A shot to prevent Lyme disease could be on its way • Hacker News Board

Re: A shot to prevent Lyme disease could be on its way

#181

Post by kortex » Tue, Aug 17, 2021, 1:54 PM UTC

PragmaticPulp wrote: post #161

kortex wrote: post #147

Graveyard of "not considered a real/serious disease/threat by the medical consensus until a frankly embarrassingly amount of time later" [x] "cadaverous particles" (washing hands after autopsies) [x] "hysteria" (likely a combination of various mental health conditions and/or PCOS, polycystic ovarian syndrome) [x] "GRID" (HIV/AIDS) [x] leaded gas bad [x] asbestos bad [x] smoking bad [?] refined sugar bad [x] Autism [x…

“Chronic Lyme” is a very challenging topic because it has become a mix of legitimate symptoms (those suffering post-treatment Lyme disease) but also a pseudoscience catch-all diagnosis promoted by bad alternative medicine practitioners. Contrary to popular belief, the CDC and medical community do actually continue to research the topics of potential Lyme persistence and post-treatment Lyme symptoms. We’re discussing…

That's fair. But I'd rather humor the quackish side of chronic lyme and see some progress being made, rather than lean to the side of dismissing them, along with people with legitimate complaints.

The inability to adequately assay Lyme speaks more to how bad we are at assaying diseases, than to the (il-)legitimacy of the disease.

Re: A shot to prevent Lyme disease could be on its way

#182

Post by inter_netuser » Tue, Aug 17, 2021, 1:55 PM UTC

gilbetron wrote: post #160

inter_netuser wrote: post #81

Earlier quoted context omitted.

This cannot be repeated enough: "few of the doctors I worked with along the years still don’t believe its true" a medical opinion is just that. an opinion . consensus often takes decades to change.

We, as patients, pass around these apocryphal stories around, but don't look at the opposite experience of doctors. Doctors constantly, and I mean multiple times per day, get patients in that tell them their symptoms are due to disease or condition or complex X. Time and again, the patient is completely wrong. No, you don't have cancer, your lymph node hurts because it is fighting off an infection, and besides if it…

Hilarious you brought this up: "No, you don't have an ulcer, you're just eating too much ice cream before going to bed."

Reflux is a very common food allergy symptom and milk is one of the most common allergen, if not THE most common.

I've had 3 or 4 scopes that showed some mild inflammation, and GIs were simply lost. I've managed to locate a 90 year old allergist who probably began practicing before there was benadryl. After recounting the symptoms I was told "it's milk. it's always milk". I was taken aback, how can anyone be so sure? Literally 5 minutes later that was confirmed by a skin-prick test.

Most physicians are garbage. The allergist was quite thorough.

The billing rate to dismiss you in 30 seconds pays about the same as a 30 min appointment. The incentives just aren't there.

Re: A shot to prevent Lyme disease could be on its way

#183

Post by arn » Tue, Aug 17, 2021, 1:55 PM UTC

inter_netuser wrote: post #165

nitrogen wrote: post #158

Earlier quoted context omitted.

trend of anti-intellectualism and distrust of doctors As someone who knows a practicing doctor who is also anti-vax, these are orthogonal issues. Sometimes, distrusting a specific doctor is the more intellectual approach.

You'd be surprised how many physicians and nurses refuse vaccination. You'll just never hear about it. AMA is one powerful beast, I wish I had a union like that. However, sometimes fun little things like this happen that show their true colors: "Starting in early 2003, the United States government started a program to vaccinate 500,000 volunteer health care professionals throughout the country. Recipients were health…

That doesn't mean distrust of vaccination in general - at least by doctors. It was for a potential bioterrorist attack. It perhaps more reflects the low likelihood or belief that there would be a small pox attack.

Meanwhile, 96% of physicians are vaccinated against COVID - https://www.ama-assn.org/press-center/press-releases/ama-sur...

Re: A shot to prevent Lyme disease could be on its way

#184

Post by misja111 » Tue, Aug 17, 2021, 1:57 PM UTC

uncertainrhymes wrote: post #148

Loughla wrote: post #138

Earlier quoted context omitted.

I'm convinced you can become and/or grow immune to Lyme, though. It's purely anecdotal. I grew up where we built our house (deep, deep in the woods). I spent my childhood on the farm there. Ticks were a constant menace, I honestly don't know how many hundreds I pulled off myself as a child. When I was able, my spouse and I purchased it and built a house. 6 months after moving in, my spouse developed Lymes disease. I…

When you were young, those ticks may not have had lyme. More importantly, you removed them. They have to be attached for 24 hours before the bacteria comes back out of the tick's gut.

No, removing them early just reduces the chance of getting Lyme. There's no such thing as a 24 hour barrier.

Re: A shot to prevent Lyme disease could be on its way

#185

Post by PragmaticPulp » Tue, Aug 17, 2021, 1:57 PM UTC

kortex wrote: post #181

PragmaticPulp wrote: post #161

Earlier quoted context omitted.

“Chronic Lyme” is a very challenging topic because it has become a mix of legitimate symptoms (those suffering post-treatment Lyme disease) but also a pseudoscience catch-all diagnosis promoted by bad alternative medicine practitioners. Contrary to popular belief, the CDC and medical community do actually continue to research the topics of potential Lyme persistence and post-treatment Lyme symptoms. We’re discussing…

That's fair. But I'd rather humor the quackish side of chronic lyme and see some progress being made, rather than lean to the side of dismissing them, along with people with legitimate complaints. The inability to adequately assay Lyme speaks more to how bad we are at assaying diseases, than to the (il-)legitimacy of the disease.

