Manhasset, NY
* Ken Liegner, MD, ILADS, Armonk, NY
* Allen Steere, MD, Massachusetts General Hospital & Harvard Medical School, Boston, MA
* Steven Phillips, MD, ILADS, Wilton, CT
* Art Weinstein, MD, Washington Hospital Center, Washington, DC
* Raphael Stricker, MD, ILADS, San Francisco, CA
* Gary Wormser, MD, IDSA & New York Medical College, Valhalla, NY

In-person attendance at the hearing is by invitation only. However, the Hearing will be broadcast live, in real-time via webcast from the IDSA Website (www.idsociety.org/lymedisease.htm) and will be archived on the web for viewing at your convenience. Information on how to attend via webcast will be posted on the IDSA website no later than one week prior to the hearing.
Comments

Diagnosing Lyme: Lies & half-truths

It irks me to see inaccurate info about Lyme on health-oriented blogs. For example, I just read the sentence: "Lyme is completely treatable. No need to panic," and now I'm really bugged. No, I don't want everybody to panic. However, it's just such unfounded casualness about Lyme that creates the illusion that one needn't seek a Lyme aware doctor's advice right away, at the first suspicion of Lyme symptoms or the presence of a tick bite. There is absolutely no evidence that the person making the claim has any awareness of just how dangerous, and multi-stage, Lyme can be when left untreated.

The same blogger also cavalierly states that "a characteristic bull's eye rash will show up within 3 to 30 days." GRrrrrr! Not true. Up to 50% of people with a Lyme infection will never show signs of the circular, red skin rash. Diagnosing Lyme is a tricky thing, part art, part science. Even ILADS doctors differ in their approach to diagnosing Lyme. I skim the blogs like a watch-dog, looking for useful information. I'm vigilant. I can sniff out a lie about Lyme faster than you can say "neuroborelliosis."

How is the blog-skimming public supposed to become informed, with half-truths and lies circulating so freely? The mis-truths and misinformation all stems back to the opinion of the CDC -- in the form of the IDSA -- that Lyme is not a serious disease. I am really looking forward to following up on the results of the antitrust investigation into the IDSA's guidelines for the treatment of Lyme. Stay tuned. I'll be posting whatever I sniff out right here.
Comments

20,000 cases? Sorry, you're wrong

Dear ABC Good Morning America,

Thank you for running the story on Lyme disease. However, I would like to challenge your reporters on one point. The number of new cases of Lyme per year is said by Lyme specialists to be ten to forty times higher than the 20,000 quoted by the CDC, and the number used in your report. Gross misdiagnosis and under-diagnosis is due in part to the notoriously inaccurate tests for Lyme that are currently in use by most infectious disease doctors in the US. These tests are the Western Blot and the ELISA.

The Lyme compound consists of the spirochetal Borrelia bacteria, plus any number of mycoplasma parasites and other pathogens. This compound is a particularly stealth bacteria that is able to evade the body's immune system, therefore protecting itself from the attack of antibiotics by drawing up a shield around itself, and hiding in various cyst forms throughout the patient's body and brain. The common tests for Lyme do not account for the sophisticated nature of this bacteria, according to researchers at the University of New Haven, Dr. Alan MacDonald and Dr. Eva Sapi.

Another reason for the misdiagnosis is the fact that no two Lyme patients present symptoms in the same way. In addition, it is not known how long the bacteria may lie dormant.

The irksome fact that the process of writing the IDSA treatment guidelines have been found to be in violation of the law has created quite a stir with patients of this devastating disease. The most profound problem is the existence of two standards of care for Lyme, which directly affects patients' health insurance and coverage of long-term antibiotics. ILADs physicians have told me that there are thousands of scientific models proving that Lyme can go chronic if undertreated or left untreated. The IDSA has ignored that scientific evidence. This is the heart of the Lyme debate.
Comments

protest the IDSA guidelines

Read this comprehensive article published in Danbury CT that cuts to the heart of the matter:

Nov 28 2006 6:39 AM
Lyme disease activists to protest
By Robert Miller

THE NEWS-TIMES

Area Lyme disease activists, dismayed by recently released treatment guidelines for the illness, will go public with their protest Thursday, rallying at Westchester Medical Center/New York Medical College in Valhalla, N.Y., where the lead author of the guidelines works.

