Chronic Lyme treatment Archives

Why is it so hard to find a Lyme doctor? Here are some reasons.

Kris Newby on March 11, 2023

In the first study of its kind, two Lyme disease experts gathered data on a question frequently asked by tick-borne disease patients: Why is it so hard to find a Lyme-treating physician? And how could there be such a doctor shortage, when there are 476,000 new annual Lyme cases per year reported from all 50 states?

Invisible’s new short course answers this question based on data from a survey-study of 155 clinicians from 30 states who treat Lyme patients. The study’s goal was to identify the problems that clinicians face when treating these patients, a first step to overcoming these obstacles. The study’s authors are Elizabeth L. Maloney, MD, a Minnesota family physician and Invisible’s education co-director; and Lorraine Johnson, JD, MBA, the Chief Executive Officer of LymeDisease.org and the principal investigator of its patient registry and research platform, MyLymeData.

The first point that the study authors make is that these patients aren’t easy. Seventy-nine percent of survey respondents said that their biggest challenge was the complexity of care required for tick-borne disease patients. Because Lyme and co-infection testing is unreliable or nonexistent, clinical exams typically take longer than is reimbursed by medical insurance. This means that clinicians lose money on these patients because the economic reimbursement model in the U.S. doesn’t work for complex and/or chronic conditions.

In many cases, Lyme patients have cognitive impairments caused by brain inflammation, making it hard for patients to communicate accurate medical histories and follow treatment protocols. About half of the providers said that their Lyme patients require more handholding and calls between regular appointments than with other diseases.

One of the most surprising findings was the stigma-burden faced by Lyme-treating physicians. Three-quarters said that they had suffered from professional stigma, including:

61% experienced a lack of collegial support
59% faced opposition from physician organizations
19% had been subject to medical board inquiries
11% had been excluded from insurance networks

“We can think of professional stigma, regulatory investigations, and failed economic models as forming a wall that not only separates patients from clinicians but produces significant disincentives for clinicians to provide care,” said Dr. Maloney. “This leads to a significant supply-and-demand mismatch, which is why patients have trouble finding a treating clinician.”

The Invisible Education Initiative, funded by the Montecalvo Foundation, is working to educate more health-care providers on the best protocols for getting Lyme patients better faster. We do this by providing free, accredited Continuing Medical Education (CME) courses that focus on vector-borne and environmental illness within a One Health framework. These courses are available to clinicians and the public. To donate to this initiative and to learn about Invisible International, please go here http://invisible.international/give.

Watch here: https://learn.invisible.international/courses/barriers-to-lyme-disease-treatment-what-the-data-is-showing/

Free course on treatment strategies for long haul COVID and Lyme patients

Kris Newby on September 20, 2022

A Dublin-based infectious disease doctor who’s treated both long COVID and chronic Lyme patients shares new research and treatment strategies for managing patients with these complex conditions, in a new continuing medical education course sponsored by Invisible International and the Montecalvo Foundation.

The course instructor is Jack Lambert, MD, PhD, a Professor of Medicine and Infectious Diseases at Mater and Rotunda hospitals, and University College of Dublin School of Medicine in Dublin, Ireland, as well as the founder of the Lyme Resource Centre in Scotland.

Dr. Lambert is also the lead author on an early, COVID-19 patient study that analyzed 155 COVID-19 patients over a year, to identify predictors and probabilities of developing post-COVID-19 syndrome. This was one of the first studies to identify severe brain-related issues, including brain fog, head pressure, sleep disturbance, memory problems, exhaustion, personality changes, and a whole host of symptoms related to inflamed nerves.

“There are clear similarities between the clinical manifestations seen in Long COVID and Long Lyme,” said Dr. Lambert.

Among the more interesting findings of the study was the prevalence of the mental health conditions associated with Long COVID:

18.3% had moderate-to-severe signs of depression one year after infection
13% had moderate-to-severe signs of anxiety at one year
21% had findings consistent with Post-Traumatic Stress Disorder (PTSD)
72% had concerning alcohol use after a year

These issues are also common among chronic Lyme patients, and for both cohorts, his most passionate plea to front-line physicians is this: “When you conduct a series of tests and find nothing wrong, don’t start prescribing psychiatric medications, suggesting that patients are just anxious, or are having trouble coping, or are having family issues that are driving their symptoms. These patients are suffering from real, inflammation-driven conditions, and we need to start by addressing these first.”

Dr. Lambert’s most important advice to medical clinics treating Long COVID and Lyme is to establish a case management process to help these very ill patients coordinate specialist visits and treatment protocols.

“Both COVID and Lyme disease can affect multiple organ systems, so case management should simultaneously address persistent infection, a deranged and disrupted immune system, and neuro-inflammation,” he said.

He admits that setting up a case management process can be challenging, even in a country like Ireland, with its free, government-sponsored health plan: “Care is fragmented, and patients are sent by their general practitioners to specialist after specialist—gastroenterology, cardiology, rheumatology, and so on. We need to do a better job of connecting and coordinating these specialists.”

As for treatment protocols, he recommends that clinicians use standard therapeutics to suppress the cascade of inflammation triggered by long COVID and to aggressively test and treat for the reactivation viruses that commonly occurs during COVID infections. He also presents study results on the use of low dose Naltrexone for symptom reduction.

This free Continuing Medical Education (CME) is brought to you by the Invisible Education Initiative and the Montecalvo Foundation. Accreditation is in-process.

Take the course here: https://learn.invisible.international/courses/long-lyme-co-infections-and-long-covid/