Latina Weekly

Health and Medicine

Lyme Disease – Ain’t A Joke !

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Lyme disease is one of those things you never really think about until it affects you or someone you know. The truth is – we should all be worried about it. Very much so! Personally, I know several people who’ve been diagnosed with Lyme disease and it’s a serious problem. Firstly, not only is the diagnosis challenging but also the treatment. Recently, I met a contractor from Long Island who had been diagnosed and treated for Lyme disease. He caught it while working in one of the most beautiful parts of the East Coast, the Hamptons. He described the infection as “one of the worst things I’d ever experienced in my entire life… I thought I was dying and the doctors thought I had HIV.” His experience is not an uncommon one – Lyme is a tricky disease, with various stages and presentations. But one thing is certain – if you have it, early diagnosis and treatment are essential. Prevention is best, but that can prove very difficult for the following reasons:

  • The ticks that carry Lyme disease are endemic to certain areas but the ticks themselves are not always obvious. One might logically assume you can always see the ticks if they’re present. Alas, the ticks that carry Lyme may transmit the disease BEFORE they are even barely visible to the naked eye. How? During early spring and summer, tiny baby lyme disease carrying ticks called “nymphs” (what a benign sounding name!) emerge and hide in the grass, waiting for their next meal. They are so small, they’re the size of poppy seeds.
  • The unsuspecting host (i.e. YOU or your dog) comes into contact with these nymphs without ever knowing it. The little nymphs although small, can still transmit Lyme disease, but you won’t see them on your skin or clothing. Now, you might spot the characteristic rash, but you might not, because…
  • Erythema Migrans the so-called “bulls eye” pattern rash associated with Lyme infections is NOT always present. According to the CDC, Erythema Migrans occurs in up to 80% of patients infected with Lyme, but that means there are at least 20% of patients who lack the characteristic rash (see the CDC website on this topic for more). The CDC recommends medical evaluation for individuals who may have been exposed if they experience any of the characteristic symptoms; the range of symptoms is wide, simply perform a google search and you’ll find a myriad of presentations. But there’s another tricky aspect to Lyme disease….
  • It may be asymptomatic. While this is unusual in the United States, one study from 2003 reported an incidence of asymptomatic Lyme of 10%. And I can tell you personally I met someone from Long Island years ago who had this exact thing occur, only to be diagnosed years later due to chronic fatigue. Which leads us to the another tricky aspect of Lyme…
  • Treatment for Lyme disease – can be incredibly difficult. This topic has been widely discussed with personal experiences publicly shared by several celebrities. Most people have heard about the ordeal Yolanda Hadid (fashion model also on Bravo’s Real Housewife of Beverly Hills) endured, but did you also know that country singer Shania Twain lost her voice (and nearly lost her career) because of Lyme disease? Unbelievable but true. Read the articles in People magazine and Country Living where Shania Twain describes how dangerous and debilitating Lyme disease is. Why? Because of the kind of bug it is – Lyme disease (which is caused by Borrelia burgdorferi) is caused by a spirochete. Do you know what other disease is caused by a spirochete? Syphilis – caused by the spirochete Treponema pallidum. Because Lyme is a spirochete, it does not necessarily respond to treatment the same way other bacterial infections do. Frontiers in Immunology addressed this issue in an article called “Hide and Seek: How Lyme Disease Spirochetes Overcome Complement Attack.” This article describes the way the Lyme-causing spirochete evades the host’s immune system. Indeed, another article published in the Journal Infection Drug and Resistance describes the current Lyme epidemic as “a medical disaster” drawing parallels with the AIDS crisis. With over 300,000 cases of Lyme disease diagnosed in the United States, the Lyme disease epidemic certainly is an area of urgent concern. But that’s not all because …
  • Individuals infected with Lyme may also be infected with other nasty tick transmitted diseases. According to Lyme Disease.Org, over 50% of patients with chronic Lyme had co-infections. Babesiosis and Bartonella were the most common ones, but there are several others and (frighteningly) they are still discovering new ones! Lyme Disease.Org publishes a list on the site at this address – https://www.lymedisease.org/lyme-basics/co-infections/about-co-infections/.

The degree of complexity and information about Lyme disease is so extensive, it’s challenging to write a simple article about it. The main takeaway point here is to be aware of Lyme disease and its seriousness. Know that the ticks that carry Lyme disease can be small and difficult to detect but are still just as dangerous. Individuals with Lyme disease are suffering with this illness every day, more needs to be done to eradicate this disease. Individuals who suffer from it should be treated with the same level of compassion as any other patient – not told they are “imagining it” or “crazy.” Lyme disease is REAL and it gets even more real when you have it! And it can happen to anyone who encounters a Lyme infected tick – even if you don’t inhabit a rural area. Lyme disease does occur in urban areas — it’s the most common tic borne illness in New York City, although the number of cases of Lyme deceased to 753 for the year 2018. Think about that, the next time you’re taking a walk in Central Park or anywhere else Lyme ticks could potentially be.

