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Lyme expert

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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Doc examines Lyme & Alzheimer's link

Lyme disease symptoms can look a lot like other diseases' symptoms, not the least of which is Alzheimer's. In late-stage, or tertiary stage of Lyme, the bug has infected the brain. It may be hard to distinguish between the symptoms of somebody with late-stage Lyme, and somebody suffering from Alzheimer's disease.

Such was the case of Paul Christensen, who was diagnosed with Lyme, treated, and then released from Stony Brook Hospital. Paul was a firefighter, yet he struggled for eight years with mental deterioration after his diagnosis of Lyme. Finally, he died due to Alzheimer's.

Paul's wife suspected that there was a strong link between her husband's diagnosis of Lyme and his death from Alzheimer's disease. If there was a connection, she was determined that other people should learn about it, in the event that it might help reduce their suffering. So, after Paul died she urged medical researcher Dr. Alan MacDonald to investigate her husband's case.

Dr. Alan MacDonald is a featured expert in the 'Interviews with Experts' series, which you can access here. In the 30 minute audio interview, he tells about the well-documented Christensen case, and he describes what he and other researchers are doing to understand the Lyme bug, so we can eradicate it.
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