In this video, Dr. Harris discusses the details of how one gets Lyme disease. He also goes into the lack of a definitive blood test to diagnose Lyme disease and why Lyme is in most cases a clinical diagnosis. He discusses the significance of treating both the Lyme bacteria and additional co-infections. He talks about the positives and negatives of antibiotic treatment and emphasizes how alternative therapies and lifestyle changes play an important role in helping to irradiate Lyme disease. Steven Harris, M.D. has been in private practice since 2001. Dr. Harris is a medical doctor (MD), board certified in Family Practice. His private practice was opened as a sole proprietorship until 2006, after which he formed a California medical corporation, Pacific Frontier Medical, Inc. Since 2001 Dr. Harris has focused his practice on the diagnosis and treatment of Lyme disease and other tick-borne co-infections. In his approach to Lyme disease he incorporates strategies found in conventional, functional and complimentary medicine. He believes that there are many effective treatments available to those with chronic and persistent Lyme. Dr. Harris has taken a leadership role in lymedisease.org (formerly CALDA -The California Lyme disease Association), a research, patient advocate group which has been largely responsible for spearheading favorable legislation protecting patients rights, expanding Lyme disease awareness and fostering continued public health education. Dr. Harris is also an active member of ILADS (The International Lyme and Associated Diseases Society). This is a professional medical society of physicians and scientists, which has become the authority on effective treatment for chronic Lyme disease. Dr. Harris graduated from the University of California, Los Angeles. He went on to Howard University for medical school and then completed a family practice residency at the University of Illinois in Chicago.
Steven Harris, and I'm a medical doctor, I went to undergrad at UCLA, I went on to Howard University for medical school, and then completed a family practice residency University of Illinois in Chicago.
So a tick bite happens. A tick is on an animal, an animal is carrying these various ticks. Some of these animals already have the infection in them from previous tick bites. A new ticks comes on the animal, attaches, the infection from that animal enters into the mid-gut of the tick. The tick then falls off the animal, and looks for a new host. The tick attaches to that host, in this case people, and within a very short time, latches on and begins feeding on us. In that mid-gut of the tick are the spirochetes, and it gets pushed back into the wound, it's almost like the tick vomits the spirochetes back into the wound. Very quickly, those organisms can disseminate in the body. We know, and there's been quite a bit of research, that within 15 to 20 minutes, these spirochetes can disseminate outside of that initial wound. We also know that the spirochetes travel better through tissue than they even did through the blood stream. So they can move from one organ to another, and through into the nervous system quite rapidly. So the best way to minimize transmission is by carefully, with a forceps, can be blunt or sharp, but with the forceps in grabbing right at the front part of the thorax, and you take upward, very slow, but firm and constantly firm pressure, to ease the tick out, the head will often pop out, attached to the body, and the tick should probably be saved, so it can be tested, but the best way to do it is by not destroying the tick, not stressing the tick out.
Many of these ticks aren't even gonna actually transmit those infections, especially if they've been removed properly, if they've been removed quickly, one should watch for a rash, there's various kinds of rashes, some ticks it seems on the East Coast are more apt to create a so called bulls eye rash, which is a fairly round rash that's red, often clear in the center that expands occasionally and gets bigger.
However in many other parts of the world, we don't actually see this rash, so you can't just watch for a rash, as a way to guide you if you have these infections. It's quite important to understand the quantity of prevalence of various infections, and make decisions often with the patient about choosing to treat prophylactically before you actually get sick. Other times what you can do is you can wait and see if someone develops symptoms. Now, that's not always a very good idea because there are many patients who do get Lyme disease, but they don't actually get sick right away. Lyme disease is a clinical diagnosis. Which means that if you get bit by a tick, and you become sick afterwards, in a way that's consistent with Lyme, and you respond to treatment, you probably have Lyme even if you one, don't do a test, or two, test negative. The tests are improving as we go, but they're not perfect. A western blot looks at your immune response to very particular pieces of the infection. So, the way that your system recognizes that infection. It's almost like it makes mirror images. There's dozens of tests we can do, some look at-at the infection, some look at the immune response, none of them are perfect. They all have limitations, we would love that perfect test, but so far there is no perfect test.
