My Open Letter to Doctors, Nurses and all Health Agencies about Lyme

I don't know if this letter will be given much credit, I am just an average individual who has been battling Chronic Lyme for 4 years.  But I was trained annually on prevention, I have a masters in environmental health, I know I was bitten, I know it was engorged, I had a rash, I got sick and yet four years later I have had to use up most of savings for treatment in the US, give up my management position and legally fight for insurance, while trying to regain as much health as possible.

I help people weekly, to try to get appropriate treatment for a bite or symptoms, to save them, so they can learn from what I have learned.  Yet, I fail, even when I send them with all the supporting documentation and studies and guide them as best I know how. https://www.linkedin.com/pulse/human-rights-violations-relapsing-fever-lyme-disease-luche-thayer

So, I have decided to write this letter, so those who care, can read it.  I beg of you,  as a member of the medical profession to just read and consider the following information.  I will reference sources for all of my points and within those sources you will find hundreds of studies to support it.  They say doctors don't have time to read all the latest science and that I can understand.  But you should know there are over 700 peer reviewed scientific papers that are showing more up to date information on Lyme and you are not being told.

Please, just please just consider what if all of this is true? What if a few minor factors in the details determine whether someone you care for ends up with a lifelong chronic illness or if they can walk away and never think about Lyme again?  What if you had the power to make sure those people never had to worry about Lyme or a lifelong illness?  Well, you do have that power doctors, nurses, and public health educators.  You most definitely do.

I write this letter pleading with all of those in health to seriously consider the items I share with you here - to save many from my demise. The solutions are so simple its ridiculous, yet from what I see the fear of Chronic Lyme is going to become a reality for hundreds of thousands more if we don't fix a few small things.

The 24 Hour Rule: If there is anything we do know about nature it is that rules don't apply.  We cannot control nature, it is not exact and we cannot assume it works the exact same way every time.  This "rule" is leaving people without treatment, giving them a false sense of security and are becoming infected every day. 

This rule was established because the tick typically attaches and feeds on a human until full. Once full it can regurgitate the blood with the lyme infection back into the human.  It takes 24 hours or more for this to occur so the rule was established for this reason.

Here is why this rule should not be followed:
1) It assumes that the tick was never attached to another host or partially fed somewhere else.  Studies have shown that ticks have partially fed, detached and attached to a new host. This greatly reduces the time before regurgitation.
http://danielcameronmd.com/have-you-been-bitten-by-a-partially-fed-tick/

2) Ticks transmit more than just Lyme and some infections that are even more debilitating that Lyme.  Studies have shown that some of these infections are transmitted in minutes.  Powassan Virus which can be deadly was proven in a study to be transmitted within 15 minutes.  I can't imagine there are too many ticks that are removed within that window, especially since the tick injects an anesthetic so you don't feel the bite. 
http://northcountrynow.com/news/ticked-new-info-lyme-disease-north-country-people-should-know-0183893

David H. Persing, MD, PhD, chief medical and technology officer for Cepheid, a California biotech firm and a world expert in molecular diagnostics.  "I don't think we know half of the agents that are potentially transmissible by ticks"

3) Lyme has been proven in animal studies to be transmitted within 6 hours.  So it is only safe to assume that is should function the same way in humans. 
http://www.lymedisease.org/lyme-disease-myth/

4) It also assumes the tick was never stressed.  If stressed it is known that the tick will prematurely regurgitate into the human host.  This could mean pressure on the tick which is possible especially if you don't even know its there.  They like to attach in hidden areas where pressure, scratching and stress would be likely, i.e. armpits, toes, head, etc.

5) Finally it assumes that the removal was proper and flawless.  Who can know whether the tick was stressed during removal and regurgitated before full removal.  Its common for removals not to be perfect and incredibly likely that at some point while preparing for the final pull the tick was exposed to some stress and regurgitated back.

"The bad news is that improper tick removal may increase the chances of infection and disease." Dr. Jorge Parada, MD, MPH, FACP, FIDSA Medical Spokesperson for the National Pest Management Association (NPMA) and infectious disease specialist, Loyola University

6) And...This rule used to be 72 hours, then 48, then 36 and now its 24.  What happens if someone doesn't get treated because its 24 today but you finally get told to apply 6 hours next year. The science is saying so, so you will eventually be told.
https://www.lymedisease.org/hard-science-on-lyme-ticks-can-transmit-infection-the-first-day/

Just Ask: Dr. Richard Horowitz, Dr. Laurie Radovsky, Dr. Burrascano, Dr. Nevena Zubcevik, Dr. Liz Zubek, they and many others have written about this.

