‘Chronic Lyme’ hornet nest still buzzing at physician convention in San Diego

Tick

(Photo courtesy Pixabay)

I had no idea the hornet’s nest surrounding the “chronic Lyme” debate still was buzzing. Apparently, it is.

I attended, “In Your Back Yard and Getting Closer: Vector Borne Illnesses.” The presenter, Dr. Stephen Gluckman, spent a huge chunk of time informing his colleagues why they should not prescribe antibiotics to individuals who claim to have an active Lyme infection but do not.

He said patients will show up complaining of “body aches and mental cloudiness” and claim it’s a Lyme infection.

Some will insist they even have tested positive for certain antibodies which may indicate a Lyme infection. There is no certain test for Lyme disease.

“The mistake is explaining the antibodies created those symptoms (they are reporting),” he said. “It’s the wrong diagnosis. Lyme is a very easy bug to treat if you have it. And you can catch it again. But it won’t be because your original bug was improperly treated and you relapsed.”

When a patient presents with a red patch that can be a bug bite, be sure to ask how long the spot has been there. Sometimes red spots go away rather quickly, Gluckman said.

Was the patient in the woods or in some other location where they could have encountered a tick or other vector? If so, for example in cases where the tick was seen and even removed, and brought it to the doctor, or removed by the doctor themselves, what diseases does that species of tick carry? Is it even a tick that carries Lyme? Focus on what diseases the species carries. Not all ticks carry the same bugs, pardon the pun. It’s very important to bring the bug into the doctor’s office, if possible.

“Don’t grease up the tick” tying to remove it, Gluckman warned. It allows the tick to hold on even tighter.

When Dr. Gluckman will prescribe antibiotics

“Yes, I’m beating this to death, which I am trying to do, and hopefully successfully,” Gluckman said. He spent at least half of the 90-minute session explaining there is a growing movement of people who believe they have active Lyme infections even though they do not test positive for it, at least not using tests that are acceptable to the medical establishment.

I waded into this “chronic Lyme story” mess almost three years ago, in 2014. First I wrote this piece for HealthlineNews, originally headlined, “No, you don’t have chronic Lyme disease.” Hate mail poured in from around the world. For months.

Then I wrote this piece about Lyme becoming the topic of debate in Washington. In a nutshell, the truth is that this movement has gained quite a bit of momentum.

But the pro-chronic Lyme people have been venomous and nasty. One woman even suggested my father really had Lyme disease and not a rare brain disease at all.

Wow.

Gluckman said he believes these patients who claim to be chronic Lyme sufferers need to be affirmed regardless. “I tell them I know they are suffering and I hope they get the proper treatment. But it’s not Lyme.

“It’s tricky when you start treating people with no objective evidence of disease.”

Gluckman said there are cases where he sees potential bug bites and is not hesitant to use antibiotics. This most often happens when people report flu-like symptoms in the summertime. This is because there is no summertime flu and depending on where a patient may have been they could have been bitten by an insect, some of which carry diseases with poor or even fatal outcomes the longer the delay in treatment.

 

Advertisements

From AIDS to Zika: Dr. Fauci has served six presidents. Great keynote address.

20170330_121240

National Institute of Allergies and Infectious Diseases Director Anthony Fauci has served six presidents over the course of his 33 years in that position.

Not only is his tenure staggering, but so is its framework: He has been our country’s infectious diseases chief from the first day of HIV.

Getting to hear Fauci speak to thousands of doctors Thursday during the opening ceremony and keynote address of the American College of Physicians Internal Medicine meeting was incredible. More than 800 doctors alone are attending this conference from foreign countries, not to mention the hundreds, even thousands of doctors from around the U.S. who are here, most internal medicine specialists. The grand ballroom literally was packed elbow to elbow, seat to seat, people standing, lining the walls.

Fauci is an amazing speaker. He has a way of getting straight to the point and often offers little tips. Tomorrow, he said, an announcement will be coming out of Washington regarding phase II trials for a Zika vaccine. So maybe I just broke that news, right here!

Thus, the title of his address this morning was, “From AIDS to Zika.”

