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Everything about Lyme disease is steeped in controversy. Now some doctors are too afraid to treat patients

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Bruce Shilton’s crippling fatigue left him bedridden for six months. Sue Faber was so forgetful, she couldn’t remember her daughters’ birthdates. And Andrea Smith’s relentless aches sent her into a deep depression.

All three Canadians say they are struggling with a chronic form of Lyme disease and feel abandoned by Canada’s health-care system.

Sue Farber, left, Bruce Shilton and Andrea Smith suffer from a chronic form of Lyme disease.
Sue Farber, left, Bruce Shilton and Andrea Smith suffer from a chronic form of Lyme disease.  (Richard Lautens/Toronto Star |Cole Burston for the Toronto Star |Steve Russel/Toronto Star)

The challenge for them, and other patients with Lyme, is that the medical community is divided on how best to diagnose and treat this controversial disease.

On one side of this deep divide are mainstream doctors who say Lyme is easy to diagnose with standard testing, and the prevailing treatment — a short course of antibiotics — is enough to kill the bacteria that causes the disease. They believe patients who think they have chronic Lyme but have no evidence of infection are grappling with other illnesses and that treating for Lyme masks the real cause of their symptoms and does more harm than good.

On the other side are doctors who say this is an extremely complex disease. It is often called “The Great Imitator” because its symptoms mimic other diseases and can affect any part of the body, including the brain, heart and nervous system. They say the standard testing is flawed, resulting in missed cases and misdiagnosis, and if it’s not caught early the required treatment is longer antibiotic use.

In Canada, treatment is based on guidelines established in the United States. But several states have passed doctor-protection laws that allow physicians to treat Lyme more aggressively with longer-term antibiotics. Here, however, physicians typically refuse to treat chronic Lyme, or they do so quietly so that regulatory agencies don’t find out.

This leaves desperately ill patients with few options, which is especially troubling because research shows people with Lyme are at greater risk for suicide. They say they are met with outright disbelief from some doctors who refuse to treat it, and tell them to stop self-diagnosing with Dr. Google. With no relief for their debilitating symptoms from our health-care system, they go elsewhere — often to the U.S. — and pay big bucks for diagnosis and treatment.

It’s a polarizing issue at a time when warmer climate is facilitating the rapid spread of blacklegged ticks across Canada. Cases of Lyme disease, transmitted through the bite of an infected tick, are at record highs and expected to rise. Figures for 2018 aren’t yet available, but last year there were 2,025 confirmed and probable cases nationwide, up from 992 in 2016. By comparison, there were 144 cases in 2009. And health officials say the number affected is probably tenfold because the disease is underreported.

“Canada is a new frontier for Lyme disease,” says American investigative journalist Mary Beth Pfeiffer, the author of Lyme: The First Epidemic of Climate Change. “It is a disease that moves into an area, takes root and doesn’t leave.”

Ticks are a greater nuisance in the summer, when people are more likely to venture into brushy and wooded areas. But they’re still around in winter, hiding out in leafy litter.

“Be aware,” says entomologist Curtis Russell, a senior program specialist at Public Health Ontario. “If it’s above 0 C and there’s no snow, blacklegged ticks can still be out and active.”

Earlier this year, the Star wrote about the spike in Lyme cases and about a provincial report by the Lyme Disease and Tick-borne Illnesses Task Force. The task force was appointed by the Ministry of Health to identify ways to improve the health of those living with Lyme. It addressed how patients say the disease is going undetected, misdiagnosed and insufficiently treated. Among its key recommendations is the need to review current testing methods and treatment guidelines. That story drew close to 100 heart-wrenching messages from readers. People were too sick to work, forced into early retirement and had spent their savings on treatment. To better understand this issue, the Star spoke with people on both sides of the divide.

A long-time lawyer and judge, Bruce Shilton stepped down from the bench on a disability leave. He couldn't continue working so he retired.
A long-time lawyer and judge, Bruce Shilton stepped down from the bench on a disability leave. He couldn’t continue working so he retired.  (Cole Burston)

Bruce Shilton was cutting grass at the family cottage in the Muskoka Lakes when he suddenly felt unsteady and had to sit down.

“It was like this big cloud rolled in.”

He didn’t know it, but that cloud was the first hint of a storm brewing deep within him that would uproot his life.

It was 1998 and Shilton was 49. The father of three had always been active, coaching hockey, T-ball and soccer. But after that unusual episode, he came down with what felt like “the worst flu of my life.”

Around this time, he was appointed as a judge of the Ontario Court of Justice. It should have been a happy time in his life. But he was inexplicably growing weaker, grappling with fatigue, brain fog and headaches. At one point, he lost 20 pounds in two weeks. By 2000, he was actively searching for answers. He saw more than 25 specialists in Ontario — including infectious disease experts, neurologists, cardiologists, nephrologists, gastroenterologists, urologists and chronic fatigue specialists — and underwent a battery of tests.

One of those tests was for Lyme disease. It’s been around for thousands of years, but was first described in the mid-1970s, when Yale University scientists researched a mysterious outbreak of arthritis among adults and children in Lyme, Conn. A bacteria called Borrelia burgdorferi, transmitted through ticks, was the culprit. The ticks pick up the bacteria during blood meals, feeding on animals such as white-footed mice, deer and birds, then pass it on to humans. Ticks must be attached for 36 hours to transmit the bacteria to a human.

If Lyme is suspected early, a clinical diagnosis should be made based on whether the patient has a rash that sometimes resembles a bull’s-eye, flu-like symptoms, possible tick exposure and whether Lyme is endemic to the region. Antibiotics should be started immediately and this treatment usually results in a full recovery.

