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IDSA

Lyme Book Excerpt - The Ghost Caller

You may know that Prednisone is contraindicated when you have Lyme. Ever wondered what would happen if you took it anyway? Before my test results had come back from IGeneX, I was prescribed steroids to stop a spreading rash.

When I finally found a doctor educated about Lyme, he expressed deep concern when I told him about the steroids, which had been prescribed by an IDSA doctor. They had replicated the Lyme bacteria, driven it into my organs and across the barrier into my brain.

The day I started on Prednisone, I began to experience auditory hallucinations--the kind you hear, not the kind you see. I also had kinesthetic hallucinations: I would wake up from a nap convinced I had a raging fever. But the thermometer always read 98.6.

The steroids took a big toll, emotionally as well as physically. The irony was, they didn't even stop the rash completely. So in my fog, I reasoned that I had to keep taking them—follow the doctor's orders. By the time I mustered the guts to disobey the doctor and stop taking it, the damage was done. I couldn't walk, talk, or think.

The following is an excerpt from my ebook, available soon:

So, I took the Prednisone. And life as I knew it started to disintegrate. As the undetected Lyme bacteria began destroying my immune system, it collided with the corticosteroids. I began to learn what it meant to fall apart.

I was in the kitchen when the phone rang. I answered. Wrong number. It rang again; I picked it up. Again, a little girl on the other end asked for someone whose name I did not know. 

Again, I told her she had the wrong number.

But the phone kept ringing. 

Each time, I picked it up and said hello. As soon as I set it down, it would ring again. To the same exact little girl I said, “sorry, wrong number.”

By the third time, I was angry and my voice was rising in pitch. “Please stop calling me,” I said. “Wrong number! Which word do you not understand?”

By then I was fuming, staring at the phone like a snake at a mouse. This was ludicrous. No normal person would keep on calling over and over, thinking she was going to get it right eventually. Isn’t that the definition of insanity? Doing the same thing repeatedly, expecting different results?

When the phone rang again, I flew into a rage. 

From another part of the house, Evan heard me yelling into the phone. He appeared in the doorway. My heart was beating fast. I wanted to hit something. I slammed the phone down hard.

“What's going on out here?” he asked.

I shot him a look to kill. “Some stupid moron will not stop calling! She’s got the wrong number.” 

He looked at me. “I didn’t hear the phone ring. Not once.”

“You were in the shower!”

“I was in the bath. I would have heard the phone,” he said. 

I am outraged at his bullheadedness. “Well, if it hasn’t been ringing, what are you saying? I’m crazy?” 

My head wobbled on my neck and I collapsed into a chair, choking back tears. I had tremors and a stammer.

Evan headed for the door. “Why don’t you call your mom,” he said, before pulling it shut behind him.


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Proposed Lyme legislation ignored by IDSA

In July, a Congressional subcommittee met to discuss a Lyme disease bill that is championed by a number of politicians in the Northeast US. The bill urges congress to approve a national strategy and money for research into prevention, diagnosis, and treatment of Lyme disease. A federal strategy would heighten awareness in all public health agencies.

The hope is that when people who are sick and infected with Lyme go to their local clinic, they may actually be able to receive medical help from doctors who understand the critical importance of early treatment. As it stands, clinics across the US are staffed by medical professionals who remain largely ignorant of it.
Lyme misdiagnoses are rampant and dangerous.

The powerful doctors’ group, the Infectious Diseases Society of America, was absent during the meeting and has remained silent about the bill. You may remember that in 2009 the IDSA opposed a similar bill, claiming that it lacked support from the scientific community.

Senator Richard Blumenthal, who, cosponsored the bill, states that Lyme disease has increased to epidemic proportions. It is the sixth most common reportable disease in the US. In the Northeast, it is second only to
chlamydia. These stats are according to Dr. Ben Beard, director of vector-borne diseases at the federal Centers for Disease Control and Prevention.

From the article “
Lawmakers call for national Lyme disease strategy,” in the Wall Street Journal, July 12, 2012: "'The tick problem is growing. The Lyme disease problem is growing," said Sen. Jack Reed, D-R.I., a cosponsor of the bill in the U.S. Senate. "This requires resources."

