Psycho-Babble Medication Thread 1098387

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Re: Number of cases of Lyme Disease in the USA?

Posted by linkadge on April 29, 2018, at 6:18:43

In reply to Number of cases of Lyme Disease in the USA?, posted by SLS on April 28, 2018, at 22:07:48

Hi SLS,

I'm no expert, but I would assume too, that there is significant discrepancy in the true incidence.

I know that many Canadians travel to the US in order to get a 'positive' Lymes diagnosis. Apparently, some people believe that our testing methods are too narrow and restrictive.

There are likely facilities which will tell 100% of their customers that they have Lymes.

While Lymes disease totally exists, I see it (to some extent) as being similar to 'gluten issues'. The number of (non-Ciliac) people who are apparently (all of a sudden) intolerant of gluten, here in Canada, is crazy.

Linkadge

 

Re: Number of cases of Lyme Disease in the USA? Lamdage22

Posted by linkadge on April 29, 2018, at 6:26:51

In reply to Re: Number of cases of Lyme Disease in the USA?, posted by Lamdage22 on April 29, 2018, at 5:34:32

Understandably people want answers, but I do believe it is foolish (and possibly harmful) to assume that 9/10 psychiatric patients have Lymes (which they don't). This is about as overly-simplistic as assuming that 9/10 psychiatric patients have low serotonin.

Overuse of antibiotics may not only lead to antibiotic resistance. Here is a recent study linking antibiotic use to heart disease.

https://www.webmd.com/heart-disease/news/20151109/widely-used-antibiotics-may-raise-heart-risks-review-finds

I would not jump to suspect Lymes, unless you had a specific reason to suspect it.

I know people don't like to hear about the genetic component of depression, because they want to believe that they can fix / cure everything. However, researchers are more clearly undersanding the presence of genetic abormalities which may contribute to depression:

A new meta-analysis of more than 135,000 people with major depression and more than 344,000 controls has identified 44 genomic variants, or loci, that have a statistically significant association with depression.

https://www.sciencedaily.com/releases/2018/04/180426130031.htm

Linkadge

 

Re: Number of cases of Lyme Disease in the USA?

Posted by SLS on April 29, 2018, at 9:32:11

In reply to Re: Number of cases of Lyme Disease in the USA?, posted by Lamdage22 on April 29, 2018, at 5:34:32

Hi, Lamdage.

> Did bleauberry get you to think?

Bleauberry motivated me to question his contention that 9 out of 10 (90%) of psychiatric cases are caused by Lyme Disease. I consider this number to be greatly inflated and a dangerous one upon which to make clinical decisions.

I have never questioned the potential for Lyme Disease to produce psychiatric symptoms. After all, both Syphilis and Lyme Disease are caused by spirochete bacteria. Syphilis has been called the "great imitator". It drove Al Capone mad. However, I still think that the 9/10 number is beyond reason.

My goal here is to produce a more realistic number. I already have some calculations, but I don't want to present them without receiving more input as to the incidence of Lyme Disease cases in the USA - just in case the CDC estimate is wrong.

> I feel stupid asking my doctor for tests-

Some people say that there is no reliable assay to test for Lyme Disease - at least for late-stage infection. Perhaps cultures can verify infection. I really don't know. Lamdage, you might as well bring up the subject of Lyme Disease with your doctor and see what he says. Perhaps it makes sense to perform a 3 month trial using doxycycline - just in case? My doctor performed a trial of doxycyline on me. It didn't seem to make a difference, but I'm glad he did it. You've tried so many things. There are a few reasons not to do it, but I am not in your position.

1. Developing "superbugs" that are resistant to treatment.
2. Upsetting the intestinal flora - which in itself can, theoretically, cause psychiatric symptoms.
3. Cardiac side effects, especially for people who are already compromised. Azithromycin and levofloxacin have been implicated.

Ed_UK can elaborate on this. I'm not sure 3 months is long enough for these effects to emerge.

For the sake of producing an estimate of the Lyme/Depression ratio, I would like Bleauberry or someone else to offer a single number to work with. It would also be nice to fact-check such a number before inserting it into a calculation, so citations would be helpful.

What is the incidence of Lyme Disease in the USA?

Bleauberry?


