Dr. Steven Harris, MD, Lyme Literate “The Big Picture”

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ContributorDr. Steven Harris, MDRead Full Bio

Biography

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.

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ContributorDr. Steven Harris, MDRead Full Bio

Biography

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.

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In this video, Dr. Steven Harris discusses the history of Lyme disease. He emphasizes that this disease has been under reported for years by the CDC and backs that up by mentioning how CDC statistics for Lyme disease went from 33,000 to over 300,000 cases a year just recently. He talks about the various ways one can contract Lyme, including how a mother can transmit Lyme to the developing fetus. He discusses the significant social and financial impact of the disease and why there continues to be controversy about the definition of late stage Lyme. Over the next five to ten years he sees the medical practice of Lyme disease changing vastly. He expresses his hopes for funding, that is mostly coming from private resources, to continue to find a better way to test for the disease and treat it. 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. The real modern history of Lyme disease goes back and where the-the organism and the disease got its name from, Lyme Connecticut in the mid 70s when a group of children developed juvenile rheumatoid arthritis in numbers that were far higher than the prevalence in America. So a young doctor, Allen Steer went to Lyme, Connecticut, interviewed many of the patients and their parents, and found that there was indeed likely an infectious cause to this. He felt that it was a virus and it wasn't until the early 80s when Willy Burgdorfer, who was working for Rocky Mountain Laboratories, part of the NIH, in Montana found that indeed a spirochete, a corkscrew shaped bacteria, was responsible for Lyme disease.

So first of all Lyme disease is the most common vector borne illness in America, and the most common tick born illness in the world. And this is a worldwide pandemic. Most countries have had cases of Lyme disease and every state in America has reported cases of Lyme disease. Initially the center for disease control felt that for years there's been about 30 to 35,000 cases a year in America. However, those were confirmed cases, and they felt that the actual number was much higher, perhaps 10 times higher. All of a sudden a few years ago, the number went up from 33,000 or so to up to over 300,000 cases, almost overnight. And the center for disease control still states that that number is an underestimation of likely new cases a year in America. There was a lot of reasons, some were political, some were scientific that really illustrated what had been going on and what many of the practitioners and patients and other advocate groups have known for many years, that there's much more than 30,000 cases a year.

There's a few different perspectives on this. Like many things with Lyme disease, there's also controversy about this. Lyme disease is, officially, by the center for disease control, an infection caused by one bacteria, Borrelia burgdorferi that's transmitted by ticks, black legged ticks. There's, uh, only one or two species, one species in the west coast and then a different species on the east coast. Now, that’s your classic and very restricted definition of Lyme disease. Actually, Lyme disease, as a concept, especially among integrated physicians, and among physicians who are in the naturopathic world, and especially among doctors who are Lyme literate, consider Lyme disease a more general term that consists of multiple systemic, intra-cellular infections that live inside of our cells, and infection disease syndrome of all of these. And that means that there's many different organisms that, with Borrelia burgdorferi, as one of them, create a complex, almost a complex illness of which both these organisms and the immune and other aspects of the body are all involved to create the disease process.

Now, there is mounting evidence that there's other ways to get the Lyme organism itself. We know that the organism can be found in breast milk, we know that it can be transferred from mother to fetus, there's hard ticks, hard bodied ticks, there's soft bodied ticks, there's big ticks, there's little ticks, there's adult ticks, there's nymphal ticks, which are basically adolescents, and usually the least well behaved. Some species of ticks carry the agents that cause Lyme. Other species of ticks cause other infectious agents. What we know is that ticks are sewers of infectious disease. They're amazing for carrying a ton of various diseases, some are bacteria, some are viruses, some are parasites, and at times, when the tick feeds on you, some of those infections are gonna be transmitted into you. Sometimes they're not. Sometimes four different infections will be unleashed by this tick into you all at once.

What we know in Lyme disease, and why we don't just call Lyme disease, for the most part, Borrelia burgdorferi is that there's at least three so called co-infections. Co-infections are infections that were someone to just get those infections, and have a normal immune system, they may not actually get sick. If they have Lyme, and they get one of these infections, or more of these infections, not only do they get sick from the actual Lyme disease, but they also get sick from these various infections, and the whole is greater than the sum of the parts.

