Disclaimer

• All the following is presented as personal opinion and does not mean to be medical advice nor in anyway to be an endorsement of any of the treatments or items listed herein.

• Always consult a physician for all medical advice. This document can contain errors or omissions and should not take the place of licensed medical care.

Lyme Disease Treatments

What do I do now?Antibiotics?

Natural Treatments?Investigating options…The Great Controversy

The Official IDSA Stance• http://www.lymebook.com/chronic-lyme-disease-science

• Excerpt New England Journal of Medicine October 2007

• "How should clinicians handle the referral of symptomatic patients who are purported to have chronic Lyme Disease?

• The scientific evidence against the concept of chronic Lyme Disease should be discussed and the patient should be advised about the risks of unnecessary antibiotic therapy. The patient should be thoroughly evaluated for medical conditions that could explain the symptoms. If a diagnosis for which there is a specific treatment cannot be made, the goal should be to provide emotional support and management of pain, fatigue, or other symptoms as required. Explaining that there is no medication, such as an antibiotic, to cure the condition is one of the most difficult aspects of caring for such patients. Nevertheless, failure to do so in clear and empathetic language leaves the patient susceptible to those who would offer unproven and potentially dangerous therapies."

Dr Brand’s Open Letter October 27, 2007

• I have been trying to divine a reason why the various medical specialty organizations (Infectious Disease, Neurology and now, Dermatology) have been racing to perpetrate a preponderance of guidelines that denounce appropriate, or at least reasonable, diagnosis and treatment for one particular medical condition. I am aware of no parallel in any other illness. It is worthwhile to state that the surprising orgasm of guidelines follows no new research findings to account for the timing of their release.

• The reason for issuing guidelines was ostensibly to avert the danger of long term antibiotic treatment. I found this particularly confounding with regard to Dermatologists, who prescribe minocycline for years on end to treat, or sometimes prevent, acne, a far less debilitating condition than chronic Lyme disease. Also, recently humorously stated, long term antibiotic treatment has resulted in some of the healthiest cows and chickens the world has ever seen.

• Logically, either the NEJM physicians are all absolutely correct and the entire Lyme community is as misguided as they attest, and our doctors as mischievous or malevolent as they allege, or they themselves are either grossly mistaken or have some motive for their savage attacks on fellow physicians, and by extension, a large and growing population of suffering patients.

• Since they are not fools and they have access to the same database that we do, including their own previous studies attesting to the persistence of Lyme following treatment, they must have some motive. At first, I examined the disclosures and recognized some conflict of interest that might offer a rationale for a few in the NEJM group, but that did not account for the other professional groups joining in the fray, all in such a well timed and coordinated fashion.

• This afternoon, I discussed these events with a colleague (my wife, Jane Kelman, M.D.). If we are correct that Lyme has been misdiagnosed and under treated, and disability created wholesale through this negligence, and this becomes an accepted public reality, that is, the reality that we already know to be true, the inevitable medical malpractice suits will destroy those physicians responsible, represented by the three major medical specialties who have been the first contact for most patients with Lyme disease. Those are the very specialties now circling the wagons in a pre-emptive attack to preserve what they recognize is a massive, catastrophic error in analysis and judgment. (continued next slide)

• While there may have been other, early motivations (the profit from vaccine development, legal testimony fees and so on), there is now one single, unifying, global reason to refute chronic Lyme: To protect themselves from the repercussions that will follow if, or rather when, the preponderance of Lyme cases and disseminated Lyme information reaches critical mass. They will try to argue standard of care by hiding behind their own guidelines and those of their closely related co-specialists. While they have different specialties, they have one common motive. This is defensive and possibly illegal manipulation of the first degree and it is the only explanation that makes sense of the whole.

• The current mania to produce guidelines has been driven by the recent explosion in Lyme information hitting every news media, with the recent publicity slanted invariably toward mentioning a controversy rather than merely stating the anti-Lyme position, as had been the case until recently.

• Major TV stations are picking up on the story, and now, with the Connecticut attorney general adding credibility, and President Bush's treatment adding visibility, the anti-Lyme docs are in an understandable panic. This is beginning to look like their perfect storm, not ours.