The classic bulls-eye rash that indicates a person has likely been bitten by a tick carrying Lyme disease.
The classic bulls-eye rash that indicates a person has likely been bitten by a tick carrying Lyme disease.  (James Gathany)

The only diagnostic test for Lyme recognized by Canadian, American and European public health authorities, is a two-tiered test. The first test is called an ELISA — enzyme-linked immunosorbent assay. If it’s positive, or indeterminate, then a Western Blot test is done. Both must be positive for a Lyme diagnosis. But because they test for antibodies — and antibodies take four to six weeks to develop in the body — they’re not good at picking up early infection.

Shilton didn’t remember a tick. But they are tiny — adults are the size of a sesame seed — and their bites are painless. And he didn’t remember a rash, but not everyone develops it. However, the wooded area around his cottage was ideal habitat for blacklegged ticks, which moved north from the U.S. into Canada, hitching rides on birds and deer, and are now thriving here. They were first spotted in the province in the 1990s in Long Point Provincial Park on Lake Erie, and now are found throughout most of southern and eastern Ontario.

Shilton wondered if the illness had gone undetected for years, spreading and hiding in different parts of the body, making treatment more challenging. But he tested negative. Medical experts were baffled. Shilton grew sicker.

Once a whip-smart lawyer — he was a prosecutor for 13 years and defence lawyer for 11 years — Shilton struggled as a judge, wrestling with fatigue and headaches. In 2004, he stepped down from the bench on a disability leave and couldn’t continue working so he retired. At one point, he was bedridden for six months because of fatigue.

“I couldn’t even walk to the mailbox at the end of my driveway,” he says. “It just totally overtook my life.”

Read More:

Research shows Lyme disease under-detected across Canada

Lyme disease cases hit record highs across Canada as tick populations expand

How to protect yourself from growing risk of Lyme disease

In 2007, Shilton’s doctor sent his blood to a commercial lab in the U.S. This time, he tested positive.

But many in Canada’s medical community don’t accept results of foreign commercial labs because their validation data is not made public, says Tara Moriarty, an associate professor at the University of Toronto and a Lyme disease researcher.

Tara Moriarty is an associate professor at the University of Toronto and a Lyme disease researcher.
Tara Moriarty is an associate professor at the University of Toronto and a Lyme disease researcher.  (Picasa)

“These companies have been found to return false-positive Lyme disease results for as many as 60 per cent of samples submitted from people who have never had Lyme disease,” says Moriarty. “(That means) at least half of the people diagnosed with Lyme disease do not actually have this infection.”

She admits there are limitations to the two-tiered test and that there are efforts underway in Canada to ensure we know the types of strains that are present. But she cautions against using for-profit commercial labs.

That’s echoed by Dr. Todd Hatchette, president of the Association of Medical Microbiology and Infectious Disease Canada (AMMI Canada), which represents physicians, clinical microbiologists and researchers specializing in medical microbiology and infectious diseases.

“I do feel for people who are suffering from chronic non-specific symptoms and looking for an answer,” says Hatchette, a medical microbiologist and infectious disease physician in Nova Scotia. “But assuming it’s Lyme disease based on nonstandardized testing and alternative methods is not necessarily the best thing for them, because it may prevent them from going on to getting diagnosed with something that can actually be treated.

“If the (two-tiered) tests are not positive, you should be looking for another cause,” he says.

But Vett Lloyd, a biology professor at Mount Allison University in New Brunswick, says most Lyme cases are missed with the standard test. She recently co-authored a study with Dr. Ralph Hawkins, a clinical associate professor at the University of Calgary. Using data from New Brunswick they found the two-tiered tests miss 90 per cent of real Lyme infections. In Ontario, she says about 80 per cent of cases are missed.

“That’s a lot of sick people who are getting negative test results who are being told it’s not Lyme disease, look elsewhere,” says Lloyd. “It’s expensive for the medical system and devastating for the health of those individuals.”

Lloyd says the two-tiered testing is dated and ineffective because it’s based on an older strain of the Lyme disease bacteria, which has evolved and mutated over the years.

Jyotsna Shah is president and CEO of IGeneX, a California commercial laboratory that is the leading alternative Lyme disease testing lab. She says the company’s methods are better at detecting infection than the two-tiered tests recommended by the Centers for Disease Control and Prevention. She says IGeneX looks for more strains of the bacteria, so if someone was bitten in another country it will get picked up because their tests look for bacteria and antibodies. And it covers the full spectrum of disease. It is better at detecting infection early on as well as in the later chronic stage of the disease, when a person may be too sick to make the antibodies the two-tiered tests look for.

“The two-tiered misses a lot of cases,” she said. “We probably (detect) most cases.”

“The tests we have developed so far are very sensitive and very specific,” she said, adding, “We follow the strictest guidelines and we make sure our tests are properly validated.”

Shah said “the false positive is not an issue with us.”

In the summer, New York State’s health department certified the company’s latest Lyme tests for use by physicians after a rigorous process.

Dr. Maureen McShane, who runs a practice in Plattsburgh, N.Y., specializing in Lyme and other tick-borne infections, such as Bartonella and Babesia, calls the two-tiered test a “setup for failure.” She uses IGeneX. But, she says, doctors shouldn’t rely on testing to begin treatment. They should make a clinical diagnosis, which is why “all Canadian doctors, and all U.S. doctors, should be familiar with symptoms of chronic Lyme disease.”

