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Caught between a tick and a hard place |
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Written by Lethbridge Herald
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Friday, 07 November 2008 |
Melissa McCloud is in a wheelchair, kept there not only by the effects of Lyme disease, but also by the politics of the medical community.
The Diamond City woman is caught in the middle of a tug-of-war between two camps with differing views on the treatment of Lyme disease, an illness, spread by ticks, with symptoms resembling the flu in the early stages but which can become progressively worse if untreated.
McCloud’s medical nightmare began a little over two years ago when she experienced what she thought was the flu. The flu-like symptoms were later replaced by new symptoms — numbness in her face and left arm, then dizziness. She grew weaker and eventually began using a cane, then a wheelchair.
After enduring a merry-go-round of failed attempts to pinpoint the cause of her condition, McCloud was finally connected with a B.C. physician, since retired, with more knowledge about Lyme disease. She began a series of treatments with antibiotics which enabled her to abandon the wheelchair and resume walking and driving.
But when the latest course of treatment ended, she ran into a brick wall in her attempt to resume the antibiotic regimen. A specialist she saw in June is part of the camp that believes if a four-month antibiotic treatment hasn’t cured the illness, the problem is something other than Lyme disease. Other doctors believe the illness can become chronic.
The Public Health Agency of Canada’s information regarding Lyme disease also suggests as much. The agency’s website says, “Patients diagnosed in the later stages of the disease can have persistent or recurrent symptoms requiring a longer course of antibiotic treatment. Treatment failure has been reported, requiring patients be retreated; the risk of treatment failure is greater in patients with long-term Lyme infection.
“If the infection continues to go untreated, the third stage of the disease can last months to years with possible symptoms including chronic arthritis and neurological symptoms. . . Fatalities from Lyme disease are rare. However, undiagnosed Lyme disease may develop into chronic disease that may be difficult to treat.”
The specialist who said no to further antibiotic treatment for McCloud suggested her improvement was due to a placebo effect. Placebo effect or not, the fact remains that with the treatment, she was walking and driving again. And since she has begun receiving treatment from a doctor south of the border (costly treatment for which the Diamond City community held a fundraiser on her behalf Friday night), she is again seeing signs of improvement. Her pain levels have decreased and she is able to stand for short periods of time.
A recent survey indicated U.S. doctors often prescribe drugs for placebo effect.
The study by the U.S.-based National Institutes of Health, published Oct. 24 in the British Medical Journal, indicated almost half of the 1,200 rheumatologists and internists surveyed said they prescribed pills two or three times a month whose benefits derive from “positive patient expectations.”
Jon Tilburt from the NIH said, “Most say they would prescribe a sugar pill for patients with a chronic painful condition if there were evidence of placebo efficacy.”
Sixty-one per cent of survey respondents believed it is ethically acceptable or even obligatory for doctors to recommend or prescribe placebo treatments. Thirteen per cent prescribe antibiotics or sedatives in such cases.
“The responses to this survey suggest a preference for active placebo treatments,” Tilburt said. “Few physicians we surveyed recommended inert placebo treatments.”
However, Tilburt also offered a caution regarding the use of active placebos, noting, “. . . prescribing antibiotics and sedatives when there is no clear medical indication could have serious adverse consequences for both patients and public health.”
Whether there’s a placebo effect at work in Melissa McCloud’s fight to recover from Lyme disease is for medical experts to debate. All she knows is, the treatment works. And that’s better than being confined to a wheelchair.
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