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Post by itsybitsyone on Apr 24, 2008 9:42:15 GMT -8
"Nancy, while this was an exceptional, albeit long, read, I do not see how it pertains to any of the current issues regarding certain practitioners offering questionable practices or charging ridiculous fees."
Well, I meant...long long long courses of antibiotics, dropping away from insurance companies (If you the other one, too, the hearing with the OMPC or whatever it was, you see how the witchunts took off) and charging cash...because the insurance companies turn them in when they do not want to pay their charges. Its quite ugly...and the doctor doesn't even get to know who complained...and sometimes it is a dr. hired by an insurance company who puts in complaints against the LLMD>
Possibly they are safer offering alternatives and dropping from insurance...
If you go read the next hearings in front of the assembly, you get to see exactly how the complaint process works, and it is horrendous.
I'm trying to see both sides here, that's all...and I think we SHOULD discuss both sides!!
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Post by LymeEnigma on Apr 24, 2008 9:45:54 GMT -8
I think that really depends on how bad the infection is and what kind of damage it has already done. I think that, unless symptoms are unmanageable or it is clear that the infection is running rampant, antibiotics should not always be prescribed. Cat's claw and symptom management may be the best course of action, for those with minimal neurological involvement. I think, in some cases, "saving" certain antibiotics for relapses or worse manifestations in the future should be considered. And, considering the possibility that the best we might do right now is remission, whether or not continuing those antibiotics to hold that remission should depend on the progression the disease has taken in the individual and whether or not neurological damage has occurred or continues to cause debilitating symptoms. I definitely think multiple courses of antibiotics should always be an option with post/chronic Lyme, but I'm not sure if I believe that being on a certain antibiotic for five years straight is any more beneficial, in the long run, than going on and off that antibiotic a handful of times in that same span. Also, in the case of those of us who experience autoimmune reactions, if those bacteria are going to be ever-present, even if in small numbers, causing continued symptoms no matter what course of treatment we continue, I'd just as soon take cat's claw and plaquenil, and call it a day ... until more thorough treatments are available. Edited to add quote, for continuity.
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Post by LymeEnigma on Apr 24, 2008 9:46:41 GMT -8
"Nancy, while this was an exceptional, albeit long, read, I do not see how it pertains to any of the current issues regarding certain practitioners offering questionable practices or charging ridiculous fees." Well, I meant...long long long courses of antibiotics, dropping away from insurance companies (If you the other one, too, the hearing with the OMPC or whatever it was, you see how the witchunts took off) and charging cash...because the insurance companies turn them in when they do not want to pay their charges. Its quite ugly...and the doctor doesn't even get to know who complained...and sometimes it is a dr. hired by an insurance company who puts in complaints against the LLMD> Possibly they are safer offering alternatives and dropping from insurance... If you go read the next hearings in front of the assembly, you get to see exactly how the complaint process works, and it is horrendous. I'm trying to see both sides here, that's all...and I think we SHOULD discuss both sides!! Can't argue with that!
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Post by LymeEnigma on Apr 24, 2008 9:50:14 GMT -8
"Dr. Phillips's testimony offers more of the controversy, and does a pretty good job, but his thoughts on blood tests and PCR leave me with a few huge questions: 1) what is this antigen capture assay he and Leighner keep talking about? Is it one of the past fad tests that has since been put to pasture? and 2) if PCR only looks for "snippets of DNA," then what are the limitations to its use? How long can a "snippet" last in the body ... and can it cause autoimmune issues that may resemble those found in active infection?" Me thinks (tho I am not sure) that's the one Yale has a patent on that they will not allow anyone else to use, and will not use it themselves...even though some scientists state it is a better test. Yale holds a patent on an antigen test that they will not release. Probably because it proves the vaccine doesn't work... Any idea where I might read more on this? You have me intrigued....