Unable to get treatment in Canada, Shilton saw McShane in New York. But he didn’t have the energy to travel there for regular treatment. In 2011, he started seeing a naturopath in the Toronto area, who’s treated him ever since. It’s been a “a roller-coaster ride,” he says, with periods of feeling good and bad.

“I’m not anywhere near normal,” says Shilton, 69, who lives in the Town of Whitchurch-Stouffville. “But I have some quality of life now, which I haven’t had in a long time.”

He goes to gym a few times week, occasionally plays golf, and last year went on a family vacation to Florida. And, he’s much more social, accepting invitations to dinners and small gatherings.

He calls Lyme “the million-dollar bite.” That’s how much it has cost him in lost salary and treatment costs, the latter amounting to $150,000.

“I’m fortunate,” he says, adding he can afford treatment. “There are many, many, many who aren’t and they suffer in silence, with disabilities and have zero quality of life.”

TREATING LYME

Sue Faber in her home office in front of a wall of research materials on the disease. Faber, a nurse, has been battling Lyme for many years.
Sue Faber in her home office in front of a wall of research materials on the disease. Faber, a nurse, has been battling Lyme for many years.  (Richard Lautens)

In August 2015, Sue Faber hit a breaking point.

For more than a dozen years she had seen an array of specialists for unexplained unusual symptoms — fatigue, forgetfulness, eye floaters, brain fog, a racing heart and a right foot that sometimes dragged. But every blood test, electrocardiogram, ultrasound, MRI and CT scan was negative.

Weeping she begged her doctor, “Is there anything, anything, anything you can think of?’ ” the 41-year-old nurse from Burlington asked.

Her doctor handed over a requisition form for blood work and for the first time requested the lab check for Lyme.

That proved fateful.

The first of the two-tier test, the ELISA, was positive, but the Western Blot was negative.

An infectious disease specialist suspected the ELISA test was a false positive. But Faber urged the doctor to run another Western Blot test, checking for European Lyme, since she had travelled there.

The test was positive.

Finally, a diagnosis. She had late-stage disseminated chronic Lyme disease, which meant the bacteria had spread throughout her body. She was started on daily intravenous antibiotic treatment.

“Within a few days, this brain cloud of fog started to lift,” she says. “It was unbelievable.”

But it didn’t last. When the treatment ended, Faber’s symptoms returned, along with new ones, including numbness in the tongue, tingling in the hands and a buzzing sensation in her legs.

Faber wanted back on the meds. But the specialist refused. That’s because mainstream doctors typically follow the prevailing treatment guidelines developed by the Infectious Diseases Society of America (IDSA), which have been adopted in various countries, including here, where they are promoted by AMMI Canada. They recommend short-term antibiotic use of up to four weeks, with a second course needed sometimes. That should be enough to kill the Lyme bug in most cases, although an estimated 10 to 20 per cent of patients remain ill with what’s called post-treatment Lyme disease syndrome.

However, other doctors follow the competing guidelines of the International Lyme and Associated Diseases Society (ILADS), which is a multidisciplinary medical society that says long-term antibiotics are needed to fight the infection.

“Because there is so much disagreement on that one fact, it has really stymied research and put patients in a position where they can’t get care,” says Pfeiffer, who began writing about Lyme in 2012 and is the only investigative reporter to cover this issue who hasn’t had Lyme disease.

In the U.S. — an estimated 30,000 cases of Lyme are reported annually, but the real number affected may be 300,000 — patient groups have been successful in getting several states to legislate protection for Lyme doctors, letting them determine treatment. Initially, some thought the new laws would have other doctors feeling more comfortable with treating Lyme, but it’s unclear if this has been the case.

“These laws are not fully protective and doctors are still very leery of treating Lyme disease,” says Pfeiffer, who knows of at least one doctor in New York who has been sanctioned. “There are far too few doctors who are willing to treat Lyme disease (in the U.S), other than the hastily diagnosed and hastily treated case.”

Lorraine Johnson, CEO of LymeDisease.org in the U.S., says “physician-protection laws do have the effect of providing a safety net for physicians who treat and that encourages them to follow their conscience.” But she added, Americans still experience a “severe access-to-care problem.”

“We have a problem in the United States, but Canada has that problem squared.”

In Ontario, New Democrat MPP Michael Mantha, a longtime advocate for Lyme patients and part of the provincial task force on Lyme, believes thousands of Canadians have sought treatment in the U.S., some spending hundreds of thousands of dollars. He also knows of people who have gone to Belgium, France and Germany.

He says that while doctors in Ontario do benefit from physician-protection laws, they are hamstrung by the prevailing guidelines. He’d like doctors to have more flexibility in choosing treatment guidelines, adding he’s in favour of anything that will benefit patients.

“Patients are suffering and Lyme disease is real,” says Mantha (Algoma-Manitoulin), who became passionate about the issue after hearing a heartbreaking story from a constituent whose daughter was denied treatment.

Professor Lloyd, of New Brunswick, has had Lyme disease and cancer.

“Both were terrifying,” says Lloyd. “But no one ever argued with me about whether I really had cancer. I was treated with compassion.”

By comparison, Canadian doctors didn’t believe she had Lyme and refused to treat her. They suggested she had Multiple Sclerosis and that she go into a nursing home for the rest of her life because her physical abilities were degenerating. Instead, she went to the U.S., was treated with long-term antibiotics and fully recovered. Lloyd doesn’t know if the bacteria is gone or dormant, capable of flaring up again.

Faber also headed to the U.S., where a doctor in Albany, N.Y., restarted her on antibiotics. Two years later, she’s still on them. To date, she has spent about $30,000 on testing, treatment and medical appointments.

