TICS: Tickborne Infections Consulting Services
A wise colleague once told me, “Everything you hear about Lyme disease is true.” I agree – I tend to believe each person or organization has some rational basis to their perspective on this debated topic. As one who seeks to reconcile rather than create or enhance conflicts, what then is our practice’s approach to Lyme disease, and especially “chronic Lyme disease” (more preferably termed Post-Treatment Lyme Disease Syndrome, PTLDS, by the CDC)?
First and foremost, we are patient advocates. We bring no presumptions or biases in meeting a new patient and listening to his/her story about what has led that individual to seek consultation, and whether Lyme Disease may be the problem (or part of the problem) or not.
Secondly, we approach our evaluations as objectively and thoroughly as possible. We spend the necessary time to gather adequate information to create a thoughtful and complete conclusion or “gameplan”, which includes more accurate diagnostic testing for Lyme Disease and it’s co-infections, as well as comprehensive testing for other non-Lyme conditions which may be causing one’s symptoms, when warranted. When evaluating any given patient for Lyme Disease, it is obviously on our list of possibilities, but we are also evaluating for the possibility that a patient may be dealing with another condition (or other conditions) – possibly *instead* of Lyme Disease, or possibly *in addition to* Lyme Disease – if Lyme Disease isn’t the final conclusion.
Having said that, the following are responses to FAQ’s we often receive regarding our approach to Lyme Disease and it’s co-infections (hereafter all referred to simply as “Lyme Disease”, for the sake of brevity):
* What is your overall experience with Lyme Disease?
Does everyone have Lyme Disease? Absolutely not. But do many people go underdiagnosed and undertreated? Absolutely yes. Both in its early and chronic stages. As patient advocates, we are committed to helping that individual by treating him/her as completely as possible, for as long as necessary, and in whatever ways necessary, as agreeable to that patient. Each individual is different – there is no cookie cutter approach to diagnosis or treatment.
* What lab tests do you use to help diagnose Lyme Disease?
Sometimes, lab testing isn’t even necessary. But when warranted, our default preference for Lyme testing is to perform the Western Blot through IGeneX. We always discuss cost and accuracy factors before deciding on which test to perform.
* What co-infections do you look for, test for?
Bartonella, babesia, and ehrlichia/anaplasma are common Lyme co-infections, though they can also occur independently of Lyme disease. Mycoplasma can sometimes be a player as well. We do regularly consider and assess for these concerns, both by clinical symptoms as well as by lab testing, when warranted. Again, we do not have a “one-size fits all” approach.
* Do you subscribe to the condition of “chronic Lyme Disease”?
Yes. We strongly believe that the large proportion of cases of “chronic Lyme Disease” are due to undiagnosed or insufficiently treated Lyme Disease when in its early stages (roughly a year or less since the initial infection). Those who are insufficiently treated often fall in the category of the CDC’s diagnosis of PTLDS, as referenced above. Still others are more severely infected or incompletely treated because of a poorer health profile, whether as a baseline prior to Lyme infection or as a consequence of it over time – often referred to as Multiple Systemic Infectious Disease Syndrome, or MSIDS, per Dr. Richard Horowitz in his book, “Why Can’t I Get Better? Solving the Mystery of Lyme and Chronic Disease”.
* Do you treat with antibiotics or in some alternative way?
Again, there is no cookie-cutter approach here. Commonly, antibiotics are a part of the treatment regimen. Rarely, one antibiotic suffices; more often, two or three are needed – usually depending on whether co-infections are present, or the suspected duration of the infection at the time of treatment initiation. Certainly, other treatment options are regularly considered, and are often necessary – especially when the individual is suffering from a more chronic disease condition, often complicated by secondary complications leading to imbalances and abnormalities with gut health, micronutrient deficiencies, hormonal/adrenal deficiencies, and more (these are common conditions inclusive in the MSIDS entity as above, and conditions which we address at Personal Care Physicians through our BioRestorations program, whether in the context of, or independent of, Lyme Disease).
* Are you a Lyme literate medical doctor? (LLMD)
Objectively, there is no official definition of a LLMD. Most Lyme-sensitive individuals in the general public would agree that this term is used to describe a doctor who is open-minded about the diagnosis of chronic Lyme disease and other tick-borne diseases, and knowledgeable about the treatment of such. We believe the information on this page reflects our open-mindedness, and regarding a knowledge base, we continue to educate ourselves over time, recognizing that there is always more to learn, and that the more we learn, the more questions we develop! Beyond that, we would let our patients speak on our behalf as to whether we would be considered an “LLMD” practice, but we would strongly suspect that most to all would.
* Do you accept insurance?
We do as much as possible. We accept PPO and Medicare plans without problem. For those who have an HMO plan, your options are to be seen on an out-of-pocket basis, or to request a referral from your primary care physician. However, even if your PCP is willing to provide a referral to us (which is atypical, since we are technically listed by insurance plans as a primary care office as well), your insurance company may still deny that request.
Your Lyme consultation begins with a simple phone call to arrange for an office visit to share your story. We are here and ready to help you.
(Note: for those past patients of Dr. Donta’s who are considering our consultative services based on his referral, but reside a distance away, our policy is to establish a therapeutic relationship by having several face-to-face discussions for the initial and first few follow up visits. Subsequently, we do have a system in place to offer follow up phone visits as an additional option to in-person visits, for your convenience… In addition, for any and all Lyme-afflicted patients, we also have Lyme-specific health coaching available through our Lyme Coach, nurse Lauren, both as in-person visits as well as phone sessions.)