Lyme disease is a clinical diagnosis, which means 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, as time goes on, but they're not perfect. One of the reasons why they're so much, in my opinion, under-diagnosis is that the western blot isn't always done. What is done is what's called an ELISA, which is also an immune test, and antibody test but it looks at the overall quantity of antibodies that one makes against the full organisms. And what we know about this organism is it doesn't induce the human body to make a very big response all the time, especially later in disease. In early disease, four out of ten times, it might make the body create a nice response, but later on it's much less than that. What happened, in reality, because Borrelia burgdorferi doesn't induce a huge response, is that many patients would have a negative ELISA test, and never actually get the better western blot. So, so many people over the decades have been left out because they had a negative ELISA and this has been a huge problem. There's still quite a bit of debate about this, in a lot of high academic circles about using the two tier test.

So to make matters worse, not all western blots are created equal either. If you think of the organism as like a small snake and these little twigs are coming off the surface of the small snake. The immune system can't really recognize that whole snake, so what it looks at are those little twigs on the surface, and those are what's called a surface proteins. Some of those surface proteins are really useful, so other organisms in the bacterial kingdom also will use those proteins. So if you look at only a couple of the really important surface proteins, or sticks, you may miss some other important ones. What we know about this disease and what Willy Burgdorfer and his other group have found over time is that those surface proteins actually change over the course of the disease. So, initially, perhaps there’s three different proteins that are important, after several months, six to 12 months in the body, there's gonna be different surface proteins. So the western blot will look totally different.

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. So there's vertical transmission of Lyme disease. We know this, that that the mother can transmit Lyme to the developing fetus. There's very likely and there have been cases of breast milk transmission of Lyme disease. There's been a few studies very early, that suggests horizontal transmission, which is person to person, transmission. It hasn't been proven, but the evidence is mounting. The likelihood of pure blood born transmission through the blood bank is very high, and we know that one can get one of the co-infections, babesia in the blood bank. The psychological toll that this disease takes on people both from causing a direct nervous system disorder, but also all of the social ramifications that happen from this disease, happen from not being believed, happen from having a good day and then five bad days, and having your loved ones not understand that you look fine, but that on the inside you feel like you're dying in 14 different ways. That one day you can walk and the next day you can't, one day you can eat, the next day you can't. The next day you don't want to, the next day you wanna eat double, the fluidity of this disease is so mind boggling that people get their minds boggled from this thing. It's horrible.

And oftentimes we talk to patients and we agree that although terrible, sometimes for relationships, cancer is an easier thing to have, because at least you know what someone has and that there's an endpoint one way or another. With Lyme that endpoint is often so nebulous and grey that the unknown, the not knowing, the feeling that you're better, and then having symptoms come back at some point, or a new symptom come up, or having 30 symptoms all scream at one time on the same day, and then in the afternoon you have an hour free and then it comes back, screaming right back at you. It's nearly impossible for everybody to stay emotionally, fundamentally intact. The financial impact is terrible, it's ridiculous, it's completely unfair. And medicines aren't covered, often tests aren't covered, almost all of the alternative treatments aren't covered, and it's remarkably difficult. Even if a patient could get her or his antibiotics and pain medicines covered for example. For the vast majority of patients who have been sick for a long time, that's not enough. That many of these other patients, these patients do need great diets, exercise programs, therapists of one sort of another, and it's a part of the devastation of Lyme disease.

Over the next five to 10 years the field of Lyme disease is probably gonna change vastly. Much more funding is coming in for studies, there's a great deal of interest that is developing among people who have resources. There are so many studies that are dealing with Lyme disease, the organism and people who have Lyme, it's very welcome. I think they'll be a lot of improvements in diagnostics. I think that there will be some very important, uh, but limited improvements in antibiotics and specific treatments for Lyme disease. Where we really need the improvement is in the understanding of chronic illness. As a society, we don't really think of chronic illness as an interplay of the body, the disease, inflammation, the immune system, we don't think of all of the variables that are involved in a process. We just think of isolating one variable, we think of one organism or one problem. Many of the sickest patients, there's no way this is just one problem, and current we can't really study them, because there's too many complex overlapping problems that are related to Lyme. 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, a bit less reductionistically. And because of that, because there's 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, the hopes and prospects are absolutely overwhelming and exciting because, with a group of people who all are dedicating to treating Lyme disease through their own personal insight, and their own knowledge base, using science and using other systems of health and health care and understanding of the world, working together in a group is the way that the sickest group of patients are gonna recover their health. And it's really quite exciting.

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