“I’m functional and able to work again,” says the mother of three, who tears up when talking about the devastating toll of Lyme. At one point, she couldn’t remember the birthdates of her children.

AMMI Canada president Hatchette says long-term antibiotic use has never been proven effective and when administered intravenously can be risky, resulting in potentially fatal bloodstream infections.

“At least five randomized controlled trials have looked at prolonged therapy, after the traditional four weeks of therapy, and none of those people in the treatment group did any better than those who received the placebo,” he says.

So how does he explain patients who say they feel better after longer treatment?

“The natural history of (chronic illness) is it tends to wax and wane. It can get worse and it can get better. And we don’t know why,” he says. “There are also anti-inflammatory effects to antibiotics that have nothing to do with treating infection that might be helping an underlying inflammatory condition. And there’s also the placebo effect.”

Last year, a study by Tulane University researchers revealed some monkeys infected with Lyme and treated with the standard four weeks of antibiotics still had the bacteria in their organs up to a year later. And a couple of monkeys actually tested negative for Lyme, but researchers then found the Lyme bacteria in their heart and bladder. The study seems to support claims by patients that the standard testing isn’t always accurate and symptoms will linger after treatment.

Overall, it’s been tough for researchers to explore problems with standard treatments because they can’t get their projects funded or articles published in mainstream medical journals, says Pfeiffer. However, change is coming. More online medical journals are making it easier to get published and non-profit foundations, such as Global Lyme Alliance, have the money to pay for research, she says.

McShane, of Plattsburgh, has seen the benefits of long-term antibiotic treatment in herself and her patients, some of whom she has treated for up to five years. But, she adds, you won’t read about that in major medical journals.

McShane was bitten by a tick while gardening in 2002, and developed flu-like symptoms. Doctors couldn’t explain her deteriorating health, then one of her patients, with similar symptoms, told her he had been successfully treated by Dr. Richard Horowitz, a top Lyme physician in the U.S. Horowitz put McShane on antibiotics for two years, and she recovered.

“If I had not found Dr. Horowitz, I would be in a wheelchair by now,” McShane says. “I was falling, having speech problems, stuttering, choking on my own saliva, facial twitches, weakness, chest pains, shortness of breath.”

Her experience inspired her to open her own practice in 2009. Since then, she has treated around 3,000 people with both antibiotics and herbs. About 90 per cent of her patients are Canadian, 50 per cent of whom are “very angry” with the public health system in Canada and the doctors who refuse to treat them. Her patients include entire families — the reason for that is some research shows Lyme may be transmitted sexually and in utero, she says.

“We need to do long-term studies,” she said. “We’re talking about the health of our future generation.”

Similarly, Faber’s ordeal propelled her into advocacy work. Last year, she co-founded LymeHope, a not-for-profit that provides education to the public and medical community. She has since collected 2,700 letters written by Canadians with Lyme on their struggles with the health-care system and hand-delivered them to the federal health minister’s office. She has launched an online petition that has more than 82,000 signatures calling on government to recognize the seriousness of this disease and take action. And she was the driving force behind the Registered Nurses’ Association of Ontario passing a resolution to advocate, at all levels of government, for the integration of ILADS treatment guidelines.

“What we’ve been asking for all along is action that is grounded in identified needs by patients,” says Faber. “There are massive chasms, with patients on one side and doctors on the other. We have to bridge this gap.”

STAYING IN CANADA

Andrea Smith suffers from chronic Lyme. She first started feeling unwell in 2009. Since the summer of 2017 she has been treated with a combination of herbal and antibiotic treatment and had been feeling much better until this fall. She is confident "this will get figured out."
Andrea Smith suffers from chronic Lyme. She first started feeling unwell in 2009. Since the summer of 2017 she has been treated with a combination of herbal and antibiotic treatment and had been feeling much better until this fall. She is confident “this will get figured out.”  (Steve Russell)

In August 2017, Andrea Smith walked out of a Toronto clinic feeling like a doctor finally had the tools needed to help her.

“It was a huge relief,” says Smith, who had for years bounced among specialists, doctors, naturopaths, criss-crossing between Canada and the U.S. for treatment.

The 49-year-old, who runs a microbrewery on Manitoulin Island on Lake Huron, had finally found someone equipped to deal with Lyme, which she calls “a Pandora’s Box.”

It’s a box she first opened in 2009, while visiting a friend in B.C. She developed a round, expanding rash and felt like she had the flu. Back home, the symptoms worsened. There was muscle and joint pain, extreme fatigue, tingling, headaches, gastrointestinal pain, dizziness, brain fog and her body temperature was out of whack, leading to day and night sweats.

For Smith, who was active running half-marathons, the pain and discomfort became unbearable. She grew depressed and filled with despair.

Doctors didn’t know what was wrong with Smith. None ever asked about a rash, which is characteristic of Lyme, and she never thought it important to mention.

After a two-tiered test came back negative, blood work at IGeneX suggested Lyme. Her doctor gave her the standard antibiotic treatment but wasn’t able to do more.

Jim Wilson, president of the advocacy group Canadian Lyme Disease Foundation (CanLyme), says even though some patients benefit from long-term treatment, doctors won’t go against the prevailing IDSA guidelines because they’re “afraid” of being “policed” by the regulatory colleges, he says.

“We’ve had doctors tell patients, ‘I believe you do have Lyme disease, but I cannot treat you. I have children at home, I’m putting my kids through college, I can’t afford to lose my licence,’” says Wilson.

