Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Lyme Disease

Episode Date: October 16, 2015

This week on Sawbones, Justin and Sydnee are dodging ticks as we explore the surprisingly short history of Lyme Disease. Music: "Medicines" by The Taxpayers

Saabones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, time is about to books. One, two, one, two, three, four. We came across a pharmacy with a toy and that's lost it out. We were shot through the broken glass and had ourselves a look around.

Some medicines, some medicines that escalate my cop for the mouth. Wow! Hello, we're bringing with us all bones, and all bones marital do of misguided medicine. I am your coach Justin McRoy and I'm Sydney McRoy You want to hear it's how lean do you want to hear a spooky story? You know what you know? I'm all in for spooky stories This is my spooky story when I was a kid I thought That lime disease and scurvy were the same thing because I knew you had to eat citrus to get rid of scurvy.

So I thought Lyme disease and scurvy were the same thing until I was like in my late teens. That's your, is that it? Are you done? Yeah, that's the spooky story. Okay, I'm confused. Which part of that is spooky? Well, the spooky part is you married me. And also we have an infant daughter.

Okay, fair, fair. Pretty spooky, right? Yeah, I don't even know if spooky would be the word. I think more like horrifying. If I contemplate it. Well, don't think about it too much. Yeah, terrifying. That's like, but it's not gonna too much. Yeah, it's like.

That's not gonna fail. I thought that, yeah, I thought they were the same thing. Sheer abject terror. Okay, well, moving on, you told me we were talking about Lyme disease and that's my antibit about Lyme disease, okay? So there. It was a good one. I thank you.

Thank you for sharing the intimate tale. It was a painful story. I'm really glad. It's okay, because in the Halloween spirit, I will tell you that for many years, I said, instead of pumpkin, I said, pumpkin. Pump, pumpkin.

Yes, I said, pumpkin. For many years. I couldn't say mischief for like the first 15 years as a ordinary. Did your parents correct you? When I said, mishfish? No. Really? See, my parents never told me that it wasn't punkman. So like I was, I thought punkman and I also thought that if I saw

like a teacher was MRS period, like it was a female teacher and were supposed to call her Mrs. whatever, I thought it was Misriz. And I called my, I remember calling my fifth grade teacher Misriz and my parents said correct me. We're gonna do better. We're gonna do me. We're gonna do better. We're gonna do better. We're gonna do better. So let's talk about Lyme disease, Justin. A lot of people have suggested

that we do Lyme disease have kind of searched and then been shocked we haven't covered it yet and so have suggested it. So thank you to Devon and Christine and Amanda and Lindsay and Tamara and Ian and Diane. Thank you guys. Lyme disease is really interesting because... That's for me to decide. Well, that's true. You can tell me at the end if this was interesting. Okay. Wait until we turn off the recording. I'll go and deal. There's a little bit of ancient

history of Lyme disease, but for the most part this is a very modern disease. We find the first description of what was probably Lyme disease from Reverend Dr. John Walker who was on the island of Jura, which is also known as deer island off the coast of Scotland. I'm presuming because there's lots of deer. Probably. Or no deer, like a notable lack of deer. Well, I wouldn't do it. Then why wouldn't it be called no deer island? It's hopeful, it's optimistic.

It's optimistic. Deerless island. Towards a dearful future. He observed some sort of illness that caused a rash and people were in a lot of pain and he described all this. And he thought it was spread by, I mean, he was talking about ticks,

but what he called them were worms that might have spread this disease. Which from the description, this is probably a lime or something like lime that he's talking about. You can find some older descriptions of skin diseases that sort of sound like the lime disease rash from Germany, but it's not clear if it is in fact lime disease. There are other tick-borne illnesses they may have been talking about. We found evidence that the bacteria that I'll tell you about that does cause Lyme disease was in a German tick

from 1884. How did we... Why would you be in Towson that guy? I don't know. A well-preserved tick that we know is German from 1884. How do you think we know it was German? Like, did he speak? To lead her. That's what she got you got I was gonna say because of his Excellent taste and beer. Okay. That's that's good. That's that's celebratory. I like that We've also found a mouse from Cape Cod from 1894 who had evidence of Lyme disease We we even found Oatsy the ice man on C Oatsy the iceatsy, the Ice Man, which I like, this was just mentioned several times, like you know, everybody's famous Ice Man.

