Dr. Daniel Cameron: Inside Lyme Podcast

Soldier dismissed from active duty after failing Lyme disease treatment

 

Welcome to another Inside Lyme Podcast with your host Dr. Daniel Cameron. In this episode, Dr. Cameron will be discussing the case of a 21-year-old soldier who was dismissed from active duty after failing treatment for multiple illnesses including Lyme disease.

The case was first described by Melanson and colleagues in a paper entitled “The Epistemic Fallacy: Unintended Consequences of Empirically Treating (Clinically Diagnosed) Chronic Lyme Disease in a Soldier.”1

“A 21-year-old, Division 1 student athlete patient presented with heart palpitations and frequent unprovoked adrenaline rushes,” wrote the authors. His symptoms were initially dismissed as stress.

Four months later, testing for Epstein-Barr virus was positive but serological testing for Lyme disease was negative. “He was diagnosed with EBV reactivation and prescribed rest and recovery,” the authors wrote.

The man graduated but remained on medical leave since his symptoms had not resolved.

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He was presumed to suffer from persistent mononucleosis like symptoms and Traumatic brain injury (TBI) attributed to possible post-concussion syndrome related to sports injuries, the authors explained.

The patient was then treated with Hyperbaric Oxygen Therapy (HBOT). However, after two sessions, it was discontinued due to an increase in symptoms including heart palpitations, flank pain, myalgias, and neuropathy.

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Although repeat testing for Lyme disease was negative, the man was treated clinically for Lyme disease based on symptoms, possible tick exposure during military trainings and the lack of other definitive findings.

He received three courses of doxycycline. Further Lyme disease tests were inconclusive.

The patient was forced to stop treatment after it worsened his symptoms, causing an increase in joint pain, intermittent nerve pain, headache, fatigue, cognitive difficulties, anxiety, mild depression, and increased chest pain.

The patient then sought treatment with a functional medicine doctor. His workup focused on mycotoxicosis in part due to his living and training environments.

He had a homogeneous single nucleotide polymorphism in the MTHFR gene suggestive a low level of metabolic detoxification and an abnormal mycotoxin urine panel.   He was treated for 3 months with IV phosphatidylcholine (up to 10 amps), IV glutathione (1,200 mg), IV Leucoviron (10mg), and subcutaneous B12 (1000 micrograms). He had minor improvements in fatigue and stamina but stopped after 3 months due to cost. His follow-up urine mycotoxin urine panel was negative.

The man remained ill and “was unable to perform moderate-or-strenuous physical exercise or cognitive activity due to the following symptoms:  cognitive impairment affecting short-term memory and ability to focus, severe fatigue, and post exertion malaise, asthma and increasing allergic-type reactions with chemical and food sensitivities as well as histamine intolerance, and progression to heat/ultraviolet induced urticaria,” wrote the authors.

“Additionally, the patient struggled emotionally with anxiety, depression, environmental stimulation (such as bright and flashing lights and loud noises), and sensitivity to stress.”

He was subsequently diagnosed with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) following resolved acute mycotoxicosis.

The young man was considered unfit for duty by the Army Medical Evaluation Board for the following reasons: “Lyme disease, mycotoxicosis, chronic fatigue syndrome, allergic rhinitis and vasomotor rhinitis.”

The authors did a great job of describing the severity of symptoms and poor function of a soldier despite evaluation and empiric treatments for CFS/ME, following resolved acute mycotoxicosis and Lyme disease. Unfortunately, the soldier was unfit for duty despite extensive treatment for a wide range of illnesses.

The following questions are addressed in this Podcast episode:

  1. Have you seen patients with this range of symptoms?
  2. What is HBOT?
  3. What is integrative medicine?
  4. What is empiric treatment?
  5. Was Lyme disease a consideration?
  6. What other illnesses were considered?
  7. Are their patients with Lyme disease that fail treatment?
  8. Are their patients with the other illnesses discussed failing treatment?

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Thanks for listening to another Inside Lyme Podcast. Please remember that the advice given is general and not intended as specific advice to any particular patient. If you require specific advice, please seek that advice from an experienced professional.

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References:
  1. Melanson VR, Hering KA, Reilly JL, Frullaney JM, Barnhill JC. The Epistemic Fallacy: Unintended Consequences of Empirically Treating (Clinically Diagnosed) Chronic Lyme Disease in a Soldier. Med J (Ft Sam Houst Tex). Jan-Mar 2022;(Per 22-01/02/03):50-55.


5 Replies to "Soldier dismissed from active duty after failing Lyme disease treatment"

  • Debby Skogman
    02/22/2022 (7:34 am)
    Reply

    Dr. C, I wish you would have written the headline differently. Who failed? The soldier or the lyme treatment? You wrote the title as if the soldier if the failure. The failure is the lyme treatment’s failure and not the soldiers. With this title you are feeding the standard narrative that it is the patients failing. Patients aren’t failing…..the treatments are. And what a difference it would make if you had titled it as treatment’s fault rather than the soldier’s.

  • T Allen
    02/21/2022 (7:01 am)
    Reply

    Welcome to my life. The VA still denies I have Lyme, ME/CFS and now MCAS, etc after 6 years. Thank God for Medicare and NDs!

    • Nicola
      02/21/2022 (6:05 pm)
      Reply

      I am astounded this poor young man got this far. With diagnosis and that amount of treatment. For five years I’ve been literally begging my GP here in London UK to reckonise me. Yet that are flat refusing to even consider Lyme disease. I am now so sick I cannot work. I have no money for private treatment. I feel scared, alone and dismissed. As well as gaslighted into believing i have mental issues causing my symptoms. I am now desperate for help, I don’t know where to turn. To sick to even get up some days, let alone write emails of complaints. I did complain about one doctor who slapped my hand away. That just made it worst at now every GP in the surgery just roll their eyes and patronise me. I now have nothing but anger & frustration also added on top of everything else. The way they have treated me for five years has been appalling. When ever I can I’ve bought doxcycline from online. I’ve also bought iver mec to keep going. Also fen Ben.

    • DorC
      02/21/2022 (6:22 pm)
      Reply

      Look for an attorney and let them fight for you, the VA does not like to recognize many illnesses.

      • Fred
        03/12/2022 (12:19 am)
        Reply

        Part of the problem are viral, bacterial infections plus parasite infestations. First thing to do is to start eating raw garlic every single day, two cloves. After that start drinking green tea two cups a day every single day plus start drinking Moringa tea infusions. Start eating oranges and red grapes and mushrooms. Find competent MD and ask him to give you prescription for Amoxicillin 750mg x 3 times a day for 7 days. Four week later you need prescription for Ciprofloxacin 250mg x 3 times a day for 5 days and you will be OK.


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