- Scott

 

Re: Number of cases of Lyme Disease in the USA? SLS

Posted by Phillipa on April 29, 2018, at 10:31:48

In reply to Re: Number of cases of Lyme Disease in the USA?, posted by SLS on April 29, 2018, at 9:32:11

I missed the 9 out of 10 that is ridiculous . I don't believe that for a minute. A doctor in Davidson NC lost his medical license for treating people for Lymes disease who didn't really have it. Last I read he was in SC. Now you have my curiousity up. Some googling later fore me. Thanks Phillipa

 

Re: Number of cases of Lyme Disease in the USA? Phillipa

Posted by ed_uk2010 on April 29, 2018, at 10:36:47

In reply to Re: Number of cases of Lyme Disease in the USA? SLS, posted by Phillipa on April 28, 2018, at 23:12:48

Hi PJ,

>The last time was tested via Western Blot test about 15 years a go still had 5 bands of positive

That shows the presence of antibodies, suggesting past infection/exposure. Doesn't suggest that you still have an infection.

>"Lymes doesn't exist in NC" so no you don't have it.

That's a bit strange. It looks like you did have an infection but received full treatment for it.

>have to wonder if this could be a cause of the back issues

I thought you had osteoarthritis? You received multiple courses of potent antibiotics for the Lyme diagnosis. If anything, the antibiotic treatment you received sounds excessive in duration.

 

Re: Number of cases of Lyme Disease in the USA? Phillipa

Posted by SLS on April 29, 2018, at 10:37:08

In reply to Re: Number of cases of Lyme Disease in the USA? SLS, posted by Phillipa on April 29, 2018, at 10:31:48

> I missed the 9 out of 10 that is ridiculous . I don't believe that for a minute. A doctor in Davidson NC lost his medical license for treating people for Lymes disease who didn't really have it. Last I read he was in SC. Now you have my curiousity up. Some googling later fore me. Thanks Phillipa

Please post what you find!


- Scott

 

Re: Number of cases of Lyme Disease in the USA? ed_uk2010

Posted by Phillipa on April 29, 2018, at 11:45:46

In reply to Re: Number of cases of Lyme Disease in the USA? Phillipa, posted by ed_uk2010 on April 29, 2018, at 10:36:47

Ed I agree and that infection control doctor said the reason I lost my taste and smell was from the Biaxin XL? Did you ever hear of something like this happening from Biaxin? Thanks PJ

 

Re: Number of cases of Lyme Disease in the USA? Phillipa

Posted by SLS on April 29, 2018, at 13:41:22

In reply to Re: Number of cases of Lyme Disease in the USA? ed_uk2010, posted by Phillipa on April 29, 2018, at 11:45:46

> Ed I agree and that infection control doctor said the reason I lost my taste and smell was from the Biaxin XL? Did you ever hear of something like this happening from Biaxin? Thanks PJ

I performed a quick search on Google. I imagine you've done the same.

I entered: clarithromycin olfactory

https://www.google.com/search?&q=clarithromycin+olfactory


- Scott

 

Re: Number of cases of Lyme Disease in the USA? SLS

Posted by linkadge on April 29, 2018, at 15:52:17

In reply to Re: Number of cases of Lyme Disease in the USA? Phillipa, posted by SLS on April 29, 2018, at 13:41:22

The other issue, is that antibiotics will throw off the entire gut bacteria balance. Gut bacteria can have very far reaching effects on mood (as we are only starting to appreciate).

A quick google search of "antibiotic + depression" reveals that antibiotics can often have a side effect of producing depression (potentially by killing off beneficial bacteria).

Linkadge

 

Re: Number of cases of Lyme Disease in the USA? ed_uk2010

Posted by Phillipa on April 29, 2018, at 17:50:31

In reply to Re: Number of cases of Lyme Disease in the USA? Phillipa, posted by ed_uk2010 on April 29, 2018, at 10:36:47

Ed correct. Osteoarthritis of back and neck area. The infection control doctor has said I would always test negative now for isn't it IGA but that IGM would be what to watch for reinfection? So at the time he wanted me then to take doxycyclline. I moved up here and could not get the doxycyclline. PJ

 

Re: Number of cases of Lyme Disease in the USA? SLS

Posted by Phillipa on April 29, 2018, at 18:06:23

In reply to Re: Number of cases of Lyme Disease in the USA? Phillipa, posted by SLS on April 29, 2018, at 13:41:22