Oatsy. Oatsy, the Ice Man, who is a 3000 year old mummy who was found to have the bacteria that causes Lyme disease. Oatsy would be a really good name for our horse. Not this spelling, but Oatsy, the horse, would be really a really positive name for our horse. I'm assuming he's a human, he's the Isman. Yeah, well it just says mummy here. See, is it

the Isman? Is it the Isman? It's the Isman. It's the Isman. Both the mutant and the pilot. They're out the 1900s. We see a lot more research being done to try to figure out because we see more incidences of like, this person had arthritis and then they also had a rash and we don't know why and we're trying to piece it together. We know that ticks carry some diseases. And so you see like different mentions of studies and then some weird symptoms like this person

also had some weird neurological problems. After the advent of penicillin in the 1940s, we see people kind of just throwing penicillin at this like, you know, this is great. We have this new drug, let's try that. But we really don't see Lyme disease described and diagnosed until the 70s. So that's like a new disease. Yes, yes, it's very new, especially in sawbones terms, very new. So I want to take you back to the summer of 1975. Okay, I'm ready. Okay, so let me give you a little bit of like info about just to give you a sense of

place and time. The number one movie that year is Jaws. Okay, okay, this is the year that SNL premiered. Oh wow. Yeah. This is the year that Rocky Horror Picture Show was first shown. I believe Wild Cherry was burning up the chart West Virginia's own Wild Cherry was burning up the charts with play that funky music white boy. Really? I don't know. Somewhere around this time. Yeah. You don't know that level keep us together. Oh yeah. It was a top song, Captain and Taneel. This was also the year that in Japan, they invented a little something called the VCR.

The video cassette recorder. Yeah. It's a very exciting time. So this is where we are. If you're listening and you're younger than 20, that was a machine that recorded, it's like Tivo. There were these giant tapes. You've probably seen these old things called cassette tapes. I'm not doing this.

You know what? They can read a book. No, they're going to read it on the internet. They don't read a book. You can read a Wikipedia. So we're in the summer of 75 and it's a hot summer. Yeah. And they're suddenly in a place summer. Oh, yeah.

And there are suddenly in a place called Lyme, Connecticut, there start to be these cases of arthritis of what appears to be rheumatoid arthritis, but in kids, lots of them, a lot more than you would expect to see just naturally, you know, people who have rheumatoid arthritis as children. So we have this cluster of cases, more and more kids are being diagnosed. Some of them have other weird symptoms, some of them have rashes, and parents are getting pretty panicked about it. As you can imagine, it's a weird disease.

Nobody knows why they're getting it, and it's causing quite a stir. So researchers from the area and then from National Institute of Health and all those kinds things kind of all collect in line to try to figure out, okay, what is going on? Where is this coming from? Epidemiologists, let's try to piece this together because clearly this is something infectious. So they start looking for a common source. They study water sources and air sources. They try to find environmental toxins.

They interview the kids and the families. And they start to see some similarities. The cases all started, the symptoms all started around the late spring to summertime. All these kids had been playing outside in wooded areas, which isn't like shocking, like, you know, their kids, it's the 70s. We don't, we don't have a VCR yet, like we just invented it. What else are they doing? Right. You know, of course they're playing outside. Like there's nothing, there's nothing to do inside.

So the kids are playing outside in one of the areas and they start asking them about contact with like bugs and ticks and things like that. And they find that a lot of the kids say, you know what, I know I was, I did have a tick on me, or their parents say, you know, I pulled a tick off of them. And quite a few of them start reporting a rash that they describe as fairly similar. So they start thinking, these researchers start thinking, you know what, this could be the tick, specifically a deer tick, a very certain kind of tick.