Telemedicine a Reality – Pager.com Offers Online Photo Diagnosis

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Telemedicine is a reality – Pager.com offers a photo-based diagnosis for skin conditions, including recommendations over the phone with in-person visits as indicated.

From the Pager.com website:

” Have a rash, bite or burn? How do you know if you should see a doctor?”

With Pager, get a first opinion & recommendation within minutes simply by following these steps:

  • First request a visit at Pager.com & take a photo of the rash and/or skin condition
  • Upload a photo of your skin problem via Pager’s secure messaging platform.
  • A Pager doctor will review and let you know within minutes what you need to do.
  • If you need in-person treatment, a doctor will come to your home or office in less than two hours.
  • Payment – If the doctor can make the diagnosis based on the photo without visiting in person, the cost is $25. If the doctor needs to see the patient in person, the cost will be $200 (or $50 for a first-time visit). Visits can be submitted to insurance for out-of-network reimbursement.
  • Available in New York City every day from 8 AM to 10 PM

 

Health Care, Medicine & the Consumer : Know Your Rights

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In the ever changing world of health care and medicine, obtaining basic health care can prove to be a challenge. Fortunately, there are many ways to locate great professionals with websites emerging specifically aimed at rating physicians and the quality of health care. Likewise, technology is making it easier for consumers to educate themselves as well as provide new and convenient services such as pager apps. Besides that, there are a few basic ways you can stay ahead of the curve to help ensure you have access to the best possible medical resources and/or avoid adverse circumstances.

1) Maintain a regularly updated list of good (and bad) doctors/health care facilities including the addresses, phone numbers and respective specialties. When a friend or relative has a medical issue, quiz them on their experience and the specifics. Record the names of any hospitals, clinics, nurses etc. If you see a relevant article in a local newspaper or online, take note and enter the information into your database. Place the list in a dry safe readily accessible location or file it with the rest of your medical records (see below).

2) Research the backgrounds of all health care provider and facilities. A quick google search costs nothing and may prove extremely valuable. Key things to look for in a physician include the name of the medical school they attended, where they did their residency, number of years in practice, any honors or awards, professional memberships and hospital affiliations. A good resource for finding the top hospitals is published annually by US News & World Report, which lists individual hospitals and the specific rank for each specialty. It is worth noting that hospitals differ in their areas of excellence– some are known for their outstanding cancer facilities and others for pediatrics, ob/gyn, etc. Did your doctor train at a hospital known for being excellent in their particular are of practice? Excellent training sets the foundation for any career and medicine is no exception.

3) Contact the state medical board to make sure your provider is licensed and there have been no adverse actions.

4) Don’t be afraid to ask questions. Being an educated consumer is one of your greatest assets in the current health care environment. Good doctors don’t mind being asked questions, in fact, they encourage them because it often leads to a better understanding of the patient’s symptoms.

5) Trust you gut instinct. As in any situation, if you don’t feel comfortable with you health care provider, don’t be afraid to say so and/or find a replacement.

6) Be a your own healthcare advocate.  You always have the right to a second opinion and should seek one should you have any reservations about the type of care being offered.

7) Dig deep.  Before you sign that consent form, make sure to read it carefully and understand what you are signing. This can be a challenge because patients may not be consented until right before a procedure. In certain instances, such as emergency procedures, there is no other choice. But for elective procedures it’s wise to ask for a copy of the consent form well ahead of the procedure date so you have adequate time to review it.

8) Always ask for a copy of your medical records — this includes written records as well as copies of any related studies– lab results, mammograms, CT, MRI, Xrays etc. This serves a dual purpose: one it shows that you are interested in your medical care and two it provides insurance against records getting lost or destroyed (facilities have rules governing how long they are required to keep your records beyond which time they may be destroyed).

9) Develop good relationships with your medical care providers. Maintain professional relationships with your providers and try to avoid adversarial situations, such as threatening to sue them if there’s a problem. Good medical professionals can be a great source of information, and it is well worth cultivating that relationship. Sending a thank you note or bringing in a small gift can mean a lot to a provider and it never hurts to do something nice. Saying thank you or showing respect and appreciation is ever more important in the fast-paced stressful world of health care.

10) Finally, know your rights. It pays to familiarize yourself with HIPAA and the laws in your particular state. For example, patients have a right to see their medical records but certain states permit parts of the record to be excluded. There are laws and regulations governing many aspects of health care and it is to your benefit to be familiar with them. The old expression “what you don’t know can’t hurt you,” definitely does not apply to medicine, in fact it’s quite the opposite. Be proactive, understand your rights and educate yourself. It could save your life someday.