A room full of people who care about Lyme disease

Over the weekend, I had the privilege of attending the LDA and ILADS sponsored  conferences on Lyme Disease.  I left Pittsburgh worried that I would find the three days of talks I planned to intend incomprehensible, boring, or simply overwhelming. I returned having soaked up hour after hour of information. The material engaged me in so many ways. As a person with Lyme Disease I found myself learning to understand my own condition, hearing about how doctors actually make treatment decisions, discovering with scientists new knowledge and promising possibilities for tackling the beast inside me. As a researcher studying Lyme disease I was delighted to discover other social scientists studying its effects in the schools and in the workplace, and to make contact with possible collaborators in the activist and scientific communities. Perhaps most surprising was the power I felt from being in a room full of other people who all understood, cared about, and had been forever changed by their encounters with Lyme Disease.

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New hope for Chronic Fatigue patients

When you live in the nether world of questioned diagnosis, you spend a lot of time wondering if perhaps those doctors who say the problem is in your head, your lifestyle, and your diet are right. In my case, I was lucky to have a variable enough illness that I was constantly reminded that I was not the cause — as soon as I felt better I did more, no matter how short a time it lasted. I never had to think about it, plan it, or convince myself to do so, I just DID.

Lyme disease patients at least have the existence of a known pathogen to hold onto when they fight the external discrimination, and associated internal questioning, that characterizes their disease. For those with Myalgic Encephalomyelitis (known popularly as Chronic Fatigue Syndrome), until this week, that did not exist. On October 8th, the journal Science published an article by Lombardi et al. titled “Detection of an Infectious Retrovirus, XMRV, in Blood Cells of Patients with Chronic Fatigue Syndrome.” (also see this discussion by the author of Osler’s Web). Pamela Weintraub, in her blog Emerging Diseases reflects on the continued efforts of physicians and researchers to label diseases like Lyme disease and Myalgic Encephalomyelitis (ME) as pyschiatric illnesses. This is a form of discrimination and institutionalized myopia that has systemic negative affects on patients. It stifles research, reduces access to treatment, and forces patients who are already fighting a difficult disease to also fight for respect. Perhaps worst of all, they must devote mental and physical energy to all of this, while simultaneously fighting the internal battles necessary to keep believing in themselves despite a lack of definitive anything and constant encounters with naysayers. Read the rest of this entry »

Letter to the editor

Our local paper had an update about Lyme disease this week. The impression it left the reader with was that there is “nothing new here”, there will be a small number of new cases this year in Allegheny county (20-30 I think the article said) and generally not to worry. Considering that this same paper had some relatively comprehensive articles about Lyme disease (e.g., this 2001 article), it ticked me off to see them waste space on something so uninformative rather than discussing tick safety education or talking about the real impact of Lyme disease on the region. I decided to write a letter to the editor of the paper.

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Are you disabled?

People with disabilities are a unique minority, a group that any of us can join at any time. I first identified with the group as a graduate student in the 90s when my hands were so non-functional that I had trouble doing many basic things …  and no one could tell me if/when I would improve. Thanks to the advocacy of many individuals with disabilities, the Americans with Disabilities Act, (and related legislation) has set accessibility standards [1], and I soon learned, for example, to press the automated door-opening button at the front of my university building.

I will never forget the day that button failed me: A stranger became very angry on my behalf, opened the door, and went on to complain to the building manager. I was shocked, upset to think of myself in the terms he obviously did. I had an invisible impairment that, at the time, some people did not believe existed (echoes of the future!). Although I was high functioning, it had eliminated my ability to play the viola (a beloved hobby) and, from the perspective of a graduate student in Computer Science, seemed to make my career of choice next to impossible.

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Picking a road by consensus

Two roads diverged in a wood, and I—
I took the one less traveled by,
And that has made all the difference

– Robert Frost

The Road Not TakenLyme politics have been on my mind recently, due to  the efforts to reconvene the IDSA panel that was responsible for creating a very restrictive definition of Lyme Disease and it’s treatment. The question I am concerned with in this post is how thinking, caring people could write down something so narrow and incomplete. The divided politics of this situation have never adequately explained to me how we got here.

Now, there is a lot of evidence that the individuals who wrote the IDSA guidelines are biased*, and that is certainly a possible explanation for what happened. In fact, as a result of investigations into this bias, a new panel has been convened. To the dismay of many individuals with Lyme disease, the new panel, although lacking conflicts of interest, still seems unlikely to make major changes to the IDSA treatment guidelines. Yet its web page states that its members are “committed to considering all points of view” and the panel is taking public comments until April 3, 2009.

Let’s for a moment take the optimistic viewpoint that the members of the panel are truly committed to this. Let’s suppose that they chose medicine because they are compassionate individuals who want to help people, that they are smart and capable of understanding scientific literature, and that they lack bias. Why do so many doctors choose to believe in a version of Lyme disease that excludes so many of us?
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Finding Support

Last night I made my first visit to the local lyme support group (you can find information about the time and location of my group by searching for the word “lyme” on this page, but note that they don’t meet in Dec/Jan/Feb, or find a support group in your area). I’m not sure why it took me so long. It took me months to find the group (I only found it thanks to the help of someone I met through my blog) and then a couple of months to be free on the night that they meet, but I think I was also apprehensive about going.