It's different than your dog tick. So don't get freaked out about the ticks on your dog. This is a very different tick. So they start studying, could it be these ticks? And there is a researcher named Dr. Willie Bergdorfer, who luckily, fortuitously, had spent part of his career studying Rocky Mountain spotted fever, which is another illness that's transmitted by ticks. He had also spent some time in Europe studying a tick-borne relapsing fever. He'd also, as he notes when you read his memoirs, like, had gone to a conference in 1949 that had proposed ticks like the deer tick as possibly being able to transmit infection.

So answer me something, Sid, that I may not have the answer, but just to give me some idea. Like, how does this happen? How does a disease just sort of go, I mean, is it literally new? Or I mean, it's obviously not what I only knew because like the ice man had it. So like, how does a disease, is this just people not connecting the dots or do you think lime disease changed in some way

that made it more prevalent? Or do you think it's just migration of the disease to a certain area, or what, how does this happen? I mean, certainly the disease migrates, that's true, and certainly we become better at recognizing it. Part of it is that this was probably described for many years before we called it Lyme disease. But the bigger thing with anything like this that's like tick-borne or any kind of insect-borne or things that

Probably had had created their own little life cycles with mammals other than humans and insects out in the woods It's really as we penetrate further into those areas that you start to see it spread to humans So this probably had to do with the fact that more and more people were living there, you know, after the industrial revolution, there was more deforestation and more people were spending more time, you know, closer to nature. There was also more of a push to get out there, you know, like that became more fashionable, right? Like getting out into the woods and.

Yes. Yes. Yes. So as you begin to see people moving into these areas and more and more for the 70s, obviously, but still. Yeah. More and more human infringement on these kinds of areas. That's when you see us get these diseases. And this isn't unique to Lyme disease or tick-borne illnesses. This is true for a lot of different illnesses. You could, you know, date the moment that they crossed from animals to human is when humans went where the animals are essentially. So if we would just, I don't know, stay in our concrete towers.

So what's it cause? You know, like we do in West Virginia. Right. What's it cause by said? Okay, so with the help of Dr. Willie Bergdorfer, they were able to isolate the organism that causes Lyme disease. It is called Burelia Bergdorferi.

As you may have guessed, Bergdorferi was not like just a crazy happenstance. It was named for Dr. Willie burgdorfer. That would be a really crazy coincidence. That would be a crazy coincidence. Your name is what? As you deserve? Borelia, it was already known. It's a type of spyrachete bacteria. Which is halfway between a spiral and a parakeet as everybody knows No accurate no accurate in sight it means if you look up what spyra-ket look like first of all other kinds of spyra-ket Not burrally, but imagine Poor five those poor things the body of a bird the head of a spiral

God's greatest mistake. Spire of Keats. And it gives you lime disease. It gives you lime disease if he looks at you. And there's another kind of spire of Keats that will go. That's stiflus. Now that's spupi. Like he was not spupi.

The spire of Keats is spupi. Somebody draw me a spire of Keats on your tattoo. If you wanted to add to a Spyro Keats, there are many pictures on the internet. You can Google them and they're very pretty. I bet they're not gonna look like, not me, they'll look like, look like, no. No, they're not gonna look like a Paracute.

No, they're not gonna look like that. Oh, that's true. I need a real Spyro Keats. Okay, so that's, you have a challenge. This is your Halloween challenge. Sproopy Halloween challenge. Leveled at you by Sovones. Please draw Justin a parakeet with the head of a spiral.

Right. Or perhaps just a spiral parakeet? A spiral, listen, if you can figure that one out, please let me know MC Esher. MC Esher Jr. out there listening. So they, seriously, though, look at pictures of spiral keats. If you see like dark field microscopy pictures, they're just beautiful. But they look like little spirals I am it's a bacteria we figured you know we figured out what it was we were we developed testing for it by 1984 and we it became a reportable disease by 1987 so since

then we've been keeping track of where it is and how much it is and and all that kind of thing it is as I alluded to it is carried by a tick the the deer tick, which is X-A-D's scapularis. It's a hard tick. That's a very important distinction in ticks, soft ticks and hard ticks. I think because they're hard. I don't touch them. When I see them, I'm gonna assume it's hard.

