If you take the time to read this it will show you the politics of the governement and insurance companies. Big Pharma have their own politics as well.

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Under Our Skin
The Untold Story of Lyme Disease

The widely held perception is that Lyme disease is a minor, nagging illness that is easily treated and cured with 14 to 30 days of antibiotics. When an individual complains of persistent illness, they are often told that the symptoms are psychosomatic or are caused by an autoimmune condition for which there is no cure. Transmission is deemed to occur solely by the bite of a tick infected with a spirochete bacteria called Borrelia burgdorferi, which is spread by deer, birds, and rodents. The conventional view holds that the disease is isolated to rural regions of the northeastern United States.

And yet others are calling Lyme disease a countrywide epidemic of major proportions, which is accruing billions of dollars in medical costs, long-term disability expenses, and lost wages. They insist that this debilitating disease has destroyed lives and in some cases has been fatal; a disease that one prominent Lyme physician called "more scary than a terrorist attack" in that it is so difficult to detect and so debilitating. They question why so many physicians are dismissing Lyme patients, denying them treatment, and accusing them of contributing to "Lyme hysteria." Those on this side of this issue claim there is substantial information supporting the existence of chronic infection in long-term sufferers. They believe that the controversy is not just medical, but rather one driven by insurance companies and politics.

Many wonder why the Center of Disease Control (CDC)-by its own admission-systematically underreports Lyme disease and contradicts aggressive treatment. According to the CDC, Lyme borreliosis is the number one vector-borne disease in the country. Statistics from the CDC indicate that there were over 23,000 cases reported in 2005. However, they acknowledge major underreporting, perhaps 10 times higher than their official estimate. In other words, there are almost 250,000 new cases a year and 2 million people in the United States suffering from chronic Lyme disease. Based on the discrepancy between their own clinical findings and that of the CDC, many researchers theorize that Lyme disease rates may be up to 100 times higher than the official CDC numbers. Although Lyme disease occurs predominantly in the northeast, cases have been documented in every state, with a large number of new infections occurring along the West Coast. To further complicate matters, the ticks that transmit Lyme also carry other bacteria, and these co-infections appear to be as complex as Lyme-and as difficult to diagnose and treat.

Animal studies have shown that in less than a week, the Lyme spirochete can deeply embed itself inside tendons, muscles, tissues, the heart, and the brain. The spirochetes can travel through blood-vessel walls and connective tissue. Complicating diagnosis, the symptoms of Lyme disease are many and can vary from one person to the next. The spirochete that causes Lyme appears to target the central nervous system. Flu-like symptoms, including fever, aches and pains, and extreme fatigue are common.

Rheumatological symptoms such as achy joints and inflammation can arise and seem also to be neuropathic in origin. Symptoms also include debilitating headaches, confusion, severe mood changes, hallucinations, paranoia, paralysis and, cognitive dysfunction resulting from encephalopathy. In some cases, what has been thought to be a severe psychiatric disorder has later turned out to be Lyme. Cardiac problems and even heart blocks have been documented. Indeed, Lyme disease and its complications have resulted in death and miscarriages in a number of cases.

There is general agreement that most cases are mild to moderate if treated promptly. But therein lies a problem. As of yet, there are no reliable tests for Lyme disease. Fewer than 50% of patients diagnosed with Lyme ever find the offending tick or telltale bull's eye rash. Available blood tests yield a high percentage of false negatives due to the crafty nature of the spirochete, which is able to change into a dormant, undetectable cyst form, or hide within white blood cells, the very cells that are supposed to destroy invading bacteria. Further, new research shows that the bacteria are able to exchange genetic material with one another and change the outer proteins of its cell walls, allowing the organisms to mutate and effectively hide from targeted human antibodies. The situation is complicated by the fact that there are over 300 strains of the bacteria that cause Lyme disease, and the test kits used by most labs don't detect all of these varieties. This results in thousands of false negative Lyme tests, delaying the treatment of many infected patients.

Lyme disease has been called the new "great imitator" because of its ability to mimic other diseases. Patients are routinely told they might have multiple sclerosis, Lou Gehrig's disease, fibromyalgia, systemic Lupus, Alzheimer's, chronic fatigue syndrome or rheumatoid arthritis. According to one physician, there is not one diagnostic feature of Lyme disease, except for the rash, that is different from any of these other conditions.

The illness can become so debilitating that previously healthy individuals cannot get out of bed and are confined to wheelchairs. Unable to work and faced with rising medical bills, many find themselves bankrupt. They become isolated, depressed, and even suicidal. While the spirochete itself is said to create depressive symptoms by invading brain cells, the toxins they emit if and when they do die-off also have been shown to trigger depression and suicidal tendencies. In many cases the psychological toll of Lyme is as devastating as the physical toll.

