symptoms of lyme or antibiotics?

I could use some advice. For context, I am a 30 year old female, located in Ohio, who has generally been in good health all of my life. I have no immune deficiencies to my knowledge. I hardly ever even get sick.

I was bitten by a tick that I found and removed July 4th. I went to my PCP immediately the next day as the bite swelled, blistered and an immediate rash formed around the bite. I was put on 3 weeks of doxycycline (100mg, 2x a day). Also maybe immaterial but I was already on 10 days of doxycycline from cellulitis on my leg. I was literally on antibiotics the day I removed the tick and the three weeks was an extension of those 10 days. So if anyone has a chance at fighting lyme early, I feel like it would be me.

I immediately started doing research on lyme disease and became an anxious wreck reading about the symptoms and possibility of chronic lyme disease. In that first week I had nausea, headaches, neck pain, clenching of jaw, chills, would feel like i was internally vibrating though I wasn't externally shaking. Never had fatigue or fever. I still don't know if those symptoms were anything lyme related or due to anxiety about what I was reading (as I read these could all be anxiety related as well).

Based on advice from this forum, I went to an LLMD on the three week mark, the day I ended the first round of antibiotics. She felt that based on my rash, I definitely had lyme and that with my symptoms may even have Bart. So under her diagnosis I continued doxycycline for another 4 weeks along with 4 weeks of plaquenil, 4 weeks of bactrim for the bart and 4 weeks of artemisinin as a natural treatment for babesia, just in case. I go back to see her at the end of the additional 4 weeks at the end of this month.

I also will be doing a blood test with my PCP (just ELISA test) and testing for co-infections through labcorp (which my LLMD ordered) next Wednesday, which will be 6 weeks post bite, so hopefully right time for testing for the antibodies.

Since week 2-3 of the bite, I really haven't been having many of the original symptoms. I still feel I am clenching my jaw, but I also recognize my thoughts are consumed with having lyme disease and this may be caused by my own self induced stress/anxiety. The only weird symptom is that my knees have been cracking a lot. They do not hurt and it is not painful, but I do not recall them ever cracking as much as they have been the past 2 weeks. I haven't been sleeping well which I have read is a side effect of bactrim and that is when I started struggling. Other than the jaw pain, knee cracking, lack of sleep and how that makes me feel, I have been feeling pretty good. I still go to work in a pretty demanding job, walk my dogs outside everyday for an hour, cook, clean, etc. with no real issues.

Assuming my tests come back negative for lyme and co-infections, my question is, should I continue antibiotics past the end of this month? I will have done 7 weeks of doxy, 4 weeks of plaquenil, bactrim and artemisinin. And remember, it was an acute bite/early detection. Should this have been enough to get everything?

My LLMD has been effected by lyme herself so she tends to be more aggressive in her treatment and wants to be aggressive with me to ensure we get the infection. So I worry that even if my tests come back negative, she will want to continue antibiotic treatment. Since I have been on antibiotics since finding the tick, I can't tell if lyme symptoms are to blame for how I feel or the antibiotics.

If she recommends additional antibiotics, should I say no? See if my few remaining symptoms go away once I am off antibiotics? If they get worse, I am early enough that I could go back and see her and go back on?

Sorry for the long post, but I am conflicted on how to move forward.

I would trust what your LLMD says. Sounds like they know what they are doing. I personally would keep taking it if I were not having bad side effects

Cracking in my knees used to be astounding, I couldn't understand it. I think it's related to the infections, as I've effectively treated that symptom has disappeared for me.

You've caught the infections early on which is great. I'd try to do anything you can to minimize your stress and anxiety about the illness. Not to minimize our situations, but what you'll read online are usually the self-selected cases of people who have the most trouble healing from these illnesses, and it can be frightening to hear those stories. Many people recover, I think best strategy is to treat to the point of eradicating symptoms.

I hear that most llmds in New England (those who really are in the trenches and have a lot of experience with these infections) treat early cases very aggressively because they know how serious it can get, so to hedge their bets they do everything they can to knock the infections out early on. It's a strong blast, but it prevent you from having to do lots of treatments in the future when the infections would be more ingrained and difficult to knock back.

I wouldn't trust the negative test, especially if you have continuing symptoms. Immune system response is highly variable, some people mount a chronic igm response and others never mount any antibody response (check out the research on immune system response by Monica Embers and Nicole Baumgarth, amongst others). The pathogen is immuno-evasive/suppressive which makes an antibody-based test somewhat unideal. Plus there are lots of strains and species which the tests aren't looking for.

If you are worried about the antibiotics may want to look into some of the herbal protocols. When to stop treatment? imo it should be several months after having cleared the symptoms. That is usually the strategy employed by most well-regarded llmds.

Post Edited (sebreg) : 8/8/2018 5:53:00 PM (GMT-6)

Honestly, it took a while for mine to resolve but I think that was due to my particular situation. I had very established infection(s), had been misdiagnosed for years and was severely ill. Plus I had all 3 infections, babesia, borrelia, and bartonella which compounded the issues. I'm not sure which infection was causing the joint crackling (crepitus), but over time as I effectively treated the infections that symptom has faded along with a host of other symptoms.

Given how early you are catching this, and that you seem to have a strong baseline, I would guess you should be able to get this to resolve fairly quickly with effective therapeutics. The key will be finding the right therapeutics that work for your case, and rotating if you aren't seeing improvements or plateauing. I found keeping a journal helpful, I was better able to track how I responded to various meds and also track changes/improvements in symptoms over time.