In 1996, when I got my first case of Lyme disease, it was still a relatively obscure disease. My doctor didn't seem to know much about it, he was very reluctant to diagnose it, and from some things he said I think I may have been his first confirmed case. By the second time I had it, five or so years later, the same doctor was very well up on all the literature and discussed the various symptoms with me, as well as the reliability of the test. And no wonder -- the disease has exploded. The CDC has just released a new estimate of the number of Americans who are diagnosed with the disease every year: 300,000. This is not an actual count but an estimate based on three different sampling exercises, but it is the best number we have. I believe it. Every field archaeologist I know has had it, most of them more than once. Just this summer three members of our six-person crew have had it. And we are careful people who know all the precautions.
Unfortunately, many doctors have not kept up like mine has. I hear stories all the time about doctors who don't even know the basics they could read off the CDC web site. One field tech on my crew was covered with bright purple blotches, hot to the touch, which is exactly what I got with my first Lyme case. Her doctor refused to recognize this as a sign of Lyme, even though the CDC has posted pictures just like it and the written guidelines list "any unusual rash" as a sign of Lyme. Ignorant doctors put all their reliance on the Lyme blood test, which far from perfect. As my doctor said, it is "no less accurate than any other medical test." It is an indication, but there are lots of others, and diagnosis should be based on all the factors rather than just the test.
As the CDC says, Lyme disease is a "tremendous public health problem." I have never been sicker than during my first bout of Lyme. Left untreated, Lyme can spread to joints, causing painful arthritis, and into the brain. There is no longer any excuse for doctors not to know about it or not to treat it aggressively.
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