Lyme disease again, is-is everywhere. So thinking of a flu like illness after a trip out in the woods is quite important to think about. Looking for ticks on pets, thinking about travel, the l- most common symptoms that happen often three to 30 days after a bite are flu-like symptoms, neck pain or stiffness, migrating muscle aches, and occasionally joint pain that initially centers in large joints. The hard part from a practitioner's point of view is to not over diagnosis it as well. So I do know that there are just bugs t-that people get. People get viruses. And so I don't wanna see Lyme everywhere if it's not there. But, when you put together the risk factors, and you put together the time, and you put together the physical exam and then you add the tests into it to give support to a clinical picture that's unfolding, then it becomes a bit more scientific. So it really takes a high end [act?] of suspicion, and really paying attention, and not dismissing flu like symptoms outright, especially in the summer time.
If Lyme disease is diagnosed early within three weeks or so of the bite, then it's remarkably treatable. There is some debate about this, is it as some studies say, one or two doses of an antibiotic, or is it four to six weeks as another group of scientists and clinicians think. But if the proper treatment is given, the disease can usually go away and not come back. Early disseminated Lyme also is a simplistic term because it suggests that Lyme may stay in one place when it's early localized, because the immune system is able to-to bridge it off from the rest of the body, when we know that that's not true, that most often, most early Lyme becomes, very rapidly, disseminated. Disseminates to the lymph nodes, and then on to the nervous system. The concept of early disseminated suggests however that it is in the body, in many more places than where it started, and that perhaps, in order to eradicate it in all of its places, that it needs a stronger course of treatment to get to all the places where it is. A very common situation that we find throughout the country with early disseminated Lyme that someone is quite sick rapidly, where they have cardiac symptoms, you have neurologic symptoms, they have lots of lymph nodes everywhere, they have liver enzyme elevation, they have kidney issues, they have bladder pain, they have muscular skeletal pain. The treatment is still, according to some societies, very short course. That it's still 15 to 30 days. I disagree with that, I feel that each person is different, and that the dissemination could go deeper in some people, can hide in some people, even if it's early.
So, not only am I gonna be looking for co-infections, [Labesia or Likia?], anaplasma and bartonella, but I'm going to treat patients until the symptoms are gone. Even if that takes longer than that initial 15 to 30 days that some other medical societies agree with. The concept of chronic Lyme disease or late stage Lyme disease as it's more appropriately called is a very, very difficult disease entity. These are the folks where we talk about Lyme disease, we think of this multiple systemic infectious disease syndrome, where there's co-infections, there's the immune system, which becomes very inflamed, both over-zealous and inefficient, so it starts creating allergies and hyper immune responses in the body, and we get hormonal imbalances, we get liver issues, we get problems with so called detoxification, we get gluten sensitivities, and other kind of food sensitivities, and this is really where the integrative medicine folks and the naturopathic physicians have had to step in, because even long courses of treatment with pure pharmaceutical antibiotics haven't been able to eradicate these infections all the time in this patient population.
Antibiotics are the mainstay of treatment for many patients. We have had patients who have used antibiotics for a very extended periods of time. And every time they try to get off the antibiotics, their symptoms relapse. So it begs the question, are these antibiotics working to the extent that we expect them to, or are they just creating a stalemate. And I feel that this is the case for many patients. Antibiotics themselves are also fraught with problems. They cause oftentimes, gastrointestinal distress, liver issues, bone marrow issues, every kind of issue we could see under the sun. There's herbs that are both antimicrobial that also kill organisms. There's herbs in other forms of treatment that enhance the immune systems own ability to fight the infection. So called detoxing the liver, detoxing the kidneys, detoxing the lymphatic’s, detoxing the skin. There's modalities such as saunas and all sorts of machines that can help the body become more aligned. There's all sorts of psychological methods to bring the mind, body, state together, to enhance healing, and so if we could calm the body, decrease the pain, help the body become stronger via diet, via exercise, via meditation that their immune system will truly improve.
Lifestyle's important, but if you have an active Lyme disease infection, lifestyle by itself is not gonna eradicate that infection. It's not gonna get somebody back to baseline, not even close. It's gonna help, and if that means taking the supplements, having better food, making those choices to exercise every day, despite the pain, that is going to get somebody better long term. So, chronic fatigue is the most common symptom in Lyme disease. Not all patients who have chronic fatigue have Lyme disease, most patients who have Lyme disease have chronic fatigue. This could be from the disease, the other corollary diseases such as some of the viruses that people get when they have the disease, because their immune system isn't working as well. This could have to do with the hormonal issues, with some of the hypothalamic, pituitary adrenal issues, which are also hormone issues but at a brain level, this could have to do with the overall level of inflammation, pain can cause a chronic fatigue. The way to-to deal with this is to try to work on as many possibly systems as you-you humanly can. That means are these potential exposures that are contributing to the inflammation? Is someone in a moldy or otherwise toxic environment? All right, let's change that environment. Is there anything that's coming into their body such as smoke, or diet, or alcohol, that's also contributing to this inflammation and their inability to be efficient, so trying to help the body be as efficient as possible via the environment and everything that goes into their body.