“Extraordinary parts in your life that you never forget,” is how he remembers the first reports of AIDS trickling in, long before we even had a name for the disease. “I was sitting in my office at the NIH clinical center and this came in front of my desk, this report, the MMRW (Morbidity and Mortality Weekly Report issued by the U.S. Centers for Disease Control and Prevention) reporting five gay men from Los Angeles with the strange situation of being otherwise healthy, also strange, curiously all gay men, with (pneumonia).

“I thought this was just a fluke, didn’t make much sense. A month later, when the second MMWR came about, now 26 men, not only from L.A., but from San Francisco, New York, and not just with (pneumonia), but also Kaposi’s sarcoma and other opportunistic infections.”

Little did Fauci know that he had come into one of the most powerful medical positions in the world just at a time when the world needed him. “And it was at that point that I really turned around the entire direction of my career and start to study this extraordinary disease,” Fauci said. “Not every outbreak was (or is) going to have global importance. This is one that was not perceived (as such) at the time, but actually did.”

Zika a new threat as mosquito transmitted or sexual transmissions multiply

Fauci admitted that Zika is now being transmitted in ways other than anyone who ever had traveled to a place where Zika previously had been present. He said “a perfect storm of global health mishaps occurred” to create the Zika crisis. He said details of a phase II Zika vaccine will come out of Washington tomorrow. He said development of the vaccine is an urgent matter.

“There’s basically not health care system in those countries and a distrust of authority,” Fauci said of Liberia, Sierre Leone, and New Guinea, where most of the 28,000 cases of Zika and 11,000 deaths have occurred.

“There are more doctors on K Street (in Washington D.C.) than in the entire country of Liberia,” Fauci said. “Now that is very difficult to swallow, but it is actually the truth.”

Hotels.com deal on my San Diego digs for doctors conference this week a sizzler

20170329_114615

It’s hardly a secret that San Diego is one of the most beautiful, safest, and cleanest cities in our entire nation. But apparently, I forgot about that!

The second I landed at midnight last night (I am three for three for landing at midnight on all my flights this year, part of the so-called “Rainbow Tour” as I’ve dubbed it), I was impressed. Even from the air, San Diego has a special twinkle. Once inside the airport, I could not believe how far and above it ranks over the many other U.S. airports I have been to recently. Clean, user-friendly, the whole nine yards.

When I walked out the front doors after getting my bag, I had a most awesome chuckle. About 20 Prius Taxis (Prii?), all about the same year as mine, were lined up. But, I was waiting for the free shuttle to the Ramada Gaslamp District (former historic St. James Hotel).

OK, now. Listen up, bargain travelers! I got 7 nights at this hotel for UNDER $800 tax included. The rate on the room door? More than $300 per night.

The rooms are very small. The even have window air conditioner units. The hotel is more than 100 years old.

But the location is second to none. It is right in the middle of everything. I’m only a five-block walk to the convention center, where the American College of Physicians’ Internal Medicine Meeting is being held (that’s what I’m here for).

Plus, the room has a coffee pot. An ironing board. An iron. A safe. I have a pretty nice view out my window (once you stand on your tip toes and look over the window air conditioner).

The hotel has one of those old, old elevators with doors and gates. I want to say McCabe’s in downtown Rock Island had one of those long, long ago? Someplace in downtown Rock Island did. I remember. And it has been that long since I have been in an elevator like that (at least since the 1970s).

Rooftop access is from the 10th floor of my hotel. The rooftop is a lovely patio that overlooks all downtown San Diego. It is stunning.

And the hotel is attached to a diner with all kinds of great food and drink. Super-duper convenient and not too pricey. The lobby looks into the restaurant through beveled glass. It’s kind of cool.

20170329_113948

Well, as always, I forgot to pack two things: A razor, and a belt. So, I’ll be walking to the mall as soon as it opens at 10, and then headed to the convention center to pick up my press pass and decide “what next.”

Thank you for following my blog! I am sure to have all kinds of interesting stories coming out of San Diego, both in terms of breaking medical research being presented at the conference and my own personal tales. Stay tuned! And…”Let’s hear it for the Rain-bow Tour! It seems to be a wonderful success! We weren’t quite sure…we had a few doubts….”