Children are particularly susceptible to Lyme disease by virtue of the amount of time they spend outdoors, and because of their still-growing immune systems. Often, when the cognitive symptoms manifest themselves, affected children are misdiagnosed by parents, physicians, and teachers as having learning disabilities, anxieties or behavioral problems. Some become so sick they cannot attend school or participate in sports, resulting in tremendous social and emotional costs.

There are also controversies surrounding the transmission of Lyme disease. All would agree that the blacklegged tick and the Western blacklegged tick are the primary vectors of the disease. These small ticks, no bigger than a poppy seed in their larval and nymphal stages, feed by piercing the skin of a host with their mouthparts and releasing the bacteria into the bloodstream. Some studies suggest that other insects may also transmit Lyme. Many believe that human-to-human contact is contributing to this epidemic. One physician's caseload includes hundreds of children whom he believes were infected while in utero or while breastfeeding. Lyme disease may be transmittable via blood transfusions, and sexual transmission has not been ruled out.

Though physicians in Europe described a Lyme-like disease as early as the mid-nineteenth century, many wonder why the disease has spread so rapidly in the U.S. since the late 1970's. One widely supported explanation is linked to the proliferation of deer, the adult tick's preferred host. In what were once farmlands, reforestation and residential developments are bringing the deer closer to humans. A single deer can carry hundreds of female ticks, each which can lay as many as 3,000 eggs. At the same time, there are few if any natural predators to cull the deer, and hunting is prohibited in many residential areas.

While it is the story of an elusive microorganism, Lyme disease is ultimately a human story. What do the untold numbers of ill patients do, after having journeyed from doctor to doctor, been misdiagnosed or told to see a psychiatrist? Often, they end up seeing one of the approximately 15 "Lyme literate" doctors in the country. These doctors spend an enormous amount of time with their patients and rely more on symptoms rather than test results to make a Lyme diagnosis. And though they acknowledge that there are risks to administering antibiotics, they believe that the physical, cognitive, and functional consequences of untreated Lyme disease warrant the risk. They claim that that those physicians who deny their patients treatment are being medically negligent. They point out that the spirochete that causes Lyme disease is in the same family as the bacteria that causes syphilis and is known to be able to hide out and then reappear, causing severe neurological illness. They explain that the immune evasion strategy of B. burgdorferi is reminiscent of mycobacterial infections such as tuberculosis or leprosy, diseases where months, not days, of antibiotics are required for a cure.

The academic physicians on the other side of the controversy claim that their evidence-based research shows that long-term antibiotics provide no more relief to chronically ill patients than placebos. They recommend that patients with persistent symptoms be given antidepressants, steroids, or pain medication to treat individual symptoms. What's more, they feel that over-prescribing antibiotics might lead to the growth of more drug-resistant strains of bacteria, an omnipresent concern in this era of bioterror threats and global epidemics.

The Lyme-literate physicians dispute the findings of the academics' pivotal chronic Lyme study (commonly referred to as "the Klempner study"). They say that their clinical experiences contradict the conclusions of this study, crying foul at the experimental design, subject selection, and conclusions of Klempner's research.

By prescribing long-term antibiotic treatment, the Lyme-literate physicians open themselves up to a political and medical firestorm. Because published Lyme treatment guidelines recommend only 14 to 30 days of antibiotics, many of these physicians have been dropped by insurance providers and have come under investigation from state licensing boards for prescribing too many antibiotics. Many believe that the insurance companies are trying to put these doctors out of business to reduce the high cost of treating chronic Lyme patients. Some call this "medical McCarthy-ism," as the insurance companies hire their own medical consultants to review patient files and reverse Lyme diagnoses without ever directly examining patients. One could certainly wonder, are the medical boards protecting the medical insurance industry or the patients they are supposed to be serving? And what happens to the patients whose treating doctors are no longer willing to do so? As the political battles rage on, all too often patients are left in a void, without medical insurance or doctors to address their physical and mental decline.

The politics of the Lyme controversy have led some to governmental action. In Rhode Island, a law was passed this past summer that mandates coverage for long-term antibiotics for the treatment of Lyme when ordered by a physician. In New York, where a disproportionate number of Lyme doctors have been investigated and prosecuted by the state medical board, a bill intended to address this was just vetoed by the governor. And New York, Massachusetts, and Connecticut have held recently held public hearings on the controversy. At the federal level, there has been outrage at the limited funding and attention this disease has received from both the NIH and CDC, and questions loom as to what motivates this apparent negligence. On the other side, mainstream Lyme experts decry what they see as mass hysteria and possible hypochondriasis, with false positives churned out by a few suspect laboratories. All the while, Lyme sufferers watch the disease sweep the country by stealth, threatening the nation's health and safety, and affecting untold lives. UNDER OUR SKIN exposes these lives, their struggles, and the tiny, relentless bug under their skin.