Treatment break

lovefishing said...
Garzie,

T-lab is in same office as dr. M. He looks at the slides themselves (obviously) and he gives much more information vs what “official” report states. I had a slide that officially stated “inconclusive” but it was conclusive to HIM. Since I am his direct patient he can do that. The hematologist who he referred me to would examine everything himself since they draw cbc in the office and you get results in 10 minutes. I do not believe T-lab counts platelets but yes they are there and you can see them.

yep - i just mean that on a CBC - in a patient who has platelet aggregation ( any bart, rickettsia, typhus, Brucella etc patient ) odd numbers for platelet counts are quite possibly erroneous - and don't necessarily mean what the people reading them think they mean.
infection or increased inflammation reactions during treatment can drive parts of the clotting response leading to platelet aggregation - see pseudothrombocytopenia.
https://www.ncbi.nlm.nih.gov/pmc/articles/pmc5164902/

worth discussing with your docs in any case

Post Edited (Garzie) : 5/27/2022 9:14:12 AM (GMT-6)

Garzie,

Can I email you?

lovefishing said...
I understand that bartonella reproduces slowly and 1 month won’t matter but symptoms from remaining bartonella can come back quickly.

Bartonella reproduces faster than Borrelia. Usually when you stop antibiotics, you should be fine for about a week or so before Borrelia starts kicking in. With Bart it's around 2 days mark when you feel the symptoms of infection again.

wladek83 said...

Bartonella reproduces faster than Borrelia. Usually when you stop antibiotics, you should be fine for about a week or so before Borrelia starts kicking in. With Bart it's around 2 days mark when you feel the symptoms of infection again.

I am not an expert but if you pull antibiotics and relapse in a few days then you were never in remission. You relapse after half-life of whatever antibiotics were keeping it in check. Like tylenol will keep a fever down and you feel well. The remaining bacteria starts becoming active and not because it reproduces. Actually AIDS is a good example. They live fine as long as they take that cocktail.

If you are still struggling with active infection then they are already active and taking a break will just prolong misery but won’t cause a “relapse”. A week off of Mepron will not cause a relapse if you are actively treating. In fact you might feel better. However, if you are symptoms free then that week off might bring symptoms back.

And then we have coinfections with one being more “dominant” and pulling back on others might have no negative effects in short term.

Rifabutin has a half life of 45 hours and that’s your 2 days.

I have “relapsed” with no change in treatment because a coinfection came out.

Getting off is a good test to see if you are in remission or just symptom free but i am not symptom free.

its a complex picture

many abx are anti-inflammatory - and suppress symptoms via mechanisms other than killing bacteria - so these effects are typically closely related to their half life's

then, we are not inert bags of fluid with abx diffusing in and out - like a test tube experiment - we have immune systems - that are doing a lot of the work to suppress the growth of the pathogens - even in sick people.

but the abx also interact with our immune systems - for instance often suppressing the white blood cells that do some of the work against pathogens - eg neutrophils

there are also differing effects of depending on where the bacteria are - eg in cells - mostly safe from most antibiotics - or free in the blood stream - or how how deep in the tissues with little blood flow so low abx penetration. so a course of abx may relatively quickly kill the bacteria free living outside cells in our blood - but not the ones inside cells or deep in tissues - which may continue to gradually cycle back out into the bloodstream over time ( as is the case with bartonella )

so individual response will vary based on all of these factors as well as the typical multiplication time of the organism - but even this is variable.

in the lab in growth medium - it may be 1hrs - but in a living animal - after the acute phase it might be many times that - as persister cells form what have very different metabolism to fast growing cells.