I have copied and pasted a few selected parts that will affect many. I have added the bold lettering to point out some of what I saw as incredible admissions and have used *'s to show where I added something, and have removed the reference numbers for easier reading.
If you can read through any of this on your own, I would greatly encourage you to read through it yourself - there could easily be something in this paper that could help your situation, especially if you are still trying to get diagnosed.
And I apologize for the length of this post. I did break up the paragraphs some for those with eye issues.
I will be getting printer ink and printing this article out!!!
"Relevance of Chronic Lyme Disease to Family Medicine as a Complex Multidimensional Chronic Disease Construct: A Systematic Review"
www.hindawi.com/journals/ijfm/2014/138016/"1.1. Definition of Chronic Lyme Disease (CLD)
Chronic Lyme disease (CLD) is considered a constellation of persistent symptoms in patients with or without evidence of Bb infection [15, 16]. Some authors use the term CLD only for patients who had been clinically diagnosed with Lyme disease and have persisting symptoms lasting more than 6 months following antibiotic treatment [8].
For this reason the term “posttreatment Lyme disease” [17, 18] or “post-Lyme disease syndrome” [10, 18] is often used.
The category of “probable Lyme disease” was recently added to the CDC surveillance case definition to describe patients with serologic evidence of exposure and physician-diagnosed disease in the absence of objective signs. ......
"1.2. Evidence on Persistent Bb Infection
There is growing and well-documented evidence to the concept of persistent Bb infection in both animals and humans .
Recent evidence shows Bb is able to escape from destruction by the host immune reactions, persist in host tissues, and sustain chronic infection and inflammation, despite aggressive antibiotic challenge "
"3.1.1. Diagnosis
...
Erythema migrans (*Bull's eye rash*) is pathognomonic and does not require any further laboratory investigations ........"
"
There is consistent evidence that the two-tier testing lacks sensitivity, cannot distinguish between current and past infection, cannot be used as a marker for treatment, is often dependent on subjectively scored immunoblots, and is considered expensive.
Moreover, the diagnosis of CLD based on clinical manifestations, serological findings, and detection of infectious agents often contradict each other. For this reason a growing number of studies support two-tier testing followed by a sensitive and reliable DNA sequencing for confirmation to support the diagnosis of CLD.".....
"3.1.4. Treatment
....Recommendations about
the type and duration of treatments in patients with CLD have no factual basis, although prolonged courses of antibiotics are likely to be helpful. Recent biostatistical review reveals that retreatment has meaningful clinical benefit in patients who had prior antibiotic treatment, with the use of longer (parenteral) antibiotic therapy often to be justified.
Doxycycline is often the preferred agent for oral treatment because of its activity against other tick-borne illnesses, but recent evidence shows that doxycycline-treatment only does not always lead to clinical improvements in either the persistent symptoms or quality of life in patients with CLD.
This finding can potentially be explained since single antibiotic use often fails to address the different morphological forms of Bb as well as biofilm formations in patients with CLD. Studies indicate the need to include cell wall and cystic and intracellular drugs in any treatment as the different morphological forms of Bb display differences in sensitivity to antibiotic treatment.
As coinfections are present in most patients, the use of specific antibiotics is required. Tetracyclines and macrolides are often used, with quinolones for alternative treatment, particularly gemifloxacin. For Bartonella henselae, Chlamydia trachomatis, and Chlamydophila pneumoniae the combination with rifampicin is recommended.".....
And who doesn't need a little validation once in a while???
"3.4. Health System Complexity
....Patients with CLD are often unsatisfied with care in conventional settings. Negative experiences are associated with reports of dismissive, patronizing, and condescending attitudes in health care providers. Studies show that consultations with complementary and alternative medicine (CAM) practitioners and use of CAM therapies are common, representing a cost to patients to be exorbitant and prohibitive."......