At the Stram Center we vow to continue our education on Lyme Disease research, stay up to date on the most effective testing and all the safe available therapies. Moreover, our years of experience in treating patients according to the whole person-integrative medicine approach allows us the most effective way to care for our patients.
Understanding Chronic Lyme Disease: A Whole System Approach
The Emergence of Lyme Disease
Lyme disease has been an elusive diagnosis. In 1975, in Lyme, Connecticut, there emerged clusters of children and adults with unusual symptoms of joint swelling and severe pain. The first 51 cases of Lyme were outlined two years later and a connection was made between the disease and the Ixodes Scapularis tick.
Finally, in 1982, Borrelia burgdorferi was unveiled as the bacterium that causes Lyme. The disease did not become reportable until 1987 when physicians were required to report all cases. 1
As stated in Holistic Primary Care, “Back in the 1990s, the prevailing conventional wisdom was that Lyme disease is a simple, relatively rare disorder that’s easy to avoid, difficult to acquire, simple to diagnose, and easily treatable with a single 30-day course of antibiotics” (p. 1). 2
Today, experienced doctors and frustrated patients tell a different story.
Chronic Lyme: Reality or Myth?
Over the last ten years, the incidence of Lyme disease has doubled. The current, heavily debated, enigmatic position by practitioners on Lyme questions whether or not it is a real medical condition caused by a bacterial infection or a psychological condition.
Based on our experience at the Stram Center and the available research, we believe that chronic Lyme disease is, in fact, a real condition as a result of the persistent presence of Lyme disease and/or its co-infections and/or the results of inflammatory proteins released by the bacteria.
Problem with a Simple Approach to the Complexity of Lyme
Fading importance of the Bulls-Eye
Currently, conventional medicine, when it does acknowledges the condition, centers around a tick bite, a bulls-eye rash, and a simple, short-term treatment of antibiotics. This simplistic approach is further aggravated by the complexity of acquiring a definitive laboratory diagnosis and the fact that, according to Duchess County, which is the highest reporting county for Lyme, only 18% of patients recall ever being bit by a tick.
As pointed out in Holistic Primary Care (Fall 2011), “If you rely exclusively on the Centers for Disease Control and Prevention (CDC) diagnostic criteria, you’ll miss about 90% of cases, as very few patients fit the strict “classic” profile defined by CDC” (p. 4).2 We cannot accept the status quo.
The Elusive Lyme Bacteria
The Lyme bacteria is very resistant and has the ability to change into different forms based on the stressors of the body’s internal environment in which it lives. Consequently, chronic Lyme disease can persist even after the administration of an antibiotic regimen. 3
There are a plethora of studies on the high incidence of relapse following short-term antibiotic therapies.4 The various forms of the bacteria may require different antibiotic treatments to affect eradication. The bacteria is also slow-growing and is able to hide in areas such as nerve tissue, connective tissue, and joint spaces, causing the multitude of symptoms and rendering effective blood laboratory analysis challenging at best. The chronic form of Lyme is more difficult to diagnose and to treat due to the various and multiple symptoms that it causes.
Prevalence is Likely Underestimated
According to some statistics, there are approximately 300,000 Lyme disease cases per year, not including those cases that are unreported or misdiagnosed.
New York State has the highest number of people reporting Lyme infection. According to the Center for Disease Control, only 10-12% of actual numbers are reported and approximately 94% of all Lyme cases come from just twelve states. Moreover, it typically takes an average of nine visits to various doctors before the diagnosis of Lyme disease is made. The percentage of patients being diagnosed at their first doctor’s visit is less than 2%; 50% of patients are told it’s in their head, while 30% are diagnosed with depression. And 80% are simply told the diagnosis is an unknown mystery. Everyday patients are suffering from real symptoms, eluding diagnosis and going untreated.
Need for Public Awareness
Learning from Past Mysterious Diseases
There runs a strong parallel between the misunderstanding of Lyme today and the misunderstanding of AIDS and other conditions throughout the 20th century.