Scott thank-you. You definitely have access to sites I don't have as surely does sound like the clarithromycin. The strange thing though is I had taste and smell throughout the two years taking the Biaxin. It was about a month after stopping the med that my taste and smell began to wan. I first had MRI of brain which showed nothing other than a miniscule microadenoma of pituitary gland and it said my neck was fused but never had surgery of neck. Must have fused on own. This was ordered by an ENT as at the time was having lasix PRK surgery of eyes. So the ENT sent me to Wake Forrest to a taste and smell center. Did the scatch and sniff and various liquids to the tongue which I failed. And a test for Sjournes was negative also. Then went to DC to another Taste & Smell center. This doc was a quack to me gave me the same testing plus 24 hour urine. Then he prescribed prednisone for I think 10 days or two weeks? And then said to take theophyline which I did not take. So even 15 or 16 years later remain without either taste and smell. I eat the same things daily three meals a day and eat a lot of the darkest chocolate when on the computer to satisfy my desire to at least enjoy texture. Definitely not overweight 5'4" weight last endo visit 122.8 lbs. So it was the meds then? The quack doc in DC was a Dr Heinkin. Used to be all over the internet . Phillipa

 

Re: Number of cases of Lyme Disease in the USA? SLS

Posted by Phillipa on April 29, 2018, at 18:12:18

In reply to Re: Number of cases of Lyme Disease in the USA? Phillipa, posted by SLS on April 29, 2018, at 13:41:22

Scott I found Dr Heinkin still practicing. Copied and pasted this link for you . Various links still exist for this doctor. Phillipa

http://www.tasteandsmell.com/doctor.htm

 

Re: Number of cases of Lyme Disease in the USA? linkadge

Posted by SLS on April 29, 2018, at 21:11:47

In reply to Re: Number of cases of Lyme Disease in the USA? SLS, posted by linkadge on April 29, 2018, at 15:52:17

> The other issue, is that antibiotics will throw off the entire gut bacteria balance. Gut bacteria can have very far reaching effects on mood (as we are only starting to appreciate).

Pretty weird, right? I read something about this not too long ago. I don't remember the details, but the interaction worked both ways.


- Scott

 

Re: Number of cases of Lyme Disease doc in NC

Posted by Phillipa on April 29, 2018, at 23:28:36

In reply to Re: Number of cases of Lyme Disease in the USA? linkadge, posted by SLS on April 29, 2018, at 21:11:47

Here is some of the doc was Huntersville not Davidson many articles on the net. Here's a link to one seems most I found started with HIV and then on to Lymes Disease. Phillipa


http://www.redorbit.com/news/health/520328/doctors_unorthodox_treatments_land_him_in_the_lyme_wars/

 

Re: Number of cases of Lyme Disease in the USA? SLS

Posted by bleauberry on May 2, 2018, at 12:34:08

In reply to Number of cases of Lyme Disease in the USA?, posted by SLS on April 28, 2018, at 22:07:48

If we knew how many people had lyme, the only way that would happen is if we knew how to accurately diagnose it. We don't. Except for an actual antibiotic challenge to see what happens, we don't.

The primary problem in the lyme wars is a lack of awareness on how to recognize it, how to diagnose it, and how to treat it. Without a solid grasp on all of that, which we are nowhere close to having, there is no possible way to do accurate number crunching. Output extrapolation results will be flawed because the input estimates are flawed.

Nobody knows the number of cases of Lyme in the USA. Anyone claiming to know is making fraudulent claims that they cannot support with critical science.

But my doctors who do this day in and day out have their own estimates. That is, only 1 in 10 lyme patients are correctly diagnosed. How do you count the rest?

I have my own estimate of the number of lyme cases in USA. It is 10X whatever we think it is.

Or more simply - a lot more than anybody wants to admit!

The bottom line is that depression patients who visit LLMDs usually come out a lot better than they went in. That is just reality. Science is so far behind the curve. Number crunching doesn't help.

> Does anyone know the incidence of Lyme Disease in the USA?
>
> Lyme Disease is the cause of some cases of depression. But how many?
>
> Only 33,000 cases of Lyme Disease are reported to the CDC each year. However, they estimate that the true incidence is 369,000. On their website, ILADS uses 300,000 as the number.
>
>
> - Scott
>
>
>
>

 

Lets play with numbers. bleauberry

Posted by SLS on May 2, 2018, at 22:50:53

In reply to Re: Number of cases of Lyme Disease in the USA? SLS, posted by bleauberry on May 2, 2018, at 12:34:08

Bleauberry.

