Lymes and ELISA

[Hammilton]

I was diagnosed with 2nd Stage Lyme's (I'm pretty sure she said second and not third, but I was bitten about 2 months ago, and have had quite bad lethargy and joint pain for about 3-4 weeks now) and the doc ordered a Western Blot, CBC, and the usuals. I don't believe she ordered an ELISA, though.

I've been doing some reading, and basically I've found that neither a Western Blot or ELISA are that effective at detecting Lyme's Disease, and that diagnosis is based almost entirely on symptomology, especially since I remember the bite and had the bulls-eye rash. I also saw that ELISA should be done first, and a Western Blot second if ELISA is positive.

So that leads me to the following questions: Why did she only order a Western Blot? And if neither of them are that effective, why order them at all?

I was told that since I'm getting tested outside of the 3-6 week window (after the bite) and in the 8-10 week range, the effectiveness drops off rapidly. That's where I'm at now, so I'm a little confused. Then again, I've read that antibodies might not even be detected until I'm outside of the 2 month window.

What's correct? Surely they can't both be.

Is there anyone else here with Lyme's? I know surprisingly little about it despite my brother and father having had it. They both sought treatment right after being bitten and finding the rash. I guess I knew it could cause symptoms, but I never really thought about it. I thought it was something that lots of people got but almost no one ever had symptoms from. I live in an area with endemic Lyme's disease (central Wisconsin).

The only other person I know of that had symptoms from Lymes was an uncle. He said that he never even had a blood test done, and was diagnosed in the secondary stage.

I know that he still has joint pain today, even though he was treated years ago.

Will the joint pain go away? Will the lethargy?

I've been on doxicycline for about 3 days, and I'm not as tired as I was, but my knees and "bad" elbow are awfully sore. Ibuprofen definitely helps, but it's not a cure-all.

My "doctor" (I think she may have actually been a Nurse practitioner) didn't seem to know much about it, she was more worried about my heart than anything else. Are there any doctors who specialize in Lyme's treatment?

 

[dcraver877]

i was diagnosed with lyme disease in august. I was admitted to the er with the supposed "swine" flu and thats where they tested my blood for lyme disease. I am seeing a LLMD (you must see a lyme literate md to get proper treatment, its a very new disease) and have been on 4 separate antibiotics and still am taking them for at least 6 months.

My doc says that the standard 3 week antibiotic treatment protocol is insufficient to kill the disease. The joint pain will subside with proper treatment but there is permanent damage done to many organs and some of it is not reversible after having it for a long time.

 

[Hammilton]

So my 2 week doxicycline treatment probably won't be good enough at all, huh?

What do you mean by permanent damage to many organs? This isn't something I'm familiar with. Lymes disease is something I'm surprisingly ill informed about despite being endemic here.

 

[longimanus]

I don't know if you have read my reply at the darker place and since that dimensional level seems to be inaccessible I will continue here.

Western blotting gives more reliable results than ELISA - it's done after ELISA because of the price. The antibodies become positive after ca. 1 month and could remain in detectable quantities even after years (mainly the IgG fraction, and now you should be "very" positive for IgM - marker of acute infection). The diagnosis could be based only on the characteristic clinical manifestation and this is enough to start treatment. Serological results sometimes only confirm.

Stage II has a relatively benign course. The joint pain is supposed disappear (there is some possibility that it could only diminish) after treatment. Yet, it is characteristic for stage III in North America that the arthritis is somewhat problematic but since you have started treatment there will be no progression expected. The two major organs affected are the brain (meningitis, encephalitis, peripheral paresis - much serious than what you describe) and heart (more rare).

Doxycyclin will work in your case (when some of the major organs is affected, however, the first line antibiotic is cephalosporin III generation parenterally; aminopenicillins for pregnant and children instead of tetracyclins). Still, it is usually accepted that the treatment with doxycyclin should continue at least 20 days, better a month.

Ah, yes, the doctor you are supposed to be treated by shoud be specialist in infectious diseases (I didn't know that LLMD is recognised as medical speciality .

 

[dcraver877]

i'm not sure about the organ thing...i just know i've had excruciating pains in my kidneys, lungs, pancreas....throughout the worst of it. I'm not an expert either but definitely do not think a 2 week doxycycline treatment is sufficient to kill off the bacteria because the spriochetes tend to hide deep in fat tissue where the antibiotics cannot reach.

 

[Hammilton]

Yeah, my card expired and I forgot to put the new one in. Things are supposed to be normal today, but they're still not. I'm not sure what the hold up is. Nothing is lost or anything though!

My doctor called yesterday and said that the Western Blot was negative, and said that it was probably a false negative. Well, she said false positive, but she is an idiot. I don't know, I had the bite, and a really obvious EM rash. She said that if I was off in how long it was between bite and test, that would make sense. I was pretty sure that it was ust about 2 months ago, but I'm not sure now. I was bit while morning dove hunting, which closed Nov. 7 here. I didn't go early season because I was busy doing house repairs (which eats so much of my time now) so I suppose I probably didn't get bit until somewhere between October 7-18th.

That would put me @ 4-6 weeks since being bitten. That would explain why I've only relatively minor symptoms. Good to know that I got in sooner than I thought I had.

Already I'm feeling less fatigued than I had been, and ibuprofen is covering my knees pretty well.