He says there’s been a chilling effect, with some physicians refusing to treat Lyme or doing so quietly because they don’t want a target on their back.

Bruce Shilton, the retired judge, had actually found two doctors in the Toronto area who would treat Lyme. But shortly after, they were both investigated by the College of Physicians and Surgeons of Ontario (CPSO), prompting one to give up his medical licence and the other to stop seeing Lyme patients altogether.

In Ontario, the CPSO says since 2011 there have been 10 Lyme-related investigations. Eight were launched after patients, or their families, complained doctors did not properly diagnose or treat their Lyme and did not take their concerns seriously. Two investigations were for doctors who treated Lyme.

In general, Wilson says, about 2 per cent of all Canadian doctors face some kind of investigation by their provincial medical colleges. But when it comes to Lyme disease, nearly all doctors known to diagnose and treat Lyme outside the prevailing guidelines have come under scrutiny.

Dr. Ben Boucher is one of them. He was questioned by the College of Physicians and Surgeons of Nova Scotia after two specialists complained that he interfered in the care of their patients. He maintains he just provided a second opinion, but says regulators threatened him with a competency assessment. So after 35 years he closed his Port Hawkesbury practice in 2013. Between 2006 and 2013, he estimates that he treated about 200 Canadians with long-term antibiotics who had travelled there to see him. When he closed his doors, there were about 100 Canadians on the wait list to see him for Lyme treatment.

The way he was treated served as a warning to other doctors, he says.

“It was a signal that you should be very careful treating Lyme and that you should follow their antiquated (IDSA) guidelines,” says Boucher.

When it comes to other infections that require antibiotics, such as pneumonia, acne or cellulitis, patients are treated until the condition improves. So, he questions, why isn’t it the same for Lyme?

Wilson and Boucher are part of an international group that has taken its concerns to the United Nations, alleging that Lyme patients are denied proper care and treatment, which is a human rights violation. And that medical and scientific experts trying to help patients access long-term antibiotics have become the targets of investigations and sanctions.

Mantha, the New Democrat MPP, knows of four Canadian doctors who were treating chronic Lyme here and moved their practices to the U.S. to avoid any hassles from the regulatory colleges.

“They just got frustrated with the system and picked up their practice and moved away,” he says. “They firmly believed people were suffering and went to a jurisdiction where they have the freedom and ability to treat people as they see fit.”

The blacklegged tick that can carry Lyme disease is typically the size of a sesame seed. The is a female which is larger than the male.
The blacklegged tick that can carry Lyme disease is typically the size of a sesame seed. The is a female which is larger than the male.  (Bernard Weil)

In Smith’s case, she couldn’t find a doctor who would treat her, so like many patients she turned to a naturopath and began herbal medication. But it didn’t help. The naturopath recommended more antibiotics, but Smith didn’t know a doctor who would prescribe them. Rather than go to B.C. — the only province where naturopaths can write prescriptions and where many patients travel for long-term antibiotic treatment — she went to Mount Kisco, N.Y., where a doctor treated her with several rounds of antibiotics.

A year later, many symptoms had improved, but not all of them. As she was unable to pay the costs of continuing treatment in the U.S., Smith’s naturopath had a new idea. She suggested a Toronto clinic that was taking patients with chronic Lyme and co-infections. There, doctors, naturopaths, osteopaths and nutritionists work together to treat the whole patient, not just the Lyme disease. Some services are covered by OHIP, such as doctor visits, but lab tests and medication are paid privately or through supplemental insurance.

Smith has been treated there since the summer of 2017 with a combination of herbal and antibiotic treatment. Blood work done there — testing is done in a Public Health Ontario lab — was negative for Lyme, but positive for Rocky Mountain Spotted Fever, another tick-borne disease.

Her doctor there, a family physician trained in emergency medicine, spoke with the Star on the condition that neither he nor the clinic be named. He says diagnosis needs to be a clinical decision, based on patient history. And while tests are helpful, they’re not definitive. He follows ILADS guidelines, and will prescribe long-term antibiotics, often more than one drug at a time.

“Many doctors and patients are uncomfortable with uncertainty, and unfortunately there is a lot of uncertainty with Lyme disease,” he says. “I will go through all the potential risks with long-term antibiotic therapy and if (patients) are in agreement we will go and start on a trial of therapy. And we monitor them closely and try to mitigate the risk as much as possible.”

To date, Smith has spent about $20,000 on treatment and drugs, in total. In the spring and summer, she was feeling better than she had in a long time, even getting her exercise bike and rowing machine out of the garage where they had been stored for years.

“I felt truly amazing, but some symptoms have slowly returned,” says Smith, whose health started declining in the fall. “It’s frustrating, but I remain optimistic … This will get figured out.”

Isabel Teotonio is a Toronto-based reporter covering education. Follow her on Twitter: @Izzy74

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Health

Sweet! Here are 7 reasons to eat sweet potatoes

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(Natural News) Sweet potatoes may not be as popular as regular potatoes, which is too bad — since they’re packed with vitamins and minerals. One cup of sweet potatoes can provide more than 100 percent of the daily value of vitamin A. It’s also rich in vitamin C, dietary fiber, and manganese. Both purple and orange varieties contain antioxidants that can protect the body from damage caused by free radicals.

Eating sweet potatoes is beneficial for your health

Sweet potatoes are brimming with micronutrients and antioxidants —  making them useful to your health. Below is a list of reasons why you should incorporate sweet potatoes into your diet.