You have been told by your physicians that 9 out of 10 (90%) people presenting with depression will actually have Lyme Disease.

> I have my own estimate of the number of lyme cases in USA. It is 10X whatever we think it is.

Nice non-answer. How much do "we" think it is?

Let's try another experiment. We need to come up with a value representing the number of people in the USA who are walking around with Lyme Disease. 33,000 cases are reported to the CDC each year. However, they estimated that the true number is 10 times higher than this = 329,000. If you were to multiply this number by another 10, we get 3,290,000. Still, this would yield a much lower number than the 90% number you keep touting. For every 100 cases of depression, 8 would have Lyme = 8%. That's still a very big number - certainly bigger than the 7 out of 1000 (0.740%) that results when you use the CDC estimate.

Okay - just for kicks:

To get to 90%, you would have to multiply the CDC estimate by a factor of 110.

That's 110x !

By the way, such a number would imply that 1 in 10 people in the USA are walking around with Lyme Disease.

Does this sound reasonable to you?

Oh, c'mon, Bleauberry. Smile.

For now, I would have to guess that the prevalence of Lyme Disease among people with depression in the USA is somewhere between 1% and 2%. However, this number will vary greatly regionally. 96% of Lyme cases occur in 14 states.

Connecticut
Delaware
Maine
Maryland
Massachusetts
Minnesota
New Hampshire
New Jersey
New York
Pennsylvania
Rhode Island
Vermont
Virginia
Wisconsin


- Scott

 

Re: Lets play with numbers. SLS

Posted by bleauberry on May 3, 2018, at 11:09:33

In reply to Lets play with numbers. bleauberry, posted by SLS on May 2, 2018, at 22:50:53

Scott I would suggest you write a book, news article, or blog post, to make the case that lyme is not much associated with psychiatry. That seems to be where your passion is. I believe working passions is a healthy good thing. Make the case that any treatment resistant patients thinking about a 2nd opinion with an LLMD are wasting their time. Make that case in a book. You are showing a great deal of passion for such a book.

> Bleauberry.
>
> You have been told by your physicians that 9 out of 10 (90%) people presenting with depression will actually have Lyme Disease.
>
> > I have my own estimate of the number of lyme cases in USA. It is 10X whatever we think it is.
>
> Nice non-answer. How much do "we" think it is?
>
> Let's try another experiment. We need to come up with a value representing the number of people in the USA who are walking around with Lyme Disease. 33,000 cases are reported to the CDC each year. However, they estimated that the true number is 10 times higher than this = 329,000. If you were to multiply this number by another 10, we get 3,290,000. Still, this would yield a much lower number than the 90% number you keep touting. For every 100 cases of depression, 8 would have Lyme = 8%. That's still a very big number - certainly bigger than the 7 out of 1000 (0.740%) that results when you use the CDC estimate.
>
> Okay - just for kicks:
>
> To get to 90%, you would have to multiply the CDC estimate by a factor of 110.
>
> That's 110x !
>
> By the way, such a number would imply that 1 in 10 people in the USA are walking around with Lyme Disease.
>
> Does this sound reasonable to you?
>
> Oh, c'mon, Bleauberry. Smile.
>
> For now, I would have to guess that the prevalence of Lyme Disease among people with depression in the USA is somewhere between 1% and 2%. However, this number will vary greatly regionally. 96% of Lyme cases occur in 14 states.
>
> Connecticut
> Delaware
> Maine
> Maryland
> Massachusetts
> Minnesota
> New Hampshire
> New Jersey
> New York
> Pennsylvania
> Rhode Island
> Vermont
> Virginia
> Wisconsin
>
>
> - Scott

 

Re: Lets play with numbers. bleauberry

Posted by SLS on May 3, 2018, at 21:48:44

In reply to Re: Lets play with numbers. SLS, posted by bleauberry on May 3, 2018, at 11:09:33

> Scott I would suggest you write a book, news article, or blog post, to make the case that lyme is not much associated with psychiatry.

Ah, but you exaggerate yet again. Black-or-white thinking, methinks. I would never say such a thing. If you actually read my full posts, you would know that I don't proclaim Lyme Disease in psychiatry to be a farce. I wouldn't.

