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Reviews |  Ross Douthat on his chronic Lyme experience

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Reviews | Ross Douthat on his chronic Lyme experience

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But even having a tentative idea of ​​what was wrong with me, like I did in the fall of 2015, didn’t mean I could calm down and trust the science, because in the case of Lyme, science has spent several decades in a state of civil war.

On one side of these “Lyme wars” is the more established and official perspective, that a short course of antibiotics is enough to kill most Lyme infections. If patients still have symptoms afterwards, they have to assume that they will eventually go away and have some sort of residual inflammation or autoimmune disease – and they definitely have should not continue to take antibiotics as if the infection is still there.

On the other side, you have the aliens faction, the doctors who insist that no, Lyme symptoms persist in so many cases – and everyone concedes that they often persist – because the infection is causing it. – even is still there, still to be dealt with. And the treatments these doctors provide are incredibly complex: because every patient is different and every infection can include not only Lyme bacteria but other so-called co-infections as well, they design tailor-made combinations of antibiotics. , “cocktails” of drugs with different modes. of action, while sometimes advocating dietary changes and plant-based diets, Epsom salt baths, and all kinds of supplements.

So the dissenting point of view is that treating chronic Lyme disease is not just a battle but a long and grueling war. Meanwhile, the orthodox view is that this so-called “war” is a high-risk intervention against a disease that may not actually exist, and dissident doctors are essentially war profiteers, exploiting desperate patients. for a cure. And both sides are gathering scientific evidence in their favor: dissidents cite research showing that Lyme bacteria can, in fact, persist in animal subjects even after receiving a course of antibiotics; the institution cites studies showing that treating chronic patients with intravenous antibiotics does not appear to provide much benefit.

As a suffering person, therefore, you must choose what form of science to believe.

In my case, that meant choosing between two doctors that I saw at the start of my odyssey.

The first, an infectious disease specialist in New York, looked avuncular and reassuring. Yes, he said, I probably had Lyme – my symptoms were adjusting, the blood tests missed a lot of cases, he saw people like me all the time. But no, I didn’t have to worry so much about the disastrous chronic cases I was now reading on the Internet. Yes, some cases of Lyme took more than a few weeks to go away, and he usually prescribed antibiotics a little longer than official guidelines. But that would be enough, he promised: I would be doing much, much better by the holidays, and well in a year.

The second doctor had a wood-paneled office at a town in our new Connecticut home, looking more like a den than a clinic, and books and pamphlets littered the waiting room, each appearing to offer a different theory on how which could be treated as an isolated case. of Lyme. He spoke to me for 90 minutes, took numerous notes, asked a thousand questions, and informed me that chronic Lyme disease was an epidemic, vastly underdiagnosed, and totally abused. Could he improve me? Probably, but I was obviously very sick, and it would take a while. Most of his patients have taken high doses of antibiotics for about a year; I may need more; some required years and years of processing.

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