"They're highly restrictive,'' said Dr. Steven Phillips, a Ridgefield physician who is the former president of the International Lyme and Associated Diseases Society. "I just cannot understand why they've chosen to ignore all the data on this.''

"They were worse than we expected,'' said Maggie Shaw of the Newtown Lyme Disease Task Force.

"In a word, I think they're a disgrace,'' said Dr. Raphael Stricker of San Francisco, who is the current president of ILADS. "They're not relying on best science. They're relying on their opinion.''

The guidelines are so controversial that Attorney General Richard Blumenthal has intervened. His office is now investigating whether the group that wrote the guidelines, the Infectious Diseases Society of America, is a monopolistic organization trying to shape treatment of the tick-borne disease without allowing other treatment options to emerge.

"It's a medical issue but also a patient issue,'' Blumenthal said. "Their guidelines limit very severely the types of diagnosis and treatment available to patients. In a way, that's anti-competitive.''

The national guidelines issued by the Infectious Diseases Society of America recommend that doctors give patients with Lyme disease 10 to 28 days of oral antibiotics to treat the disease, with another month allowed for persistent symptoms.

But the guidelines -- now posted on the Web site of the Centers for Disease Control and Prevention -- deny the existence of chronic Lyme disease, saying there's no medical evidence that the bacteria that causes Lyme survives antibiotic treatment.

It also emphasizes using either the characteristic bull's-eye rash or blood tests to help correctly diagnose the disease -- two methods Lyme activists say can lead to Lyme cases being missed.

Diana Olson, spokeswoman for the infectious diseases society, said the 14 doctors who worked on the guidelines -- led by Dr. Gary Wormser, an infectious disease specialist at Westchester Medical Center/New York Medical College -- studied more than 400 published medical reports on Lyme disease before coming to their conclusions.

"This is the best science has to offer,'' she said.

Olson said the society could not take into account things like patients' anecdotal accounts of their Lyme disease treatment in writing the guidelines. Nor, she said, did it concern itself with whether insurance companies would pay for treatment outside those guidelines.

She also said that guidelines are just that, and that patients and doctors are free to find different treatments that work best for them.

She also said the society is cooperating fully with Blumenthal's office.

"In our experience, we've never heard of this kind of investigation,'' she said. "But we stand behind our methods and our recommendations.''

But Lyme activists and doctors who support a more liberal approach to treating the disease said the new guidelines are highly restrictive, not allowing doctors any latitude in treatment.

Perhaps the most contentious point is whether chronic Lyme disease even exists.

Many Lyme patients and their doctors contend the standard treatment for Lyme disease sometimes fails, or never gets administered to begin with.

When that happens, they say, the bacterial spirochete that causes the disease can re-emerge in the body, causing a bewildering array of symptoms -- including arthritis, chronic fatigue, heart problems, memory loss, depression, and neurological disorders including loss of sight and hearing.

To treat these symptoms -- and those of several other tick-borne illnesses, which can overlap -- these doctors recommend several months or even years of antibiotics, often using a mix of drugs.

The infectious disease society, however, said that these symptoms are "nonspecific'' and associated with many other illnesses, not Lyme infection. They also caution that there are medical problems -- including the development of drug resistance -- that should lead patients to avoid long-term antibiotic care whenever possible.

But Phillips of Ridgefield and Stricker of San Francisco said this approach ignores the hundreds of studies that now show the Lyme bacteria can bury itself in muscle tissue, lie dormant, then re-emerge.

"There (have) been 18,000 papers published on Lyme disease,'' Stricker said. "So saying you're looking at 400 means you've only looked at 5 percent of the research."

"The evidence just continues to grow and grow on this,'' Phillips said. "To ignore a whole section of this research, as if it doesn't exist, raises questions for me.''

Because of the prestige the infectious disease society carries, Lyme activists say insurance companies will now be even more adamant about refusing coverage beyond 28 days of antibiotics -- something, they say, that has already begun.

They also say the new guidelines will stifle new treatments, because doctors will fear they'll be disciplined if they step beyond the guidelines.

"This isn't theoretical,'' Blumenthal said. "It will come down to a matter of dollars and cents.''

Contact Robert Miller
at bmillernewstimes.com
or (203) 731-3345.
Comments