My doctor happens to be Robert C. Bransfield, MD. Let that sink in.

> That seems to be where your passion is.

My passion is to help people - including myself. I try to keep an open mind without allowing myself to become brain washed or indoctrinated.

> I believe working passions is a healthy good thing.

How very patronizing of you.

> Make the case that any treatment resistant patients thinking about a 2nd opinion with an LLMD are wasting their time.

No. You've got me wrong - again.

I think that it is a waste of someone's time and emotional energy (not to mention financial resources) to seek out Lyme infections as their first stop on the road to wellness. 9 in 10. Remember? You contend that 90% of people who are suffering with depression actually have Lyme Disease.

Your numbers don't work. Please excuse my use of science and a touch of algebra.

I don't want to write books - at least not books regarding mental illness. When I find the right treatment, which should be soon, I might want to get as far away from psychiatry as possible. We'll see.


- Scott

 

Re: Lets play with numbers. SLS

Posted by bleauberry on May 4, 2018, at 8:37:46

In reply to Re: Lets play with numbers. bleauberry, posted by SLS on May 3, 2018, at 21:48:44


>
> Ah, but you exaggerate yet again. Black-or-white thinking, methinks. I would never say such a thing. If you actually read my full posts, you would know that I don't proclaim Lyme Disease in psychiatry to be a farce. I wouldn't.

Not an exaggeration and not black and white. You are in the camp that says psychiatric patients should consider lyme as one of the less likely causes of their issues. And you feel passionate about that. We live in one of the countries on earth where you can speak your opinion freely - unless you are on a college campus - and so sharing differing opinions is a good thing in my world. Many places on earth you cannot do that. We are free to disagree.

>
> My doctor happens to be Robert C. Bransfield, MD. Let that sink in.

Never heard the name.
I like the names of doctors who take 20+ year treatment resistant depression patients and hand them remission. I don't care what their name is or what their credentials are or how many research projects they've done or how many books they've written or how many patients they've treated or how many world class institutions they have worked in. I only care that they can deliver results. I have some favorite names that do that. Bransfield is not one of them.

While he has a reputation of dealing with psychiatry and lyme, he has not done much for you that I can see. He has not delivered you remission or even anything close to it. If I were in your shoes - and I was - I would seek a second opinion from an LLMD.


>
> > I believe working passions is a healthy good thing.
>
> How very patronizing of you.

Kind of an undeserved snarky comment. ??? It's ok. I get it.

Let's NOT play with numbers.

Let's get a 2nd opinion from an LLMD which will cost you $300 and 2 hours of your time.

Bransfield has had plenty of opportunity. It's time for another approach.

imo

 

Re: Lets play with numbers.

Posted by SLS on May 4, 2018, at 11:25:11

In reply to Re: Lets play with numbers. SLS, posted by bleauberry on May 4, 2018, at 8:37:46

> > My doctor happens to be Robert C. Bransfield, MD. Let that sink in.

> Never heard the name.

You really ought to read what you post.

http://www.dr-bob.org/babble/20180331/msgs/1098360.html

> I like the names of doctors who take 20+ year treatment resistant depression patients and hand them remission.

He qualifies, then. You would like his name.

> I don't care what their name is or what their credentials are or how many research projects they've done or how many books they've written or how many patients they've treated or how many world class institutions they have worked in.

This is really sad.

You can't possibly know the contributions to science and success rates of all the people you just denegrated.

> I only care that they can deliver results.

I guess you feel that you are unique in this regard?

> I have some favorite names that do that. Bransfield is not one of them.

How could he possibly be a favorite of yours if you never heard the name? You don't frequent the ILADS site? He was the president there for awhile. I don't understand why you would dismiss him so quickly when you don't know anything about him. It would shock the hell out of you to learn just how little your opinions of doctors means to me.

> While he has a reputation of dealing with psychiatry and lyme,

You finally got around to using Google?

> he has not done much for you that I can see.

I wouldn't expect that you could see that far. Besides, my house is surrounded by trees.

> He has not delivered you remission or even anything close to it.

It took you long enough to play that card. You are quite presumptuous. Remember, you can't see that far, so you really don't know how close or how far from remission I have been.

Bleauberry, you are a wealth of knowledge about a great many things. Your numbers just don't work.


