antibiotics decision - how low would you go?

[jason80]

This is a risk-reward question and has nothing to do with the probability that you have Lyme/coinfections.

Assume that the true probability of having Lyme > 50%. Then it is probably an easy decision to pursue antibiotic therapy (say 3 to 6mo trial). However, let's say the true probability of having Lyme/coinfection < 1%, then probably most of us would move on and assume we don't have Lyme and forget it. I also assume that the more severe the symptoms, the lower the threshold probabilty for pursuing ABs.

What is the lowest probability of having Lyme/coinfection, that you would still (or have already) pursue/d the 3-6 mo trial of antibiotics. (I'm assuming oral only, I would assume IV the threshold drops accordingly). This vote has nothing to do with what you think is your own probability, just your decision threshold if you were given true probabilities of illness given below. Thanks.

[patsy10]

JackieCalifornia and wonko described it to a tee.  I was barely functional.  I could barely make it to my mailbox my legs were so weak.  I would have tried almost anything to get better.

[wonko]

Given my same level of disability before I started treatment, and the same rate at which I was deteriorating, then no, it would not make a difference if it was IV or oral therapy.  I'd worry more about it, but not enough to stop me from trying it.

Also contributing to my determination to try antibiotics was that I had tried several other options:  Neurontin, lyrica, steroids, and of course, "wait and see."  I also tried lifestyle changes, including quitting smoking (I hit one smoke-free year next week!), quit drinking, changed diet, exercised when I could, etc.  

So Lyme/antibiotics wasn't just a random option, I was very engaged for all of 2008 in pursuing the source, and hopeful cure, to my worsening problems.

I wouldn't endorse anyone with test results as vague as mine to dive right into antibiotics.  So I guess previous attempted alternative treatments, if any, are another precursor to the poll.  
  

[jason80]

You're both correct. And I think the severity of the symptoms is the largest factor. Secondarily is one's own expectation of the side effects and anticipated benefits of ABs. There is never an easy poll when it comes to health issues, particularly Lyme.

If IV AB is the main therapy does that change your numbers much?

[JackieCalifornia]

I think the answer turns on how sick you are when told you have Lyme+.

If I was just a little miserable, I'd be more inclined not to treat; but I was, like Wonko, virtually non-functional on a daily basis at home and at work.  I hurt, I couldn't think, I was beyond anxious:  I had no life anymore and it was going downhill fast.

I had zero choice.

So the poll might give a more useful response if you give a standard for how functional/nonfunctional you are when you are faced with the meds/no meds decision.  ("Assume you are functioning at 50% your pre-illness level.")  Like Lyme, nothing is simple.

Thanks for doing this.  Thought-provoking.

[wonko]

I had to read this a couple of times, but I think I understand your design.

I voted 1-3%, and in keeping with my verbosity, here is why:  The alternative I was facing was that I had an incurable condition.  That and I was quickly losing my ability to work.  So even if my odds of actually having Lyme/co's were in the 1-3 % range, I would still find it worth the risk to try several months of oral antibiotics.

Note: I am about four months into my oral antibiotic treatment, and have not suffered any ill side effects other than Herx reactions, which I don't really count and are part of healing.  I take a probiotic, pulse 3 different antibiotics, and take 1 day a week "off" from any medication.  For me, the Herx reactions and gains I've made from the treatment are better evidence than any of the blood tests.

Interesting and thoughtful poll question!