• The attorney general of Connecticut is at least half right. He is focused on the antitrust implications, but, if he is not already, will become aware of the motive behind their conspiracy: Besides restraint of trade, the effect on many infectious disease, neurological and dermatological physicians will be massive lawsuits for negligence involving failure to properly diagnose and treat, with readily provable losses of health and income directly attributable to medical malpractice.

• I am elated by recent events. If the anti-Lyme doctors had simply muddled along, permitting a situation where some Lyme patients got treatment, some didn't, and things were confused, they might have survived longer. However, probably a result of overactive egos, maybe the new preeminence of certain individuals, they decided to go in for the kill, staging the current guideline ploy to finish us off once and for all, literally killing us off by providing permission for insurance companies to deny treatment. This move, paradoxically, will prove to be their undoing, not ours, as it provides a prima facie case for conspiracy.

• We have only to keep telling the truth: That Dr. Feder et al make their case by selectively employing particular studies, avoiding others which refute their position, even ignoring their own past studies and pronouncements.

• Their duplicity is transparent and the heat is building.

• Richard Brand, M.D. / 120 N. Main St / New City, NY 10956 / 845-638-2626

• Attorney General's Investigation Reveals Flawed Lyme Disease Guideline Process, IDSA Agrees To Reassess Guidelines, Install Independent Arbiter

• May 1, 2008• Attorney General Richard Blumenthal today announced that his antitrust

investigation has uncovered serious flaws in the Infectious Diseases Society of America's (IDSA) process for writing its 2006 Lyme disease guidelines and the IDSA has agreed to reassess them with the assistance of an outside arbiter.

• The IDSA guidelines have sweeping and significant impacts on Lyme disease medical care. They are commonly applied by insurance companies in restricting coverage for long-term antibiotic treatment or other medical care and also strongly influence physician treatment decisions.

• Insurance companies have denied coverage for long-term antibiotic treatment relying on these guidelines as justification. The guidelines are also widely cited for conclusions that chronic Lyme disease is nonexistent.

• "This agreement vindicates my investigation -- finding undisclosed financial interests and forcing a reassessment of IDSA guidelines," Blumenthal said. "My office uncovered undisclosed financial interests held by several of the most powerful IDSA panelists. The IDSA's guideline panel improperly ignored or minimized consideration of alternative medical opinion and evidence regarding chronic Lyme disease, potentially raising serious questions about whether the recommendations reflected all relevant science.

• "The IDSA's Lyme guideline process lacked important procedural safeguards requiring complete reevaluation of the 2006 Lyme disease guidelines -- in effect a comprehensive reassessment through a new panel. The new panel will accept and analyze all evidence, including divergent opinion. An independent neutral ombudsman -- expert in medical ethics and conflicts of interest, selected by both the IDSA and my office -- will assess the new panel for conflicts of interests and ensure its integrity."

• Object of Treatments –Kill Spirochetes!!

What spirochetes hate!!

1. Oxygenation2. Heat3. Saline environments4. Antibiotics5. Anti-Inflammatory Diet

Spirochetes multiply in certain environments more quickly than in others. We need to discover which environments they don’t like.

Herx reaction-- Your body reacts to treatments. You are usually sicker , then get better. You can get rashes, stomach aches, hot flashes, headaches and many other reactions. These below, are good to relieve symptoms .

1. Charcoal2. Ginger3. Apples/pectin4. Baking soda Next—The Great Controversy

• Medical Dr. route— antibiotics

• Types of antibiotics: a. Dr. Burrascano's treatment for early Lyme, the acute phase of the disease.... It is Doxcycline, 400 -

600 mg daily, taken in doses of 200 mg.... This is taken for six weeks minimum and for a month since the last symptoms has subsided.... This protocol has an 80% success rate, add the salt/C protocol to it and it comes close to 100%...

If you don't treat that bite now and you do have Lyme, you can quickly move to the chronic stage of the disease in just 4 - 6 short quick months.... This is the part of the disease you want to avoid at all costs....  The acute phase is manageable, the chronic phase is life altering and often debilitating. Some do Dr. B's protocol just as a precaution in the very beginning.

