Tick bite three weeks ago

I was bit by a large black tick in the Santa Cruz mountains of Ca. about three weeks ago.  The tick was embedded for 16 hours.  Six days later I had the bulls-eye rash.  The following day I started doxycycline, 200mg/day.  A slight fever started that day as well.  The emergency care MD wasn't too concerned about the bite but was more concerned that I continue to live an active lifestyle.  I immediately felt better and, stupidly, took a casual approach to the treatment during a week-long ski trip.  When I returned home, I experieced fever, joint pain, stomach issues, dirrariaha, headaches and caught a cold and, which unusual for me, went immediately into my chest or bronchi.

My regular MD now has me on 400mg/day of dioxy and I am slowly getting better after one week of intensive R&R.  12 to 14 hours/day of sleep, no work, no exercise, microbiotics, no alcohol, etc.  My MD prescribed two 10-day courses of dioxy and instructed me to get the second course only if I still have symptoms.  Given the insiduous nature of Lyme, should I continue dioxy after I no longer notice symptoms?  I have had no adverse side effects yet.  How do I keep my partner from getting Lyme too?

thanks

[JackieCalifornia]

Allan,

These are all good thoughts and valid concerns in my non-medical view.

Two questions pop into my mind:

--Were you evaluated for co-infections, which are other diseases carried by the same ticks?  There is apparently a fairly high incidence of co-infections (maybe 50%?) and nonLyme docs don't seem particularly interested in them.  They need separate testing and often different treatment from Lyme, so if you aren't feeling 100% after your doxy treatment is done, I'd go find a Lyme specialist (LLMD, which is not what the docs call themselves, but what we patients tag them to note their advanced understanding of the risks of underdiagnosis and undertreatment of Lyme+).

--I would definitely finish all the meds including the refill.  Lyme bacteria apparently have a long reproductive cycle compared to most other bacteria, but because it is when dividing that bacteria are most susceptible to antibiotics, it's important to keep meds at bug-killing levels over enough generations of bacteria to wipe them out or crush them to the point that your immune system can handle the rest.  Whether the length of time you have been prescribed meds is enough, I can't say.  I have never heard nonLLMDs speak to this aspect of Lyme, i.e., its long reproductive cycle, so don't know why they aren't focussing on this.

--There's also the problem with Lyme that they have (in Star Wars parlance) cloaking devices called biofilms, where they can hide and avoid detection by the immune system.  If you can't see them, you can't kill them.

--Lyme bacteria also infiltrate the endocrine system and mess with nearly everything as a result.  Thyroid etc.

I highly recommend ILADS [dot] org, on the tab 'About Lyme', third or so item down, Burrascano's 'Diagnostic Hints and Treatment Guidelines'.  They are written conversationally but for MDs and are accessible to mere humans.  I read them again every so often.  ILADS is the main LLMD organization that is taking the battle to the bugs and to the CDC/IDSA [Infectious Disease Society of America], who think a couple weeks of meds is more than enough and if you're still sick afterward, it's an autoimmune reaction.  Yeah, right.  

The approach your docs are taking may be sufficient, but you are very wise to be cautious.  The time to kick Lyme most easily is early on, before it moves in the sofa and beer fridge and gets comfy.

You are asking the right question imho.  Read Burrascano and scout the ILADS website for other interesting bits.  I'll send you a private message with the name of an LLMD kind of in your area if you're interested in a second opinion.  We don't post LLMD names in the open because in some states, docs don't have freedom of conscience laws protecting their ability to practice as they see fit.

Hope you're better soon and for good.  Best wishes --