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Post by LymeEnigma on Apr 24, 2008 9:52:31 GMT -8
Check out this gem: "Patients with multiple erythema migrans lesions were more likely than patients with single erythema migrans lesions (P < 0.001) to have a positive antibody titer at baseline (63% compared with 17% for IgM; 39% compared with 16% for IgG). Fifty-seven percent of patients who had relapse were seronegative at the time of relapse." Azithromycin Compared with Amoxicillin in the Treatment of Erythema Migrans: A Double-Blind, Randomized, Controlled Trial Benjamin J. Luft, MD; Raymond J. Dattwyler, MD; Russell C. Johnson, PhD; Steven W. Luger, MD; Elizabeth M. Bosler, MPH; Daniel W. Rahn, MD; Edwin J. Masters, MD; Edgar Grunwaldt, MD; and Shrikant D. Gadgil, MD www.annals.org/cgi/content/full/124/9/785
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Post by itsybitsyone on Apr 24, 2008 12:58:48 GMT -8
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Post by itsybitsyone on Apr 25, 2008 4:27:24 GMT -8
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Post by LymeEnigma on Apr 25, 2008 8:07:35 GMT -8
My jaw is still agape ... that test has been around since 1997?!
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Post by itsybitsyone on Apr 25, 2008 8:16:37 GMT -8
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Post by LymeEnigma on Apr 25, 2008 8:44:53 GMT -8
"The Government has certain rights in this invention."
Nice....
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Post by itsybitsyone on Apr 25, 2008 9:25:22 GMT -8
Sorta kinda fits in this discussion...I'll put it in a better place later Borrelia burgdorferi detected by culture and PCR in clinical relapse of disseminated Lyme borreliosis. Oksi J, Marjamaki M, Nikoskelainen J, Viljanen MK. Ann Med 1999 Jun;31(3):225-32 www.ncbi.nlm.nih.gov/entrez/quer ... t=Abstract www.annmed.org/duo/annmed.check_ ... 25-32.html A total of 165 patients with disseminated Lyme borreliosis (diagnosed in 1990-94, all seropositive except one culture-positive patient) were followed after antibiotic treatment. 32/165 = 19,4% had clinical relapse after more than 3 months antibiotic treatment for borreliosis. In 13/32 (40,6%) could the relapse be verified by either positive PCR (12) and/or positive culture (3) for B. burgdorferi. 2/104 (1,9%) of the asymptomatic had positive PCR. These were not treated and didn't have sign of relapse since, according to personal communication (120900) with Oksi. At time of proven relapse 6/13 (46%) were seronegative (12/13 were seropositive at initial diagnosis, i.e. 5 pts. developed seronegativity despite proven persistency ) 5/13 (38%) had circulating immunecomplexes, of these 3 were seronegative. 1 patient (10) was seronegative throughout the whole course of illness despite both positive culture and PCR in CSF and positive biopsy and plasma PCR at relapse This patient had been treated with ceftriaxone IV 2g for 3 weeks, followed by 24 weeks of doxycycline 100 g bid and amoxicillin 1 week - a total of 28 weeks (6-7 months). 1 patient (8) had been treated for as long as 47 weeks (11 months) including 7 weeks of intravenous ceftriaxone - primary diagnosis was confirmed by positive biopsy and the relapse 44 weeks after treatment confirmed by a positive plasma PCR. 1 patient (2) had relapse 130 weeks after 1. treatment, that had lasted 16 weeks. Pt. was seropositive initially (both IgM and IgG), but seronegative at relapse, relapse confirmed by positive PCR, no history of reinfection in the meantime.
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Post by itsybitsyone on Apr 25, 2008 9:29:00 GMT -8
Not so sure that continued use of antibiotics isn't needed in some cases...until we have a better answer...for some people...
I think ILADS looks at all this and that's what they think...and truth is, you cannot blame them. What you can blame them for is all the hocus pocus that they allow some of their doctors to do...
Oh, we are far from done...there's tons of stuff
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Post by LymeEnigma on Apr 26, 2008 8:09:00 GMT -8
Not so sure that continued use of antibiotics isn't needed in some cases...until we have a better answer...for some people... I think ILADS looks at all this and that's what they think...and truth is, you cannot blame them. What you can blame them for is all the hocus pocus that they allow some of their doctors to do... You and I are definitely on the same page on that. Bring it on! Maybe we should start our own "proof of antibiotic resistance" thread.... If memory serves we have a similar thread, but I'm not sure if we have one devoted just to sources.
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Post by itsybitsyone on Apr 29, 2008 6:58:17 GMT -8
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Post by LymeEnigma on Apr 30, 2008 13:05:00 GMT -8
The link isn't coming up correctly. Could you edit and add url code, so the link stays intact?
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