There is a striking similarity in the sentiments by the patients in their diagnosis and treatment for Lyme as was the case over 20 years ago for AIDS. As put forth by Steve Epstein, PhD, “these diseases have in common the demand on the part of the sufferers that their mysterious condition be acknowledged as legitimately medical. Sufferers find themselves in a state of an anxiety provoking experience in which they question their own sanity precisely because of the realness of their experience in the face of public medical doubt.”5 In the same way that clinical attention, public awareness, and funding were brought to the issue of AIDS and other once-mysterious conditions, similarly today this must be done for Lyme.
Need for Policy Change
Disparity of Funding
There is a wide disparity in funding for Lyme disease compared to other diseases such as West Nile Virus.
In 2004, California Lyme Disease Association reported the government spent 18 times more funding West Nile Virus than it did for Lyme Disease despite Lyme Disease being reported nearly 8 times more than West Nile.6 Today, those numbers have not improved: the NIH budget for 2012 requests $25 million dollars with 150,000 Americans reported, compared to $46 million for West Nile Virus with only 3,630 Americans reported and the CDC funding request for 2012 is $5 million for Lyme and $20 million for West Nile Virus. 7
In Health Affairs, Laurie McClellan sheds light on a critical aspect of the problem.
She states, “during my research, I’d discovered that a state medical board once had suspended this doctor’s license for prescribing long-term antibiotics. I felt like an outlaw entering that office—and also like someone desperate for help.” 8 Given the liability associated with the treatment of Lyme disease, a policy change is necessary in order for us to be able to effectively carry out this model. It is more necessary than ever that there be a forum in which patients and providers can feel comfortable, safe, and have evidence-based treatment approaches towards the eradication of this disease. Practitioners should not fear the suspension of their licenses and patients should not feel desperate for help in the pursuit of treatment of Lyme disease. Furthermore, insurance coverage must play a significant role in making access to proper treatment possible.
Stram Center Experience and Treatment
At the Stram Center, our practitioners are trained both by the International Lyme and Associated Diseases Society, (ILADS) the foremost scientific and research organization for Lyme disease diagnosis and treatment; and each individually by internationally renowned physician on Lyme disease, Dr. Richard Horrowitz with whom we collaborate for the care of our patients.
Given our experience using the integrative model to treat our patients since 2003, we work first and foremost with the patient's story. This is also how we follow the progression of their disease and on to recovery.
We address the patient's lifestyle which includes diet, exercise, and social environments at work and home; we continue to monitor and review the biological terrain from which their medical condition is evaluated using state of the art laboratory analysis, including and not limited to Lyme testing, immunological testing, nutrient testing, and potentially stool and urine testing as well.
Our treatment is based on honoring the interconnection of the whole person, the pathology they are faced with and the multitude of treatment options that are available. We pool this knowledge together, with the patient, to formulate a customized treatment plan.
This plan will include:
- utilization of food as medicine;
- assessing nutritional intake;
- judicious and safe use of antibiotics when appropriate;
- nutritional and herbal supplements when appropriate;
- manual therapies such as acupuncture to augment treatment.
The Stram Center practices medicine in a whole system approach to the care of our patients. Our treatment navigation is guided by listening to our patients tell their unique story.
Joe's Testimonial: "The practice of Dr. Stram is the most incredible healing practice that I have ever been involved with."
Make an Appointment Today
Please call the Stram Center: 518 689-2244 if you would like to make an appointment to address Lyme.
1. A Brief History of Lyme Disease in Connecticut Department of Public Health, State of Connecticut, 02 June 2008.
2. Goldman, Erik. "Shape Shifters, Hidden Accomplices & Nature's Dirty Needles: Confronting the Challenges of Lyme Disease." Holistic Primary Care Fall 12.3 (2011): 1+4.
4. "Relapses and Failure Rates Using Short Term Approaches" California Lyme Disease Association, 2006.
5. “Impure Science: AIDS activism and the politics of knowledge.” Steve Epstein
6. "Disparity in Funding: Lyme vs. West Nile." California Lyme Disease Association, 2004.
7. “Government Research Funding." ME/CFS Worldwide Patient Alliance, 2009. Mar. 2012.
8. "Chronic Lyme Disease: It's Time To Solve The Medical Mystery Inside An Enigma." McClellan, Laurie, Health Affairs