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An Editorial Postscript on Lyme diagnosis and treatment

by Ken Casanova

Consideration should be given to whether a "ME/CFS" or "FM" Western-blot-negative patient has had prior tick exposure.

Anyone ill with Lyme disease for 1 to 2 months has progressed to a chronic Lyme-disease state. Antibi­otic treatment for chronic Lyme involves oral antibiotic therapy for 4 to 6 months; for more seriously ill pa­tients, or patients ill beyond one year. Dr. Joseph Bur­rascano, Jr. (another Lyme-disease expert), recom­mends intravenous antibiotics for 6 to 10 weeks or longer, followed by oral treatment or intramuscular in­jections for many weeks or months thereafter.

Because of the potential length and intensity of this treatment regime, it is sensible, to the extent possible, to try first to determine whether or not patients really have Lyme before committing them to treatment on an "operational" basis.

There are other tests besides the Western-blot. According to Dr. Burrascano, "Antigen tests including PCR are now available... sensitivity re­mains poor, possibly less than 30%.. . Therefore, multi­ple specimens must be collected to increase yield..."

There is also a Lyme Urine Antigen Test.  Moreover, in a chapter from his new book, The New Lyme Disease: Diagnostic Hints and Treatment Guidelines for Tick-­Borne Illnesses, Dr. Burrascano lists a series of fac­tors, signs, symptoms, and laboratory tests, that­—when evaluated together—can indicate the presence of Lyme as "Highly Likely," "Possible," or "Unlikely."

A patient should spend some time educating himself or herself on diagnostic methods, treatments, and who are the most experienced Lyme clinicians, based in part on their use of the most current diagnostic and treatment approaches.

You can obtain Dr. Burrascano's 1998 and 2000 recommended treatments for Lyme online. Also, here in Massachusetts, you may contact the Massachusetts Lyme Disease Coalition, P.O. Box 1916, Mash­pee, MA 02649, 1-508-563-7033, for further informa­tion.