> But I'd rather humor the quackish side of chronic lyme and see some progress being made,

That would have the opposite effect, because many (or likely most) of them never actually had Lyme disease.

That’s the problem: “Chronic Lyme” has attracted too many pseudoscience practitioners who lazily blame everything on undetectable Lyme. They diagnose based on symptoms alone and/or employ tests with known extreme false positive rates while dismissing mainstream tests that have been validated.

The more you mix those false patients into the real Lyme population, the more you dilute the real signal from actual patients.

Humoring the quackery doesn’t advance the science.

If you want progress to be made in a field, it’s important to be diligent about keeping the quackery out.

Re: A shot to prevent Lyme disease could be on its way

#186

Post by istjohn » Tue, Aug 17, 2021, 1:58 PM UTC

inter_netuser wrote: post #51

voisin wrote: post #49

Earlier quoted context omitted.

How are you getting checked? I understood (perhaps wrongly) that the blood tests are only accurate well beyond the window with which the medications are effective, creating a chicken and egg issue.

why is there a window? people report recovery after several years with an appropriate treatment.

The bacteria migrates throughout the body over time, including into the brain and spine, so it's easier to eliminate when treated promptly.

Re: A shot to prevent Lyme disease could be on its way

#187

Post by megous » Tue, Aug 17, 2021, 1:59 PM UTC

darkerside wrote: post #127

jacksonkmarley wrote: post #108

Earlier quoted context omitted.

Being able to detect Borrelia Spirochetes is not equivalent to linking them with chronic symptoms.

Most CDC / IDSA folks will tell you that a course of antibiotics will rid the body of Lyme in all cases. The presence of spirochetes here should be enough for them to stop using that language. But it likely won't because there appears to be a systemic organizational bias against Lyme as a chronic condition, and I'm not sure why.

Presence 4 years or so later. So, maybe the patient was infected again some time after initial treatment?

Re: A shot to prevent Lyme disease could be on its way

#188

Post by doctorhandshake » Tue, Aug 17, 2021, 1:59 PM UTC

technothrasher wrote: post #142

Whitespace wrote: post #62

I caught Lyme earlier this year. Recently moved to upstate NY (20 miles from Lyme, CT) and tick checks are a daily thing. Found an adult embedded in my side. Developed a 103ºF fever and fatigue. Dr. took blood for the Lyme test but didn't wait for a positive and prescribed 2 weeks of Doxycycline. A few days later I found a bullseye rash on my leg (not near the bite area) which pretty much confirmed it. I felt 100% ar…

> Recently moved to upstate NY (20 miles from Lyme, CT) Wait, what? The only part of NY 20 miles from Lyme is the tip of Long Island. It's at least 60 miles from anything upstate.

For folks in NYC, ‘upstate’ is used loosely to mean ‘a place in NY state you access via queens or the bronx’.

Re: A shot to prevent Lyme disease could be on its way

#189

Post by polynox » Tue, Aug 17, 2021, 2:00 PM UTC

inter_netuser wrote: post #121

polynox wrote: post #96

Earlier quoted context omitted.

Being wrong is the essence of science. By contrast, lyme disease is (1) more than 40 years old, (2) not contagious, and (3) has no political headwinds. There is little reason to distrust CDC on this.

Several states felt it was necessary to pass laws regarding Lyme and provide immunity to physicians willing to treat long haul covid...errr long haul lyme patients. Seems rather naive to presume they had to pass new laws because Lyme has no political headwinds. It has plenty of controversy around it, for better or worse.

I was able to substantiate your comment about the laws being changed in two California bills (2013 AB1278 and 2005 AB592) amending BPC 2234.1 that appears to relax restrictions about treatment of "persistent" Lyme disease.

I do not think it is relevant to the point in this thread that is discussing whether Lyme disease does or does not result in a bullseye rash (Erythema Migrans or EM), and the CDC claiming that in 70-80% of cases the rash is present, which you baselessly disputed and edited your comment to accuse those of downvoting "facts".

As an example of what "evidence" might be, a 2009 paper [1] in Current Problems in Dermatology refers:

> EM is by far the most frequent manifestation of Lyme borreliosis. In the USA, more than 70% of patients registered with Lyme borreliosis had EM [28]. Among 1,471 patients shown to have Lyme borreliosis in an epidemiologic study in southern Sweden, EM was seen in 77% of all cases, and was accompanied by other signs of the disease such as nervous system involvement, arthritis, lymphocytoma and/or carditis in only 6.5% [29]

You can dispute those referred studies if you wish, but I think it would be hard to argue that CDC's statement that Lyme disease is characterized by EM in 70-80% of cases is untrue.

[1] Strle, F., & Stanek, G. (2009). Clinical Manifestations and Diagnosis of Lyme Borreliosis. Lyme Borreliosis, 51–110. doi:10.1159/000213070

Re: A shot to prevent Lyme disease could be on its way

#190

Post by ollifi » Tue, Aug 17, 2021, 2:00 PM UTC

kortex wrote: post #147

Graveyard of "not considered a real/serious disease/threat by the medical consensus until a frankly embarrassingly amount of time later" [x] "cadaverous particles" (washing hands after autopsies) [x] "hysteria" (likely a combination of various mental health conditions and/or PCOS, polycystic ovarian syndrome) [x] "GRID" (HIV/AIDS) [x] leaded gas bad [x] asbestos bad [x] smoking bad [?] refined sugar bad [x] Autism [x…

Isn’t Hysteria the other way round than those other diagnoses on the list? It used to be diagnosed but since doctors don’t believe in it anymore.