They improve brain function

The purple variety of sweet potato contains anthocyanins. Anthocyanins are known for their anti-inflammatory properties. Studies have revealed that anthocyanins are effective at improving cognitive function. Moreover, the results suggest that purple yams can help protect against memory loss. Antioxidants from the purple variety safeguard the brain against damage from free radicals and inflammation.

They aid digestion

Sweet potatoes are rich in dietary fiber. This macronutrient prevents constipation, diarrhea, and bloating by adding bulk and drawing water to the stool. In addition, fiber keeps a healthy balance in the gut by promoting the growth of good bacteria.

They slow down aging

The beta-carotene in orange sweet potatoes can help reduce damage caused by prolonged sun exposure. This is especially true for people diagnosed with erythropoietic protoporphyria and other photosensitive diseases. Sweet potatoes also contain antioxidants that protect against free radical damage. Free radicals are not only linked to diseases but also premature aging.

They boost the immune system

Orange and purple sweet potatoes are loaded with a good number of antioxidants that help protect the body from harmful molecules that cause inflammation and damage DNA. This, in turn, protects the body from chronic diseases like cancer and heart disease.

They can prevent cancer

Eating sweet potatoes can help protect against various types of cancers. The compounds in sweet potatoes restrict the development of cancer cells. Test tube studies have shown that anthocyanins can prevent cancers in the bladder, breast, colon, and stomach.

They lower blood sugar

Despite its relatively high glycemic index, studies have shown that the regular intake of sweet potatoes can help lower blood sugar, thanks to the presence of dietary fiber. While fiber falls under carbohydrates, it is digested differently, compared to starchy and sugary forms of carbohydrates. Interestingly, insulin doesn’t process fiber (unlike other types which get turned into glucose), and it only passes through the digestive tract.

They promote healthy vision

Orange sweet potatoes are rich in a compound called beta-carotene, an antioxidant which transforms into vitamin A in the body. Adequate intake of vitamin A promotes eye health. Conversely, deficiencies in vitamin A have been linked to a particular type of blindness called xerophthalmia.

Sweet potatoes are easy to incorporate into your everyday meals. They are best prepared boiled but can also be baked, roasted, or steamed — they can even replace other carbohydrates such as rice, potatoes, and toast. (Related: Understanding the phytochemical and nutrient content of sweet potato flours from Vietnam.)

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Health

Frostbite: What it is and how to identify, treat it

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Manitoba’s temperature has plummeted to its coldest level this season, triggering warnings about the extreme risk of frostbite.

Oh, we know it’s cold. We can feel Jack Frost nipping at our noses. But what about when he gnaws a little harder — what exactly does “frostbite” mean?

People tend to underestimate the potential for severe injuries in the cold, says the Winnipeg Regional Health Authority. We laugh off the sting of the deep freeze, rub our hands back from the brink of numbness and wear our survival proudly like a badge.

That’s because, in most cases, frostbite can be treated fairly easily, with no long-term effects.

But it can also lead to serious injury, including permanent numbness or tingling, joint stiffness, or muscle weakness. In extreme cases, it can lead to amputation.

Bitter cold can cause frostbite in just minutes. Here’s how to recognize the warning signs and treat them. 0:59

Here’s a guide to identifying the first signs, how to treat them, and when to seek medical help.

What is frostbite and frostnip?

Frostbite is defined as bodily injury caused by freezing that results in loss of feeling and colour in affected areas. It most often affects the nose, ears, cheeks, chin, fingers or toes — those areas most often exposed to the air.

Cooling of the body causes a narrowing of the blood vessels, slowing blood flow. In temperatures below –4 C, ice crystals can form in the skin and the tissue just below it.

Frostnip most commonly affects the hands and feet. It initially causes cold, burning pain, with the area affected becoming blanched. It is easy to treat and with rewarming, the area becomes reddened.

Frostbite is the acute version of frostnip, when the soft tissue actually freezes. The risk is particularly dangerous on days with a high wind chill factor. If not quickly and properly treated, it can lead to the loss of tissues or even limbs. 

Signs of frostbite

Health officials call them the four P’s:

  • Pink: Skin appears reddish in colour, and this is usually the first sign.
  • Pain: The cold becomes painful on skin.
  • Patches: White, waxy-feeling patches show when skin is dying.
  • Prickles: Affected areas feel numb or have reduced sensation.

Symptoms can also include:

  • Reduced body temperature.
  • Swelling.
  • Blisters.
  • Areas that are initially cold, hard to the touch.

Take quick action

If you do get frostbite, it is important to take quick action.

  • Most cases of frostbite can be treated by heating the exposed area in warm (not hot) water.
  • Immersion in warm water should continue for 20-30 minutes until the exposed area starts to turn pink, indicating the return of blood circulation.
  • Use a warm, wet washcloth on frostbitten nose or earlobes.
  • If you don’t have access to warm water, underarms are a good place to warm frostbitten fingers. For feet, put them against a warm person’s skin.
  • Drink hot fluids such as hot chocolate, coffee or tea when warming.
  • Rest affected limbs and avoid irritation to the skin.
  • E​levate the affected limb once it is rewarmed.

Rewarming can take up to an hour and can be painful, especially near the end of the process as circulation returns. Acetaminophen or ibuprofen may help with the discomfort.

Do not …

There are a number of things you should avoid:

  • Do not warm the area with dry heat, such as a heating pad, heat lamp or electric heater, because frostbitten skin is easily burned.
  • Do not rub or massage affected areas. This can cause more damage.
  • Do not drink alcohol.
  • Do not walk on your feet or toes if they are frozen.
  • Do not break blisters.

