Who you see matters
There is a phrase that the Lyme community uses that has upset the rest of the medical world: Lyme-Literate Doctor. This phrase has been developed and used to specifically highlight those who are highly educated and experienced in diagnosing and treating Lyme and tick-borne diseases. They are heavily networked with other Lyme-Literateproviders and consult with on difficult cases. When this phrase has been spoken in a primary care physician’s office, the conversation can take a sudden downward turn. Most doctors that I’ve spoken with who are not considered “Lyme-Literate” take great offense to this phrase because they feel that it implies that they are “illiterate.” The Lyme community uses this as a basis when seeking out a provider who has vast knowledge about the fastest growing, multi-systemic, complex, infectious disease.
I personally have no qualms whatsoever about using it. I think it pays honor and respect to those providers who saved my life. I went through 23 different doctors and specialist who could not figure out what was medically wrong with me and who misdiagnosed me many times over. And I continued to grow sicker with every passing day. Lyme-LiterateProviders who, knowing that they live or practice in an endemic region, take it upon themselves to study and learn on a continuing basis about new strains, new diagnostic tools and up-to-date treatment protocols. Researchers from Yale and John Hopkins are consistently discovering new strains that existing protocols do not respond to. They are constantly running trials to find new treatments that combat, slow down and potentially eradicate the bacteria. Lyme Disease and Anaplasmosis are not the only concerns Maine residents need to be concerned with. We have Babesia residing here and that is a malaria-based tick-borne disease that does not respond to the typical Lyme Disease treatment of Doxycycline. The treatment protocol for Babesia is so completely different from Lyme and Anaplasmosis, even though early in its infection state, it can mimic Lyme. So many tick-borne diseases start off mimicking Lyme so when a patient present to the PCP saying they were bitten by a tick and the doctor runs a Lyme test, often it comes back negative. The CDC has gone on record to state that the existing ELISA test many doctors run in their offices is at best 40% accurate. So, with a negative test, the patient goes home and if infected, it slowly spreads.
So why is it important who you seek out when you think that you’ve been exposed to a tick-borne disease? A few weeks ago, I wrote about the Two Standards of Care that providers follow. Both scientifically evidence-based guidelines however, one set (IDSA) is outdated and has been removed from the National Guidelines Clearinghouse (NGC) while the other set (ILADS) remains current and in effect. The NGC is an initiative of the Agency for Healthcare Research and Quality (AHRQ), under the umbrella of the U.S. Department of Health and Human Services. The NGC recently adopted the Institute of Medicine (IOM) standards for developing trustworthy guidelines, which define the highest level of excellence that a guideline can achieve. Guidelines posted on the NGC website must now satisfy these standards.
What is frustrating for patients is that medical providers are so divided on this matter that it has greatly influenced whether insurances will cover doctor visits and much needed treatment protocols. At one time, there were two equally divided sides in this battle. However, since 2013, the CDC has acknowledged that there are flaws with testing and even treating. They have started participating at national Lyme conferences, sharing what they know and helping to pave the way to collaborative efforts ~ all in the name of patient care. Sadly, there seems to be a third party that has developed. It’s the medical community that continues to adhere to the outdated guidelines and turning a blind eye to anything else and it is their patients who suffer because of it. Because those patients see providers who are not aware or who refuse to acknowledge the faultiness of the tests, who are not knowledgeable about the complexity of tick-borne disease and therefore do not recognize how it manifests in a patient’s body at chronic levels. These are the same doctors who continue to throw 14 days of antibiotic at bacteria that has a 28-day life cycle. The very same who dispute chronic Lyme even exists.
There are available educational tools, workshops and conferences for providers who want to know more about Lyme and tick-borne disease. But as for the patient, it really does matter who they see. You want to see someone who uses up-to-date protocols, who is deeply knowledgeable about these diseases and who is heavily networked with other Lyme providers who can step in and consult when needed. By definition, these doctors are working in the best interest of the patient.
Paula is the president of the MLDSE, the Maine-partner of the national Lyme Disease Association, a member of Maine’s CDC Vector-borne Workgroup and active in Maine’s Lyme legislation. You can reach her at email@example.com