It looks hard. On the West Coast, this can be carried by X-A-D's Pacificus, which is slightly different, but we don't really see it much on the West Coast. It's a mainly new England disease. It is spreading south. We're seeing it more and more like in our area. There were actually four more counties in West Virginia.

We're added to the list of endemic counties for Lyme disease in August of this year. So very recently, it's still not in our county. We still don't have it in our county. Yeah, but it is spreading further south, probably as the animals move. But you know what? That doesn't mean so much because I bet a lot of people

who get ticks are out in another count. Like they would be traveling anyway, right? Like when I got to take on my head, I was in Lawrence County, Ohio, out Lake Vesuvius, camping. Exactly. Exactly. Which is funny.

It's funny to think about you out camping. I mean, I love you, but you're not exactly like Justin the outdoorsman. I mean, he's got a campground, right? Like we had some of the luxuries of home, electric griddle, what not. Was that one way what was Travis? No, no, no, this is when I was little.

And when I got home, I was watching cartoons and I thought I had some March mill in my hair and I picked out for an hour before I finally just yanked it out and realized it was a two cause your day, man. I felt that's right on another podcast for maybe this podcast, please let me know or don't I don't it doesn't really matter to me, but it was the worst thing. I still remember it with perfect crystal clarity. That would be that would be awful.

Um, I've never had a tick and I'm glad. Yeah. It's the time I went camping with Travis and we had to dump out all our beer. Yeah. Now that's spooked. That we got caught by what park rangers park rangers But I was awful sad day. You know what saddest about that that actually happened before we got there But the just the story of it was so so visceral to you that you have like it is formed itself in your mind I feel like I was there like I told us about it when we got there

and I felt like it's pain. Like I could see it. I could see that it happening. So how does the bacteria get from the tick into you? Well, that's pretty obvious, right? Yeah. The tick bites you and eats it. It's close to suck your blood.

So it's all blood. Exactly. So the bacteria lives in the gut of the tick and when it attaches to you and starts feasting on your blood, the bacteria has to make its way. Feasting, eh? Not just eating. No, feasting.

Feasting. It is how we're doing. Drinking deep little friends. The bacteria has to migrate from the gut of the tick to its salivary gland so it can then get into the little wound that it's created. Just stick it down, spit it with the spit and that it's created, you know, just like stick it down like like spit it With the spit and the bacteria. I'm kind of the worst. I know I know stop it This takes by the way this process the bacteria moving and then getting from the salivary glands into you takes at least 36 hours

maybe more Usually more and this is probably why it's a lot easier for the tick to give this to like deer and mice and other mammals. Yeah, go ahead, crap. Because yeah, because well, they don't have like opposable thumbs. They can't like get the tick off as easily. They can't freaked out by it like we are. They can't open the jar of acetylene to your head of it.

But this is good for you to know because if the tick has not been on you for at least 36 hours, it can't give you anything. There's no way it gave you anything. It has to be there that long. And if you're not sure if the tick's been on you that long, engorgement is an important point. So I thought I would tell you a little bit about tick engorgement. Oh great.

That's just how I was hoping to spend my Friday. Now, if you have never seen a tick on you or certainly an engorge tick on you, again, you can fight because I hadn't. I've never had a tick on you or certainly an engorged tick on you. Again, you can fight because I hadn't. I've never had a tick on me. I've actually never picked a tick off of a patient. They usually pick them off before they come in and then tell me about it. But if you see a tick that's engorged, you'll know right away. It looks like, have you ever felt like a blood blister? Like a little blister that's just...

That's what they look like. Huge and swollen and red. And I mean, you know, like when you seeister that's just, that's what they look like huge and swollen and red. And I mean, you know, like when you see the little teeny ticks, especially, I didn't mention this, the nymph form of the tick, like the younger form of the tick is the one that's more likely to spread this, simply because they're tiny. They're about the size of a poppy seed, they're very small.

