Trigger fingers-Lyme or one of coinfections?

[Stargazer_Lilies]

I am trying to figure out which cause trigger fingers in all of my fingers except thumbs.  Plaquenil did a good job keep it at bay. While on doxycycline 200mg daily, I experiment by cut down Plaquenil to half dosage. For three weeks, there is no change, then fourth week, my fingers goes crazy. I upped the dosage back, and one week later, fingers behaves.

While on rocephin IV and still taking plaquenil, for first few days, with herx, the trigger fingers came back then stops. My fingers still does not feel right and never did since trigger fingers started few years ago.

The question is lyme did this? Or one of co-infections, such as mycoplamsa? Or what?  I read about mycoplasma being implicted. If it is mycoplasma, what will kills it?  Obviously Plaquenil didn't really kill it completely.

[Ricobord]

I don't know about trigger fingers specifically, but Lyme likes to live in connective tissue. Plaquenil is a primary treatment for connective tissue disorders because it makes the body more alkaline.  There is something about being more alkaline that eases inflammation in connective tissue.  

My LLMD prescribed it for me along with Biaxin, which is used to treat intracellular Lyme and Bartonella. He said that the Plaquenil makes the body more alkaline, which allows the Biaxin to more easily penetrate infected cells. He said P makes Biaxin up to 40% more effective.

And so, that might explain why P helped your fingers, but not permanently.  P eases inflammation, but does nothing against an infection.

[Stargazer_Lilies]

Okay, there are confusion here.  Plaquenil was rx by my rheumatologist two years ago for RA, an autoimmune diseases, it supposes to help with inflammation, even although it is anti-malarial medication. Plaquenil is first line of treatment for RA.

When I first saw him, he felt I had early stage RA, even with only weak anti-CCP antibody, and based on my symptoms of daily morning stiffness and trigger fingers.  

Earlier this year, I was having crazy symptoms, and negative anti-CCP antibody and negative/normal for RA and all other autoimmunes. He discussed with me about reduce the dosage to see what happens.

He was starting to have doubt I have RA at all, because RA does not explain new, and revisited symptoms from past. In end, in March,  he refers me to hematalogist, then in turn, to infectious disease specialist to investigate chronic low grade fever, chronic low WBC, and bone pains.  At the same time I was already referred to neurologist to investigate neurological symptoms.

At that time I was happened to be on doxycycline, rx by my dermatalogist for skin infections.  All of it was way before I was dx with lyme by neurologist at the end of May.

In retrospect, it is clear plaquenil only holds it at the bay, whatever it is. I would like to find out what it is so I can get proper treatment, that is proper med and proper lenght of treatment for whatever cause my trigger fingers.  Doxy/Plaquneil is obviously inadequate.  

You say one need to complete treatment, how do we know treatment is long enough , and symptoms has been free for long enough to consider treatment complete and to see if cure taken place.  That's what I am trying to figure out because lyme, unlike other diseases, can hide, laying dormant  so on.

It seem it is irony, if we think we complete the treatment, but cure didn't taken place, we have give bacterica opportunity to develop resistance because treatment is not in place anymore.  Unless you meant if treatment is not in place, then bacterica does not have opportunity to weaken, thus no breeding of "fittest of survival".

The problem with Plaquenil is it take 2-3 month for it to become effective. That's the reason why rheumatologist wanted me to tritate it down slowly--If  stop it altogether, it'll take 2-3 months for it work again. My fingers are too precious for me,  so hence half dosage.  

My LLMD never say a iota about plaquneil, about whether i should stay on it or get off it. Nothing.  Plus he doesn't want to test for co-infections right now, but may do so at later date.

So I have to educate and adovocate for myself, and fight current "LLMD" or regular MDs to test a narrow list of possible causative organism that may cause trigger fingers. Maybe it is organism that can be monitored by lab works, who knows.

I am facing a hard decision to make with my dermatalogist about whether doing facial skin biopsy and leave scar on my face just to find out what it is I am infected with that does not respond to doxy/terta, ethoymicin, and such but to rocephin IV.

It would be nice if my dermatalogist and I could figure it out by blood work if we could narrow down list of organisms to test for. We don't want to do repeat skin biopsy, each time to test for something else if previous turn up negative.

Synovial fluid biospy next for my trigger fingers? Will they even know what to look for? It would take a lot of sample to test for "everything" to see what turns up.

So I am just asking around to see what infection is known to cause trigger fingers that accompany with Lyme to narrow down the list of organism to test for, so I can get proper abx for it.  

[JackieCalifornia]

To my understanding, your approach is not scientifically or medically sound.  The idea is to complete the treatment and then see if the cure has taken.  To lighten the dose in mid treatment invites failure and antibiotic resistance, which creates mutant organisms that put us all at risk.  

=============== from wikipedia: =======================
Various microorganisms have survived for thousands of years by their being able to adapt to antimicrobial agents. ... These microorganisms employ several mechanisms in attaining multidrug resistance. ...

===>>> Many different bacteria now exhibit multidrug resistance, including staphylococci, enterococci, gonococci, streptococci, salmonella, Mycobacterium tuberculosis, and others. ...

===>>> To limit the development of antibiotic resistance, one should:

==    Use antibiotics only for bacterial infections
==    Identify the causative organism if possible
==    Use the right antibiotic; do not rely on broad-range antibiotics
***==    Not stop antibiotics as soon as symptoms improve; finish the full course
====================================================
Ask you doctor.  S/he will, I trust, not be amused.  

You do neither yourself nor any of the rest of the planet any good by what you are doing.  You put us all at risk.

[Stargazer_Lilies]

Plaquenil seems only to hold whatever cause the trigger fingers at bay, and I need to figure out what it is, and so I can figure out what abx to add on to eradicate them from my joints. .

[Stargazer_Lilies]

True, but then how do I know treatment is working if I don't cut down plaquenil to see if trigger fingers has gone away for good.

It applies to  any symptoms, for instance how do I know if trigger fingers is gone for good? In the other word, eventually,  how do I know if lyme and coinfections is gone for good?

One would have to stop med after having no symptoms for a while. That's what I did--cut down plaquenil to test the waters. That was before I had spinal tap and dx of lyme.

[JackieCalifornia]

I don't know, but cutting down on the meds dosage gives the bacteria the chance to be only weakened and not killed, so the bugs that survive are developing immunity to the antibiotic.  Not good.

The saying "What doesn't kill you makes you stronger" applies to bacteria too.