The legislation provides for the establishment of an advisory committee made up of researchers, patient advocates and agencies, as well as the coordination of support for developing better diagnostic
tests, surveillance, research and other efforts.'”

Will this be the year that legislators do the right thing and go on the attack against Lyme disease? I continue to hope that influential IDSA doctors – who see their own patients ravaged by the disease – will soon take a stand for more awareness of this increasing epidemic.

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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.

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Clashing views at the IDSA hearing

Thursday's day-long IDSA hearing in Washington DC offered a fascinating glimpse into the opposing perspectives on Lyme disease treatment. Scattered into the testimony were flashes of tension and emotion. If you crave power point presentations, it was right up your alley. It was also an exercise in stamina for the participants. The entire hearing will be archived online for one year at idsociety.org.

As the hearing proceeded, I was most interested in the tension developing between the presenters' testimonies. For example, Eugene Shapiro, MD, a Lyme disease specialist at Yale University, stated that he thinks it is very important to engage in additional research about how to help persons suffering from medically unexplained symptoms. He also stated that in his view, there is "no scientific justification for changing current IDSA recommendations related to duration of antibiotic treatment of Lyme disease."

Then came Brian Fallon, MD, of Columbia Medical School. Notably, Dr Fallon began his presentation by stating that he is not a member of either IDSA or ILADS. He's a psychiatrist belonging to the American Psychiatric Association. In direct opposition to Dr Shapiro's statement, Dr Fallon referred to a blind study in which repeated antibiotic treatment has been found to be effective, yet is not recommended due to the risks. He also made it clear that repeated antibotics have been shown to be effective for the fatigue associated with Lyme disease. However, not for pain or any of the other symptoms related to Lyme.

Dr Fallon suggested that doctors could approach this risk factor by talking to patients about the risks. Discussing the risks of medications is something, he says, doctors do every day. He also mentioned that the testing has only been done on two specific antibiotics, and added that it might be a mistake to make recommendations based on those tests about antibiotics in general.

The most emotional moment of the hearing (that I saw) occurred when Dr Ken Liegner, ILADS member, showed a video clip of his patient Vicki Logan from June 22, 2001. Vicki had sought all kinds of treatment, according to Dr Liegner, in trying to deal with what he reminded the panel is still to be considered a "formidable pathogen." As the result of a misdiagnoses, she had been given coricosteroids early in her treatment. After all her treatment, spirochetes were found in her pericardium (the thin membrane that surrounds the heart).

The video was evidently recorded as Vicki lay dying in a hospital bed. She is so weak with advanced Lyme disease that you can barely make out the words as she says, "I hope that what happened to me will benefit others who wind up in the same situation." She also had words of praise for Dr Liegner, telling him on-camera that without his help she wouldn't even have lived as long as she did. It was a tearful moment for me.

I'm curious about your opinion. Does your doctor (or doctors) talk to you about the risks involved in the treatment options for Lyme disease?
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IDSA hearing - message from Tina Garcia of L.E.A.P.

On the eve of the hearing in DC, patient advocate and panel member Tina Garcia sends us this message. I will be interviewing Tina very soon, so watch this blog - it will be posted for free to anyone who wants to hear directly from her what the hearing was like. Please feel free to forward the following note to any other Lyme groups who might be interested:

I just wanted to send out a huge thank you to all on Eurolyme and other groups who have shown me so much support! I am here in DC anxious to attend the Hearing!

I thought I'd write to let everyone know that the lime green ribbon campaign is being done in conjunction with media coverage of the Hearing and it is not a demonstration of any sort.

It is a way to get more media attention at the Marriott across from the Ronald Reagan Building, where the Hearing will be held. I am here and watching it all unfold and I assure you that it is an awareness campaign and not a demonstration. It is defintely not a campaign that will negatively effect the Hearing or offend the Review Panel in any way.

This is a very critical moment for the Lyme community, patients and docs. I would ask everyone to please focus strongly on the bond that we all share in this community and muster all the strength and courage we can to unite as a community. We must rise above the disagreements and conflicts that occur between advocacy groups and form a cohesive community of patients and doctors.