I’ve already joined a number of email lists (my favorites include Robynns_Lyme_List@yahoogroups.com (which sends out news articles on lyme disease) and <yourstate>Lyme@yahoogroups.com (this is an activist group so you should join the one that’s specific to your state). I also subscribe to the lyme disease research database news blog. There are also some online forums that don’t go straight to my inbox, and as a result I am terrible about visiting them.

So why the apprehension? I guess it’s the fact that every person I encounter seems to have a different solution, which can be overwhelming given my own uncertainty about what to do. And maybe the fact that the few people I encounter who have been cured can’t seem to explain how in a way I can use. And finally the depressing fact that so many people with lyme are facing so many difficulties, from doctors who won’t listen to them to insurance companies that won’t pay for their treatment, even assuming they know what treatment will help. If reading about people online was so depressing, how could meeting people in person be better? But after a month of feeling worse than ever, I was desparate to find people to talk to who could understand what I was going through. So I arranged for a babysitter, and headed out to the Etna support group.

I’m so glad I went. This month’s group included two women who had lyme years ago and were better, one person I know through the blog, and a mother and her two children (who both have lyme disease). The format was simple — we all told our stories (either the whole story or the last month depending on how new we were to the group) and everyone else listened and answered questions when they could. For example, I learned about a new doctor who could help with my mold exposure, and the group was able to put a name to my most recent symptom (“air hunger“) a search term which helped google answer many questions for me later that evening. It was a very late night for me, but it was worth the time and the impact of the late night.

My anxiety was not entirely misplaced. There is no question that the stories of the people around me were as complex, difficult, and frustrating as the stories I’d been reading in my email and in books. But there is a big difference between reading such a story in brief in a news article, and being able to talk to someone in person. I could ask questions. I could see the bravery and power of the people around me. Each of them was a warrior who had taken her health in her hands and fought for her rights. Some had already won, others were just starting, but instead of feeling depressed, I left the group feeling inspired.

I also left realizing (yet again) just how lucky I am. And it makes me even more angry about the situation that I and so many other patients face. I have many many resources at my disposal, from a (twice) positive western blot to excellent research skills, financial resources that allow me to visit many different doctors, an extremely supportive family and work environment, and friends who knew and recommended the doctors I am seeing. Despite all of this, it took a long time before I was diagnosed; I have often had to “prove” to a new physician that I have lyme disease; my first round of medication was stopped earlier than it should have been (or I would not still be positive now) and I struggled to find balanced information about my disease. I still struggle to find a treatment protocol that I can completely believe in. If, like many other patients with chronic lyme, my test results were less conclusive, my finances or work environment less secure, my family less supportive, or I had less information at my disposal, these problems would only multiply.

So as patients, we are engaged in a battle for our lives, as parents a battle for the lives of our children. If we fail, we are labeled with disabilities like Chronic Fatigue, MS and ALS and told to live with it. Our disability may progress, with the many obvious consequences. This not only hurts us, but also introduces costs to society (e.g. medical; taking someone out of the work force). This battle requires us to become activists; may require us to diagnose ourselves, select treatment options, and corral doctors. In a battle this serious, we’d be crazy not to join forces. We can give eachother strength, reassurance, and validation. We can share information and plans. So if you haven’t done so yet, find a support group or form one. You’re not alone.

What a week

Well, it seems my “flare up” is finally over. That makes me very happy, as the pounding headaches, fatigue, and difficulty thinking/concetrating were one of the worst flare ups I’ve experienced. I’m sure that it was made worse in large part because instead of following my own advice I was trying desperately to do exactly what my body did not want — concentrate, write, and produce good work for the CHI deadline. Luckily even the worst days usually included an hour or two when I could do so without pain, but I was dumb enough to try for more on some days (or at least push the edge by doing relevant busy work instead of leaving work aside).

That said, I’m proud to say that my students and collaborators and I submitted 4 papers (three longs and a short) to CHI this year. Not bad considering I effectively had one hand tied behind my back :).

Those of you familiar with CHI might be wondering, under the circumstances, why it was that I made a post to my blog on Friday before the CHI deadline had past. My best explanation is that as I approached the CHI deadline, it became increasingly clear to me just how important it is to me to find a cure. And the current horrid state of affairs is that not only is there no cure, but folks are arguing over whether what I have even exists. This affects the treatment available to patients, the funding available to researchers, and the public health measures being taken to prevent the spread of the disease or educate people about it.

So there I was trying to work on my CHI papers, and instead I found myself calling the offices of senators and congressmen. I guess it’s not surprise how important this is to me — how about you? if you’re taking the time to read this, maybe you can take the time to make a phone call too.

Take action!

This is just a reminder to anyone with lyme or a loved one with lyme that there is a lot of work to be done in terms of supporting patients rights and a strong research agenda. One thing that needs attention right now is talking to members of congress about two Lyme bills (HR 741/S1708) that are currently held up in commitee.

If you wish to help educate congress about these issues, you can find lots of details on the Lyme Disease Association  Legislation Website. You can make a difference with just a few phone calls!