I want to start off by thanking you for reading my column each week and thanking the newspapers for giving me this platform to reach so many readers with information about Lyme and tick-borne diseases.

Disclaimer: I am not a medical provider, nor do I play one on TV. I am simply a patient who has gone through something horrible and came out on the other side, better for it and who has been given an opportunity to share and help others. My column might only come once a week, but I am busy 365 days a year helping people who reach out to me via phone calls, emails and even in person. I am also able to help others during our support meetings that we host March through November and that will be starting up again next month. We meet in Brunswick, Rockland and Damariscotta and details can be found on our website. I really enjoy meeting and talking with people because it gives me the opportunities to discuss things that I can not touch here in my column. But outside this page, the sky’s the limit as to what we can talk about and I’d like to share some of the more common topics of conversation here with you this week.

Q1: Why am I still sick/symptomatic after my Lyme treatment?

A1: I get this question almost daily and my initial response is “Were any co-infections ruled in or out?” Knowing that ticks can carry more than one tick-borne disease, sometimes other infections are not diagnosed and can be revealed once treatment starts. My other response is “What were you diagnosed with and how long was your treatment dosage?” Research has shown that the bacteria has a 30-day life cycle and because there is controversy surrounding adequate treatment dosage, not all patient’s get the same length of treatment. Who you see matters is a topic that I cover all the time.

Q2: I have been to several doctors and they can’t seem to agree on what is wrong with me. Why?

A2: Diagnosing tick-borne disease can be difficult without the knowledge of a tick bite. Because Lyme mimics so many other chronic illnesses and the need for more reliable testing is so warranted, it is not uncommon for patients to see multiple providers and get many different diagnoses before knowing what they are dealing with. Often, patients have gone from acute infection to more chronic and debilitating and that alone can make it that much harder to diagnose and longer to treat.

Q3: I started my treatment and I feel so much worse. Why?

A3: Initially, I would ask if there is any allergic reaction. If not, sometimes taking harsh meds on an empty stomach is the cause. Other times, if the ill feeling comes on quickly but days or weeks into treatment, it can cause what is known as a Jarisch-Herxheimer reaction “herx”, an abrupt onset of fever, chills, myalgia, headaches, tachycardia, hyperventilation and hypotension. Every patient reacts differently based on the severity of the herx. Herxing can last a few hours to a few days. Often it is triggered by the introduction to a new medicine and/or dosage increase. It’s your bodies way of dealing with an onslaught of bacteria dying off quickly inside your body. Some patients remain at home in bed while others can find themselves at their doctor’s office or emergency room. Fluids and rest can help while taking a shower can make it worse. It’s essentially your body’s way of purging a high amount of bacteria that has died off. There are natural products that can help your body assist with the dispelling of die off, reducing herxheimer reactions and making treatment more tolerable. Let’s talk!

Q4: I tease my spouse that they are a “tick magnet” but it’s not funny. Why would ticks be more attracted to them and not me?

A4: I covered this topic not too long ago. Ticks find their blood meals through “questing” they use their antennae to sense heat and carbon dioxide odors. Some diets and medications can enhance or diminish a person’s body odor. The best way to avoid having a tick encounter is to wear repellents or incorporate garlic into your diet. Garlic is a natural repellent to insects.

Q5: Please settle this argument: Do ticks jump?

A5: No, ticks climb and crawl and can get on their hosts when we brush against a tree or shrub. With their antennae, they can “sense” (carbon dioxide and heat) that their host meal is nearby and so they climb out the end of the branch and while holding on with their back legs, put out their front legs and wait to attach to their host. This is called “questing”. Blocking your scent by wearing repellent on your skin and treating your clothing is a primary defense against having a tick encounter.

Q6: I was bit by a tick but didn’t get a bulls-eye rash so I’m all set, right?

A6: Ticks can carry many different diseases and less than 40% of all positive Lyme cases produce the Erythema Multiforme (EM) rash (also known as the bulls-eye rash). There are a couple reasons why you didn’t get the bulls-eye rash. One, because the tick that bit you didn’t transmit any infection or Two, the tick that bit you could have transmitted a different tick-borne disease that doesn’t produce an EM rash or Three, your body’s immune system hasn’t responded to any initial threat factor. Your immune system has to acknowledge the presence of an infection and then based on how well your immune system is working, you will get a response of symptoms that can vary patient to patient. Some rashes are misdiagnosed as cellulitis or spider bites. I had a rash that looked more like a blurred paint streak. Last I checked, the growing list of symptoms had topped 300 and was growing and since not all patients present the same way, it can take a while to muddle through everything and figure out the root cause.

Q7: I want to get tested. What test should I tell my provider to order?

A7: If it were only that easy. If your medical provider doesn’t know what test to order, then you need to find a Lyme literate provider. Not all medical providers are knowledgeable or experienced in diagnosing and treating tick-borne disease but the ones that are will know to do a proper intake assessment, will know what tests to order and will know how to treat based on the results. There are individual tests as well as comprehensive panels. Not all labs or lab tests are the same and blindly checking off all the boxes can be costly. Igenex is the gold star standard for testing but they do not take insurance other than Medicare. Accurate and highly reliable but costly. My go to for accurate, reliable and affordable testing? Medical Diagnostic Labs (MDL) based in NJ. They take all insurances including Mainecare and Medicare and out-of-pocket expenses for self-pay are very affordable.

Q8: Is it true that antibiotics are the only way to cure Lyme and Tick-borne disease?

A8: There are many, many different treatment protocols used in treating Lyme and tick-borne diseases. And because patients all present and respond differently, having a medical provider that has access to a vast amount of treatment options is in the best interest of the patient. Western medicine, oral antibiotics, iv therapies, tinctures, hyperbaric chamber therapy, Chinese herbs, homeopathic and naturopathic remedies. The recipe for repair is unique to each patient based on their infection, their genetics and any other health issues that may impede their recovery. What works for one patient may not for another and so having a knowledgeable provider with a vast amount of resources to fine tune their patient’s treatment only enhances a patient’s recovery outcome. During my years of treatment, I tried many different protocols. We kept what worked, tossed what didn’t and explored more options. I’m thankful for a provider that didn’t give up on me!

I am happy to share more Q&A with you but please, if you need help or have a question, don’t hesitate to reach out to me. I do all this for you in hopes of changing the trajectory of the path that you are on and getting you closer to health and wellness.