We must not allow our actions to be dictated by reactions to efforts that might make us stray from the path we are on. Let's unite and work together, for there is strength in numbers. United we stand -- divided we fall. We can stll hold on to the uniqueness of each of our advocacy groups, but at this crucial hour, we must be willing to work together and appreciate each other's uniqueness and admire each other's strengths and efforts to make a difference for all.

PLEASE FORWARD THIS TO ALL GROUPS AND LISTS AND DISCUSSIONS ASAP.
I AM PRESSED FOR TIME, SO IF YOU CAN ALL FORWARD THIS MESSAGE FAR AND WIDE, I WOULD TRULY APPRECIATE IT! THANK YOU!

In Solidarity,

Tina J. Garcia
Lyme Education Awareness Program
L.E.A.P. Arizona
www.leaparizona. com
P.O. Box 2654
Mesa, Arizona USA
480-219-6869 Phone
480-830-2788 Fax
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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
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Speak up for Lyme survey

Patient survey

Patient advocate Lorraine Johnson, JD, MBA, of the California Lyme Disease Association (CALDA) will be testifying before the IDSA review panel on July 30. This survey, which takes about 5 minutes to complete, will be used to support her speech. Your identity will remain anonymous.

Lorraine writes:
You can get more information on what is happening with the hearing by visiting the CALDA website at www.lymedisease.org and visiting my blog there by clicking news and blogs and then Lyme Policy Wonk. You can also visit my blog by going to www.lymepolicywonk.org.

Please support the good work that CALDA does by becoming a member and helping us advocate for Lyme patient rights.


If you wish, you can watch the July 30 hearing live on the internet at the IDSA website (idsociety.org).
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IDSA submits letter to Waxman

Things are heating up in Washington DC as the July 30 hearing approaches.

Below is an excerpt from a letter written on June 25, 2009 and sent by the IDSA to US Representative Henry Waxman, Chairman of the House Energy & Commerce Committee. In it, the IDSA makes clear that it opposes the bill regarding Lyme disease treatment (H.R. 1179), which was recently reintroduced in the House of Representatives.

Here is a partial excerpt:
We believe it is important that Members of Congress who are considering co-sponsorship of H.R. 1179 be fully apprised of IDSA’s view, which is aligned with the broader medical and scientific communities’ view, that the long-term use of antibiotics for the treatment of Lyme disease is unproven and potentially harmful to the patients being treated and to the public’s health (due to the potential creation of drug-resistant organisms).

Further, it is IDSA’s position that no reliable evidence exists that supports the designation of Lyme disease as a chronic disease. Two recent reviews -- one published in the New England Journal of Medicine (N Engl J Med 357:14; October 4, 2007) and the other in the American Journal of Medicine (2008) 121, 562-564 -- give evidence-based assessments of Lyme disease diagnoses and the recommended treatments which substantiate our position.
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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.
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Lyme review panel members stir concern

At last, the IDSA (Infectious Diseases Society of America) has selected members to review the guidelines for the treatment of Lyme disease. Lyme awareness groups are alarmed at the placement of Carol J. Baker, MD, as the committee chairperson. Notably, there are also no ILADS (International Lyme and Associated Diseases Society) members on the review panel.

Lynn Shepler, MDJD, shares her concerns:

CAROL J. BAKER, MD, head of the new committee formed as a result of AG Richard Blumenthal's investigation, is Past-President of IDSA, and lists her chief interests as "VACCINOLOGY," "CLINICAL TRIALS," AND "VACCINE POLICY." She has published "more than 100 articles on vaccine research."

Dr. Baker is also a member of the Advisory Committee for Immunization Practices of the Centers for Disease Control and Prevention.

Was Dr. Baker a member of the Advisory Committee for Immunization Practices of the CDC at any point when past or future Lyme disease vaccines have been discussed --- formally, or informally?

The team she is part of at "The Center of Vaccine Awareness and Research" in Houston, Texas describes itself as "dedicated to improving the health of children from infancy through adulthood by promoting vaccinations and educating families and health care providers on all available vaccines."

Uh, does this include the Lyme vaccine(s)? Dr. Wormser's principal conflict of interest was that he was consulting to pharmaceutical companies on Lyme disease vaccines --- something he knew about and refused to disclose to IDSA administrators.