So you can miss them, it looks like a freckle. You wouldn't even know they were on you. You could be covered in them right now. And you were the worms. And they looked like little freckles, and you wouldn't know they were on you. You could be covered in them right now You are the worms. And they would look like little freckles And you wouldn't know for sure until you like scratched them and they came off Can we please go to the building department? I'll give you anything But anyway if they get in gorge, they look giant and red and pulsating and nasty. I'm going. I'm going without you But it seems that I skill it my cards for the mouth.

Okay, I've girded my psyche to hear more about Lyme disease. I would thank you to steer clear of encouragement and encouragement related topics, madam. And maybe tell me how I know if I have Lyme disease, which by the way, 100% sure I have now. Thank you. How do I know for sure, which I do? Okay, so we'll just move past the tick biting you and transmitting the bacteria to you. Oh, thank you.

And it seems that that's already happened. There are three stages of Lyme disease. The first stage, early localized disease, is what, like, if you've ever heard anything about Lyme disease, you probably heard about a rash. And it is classically called the bull's eye quote unquote rash because it looks it's supposed to look like a bull's eye. It's also called erythema migraines, but that is the most common.

That is the thing that we can tell you for sure you have Lyme disease if we see it. It only happens in about 80% of patients, so there are still people who have Lyme disease who don't get that rash. And the trickier thing is that only about 19% of people who get the rash, it really looks like the classic textbook medical school bullseye rash that they tell us about. So sometimes it can just look like a big red spot, a big reddish blue spot. You can even have multiple of them. Sometimes it can blister. But the point is there's a big rash. It has to be 5 centimeters or greater to qualify, so it's pretty big. And it expands. And the only other symptoms you're

going to get other than the rash, which by the way isn't like itchy or painful or anything, it's just there, are like flu-like symptoms. So like really non-specific, some, you know, fevers and chills and body aches and that kind of thing. You know, nothing that you would ever, you know, without the rash, you would never come in with these symptoms and us say, Lyme disease, especially here. I would say, you got the flu, you got a virus, whatever. If you don't catch it in this early stage and treat it, you're going to move on to early disseminated disease,

which could mean more rashes, it could mean more body aches. You could start to get some joint pains, and you can get some more serious effects at this point. This is why Lyme disease is a bigger deal, is because then you can start getting like inflammation of your heart called carditis, it can cause abnormal heart rhythms, and you can get neurological effects,

even things like meningitis. Sometimes just like neuropathy, like numbness tingling or weakness somewhere, but you can actually get meningitis from Lyme disease. I gotta say, and I know there's a third stage, but like at this point, especially, this sounds like it would be a monster to try to diagnose. This is a crazy constellation of symptoms. It is very hard to diagnose. I'll definitely mention that. It is a very difficult thing, especially if you didn't have the rash and... Oh, you say that in the notes. Wow, I just

put that together myself. No, it is, it's very hard to diagnose. Genius, junior doctor. You've been listening to me I think. You've been paying attention. Yeah. Good job. Well you're sitting really close to me and I love you a lot. And I talk really loud. Yeah.

And I got the handle on it so it's like, yeah. So you're right. It is really hard to diagnose especially, you know, if you have the rash and you have the history of tick exposure, much easier, you know, that's a slam dunk, especially if you live in an area like New England, you'd be much more likely to notice, you know, to recognize this and treat it. If you're living here in this county in West Virginia where it's not endemic, you'd be much less likely. And certainly in Southern states or out west, you wouldn't ever think about this.

