Conquering Lyme disease Science bridges the great divide
Book - 2018
Lyme disease is the most common tick-borne illness in the United States, with more than 300,000 cases diagnosed each year. However, doctors are deeply divided on how to diagnose and treat it, giving rise to the controversy known as the "Lyme Wars." Firmly entrenched camps have emerged, causing physicians, patient communities, and insurance providers to be pitted against one another in a struggle to define Lyme disease and its clinical challenges. Health care providers may not be aware of its diverse manifestations or the limitations of diagnostic tests. Meanwhile, patients have felt dismissed by their doctors and confused by the conflicting opinions and dubious self-help information found online. In this authoritative book, the Co...lumbia University Medical Center physicians Brian A. Fallon and Jennifer Sotsky explain that, despite the vexing "Lyme Wars," there is cause for both doctors and patients to be optimistic. The past decade's advances in precision medicine and biotechnology are reshaping our understanding of Lyme disease and accelerating the discovery of new tools to diagnose and treat it, such that the great divide previously separating medical communities is now being bridged. Drawing on both extensive clinical experience and cutting-edge research, Fallon, Sotsky, and their colleagues present these paradigm-shifting breakthroughs in language accessible to both sides. They clearly explain the immunologic, infectious, and neurologic basis of chronic symptoms, the cognitive and psychological impact of the disease, as well as current and emerging diagnostic tests, treatments, and prevention strategies. Written for the educated patient and health care provider seeking to learn more, Conquering Lyme Disease gives an up-to-the-minute overview of the science that is transforming the way we address this complex illness. It argues forcefully that the expanding plague of Lyme and other tick-borne diseases can be confronted successfully and may soon even be reversed. -- Provided by publisher.
- Subjects
- Published
-
New York :
Columbia University Press
[2018]
- Language
- English
- Main Author
- Other Authors
- Physical Description
- xxviii, 421 pages : illustrations ; 24 cm
- Bibliography
- Includes bibliographical references and index.
- ISBN
- 9780231183840
- Acknowledgments
- Preface
- Basic Terminology
- 1. What Is Lyme Disease?
- Basic Facts
- A Bird's Eye View
- 2. The Early History And Epidemiologic Surveillance
- What Was the Infectious Agent of Lyme Disease?
- The Spread of Lyme Disease and National Surveillance
- 3. What Are The Symptoms And Signs Of Lyme Disease?
- Early Localized Stage
- Early Disseminated Stage
- Late Disseminated Stage
- Post-Treatment Lyme Disease Syndrome
- 4. What Do The Diagnostic Tests Tell Us?
- Blood Tests
- Urine-Based Tests
- Spinal Fluid and Brain Tests
- Other Tests
- Summary
- 5. The Great Divide And The Lyme Wars
- What Is the Great Divide?
- What Are the Lyme Wars?
- Concluding Comments Regarding the Great Divide and the Lyme Wars
- 6. Why Would Symptoms Persist After Antibiotic Treatment For Lyme Disease?
- Persistent Infection Hypothesis
- Residual Damage Hypothesis
- Persistent Immune Activation and Inflammation Hypothesis
- Neural Network Dysregulation Hypothesis
- The Relationship Between Immune Activation and Depression
- The Connection Between the Gut Microbiome and Mood
- Somatization, Anxiety, and Chronic Symptoms
- 7. What Are The Treatments For Lyme Disease?
- Treatment of Early Lyme Disease
- Treatment of Later-Stage Disseminated Lyme Disease
- Treatment Failures and Borrelia Persisters
- Risks and Benefits of Antibiotics
- Treatment of Post-Treatment Lyme Disease Syndrome
- Other Therapeutic Strategies
- 8. Other Tick-Borne Infections
- Common Tick-Borne Infectious Diseases
- Other Tick-Borne Infectious Diseases
- Other Vector-Transmitted Infections (Possibly by Ticks)
- Other Disorders Caused by Ticks but Not Inducing Human Infection
- 9. What Other Noninfectious Diseases Cause Lyme-Like Symptoms?
- Celiac Disease
- Chronic Fatigue Syndrome
- Chronic Heavy Metal Poisoning
- Chronic Inflammatory Demyelinating Polyneuropathy
- Fibromyalgia
- Lupus
- Major Depressive Disorder
- Malignancy (Cancer)
- Multiple Sclerosis
- Panic Disorder
- Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus
- Postural Orthostatic Tachycardia Syndrome
- Sleep Disorders
- Somatic Symptom Disorder
- Vitamin B12 Deficiency
- 10. Lyme Disease Prevention and Transmission
- The Ticks
- Prevention Recommendations
- Transmission
- Lyme Disease and Pregnancy
- The Lyme Disease Vaccines
- New Developments in Prevention
- 11. Suggestions To The Patient Seeking Evaluation Or Treatment
- How to Approach the Visit
- What to Bring to the Appointment
- Seeking a Second Opinion
- Tips for Navigating Online Health Information
- 12. The Experience Of The Patient With Chronic Symptoms
- The Politically Charged Climate and Its Impact on the Physician-Patient Relationship
- Protean Nature of the Presentations of Lyme Disease
- The Variability of Course: Waxing and Waning Symptoms
- Psychological Ramifications of an "Invisible" Chronic Illness
- The Fact that Lyme Disease Can Affect the Brain and Sensorium
- Uncertainty Surrounding Diagnosis, Treatment, and Prognosis
- The Role of Mental Health Care and Resiliency
- Conclusion
- 13. Frequently Asked Questions
- Signs, Symptoms, and Diagnosis
- Overlap of Lyme Disease with Other Diseases
- Testing and Treatment for Lyme Disease
- Ticks
- Miscellaneous
- 14. The Good News Emerging From Lyme Disease Research
- Recognition that Borrelia Persist
- Repeated Antibiotics Can Help
- Persister Borrelia Burgdorferi Spirochetes May Necessitate Different Treatment Approaches
- Recognition that Persistent Symptoms After Treatment for Lyme Disease Have Been Associated with Objective Biologic Findings
- Recognition that Lyme Disease Infection May Lead to Abnormally Active Neural Pathways
- "Omics Research" Can Help Improve Diagnostics and Clarify Pathophysiology
- Identification of a New Tick-Borne Infection Causing Symptoms Similar to Lyme Disease
- New Prevention Strategies
- Generic (Brand) Drug Names
- Glossary of Terms
- References
- Index
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