Seek immediate medical attention

While you can treat frostbite yourself if the symptoms are minor — the skin is red, there is tingling — you should seek immediate medical attention at an emergency department if:

  • The exposed skin is blackened.
  • You see white-coloured or grey-coloured patches.
  • There is severe pain or the area is completely numb.
  • The skin feels unusually firm and is not sensitive to touch after one hour of rewarming.
  • There are large areas of blistering.
  • There is a bluish discolouration that does not resolve with rewarming.

Be prepared

The best way to avoid frostbite is to be prepared for the weather in the first place.

Wear several loose layers of clothing rather than a single, thick layer to provide good insulation and keep moisture away from your skin.

The outer garment should breathe but be waterproof and windproof, with an inner thermal layer. Retain body heat with a hat and scarf. Mittens are warmer than gloves because they keep the fingers together.

Be sure your clothing protects your head, ears, nose, hands and feet, especially for children.

Wind chill and frostbite rates

Wind chill: 0 to –9.
Frostbite risk: Low.

Wind chill: –28 to –39.
Frostbite risk: Moderate.

Exposed skin can freeze in 10-30 minutes

Wind chill: –40 to –47.
Frostbite risk: High.

Exposed skin can freeze in five to 10 minutes.

Wind chill: –48 to –54.
Frostbite risk: Very High.

Exposed skin can freeze in two to five minutes.

Wind chill: –55 and lower.
Frostbite risk: Extremely High.

Exposed skin can freeze in less than two minutes.
 

NOTE: In sustained winds over 50 km/h, frostbite can occur faster than indicated.

Source: Environment Canada

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Awkward Flu Jabs Attempted at Golden Globes

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In what can only be described as a new level of propaganda, hosts Andy Samberg and Sandra Oh featured a flu shot stunt during the 76th Golden Globe Awards ceremony. They told the audience to roll up their sleeves, as they would all be getting flu shots, while people in white coats stormed down the aisles, syringes in hand.

Most of the audience looked thoroughly uneasy at the prospect of having a stranger stick them with a needle in the middle of an awards show. But perhaps the worst part of the scene was when Samberg added that anti-vaxxers could put a napkin over their head if they wanted to be skipped, basically suggesting that anyone opposed to a flu shot deserved to be branded with a proverbial scarlet letter.

The flu shots, for the record, were reportedly fake,1 nothing more than a bizarre gag that left many people stunned by the Globe’s poor taste in turning a serious medical choice into a publicity gimmick.

Flu Shot Stunt Reeks of Desperation

Whoever came up with the idea to turn the Golden Globes into a platform for a public health message probably thought it was ingenious, but the stunt only serves as a seemingly desperate attempt to make flu shots relevant and in vogue. During the 2017 to 2018 flu season, only 37 percent of U.S. adults received a flu shot, a 6 percent drop from the prior season.2

“To improve flu vaccination coverage for the 2018-19 flu season, health care providers are encouraged to strongly recommend and offer flu vaccination to all of their patients,” the U.S. Centers for Disease Control and Prevention (CDC) wrote. “People not visiting a provider during the flu season have many convenient places they can go for a flu vaccination.”3

Yet, perhaps the decline in people choosing to get vaccinated has nothing to do with convenience and everything to do with their dismal rates of efficacy. In the decade between 2005 and 2015, the influenza vaccine was less than 50 percent effective more than half of the time.4

The 2017/2018 flu vaccine was a perfect example of this trend. The overall adjusted vaccine effectiveness against influenza A and B virus infection was just 36 percent.5

Health officials blamed the flu season’s severity on the dip in vaccination rates, but as Dr. Paul Auwaerter, clinical director of the division of infectious diseases at Johns Hopkins University School of Medicine, told USA Today, “[I]t is also true that the vaccine was not as well matched against the strains that circulated.”6

But bringing flu shots to the Golden Globes, and calling out “anti-vaxxers,” is nothing more than “medical care, by shame,” noted Dr. Don Harte, a chiropractic activist in California. “But it was entertaining, in a very weird way, including the shock and disgust of some of the intended victims, notably [Willem Dafoe],” he said, adding:7

“This Hollywood publicity stunt for the flu vaccine is one of the stupidest things I’ve ever seen from celebrities. But it does go with the flu shot itself, which is, perhaps, the stupidest of all the vaccines available.”

Did 80,000 People Really Die From the Flu Last Year?

The CDC reported that 79,400 people died from influenza during the 2017/2018 season, which they said “serves as a reminder of how severe seasonal influenza can be.”8 It’s important to remember, however, that the 80,000 deaths figure being widely reported in the media is not actually all “flu deaths.”

According to the CDC, “We look at death certificates that have pneumonia or influenza causes (P&I), other respiratory and circulatory causes (R&C), or other nonrespiratory, noncirculatory causes of death, because deaths related to flu may not have influenza listed as a cause of death.”9

As for why the CDC doesn’t base flu mortality estimates only on death certificates that list influenza, they noted, “Seasonal influenza may lead to death from other causes, such as pneumonia, congestive heart failure or chronic obstructive pulmonary disease … Additionally, some deaths — particularly among the elderly — are associated with secondary complications of seasonal influenza (including bacterial pneumonias).”10

In other words, “flu deaths” are not just deaths directly caused by the influenza virus, but also secondary infections such as pneumonia and other respiratory diseases, as well as sepsis.11

According to the CDC, most of the deaths occurred among those aged 65 years and over, a population that may already have preexisting conditions that makes them more susceptible to infectious diseases. As Harte said of annual flu deaths, “[M]ost if not all, I would assume, are of people who are already in very bad shape.12

CDC Claims Flu Vaccine Reduces Flu Deaths in the Elderly — But Does It?