For joint muscle pain, one needs to stop what's driving that pain, which is often in the infections, but it's also a hyper inflammatory response, so you need to calm the system down, you do need either kill the bugs or get the immune system not caring about the bugs so much. So you need to help the immune system not be so over aggressive because of underperformance, and I feel that that's probably what's happening with a lot of pain. The immune system isn't able to efficiently attack the infections, and as a result it becomes overzealous to the things that are normal in the body. Helping normalize the immune by helping offload some of the extra waste that's in the body, and the acid in the body that's helping to contribute to this, all this can help decrease pain to some degree.
The brain fog is to the point of causing full depersonalization in people. Brain fog we often times thing of ammonia. We think of the yeast overload, we think of the bacteria, we think of the gut bacteria, we think of other toxic aspects that are happening to create this ammonia, and you try to offload the ammonia to help with brain fog. Sometimes you can use eflornithine, you can use all these other things that help decrease ammonia, and if you can get them to the right places in high enough quantities, then all lot of times the brain fog can go away. Neuropathy means there's either pain, or lack of sensation in some of the various peripheral nerves, the distal nerves. This could be coming from the brain, that perhaps the wrong signals from the brain are being sent to the distal nerves, so is this a brain problem? If so, it needs to be worked on in the brain. If the neuropathy is from an over-inflammatory process, then inflammation needs to be decreased, and the system that's driving that inflammation needs to be decreased or eliminated. It's often times bartonella when there's Lyme, can cause neuropathy, heavy metals can cause neuropathy, tons of other environmental-again, phosphates can cause neuropathy, so there's a contributory effect all which adds together causing the final result of the neuropathy. Thankfully, there's a lot of new stem cell research, and if it's inflammatory or degenerative, the stem cells could be pretty awesome.
Patients have to become self aware. They need to realize that much of this is the disease process itself. And to be able to piece out what likely is the disease, and what are the effects of either meds, or the stress or having been told by doctors that I don't have an illness, or by having my love ones leave me or not understand or me not be able to participate in their lives to see how much of this disease is related to physical disease versus what’s happened because of the physical disease. Now that's a really difficult thing to do, and it's not anything that one person can often do by themselves, and a lot of times they don't trust the providers and others to even guide them in this, and a lot of times we don't know ourselves, what part is what part, but we do know that there's a physical component to this. Part of helping patients manage their expectations is developing a relationship with them. Being honest with them. When the provider doesn't know you have to be honest that you don't know. And there's a lot of times that we don't know. Often times we do know what the next likely steps are, and so often if we can guide patients within a short time frame about what likely is gonna be the outcome of this various treatment, or this various symptom and how it's going resolve, what we usually tell patients who come in and who've been sick for a very long time is that there's going to be, oftentimes in the beginning of treatment, a much worsening, and then we walk-walk the though some of the worsening.
Then the next stage is oftentimes that perhaps there's a day where the bad part of the day isn't quite so bad, and the good part of the day is better than usual. Then they have a day where they don't have many symptoms at all. And then they have a few days a month where they don’t have symptoms. So a lot of times when you can talk about after having seen it, the quality of symptoms that they're gonna have, the length of time that these symptoms are gonna last, we won't know that until we start seeing treatment, it's a downward spiral for a lot of people. It's very tough.
Treating kids with Lyme has its own particular set of challenges. On the flip side, most kids improve remarkably, most of them recover who have Lyme disease, and it's wonderful to see. However, the process can still be quite long, and there can still be relapses and there can still be flare-ups, it's still quite difficult knowing that yes, they feel sick, yes, they can't read as fast and write as fast sometimes, that there are days that they need to take breaks. And letting them become more aware, showing them how to become more aware of their body and when they need to rest. To have them become better self monitors of their own behavior, and their own feelings is one of the best ways to work with them as you go. And so as a society what we need to do, and it seems that we're moving in that direction, is understanding chronic illness a bit more holistically. There are so many incredible providers, so many amazing doctors and naturopathic physicians and other forms of practitioners out there who are starting to work together like never before as a team because with a group of people who all are dedicated to treating Lyme disease through their own personal insight, and their own knowledge base using science and using other systems of health, and healthcare and understanding of the world working together in a group is the way the sickest group of patients are gonna recover their health, and it's really quite exciting.
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