Dr. Burrascano, a well know and respected LLMD, has an excellent protocol for early stage Lyme using Doxcycline. Here it is:

ANTIBIOTIC CHOICES AND DOSES

ORAL THERAPY: Always check blood levels when using agents marked with an *, and adjust dose toachieve a peak level above ten and a trough greater than three.  Because of this, the doses listed belowmay have to be raised. Consider Doxycycline first in early Lyme due to concern for Ehrlichia co-infections.

*Amoxicillin- Adults: 1g q8h plus probenecid 500mg q8h; doses up to 6 grams daily areoften neededPregnancy: 1g q6h and adjust.Children:  50 mg/kg/day divided into q8h doses.

*Doxycycline- Adults:  200 mg bid with food; doses of up to 600 mg daily are often needed, as doxycycline is only effective at high blood levels. Not for children or in pregnancy.

TREATMENT CATEGORIES

PROPHYLAXIS of high risk groups- education and preventive measures.  Antibiotics are not given.

TICK BITES - Embedded Deer Tick With No Signs or Symptoms of Lyme (see appendix):Decide to treat based on the type of tick, whether it came from an endemic area, how it was removed,and length of attachment (anecdotally, as little as four hours of attachment can transmit pathogens).  The riskof transmission is greater if the tick is engorged, or of it was removed improperly allowing the tick's contentsto spill into the bite wound.  High-risk bites are treated as follows (remember the possibility of co-infection!

1) Adults:  Oral therapy for 28 days.  2) Pregnancy:  Amoxicillin 1000 mg q6h for 6 weeks.  Test for Babesia, Bartonella and Ehrlichia.   Alternative: Cefuroxime axetil 1000 mg q12h for 6 weeks.3) Young Children:  Oral therapy for 28 days.

If symptoms are present, this protocol is important... Again, 400 - 600mg daily... Also, this is taken in doses of 200 mg twice or three times daily, not 100 mg doses.

EARLY LOCALIZED - Single erythema migrans with no constitutional symptoms:

1) Adults:  oral therapy- must continue until symptom and sign free for at least one month, with a 6 week minimum.  A minimum of 6 weeks, but continue on the Doxcy for one month past the last symptom... 2) Pregnancy:  1st and 2nd trimesters:  I.V.  X 30 days then oral X 6 weeks3rd trimester:  Oral therapy X 6+ weeks as above.Any trimester- test for Babesia and Ehrlichia3) Children:  oral therapy for 6+ weeks.

DISSEMINATED DISEASE - Multiple lesions, constitutional symptoms, lymphadenopathy, or any other manifestations of dissemination.  EARLY DISSEMINATED:  Milder symptoms present for less than one year and not complicated by immune deficiency or prior steroid treatment: 1) Adults:  oral therapy until no active disease for 4 to 8 weeks (4-6 months typical)  2) Pregnancy:  As in localized disease, but treat throughout pregnancy.   3) Children: Oral therapy with duration based upon clinical response. ( Chronic treatments up to 4 yrs)

On your own– pray and decide

1. Hot tub baths or Saunas, for 104 degrees for 20 minutes once a day or alternate with, epsom salt baths each day.

2. Epsom salt baths, 2 cups, warm/hot for 20 minutes

3. Salt/C– equal amounts starting at ¼ tsp each(1 gram). 2x,3x,4x a day and up the doses periodically until your body can handle 12 grams a day each

4. Exercise & sweating

5. Deep breathing exercises

6. Deep tissue massage

7. Sunshine! I believe it is imperative! Controversy?

8. Anti- Inflammatory Diet

9. Study your body! Read to educate yourself.

10. Supplements: Evening primrose, cats claw, magnesiumApple cider vinegar ,& pantothenic acid for inflammation.

11.andrographis, smilex,

Japanese knotweed, and Cat's Claw) to my antibiotic regimen

• Other options• LLMDs—Literate Lyme Medical Doctor

Next meeting:Living with Lyme disease, God’s Way

•There is more to Lyme disease than treatments.

•Physical, Psychological/Emotional,

Spiritual, Social