Since people aged 65 and over are those most at risk from flu complications and death, the CDC has been vocal in their claims that the flu shot significantly reduces flu-related deaths among this population. The research, however, says otherwise.

Research published in 2005 found no correlation between increased vaccination rates among the elderly and reduced mortality. According to the authors, “Because fewer than 10 percent of all winter deaths were attributable to influenza in any season, we conclude that observational studies substantially overestimate vaccination benefit.”13

A 2006 study also showed that even though seniors vaccinated against influenza had a 44 percent reduced risk of dying during flu season than unvaccinated seniors, those who were vaccinated were also 61 percent less like to die before the flu season ever started.14

This finding has since been attributed to a “healthy user effect,” which suggests that older people who get vaccinated against influenza are already healthier and, therefore, less likely to die anyway, whereas those who do not get the shot have suffered a decline in health in recent months.

Journalist Jeremy Hammond summed up the CDC’s continued spreading of misinformation regarding the flu vaccine’s effectiveness in the elderly, as they continue to claim it’s the best way to prevent the flu:15

[T]here is no good scientific evidence to support the CDC’s claim that the influenza vaccine reduces hospitalizations or deaths among the elderly.

The types of studies the CDC has relied on to support this claim have been thoroughly discredited due to their systemic ‘healthy user’ selection bias, and the mortality rate has observably increased along with the increase in vaccine uptake — which the CDC has encouraged with its unevidenced claims about the vaccine’s benefits, downplaying of its risks, and a marketing strategy of trying to frighten people into getting the flu shot for themselves and their family.”

Death of Vaccinated Child Blamed on Not Getting Second Dose

In January 2019, the state of Colorado reported the first child flu death of the 2018/2019 flu season — a child who had received influenza vaccination. But instead of highlighting the vaccine’s failure and clear limitations, the Colorado Department of Public Health and Environment blamed the death on the child being only “partially vaccinated.”

“It’s an unfortunate but important reminder of the importance of two doses of influenza vaccine for young children who are receiving influenza vaccine for the first time,” Dr. Rachel Herlihy, who is the state communicable disease epidemiologist, said in a news release.16 For those who aren’t aware, the CDC notes that one dose of flu shot may not be enough to protect against the flu. Instead, they state:17

“Children 6 months through 8 years getting vaccinated for the first time, and those who have only previously gotten one dose of vaccine, should get two doses of vaccine this season …

The first dose ‘primes’ the immune system; the second dose provides immune protection. Children who only get one dose but need two doses can have reduced or no protection from a single dose of flu vaccine.”

Not only may the flu vaccine fail to provide protection against the flu, but many people are not aware that other types of viruses are responsible for about 80 percent of all respiratory infections during any given flu season.18 The flu vaccine does not protect against or prevent any of these other types of respiratory infections causing influenza-like illness (ILI) symptoms.

The chance of contracting actual type A or B influenza, caused by one of the three or four influenza virus strains included in the vaccine, is much lower compared to getting sick with another type of viral or bacterial infection during the flu season.

Does Flu Vaccine Increase the Risk of Influenza Infection, Contribute to Vaccine Shedding?

There are serious adverse effects that can come along with annual flu vaccination, including potentially lifelong side effects such as Guillain Barré syndrome and chronic shoulder injury related to vaccine administration (SIRVA). They may also increase your risk of contracting more serious flu infections, as research suggests those who have been vaccinated annually may be less protected than those with no prior flu vaccination history.19

Research presented at the 105th International Conference of the American Thoracic Society in San Diego also revealed that children who get seasonal flu shots are more at risk of hospitalization than children who do not. Children who had received the flu vaccine had three times the risk of hospitalization as children who had not. Among children with asthma, the risk was even higher.20

There’s also the potential for vaccine shedding, which has taken on renewed importance with the reintroduction of the live virus vaccine FluMist during the 2018/2019 season. While the CDC states that the live flu virus in FluMist is too weak to actually give recipients the flu, research has raised some serious doubts that this is the case.

One recent study revealed not only that influenza virus may be spread via simple breathing (i.e., no sneezing or coughing required) but also that repeated vaccination increases the amount of virus released into the air.21

MedImmune, the company that developed FluMist, is aware that the vaccine sheds vaccine-strain virus. In its prescribing information, they describe a study on the transmission of vaccine-strain viruses from vaccinated children to nonvaccinated children in a day care setting.

In 80 percent of the FluMist recipients, at least one vaccine-strain virus was isolated anywhere from one to 21 days following vaccination. They further noted, “One placebo subject had mild symptomatic Type B virus infection confirmed as a transmitted vaccine virus by a FluMist recipient in the same playgroup.”22

Are There Other Ways to Stay Healthy During Flu Season?

Contrary to the CDC’s and Golden Globe’s claims that flu vaccinations are a great way to prevent flu, other methods exist to help you stay healthy during the flu season and all year, and they’re far safer than annual flu vaccination. Vitamin D testing and optimization have been shown to cut your risk of respiratory infections, including colds and flu, in half if you are vitamin D deficient, for instance.23,24

In my view, optimizing your vitamin D levels is one of the absolute best respiratory illness prevention and optimal health strategies available. Influenza has also been treated with high-dose vitamin C,25 and taking zinc lozenges at the first sign of respiratory illness can also be helpful.

Following other basic tenets of health, like eating right, getting sound sleep, exercising and addressing stress are also important, as is regularly washing your hands.

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