Dr. Wormser was head of each of the two IDSA guidelines on Lyme disease that have been issued. In my personal opinion, both versions of the IDSA guidelines have been biased in favor of vaccine commercialization.

By my reasoning, the need to deny the existence of persistent infection is part of the drive to commercialize Lyme disease vaccines that are not otherwise ready for market. Persistent infection is an important scientific problem that needs to be solved before any vaccine trials can be done. Instead, Wormser et al simply lie, and maintain the patients are sick with "something else."

So, instead of Dr. Wormser, we have a prominent vaccinologist, and former President of IDSA as the head of the committee? On the face of it, I find this very alarming!

(Please post this information to any Lyme disease discussion board to educate patients about the possible biases on the part of members of this new committee).

Following is a list of Lyme review panel members:

Carol J. Baker, MD,
Chair Baylor College of Medicine
Houston, TX

William A. Charini, MD
Peabody, MA

Paul H. Duray, MD (retired)
Westwood, MA

Paul M. Lantos, MD
Duke University Medical Center
Durham, NC

Gerald Medoff, MD
Washington University School of Medicine
St. Louis, MO

Manuel H. Moro, DVM, MPH, PhD
National Institutes of Health
Bethesda, MD

David M. Mushatt, MD, MPH & TM
Tulane University School of Medicine
New Orleans, LA

Jeffrey Parsonnet, MD
Dartmouth‐Hitchcock Medical Center
Lebanon, NH

Cmdr. John W. Sanders, MD
U.S. Naval Medical Research Center Detachment, Peru
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Chronic Lyme Disease

Chronic Lyme disease is controversial. It is what appears to affect those of us who still suffer from Lyme symptoms after finishing a standard IDSA recommended dosage of antibiotics. In some cases, chronic Lyme manifests in Lyme patients who received antibiotics for treatment, but weren't given a strong enough dose for a long enough time.

Some Lyme symptoms seem almost livable. Tinnitus, for example. Talking from personal experience only, I can live with it. This is not to say that I like it. On the contrary. I'm a classically trained musician, peculiarly sensitive to noise. You know those people who wince at the out-of-tune piano at the community concert? That would be me. I'm not exactly proud of that, just sayin'. So, losing my hearing partially to tinnitus has really sliced into my enjoyment of natural sounds. The tinnitus might go away some day. For now, it sure seems chronic. There are metallic crickets playing at varying volumes inside my head, 24/7.

Other chronic Lyme symptoms are far more serious. For example, medical evidence suggests that rheumatoid arthritis is one result of untreated, or undertreated Lyme disease. As many as 60% of people with untreated Lyme may develop chronic arthritis.

Central nervous problems, such as facial paralysis and meningitis are said to occur in 10 to 20% of people who are undertreated or never treated for Lyme.

Heart symptoms occur in a small percentage of Lyme patients. A jumpy, pounding irregular heart can vary the gamut from being not at all bothersome, to very scary. The jumpiness can occur either because of an infection in the heart, or an electrical conduction that requires the patient have a pacemaker implanted.

Chronic Lyme is controversial because doctors don't all agree that these long-term symptoms of Lyme are indeed still considered Lyme. Whatever you call them, they need to be tended to.

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How to find a Lyme doctor

Currently, there are two standards of treatment for Lyme disease. If you have Lyme symptoms, or suspect you may have Lyme, please contact a Lyme literate medical doctor, or LLMD. Go to the Lyme Disease Association doctor referrals page.

You'll need to register using your email address, and follow the simple directions to find a doctor near you. It doesn't take long and it's easy to do. If you need a Lyme specialist, we urge you to find one soon.

Infectious disease doctors (IDSA) may not have knowledge of Lyme disease, and may lack the experience that ILADS specialists can offer in diagnosing and treating Lyme. ILADS member Ginger Savely, RN, has treated over a thousand patients suffering with Lyme symptoms. She says "you can get better!"

