Conquering Lyme disease : science bridges the great divide

Conquering Lyme disease Science bridges the great divide

Brian Fallon

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.

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Subjects
Lyme disease.
Published
New York : Columbia University Press [2018]
Language
English
Main Author
Brian Fallon (author)
Other Authors
Jennifer Sotsky (author)
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
Review by Choice Review

Lyme disease is caused by a tick-borne spirochete (Borrelia burgdorferi); its most typical symptom is a red, bulls-eye rash. Antibiotic treatment soon after infection often cures it. In the remaining cases, the disease does not resolve or it resurfaces, giving rise to what the authors call the "Lyme Wars." There is a substantial lack of consensus among clinicians, researchers, and patients themselves regarding the causes, outcomes, and treatments of these seemingly incurable cases. To complicate matters further, the disease can take many unexpected forms. Fallon and Sotsky (both, Columbia Univ. Medical Center) contend that recent medical advances are clarifying the diagnosis and treatment of these puzzling cases, and the Wars may soon be ending. If so, this is timely. The CDC estimates an incidence rate of 300,000 cases per year in the US, indicating the nation is faced with a Lyme disease epidemic. This work discusses the disease's discovery and epidemiology, clinical symptoms, case studies, treatments, and prevention methods. One cannot say "it's just Lyme disease." Lyme disease is a serious public health concern as well as a personal threat. By presenting an accessible, measured examination of the disease and synthesizing current research, the authors offer readers a great service. Summing Up: Highly recommended. All readers. --Thomas P. Gariepy, Stonehill College

Copyright American Library Association, used with permission.
Review by Publisher's Weekly Review

Fallon and Sotsky, the director of the Lyme and Tick-Borne Diseases Research Center and a psychiatry resident at Columbia University Medical Center, respectively, assemble a sturdy reference on an illness whose varied presentations can bedevil patients and caregivers alike. The authors candidly warn of the technical density of much of their material. The first four chapters on Lyme's early history, signs and symptoms, and diagnostics, as well as a later chapter on treatment options, will be well over the heads of most laypersons. The authors zero in on the unsettling effects that medical uncertainties have on patients and their families, lavishing praise on those who've "played a pivotal role in shaping our understanding" of the disease that has led to better insurance coverage and funding. The authors also hail new discoveries and "the biotechnology revolution" in diagnosing and treating Lyme, offering practical advice and resources for disease prevention and transmission. Perhaps most poignant is their analysis of the daunting experience of being a Lyme patient. But there's hope, too: "Medical professionals are gradually waking up to the complexity of Lyme disease and to the real suffering of patients with chronic symptoms." Aimed at specialists, Fallon and Sotsky's heady volume presents the multidisciplinary cadre aiming to restore Lyme patients "to their former well-being and good grace." (Dec.) © Copyright PWxyz, LLC. All rights reserved.

(c) Copyright PWxyz, LLC. All rights reserved
Review by Library Journal Review

These two works speak to a need for ongoing discussion of Lyme disease, even if it is no longer considered newsworthy. In Conquering Lyme Disease, colleagues (Columbia Univ. Medical Ctr.) and coauthors Fallon and Sotsky push readers to grapple with some underlying scientific principles. Readers will have a better sense of where the research is today, where treatment falls short, and what the future may hold. Although the book is meant for both a general audience as well as practitioners, it seems more appropriate for lay readers. There are sections on how doctors deal with chronic illness, a FAQ, and listings of other diseases that have similar symptoms to Lyme. Optimistic in tone, this book predicts a positive outcome against the illness in the near future. Naturopathic physician, former health journalist, and Lyme disease patient Ingels's The Lyme Solution is geared to those who have tried all the standard Center for Disease Control Guidelines for Treatment and are still suffering. Much like Fallon and Sotsky, he explains that science, and medicine in particular, are about progress. His personalized approach is patient focused and uses minimal jargon. Ingels sees Lyme disease as something to mitigate, if not cure. For readers amenable to naturopathic healing, he provides actionable items-recipes, lifestyle changes, supplements-and explicitly states that this may not work the first time around. In appendixes, Ingels also discusses other tick-borne diseases readers might have and other autoimmune disorders that could be caused by chronic Lyme disease. This is an interesting juxtaposition when compared to the section in the -Fallon and Sotsky book on conditions that may have similar symptoms but are not Lyme. VERDICT Chronic Lyme sufferers may find either work helpful. Readers looking for a more science-focused discussion will prefer Conquering Lyme while readers looking for a more actionable course will prefer The Lyme Solution.-Rachel M. Minkin, Michigan State Univ. Libs., East Lansing © Copyright 2017. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.

(c) Copyright Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.

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