And you probably shouldn't, by the way, don't, you know. But at this point, you're going to be sick enough that you're going to be in the hospital and we may be testing you for stranger things, hopefully. But yeah, it wouldn't be obvious if this is all you had. If you were still not diagnosed and treated, it can progress to the late stage, which is when you get a lot of the more severe arthritis, which is probably what these kids in 1975 had, because they hadn't been treated treated because nobody knew what they had. And you can get some more severe neurological problems like permanent peripheral neuropathy,

meaning like numbness and tingling in your hands or feet. You can get changes in your personality stuff, gotten cephalopathy, you know, some permanent stuff can begin to happen. Not all of it is permanent, even if you treat it in this late stage, most of the time all your symptoms will go away. But there are some things that if it progresses this far, may stick with you. So one important thing, so those are the three stages of Lyme disease itself. Now hopefully you catch it, the earlier the better, and you treat with antibiotics, which

I'll tell you about, it's really easy to treat, and it goes away. That's the hopeful thing. What can happen is that if it progresses long enough before somebody catches it, like let's say you don't remember you were bitten by a tick and you never had the rash, so nobody really knows what they're looking for. You can have something called post-treatment Lyme disease syndrome, which are patients who have been diagnosed and treated appropriately. They already had the right course of antibiotics, but they persist to have symptoms longer than

six months, because you expect all of these things to they persist to have symptoms longer than six months. Because you expect all of these things to resolve by six months once you've been treated. Probably a lot sooner if you've been treated early on. Is that common? What post-traitor? No, it's not common. It's uncommon.

But some patients have it, and the later you were diagnosed and treated, the more likely you are to develop some long-term arthritis. And some, like I said, some neuropathic pain. This is very rare, but it is a huge impact on the lives of patients who have it because they get the antibiotics and they expect to feel better and they wait and they wait and they wait and they do feel better, but there are still some things hanging around and it can be really tricky at that point to say like, did you get it again? Is this something new? Is this a...

Lime disease too? Yeah, because you can get it again, you know, just because you had lime disease once more treated, it doesn't mean you can't get it again. You mentioned it's really hard to diagnose. Is there some sort of test that you can do to just grab some blood and test it for lime disease? There are many tests you can do. There is a very specific, if you go to the Centers for Disease Control website or the Infectious Disease Society of America website, which is, by the way, where a lot of this information comes from that I'm giving you, from the IDSA and from the CDC.

If you have questions about Lyme disease, I would refer to one of those two organizations, especially the CDC, because it's really user-friendly. They have stuff that is meant for me as a physician to read, and then they have lots of stuff that's meant for people without any medical background to read, you know. But they will tell you there are two tests that they recommend and you do them in a specific order. It's very precise the way we do the testing. The first test looks for certain antibodies. If this test is negative, you're good to go. You don't have Lyme disease. If this test comes back positive, or sometimes it can be equivocal, then there's a follow-up test that you can do that's a little more specific to try to figure out if you really do have Lyme disease. Even when done in the right order and when the, because there are certain time frames, you have to do them. Even with all that,

you can still get false positives on these tests. So as you can imagine, that makes it really tricky, because now a test has come back positive for Lyme disease. You know, maybe a second test came back positive for Lyme disease. So you think maybe this person has Lyme disease, this still might be wrong. It's good to know that if you have the rash and a definite history of a tick exposure,

especially if you know it's been more than 36 hours that the tick was on there, you don't need to do all this. You just treat them. Yeah, you don't do any of this testing if you have those two things. What's the treatment? The treatment is pretty easy. It's just antibiotics very commonly, you know, commonly available antibiotics. Doxycycline is a great one, but there's lots of other alternatives. It can be 14 up to 28 days depending on what stage you're in and what symptoms you have. If

you're more severely ill, if you're into the heart effects or the neurological effects, the late stages, then you may be sick enough to actually need some IV antibiotics. So there's another antibiotic septar axon we use. Again, we're talking about 14 to 28 days courses of treatment that would be the most you would need. And you may or may not have to be hospitalized for part of this. Again, it kind of depends on how sick you are. But I imagine the best course of actually would just be not to get a line to these. Absolutely. So the best thing to do is prevention. Don't get tick bites. If possible, stay away from

ticks. That's a good. Oh great. You see why it's coming. It's like not here. Run. Like they don't move fast. They're not side.