If Lyme is left untreated it can be debilitating. The good news is you can get better. Find a doctor who knows how to diagnose and treat Lyme now.
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ABC covers Lyme debate - part 2


Watch the video


* Lyme disease tests are often misleading
* Lyme symptoms can mimic hundreds of other conditions
* Many Lyme patients do not receive a correct diagnosis until the Lyme bacteria has had a chance to replicate throughout their body


Does your doctor know how to test for Lyme? Is he or she Lyme aware? ILADS physician Dr. Raphael Stricker told us in an exclusive LDRD interview that the conventional Lyme tests have a "coin-toss sensitivity," meaning that you could get the same results if you just flip a coin.

Do you have to go outside IDSA recommendations to get the answers you need? The woman in this news story considers herself virtually cured of Lyme, after two and a half years of antibiotics therapy.

Are some conventional doctors beginning to understand that these tests, developed over 30 years ago, are outdated and inadequate?

Watch this brief news story on the great Lyme debate. Journalist Kathy Fowler continues the 3-part investigation. Leave your comments here and also send drop her a note at lyme@wjla.com Please share this link with others you know are concerned about Lyme disease symptoms.
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ABC covers the Lyme Debate


* Is Lyme disease an unrecognized epidemic?
* If left untreated, will it become chronic?
* Can Lyme be treated with long-term antibiotics?



Or do you believe, as IDSA docs do, that the Lyme epidemic is nonexistent? Is chronic Lyme disease all in the patients' head? Are long-term antibiotics dangerous?

These questions simmer at the heart of the great Lyme debate, which is played out every day in decisions made by IDSA doctors on one hand, and ILADS physicians on the other. The IDSA is currently reviewing its treatment guidelines.

Who's correct? Where do you stand? Anyone who has ever been doubted by their Infectious Disease doctor, and all of us whose lives are affected by Lyme will want to watch this three part story.

ABC News covers the Lyme controversy. Take a look. If you appreciate this report, please take a moment to call or email ABC and let them know. Our opinions as viewers matter to them.

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Lyme story airs!

According to Brooke Landau, Lyme activist and TV news reporter, television stations listen and respond when they are deluged with requests from viewers to air stories about a specific topic. Viewers are their bread and butter. Please take the time to comment on the ABC website to let them know you appreciate the story they aired this morning about the documentary film, Under Our Skin. Here's my comment to them:

Thank you, thank you for bringing this growing epidemic to light. However, as many have already noted, the majority of people suffering with Lyme disease never saw a tick bite, and never had the bull's eye rash. In addition, the tests for Lyme have what one physician refers to as "coin toss sensitivity," meaning that if you toss a coin, you get results that are just about as accurate as using the ELISA or the Western Blot for testing positive. According to ILADs physicians I have interviewed for the Lyme Disease Research Database, the CDC has a long history of ignoring scientific evidence for the existence of chronic Lyme disease. Thanks to CT Attorney General Richard Blumenthal, the IDSA is now being forced to review its Lyme disease treatment guidelines. People who are suffering with Lyme due to misdiagnosis, under-diagnosis, and simple ignorance have long been forced to become their own health advocates, often at a time in their lives when they are extremely sick. I applaud you for airing this segment on the Lyme controversy, yet I am disappointed to see that your reporters did not bother to investigate the accuracy of the numbers of new cases of Lyme reported each year. As someone else commented, that 20,000 quote is hideously underestimated. Next time, I hope you have the courage to quote numbers that are closer to the actual truth.

In the Lyme documentary Under Our Skin, filmmaker Andy Abrahams Wilson (Open Eye Pictures) exposes the cruel dismissal that the medical establishment frequently gives people who are sick and suffering with Lyme. The film opened in April at the Tribeca Film Festival in NYC. Andy is featured in the LDRD's interview series.
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300 Protest IDSA guidelines

Among the protest signs held up by attendees was a little boy's that read, "All I Want For Christmas is My Medicine."

Reporter Liz Anderson of the Journal News in Westchester, PA, covered the rally which took place on November 30:

Protesters cheered Dr. Joseph Burrascano, vice president of the International Lyme and Associated Diseases Society, which supports the use of long-term antibiotics in some cases and has called on the IDSA to retract the recommendations.

"If they weren't so seriously flawed, I would say it was a joke," he said of the guidelines. He urged those at the rally to fight back "by uncovering the truth."

Read the entire article here.
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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.
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