The Bullseye Rash: It is becoming more known that a very small minority of people with Lyme are likely to see a bullseye rash.  But what is less known is that only 9% of that minority will show the typical bullseye rash.  But people are being told their rash is not a bullseye and therefore do not have lyme - not true.  There are a minimum of 7 types of rashes that are representative of Lyme and a rash suggests infection.  
https://www.ncbi.nlm.nih.gov/pubmed/17945460

I know of far too many Chronic Lyme patients that were once told they had a spider bite.  Please don't assume so quickly.  There are some good resources for the different types of lyme rashes:
http://www.bayarealyme.org/blog/lyme-disease-bullseye-rash/
https://www.cdc.gov/lyme/signs_symptoms/rashes.html

The One-Day Prophylactic (preventive) Treatment: is based on only one study that was only successful in 4 out of 5 patients and by successful they mean the rash was prevented, not the Lyme.  
http://vermontlyme.com/2017/04/24/problem-single-dose-doxycycline-tick-bites/

"IDSA sometimes recommends a one-time 200-mg dose of Doxycycline. The only study supporting a single dose of Doxycycline demonstrated that it could prevent rashes but did not study whether it could prevent any chronic manifestations of Lyme disease." Dr. Daniel Cameron, International Lyme and Associated Diseases Society (ILADS) 
http://danielcameronmd.com/importance-second-opinion-prophylactic-treatment-tick-bite/

ILADS recommends that prophylactic treatment should be implemented for at least three weeks, with follow-up after a tick bite [as Bb Lyme spirochetes have the ability to penetrate the body and cells in less than 24 hours following an embedded tick bite]. http://www.tandfonline.com/doi/full/10.1586/14787210.2014.940900

I know of people that were prescribed the one day dose many days after the bite.  Both treatment guidelines will tell you thats pointless by then.  But, I just don't understand why a few weeks treatment of antibiotics is withheld based on one, not very successful study vs the hundreds that are showing Lyme persistence.  This is not about whether you get a rash or not, this is about whether you get a lifelong debilitating disease. Please treat the bite...properly. You have the collective ability to save thousands.
https://sites.google.com/site/getitrighttreatthebite/

And if you do decide to prescribe the one-day dose that eliminates the rash,  please consider that you have eliminated the single, most powerful symptom to diagnose a Lyme infection, the best symptom to tell you, without a doubt, that this person needs many weeks of antibiotics.

A rash and/or flu like symptoms following a tick bite: it's lyme, treatment is needed.  There is no debate here, please treat.  

And if I could ask one more favour here: please talk to your patients about the two different guidelines that presently exist for treatment.  Canada's Federal Framework on Lyme now refers to both treatment guidelines and The Federal Health Committee has formally requested that both be referred to on the Public Health Website (but things move slowly) so I ask that you know both: ILADS & IDSA.  You are not going to find many specialists in Canada that agree with me on that.  There are very few ILADS doctors in Canada which could explain why we all have to travel to the US for help.  You should know: the ILADS Guidelines are presently the ONLY ones that comply with the National Guidelines Clearinghouse and the Institute of Medicine.
http://www.ilads.org/ilads_news/2015/ilads-treatment-guidelines-are-now-summarized-on-the-national-guideline-clearinghouse-website/
https://www.guideline.gov/summaries/summary/49320/evidence-assessments-and-guideline-recommendations-in-lyme-disease-the-clinical-management-of-known-tick-bites-erythema-migrans-rashes-and-persistent-disease

The reason I ask that you share both is because one suggests 2-3 weeks treatment and the other 4-6 weeks treatment with symptoms.  It breaks my heart when someone is given 2 weeks with symptoms when 2-4 more could eliminate the fear of Lyme for good.  The only time you can 100% cure Lyme is at the very beginning.  The further away you get from initial infection, the more persistent the bacteria gets and the more irreversible damage is done.
http://www.ilads.org/lyme/treatment-guideline.php
https://canlyme.com/just-diagnosed/treatment/

I understand we want to decrease the use of antibiotics.  But at what cost?  Is this the place and time to be stingy?  I can promise you no one dealing with Chronic Lyme would tell you that saving 2 weeks of antibiotics is worth the hell they now live in.  Oh and by the way, my dog was given 6 weeks treatment with symptoms.

And finally, the Minister of Health for Ontario sent a letter last year (2016) to the College of Physicians and Surgeons stating that Lyme should be primarily a clinical diagnosis and not to rely on the blood test to be positive for treatment.  
http://ocfp.on.ca/docs/default-source/default-document-library/minister-letter-to-docs-re-lyme-2016-07-29_english.pdf?sfvrsn=582df889_0

I think the fact that the blood test is inadequate is becoming well known in the medical community. You may note that just last month (June 2017) the Centre for Disease Control (CDC) finally released this fact and suggested you should treat with antibiotics upon suspicion.  So, although it is too late for me and many others (I was not treated because my blood test was negative) I hope this information may save some.  But you should note the CDC is often who we look to for this type of direction.  They came forward with this much too late and way behind Ontario's efforts.  So what other information might we be getting a little to late.

Just know, the science is there to say the bacteria is persistent, can become chronic and infection can be quite rapid.  Please don't dismiss the patient that was once bitten and treated as they could have a chronic infection. Please don't under treat a patient who is just bitten. You have the power to cure them, then and there, for good.  What an amazing influence you can have on the management of this illness.
http://lymeconnection.org/news_publications/meet_the_lyme_disease_experts.html/title/dr-richard-horowitz

Thank you for taking the time and for your consideration.
Yours in fighting Lyme,
Kristy