We're not there anyway. That's their domain. So try to stay away from tick concentrated areas. A lot of people aren't going to do that. So when you do go into areas where there are ticks, especially the deer tick, you want to wear like light colored long-sleeved and long pants, you know, clothes, that kind of thing to protect your skin. Deat is useful as a ticker pellet. If you're not going to do all that, you want to do a tick check within 36 hours of coming in. So you've been outside, you've been around ticks, have somebody or, you know,

wait a minute, but wait, what if you were out for more than 36 hours, what if you're camping? You should probably do within 36 hours of when you've been outside. Yeah. So maybe tick checks while you're camping. Ticks checks. Consulate. It can be very romantic, you know. Yeah, sure. Out there in your tent alone, strip down and check each other for ticks. Explore your lover's body. For ticks. For ticks. And you really have to look closely, because like I said, the nymphs are like poppy seed size. I'm not doing this with you again, small, move on.

Another thing that can be helpful is if you've been outside for a short period of time, you can bathe within two hours of coming in, that's actually been shown to reduce the risk of gain-lime disease. Watch out for your pets. You can't get lime disease from your pet, but they could carry in a tick that has Lyme disease and then the tick gets on you. So, if your ticks have been outside and areas where there are, or if your pets have been outside and areas with deer ticks, think about that.

Interestingly, there was a vaccine briefly. Oh, great. Cool. In the Vepisid. No, because there's not now. It was called Lyme Ricks. It came out in 1998. It was really cool the way it worked. It attacked the specific ospe protein that is mainly produced when the

bacteria is inside the tick. So it's produced by the bacteria inside the tick. The vaccine makes you make antibodies against it. So you make antibodies that target that protein. I think I misspoke there. So does that make sense? You make antibodies, they target the protein that is inside the tick. So they are probably mainly attacking the tick's bacteria

while it's attached to you. It's crazy. Also after it's inside your body, but mainly while it's attached to you. Anyway, it was a very cool vaccine, about 78% effective, which is not too bad. But there was a lot of worry about adverse effects. There was a lot of media concern. There was some, maybe a little bit of undue panic.

It wasn't a perfect vaccine, and there probably were some people who were going to have some adverse reactions to it. Ultimately, if people had used it and if they hadn't pulled it from the market and if we had years of data collected on it, we may have found that it was a good vaccine that was worthwhile. I don't really know because it was pulled from the market in 2002, mainly because Black Soast Smith climb wasn't making enough money off of it. But at that point, there wasn't enough of a database to tell you, was it really worth all the panic

that it caused? I don't know. I don't know what to tell you. It may have been a great vaccine. It's not around anymore. There is controversy. And I know everybody who's been listening to this episode is probably not everybody. But there are a lot of people listening who are waiting for us to talk about the controversy

that has to do with Lyme disease. Okay. And that's with something just. We didn't, as you can tell from the time indicator, on your podcast player. Yeah, I don't want to belabor this point because our podcast is supposed to entertain you, hopefully inform you a little bit, and make you happy and make you feel good. And my job is not to lecture you or to, I'm not your doctor. I'm your friend. Go talk to your doctor if you have real concerns about these issues. If you have real questions. But I am going to give

you the information that, again, it's available widely from the Centers for Disease Control, from the Infectious Disease Society of America, and also from, you know, the American Academy of Pediatrics. You're talking around this. You're talking around this. I love it. What is it? What are you talking about? So there is a term that you will hear called chronic Lyme disease.

This is a term used to describe people who continue to have symptoms associated with Lyme disease longer than the six month time frame that we would expect after they've been treated. So we know that this happens though, right? Right. Post-treatment Lyme disease syndrome. Yes. This is most likely, most of these patients have post-treatment Lyme disease syndrome. The controversy comes in with, do they still have an active infection?

Now, the accepted medical position by all major medical organizations is that no, there is no active infection. And why does that matter? Because then that means you don't need more antibiotics. You know, if these are just the sequela that are left over after you've had an infection and been treated, not to minimize them, they're still severe, but you don't need to treat them with more antibiotics.