- Scott

 

Re: Lets play with numbers. SLS

Posted by Phillipa on May 4, 2018, at 11:42:54

In reply to Re: Lets play with numbers., posted by SLS on May 4, 2018, at 11:25:11

Scott sorry to interupt your conversation but I just had to google your Doctor Is it the Robert C. Bransfield, MD? He is all over google for working the lymes disease. I had no idea this was your doctor. You are seeing the best by what I read Phillipa

 

Re: Lets play with numbers. Phillipa

Posted by SLS on May 4, 2018, at 14:21:56

In reply to Re: Lets play with numbers. SLS, posted by Phillipa on May 4, 2018, at 11:42:54

> Scott sorry to interupt your conversation but I just had to google your Doctor Is it the Robert C. Bransfield, MD? He is all over google for working the lymes disease. I had no idea this was your doctor. You are seeing the best by what I read Phillipa

Prior to my seeing Dr. Bransfield, I couldn't get off the couch or read more than 2 consecutive sentences. I had to learn by skimming. I like that he thinks outside the box. I feel substantially better for taking prazosin at high dosages. Only a handful of doctors would have thought to try this on me. He is becoming less available to see as a private patient because he spends so much time on speaking tours about the neuropsychiatric effects of Lyme Disease and other tick borne infections. Right now, he speaks about the occurrences of suicidal and homicidal ideations in Lyme Disease. The first thing he did with me given my history was to screen me for Lyme Disease and give me doxycycline to see if it would provoke a Herxheimer reaction. I am fortunate to have Dr. Bransfield as a resource. We talk about mental illness and psychopharmacology from a number of perspectives. His approach towards mental illness is eclectic. Another area of interest of his is ADHD. He is still passionate about medicine and really loves learning. It is scary how good his memory is. I don't know. All I can say at this point is that he doesn't go out of his way to diagnose 90% of his patents with Lyme Disease.

I'll try to keep an open mind. If I get well by using a triple-antibiotic treatment regime, I'll be the first to extol the the brilliance of Bleauberry in his crusade. In the meantime, I have a plan that involves trialing 3 antidepressants. Oh, I just remembered. I was placed on a huge amount of various antibiotics combined administered as a continuous IV drip over the course of 20 days when I was hosptitalized with sepsis. It worked for the sepsis. No change in depression. I guess that makes me 1 in 10?


- Scott

 

Re: Lets play with numbers. SLS

Posted by Phillipa on May 4, 2018, at 18:33:16

In reply to Re: Lets play with numbers. Phillipa, posted by SLS on May 4, 2018, at 14:21:56

I remember the sepsis and how deathly sick you were. You definitely trialed a lot of heavy duty antibiotics being IV and being in the hospital so long. Definitely you are the 1 in 10. I remember you had to learn to walk again. Has all your strenght returned. You sure have been through a lot. Hoping the triple anti depressants work well for you. You lucked out by becoming the Doctor's patient when you did. Kudos to you Scott. Phillipa

 

Re: Lets play with numbers.

Posted by SLS on May 4, 2018, at 19:24:32

In reply to Re: Lets play with numbers. SLS, posted by Phillipa on May 4, 2018, at 18:33:16

> I remember the sepsis and how deathly sick you were. You definitely trialed a lot of heavy duty antibiotics being IV and being in the hospital so long. Definitely you are the 1 in 10. I remember you had to learn to walk again. Has all your strenght returned. You sure have been through a lot. Hoping the triple anti depressants work well for you. You lucked out by becoming the Doctor's patient when you did. Kudos to you Scott. Phillipa

Most of my strength has returned, but my stamina sucks. This is more a product of my depression, though. Yes, I was pretty sick. I was delirious before I made it into the emergency room. Septic shock. I could not believe my inability to balance and walk when I was discharged from the hospital. It took a lot of work to learn how to walk again. The whole thing was a nightmare.


- Scott

 

Re: Lets play with numbers.

Posted by ed_uk2010 on May 6, 2018, at 10:58:39

In reply to Re: Lets play with numbers. SLS, posted by bleauberry on May 4, 2018, at 8:37:46

>....a 2nd opinion from an LLMD.

Scott's doctor sounds very Lyme literate indeed. To me, Lyme literate implies an excellent knowledge of Lyme disease. I'm guessing this means a good ability to rule it out, rather than diagnosing it based on vague symptoms in a very high proportion of patients seen.


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