What does sequela mean super quick? Just like the effects, the after effects kind of thing. But if you do have an active infection, obviously we would need to give you more antibiotics. That is where the the issue lies there are Physicians who are proponents of continuing to treat Lyme disease as long as any symptoms remain and these symptoms can be incredibly vague They can be muscle aches and pains. They can be fatigue, headaches, things that may be

attributable to a million other diseases. And so there are patients who end up on quite literally years of IV antibiotics. This position is not held by any, like I said, major medical organization. What the Centers for Disease Control or the IDSA will tell you is that likely these patients either have post-treatment Lyme disease syndrome, which is a very real entity, or they have something else that just is, we're just lumping in with Lyme disease and we need to do a

little more digging and talk with these patients more and take care of them because they have very real symptoms that probably aren't going to be addressed by long-term antibiotics. And studies again and again show that long-term antibiotics are no benefit over placebo in these patients. So if you are questioning whether or not you still have symptoms, you've been diagnosed with Lyme disease, you've been treated and you still have symptoms and you're wondering what to do next.

I would go talk with your physician about this, ask them what the safest thing, what the best thing to do is what are the recommendations, what are the guidelines. There are negative side effects from obviously from getting long-term IV antibiotics depending on what they choose. It can hurt your liver, your kidneys, not always, but this can happen. Also, when you have an IV access, an intravenous access for a long time, as you would need, if you were going to get extended antibiotics for anything, anything that we treat with extended antibiotics, that's a source of infection.

So you can get infections in your skin or at the site or in your bloodstream, which can put you at risk for a lot of other problems. So if you have had Lyme disease and you've been treated and you think that you may still have symptoms or you have concerns, please go speak with your physician about it. Don't just trust the internet. And if your physician says you have chronic fantasies, you may want to get a second opinion, right? Because it sounds like he might be an outlier.

I think that I would ask for a second opinion at that point too, because yes, that is not the accepted medical position at this point. But again, I would encourage you, this is, and we say this a lot, and this is true, not just for medical things, this is true for like anything, right? Don't just trust the internet.

I'm sorry internet, but you know, for every time you help me out, you let me down 10 more times. So don't just Google this and take what you said, because there is a lot of misinformation out there, a lot of things that I wouldn't just trust. I would go speak with your physician if you're unsure, get a second opinion.

Again, don't listen to me, and don't trust. I'm just another voice on the internet, right? Go go talk to your doctor about this issue Thank you the maximum fun network for having us as part of their program. Hey, we we Did a guest spot on the Oda Ross and Carrie show. Thank you to Ross and Carrie for handling our show last week. I really enjoyed their episode. And we did an episode of their show where we went to the mystery hole in West Virginia.

And it's a popular tourist trap. And we investigated the paranormal claims there. And it was a lot of fun. And it was super cool and it was a lot of fun. So thanks Ross and Carrie for letting us do that. You search on iTunes or what have you, you can find that. I also wanted to tell you that Aunt Cool, Sydney Sister Riley, frequent podcast guest host, is doing a fundraiser for her speech and debate team. This is the next generation of West Virginia podcast here.

It starts with speech and debate. It starts with speech and debate. She's doing a fundraiser to try to help raise money for her team. If you'd like to donate to that, even a couple bucks that really mean the world to her. You can find that on our Facebook page. Just search for, search for, you know, saw bones on Facebook and you'll scroll that you'll find it. You'll see the link right there. I really appreciate that. Thank you so, and scroll that you'll find it. Yeah. You'll see the link right there. I really appreciate that. Thank you so much in advance if you're able to kick in a couple bucks.

And thanks to TaxPaid for letting us use your strong medicines. See you in our natural repartement. That's gonna do it for us, said. Yeah, thank you guys for listening. Sorry, this episode was a little bit late this week, you know. Yeah. Life, right? Am I right?

We're just out there doggin' ticks. Just out there doggin' ticks. And until next week, my name's Justin McRoy. I'm Sydney McRoy. And as always, don't drill a hole in your head. Alright! Maximumfund.org Comedy and Culture, Artistone, Listener Supported.