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Alternatives to Lyme Gone Chronic
By Dylana Accolla, Lac . Illustrations by Joshua Gorchov

In a world colored by unfathomables, chalk up another to the chronic Lyme disease dispute. There has been a long-standing controversy in the medical community as to whether Lyme disease is easily diagnosed, treated, and cured. One side, according to the Foundation for the Advancement of Innovative Medicine, states that diagnosis is easy and that Lyme is almost always cured within four weeks of antibiotics. If the patient is still sick after those four weeks, this group (mostly HMOs and those dependent on them) claims that either the patient was incorrectly diagnosed, that the continuing symptoms are psychosomatic, or that the patient now suffers from an autoimmune problem that was caused by the original Lyme infection—and that there is no treatment for this autoimmune problem.

The other side, made up of mostly chronic Lyme patients and their physicians, contend that Lyme persists beyond four weeks, due to the hard-to-kill bacterial infection and/or to the presence of co-infection. These patients point out that there is no definite test to show when someone has Lyme and/or is cured of it. They claim they do much better when treated beyond the four weeks of antibiotic treatment and that their subjective experience is supported by a body of peer-reviewed scientific research.

To some of those who feel they have the hotly debated chronic Lyme, the relief brought by long-term antibiotics is akin to a life raft. To others, the arduous path of long-term antibiotics is a treatment more painful than the disease itself. Opting out of allopathic medicine, these patients explore unconventional treatment options. This article explores what a few of the practitioners treating long-term Lyme have to offer. TREATING THE BIG LYME PICTURESteven J. Bock, MD, has been treating Lyme disease in Rhinebeck for 17 years. Seventeen years have given Bock plenty of time to develop useful clinical insights on a disease characterized by so many unanswered questions. First and foremost, he said during a telephone interview, the only way to diagnose and treat Lyme is to look at the patient's whole picture. "We decided to look at the person who has the Lyme disease, not the Lyme disease itself," he said. "Is this a chronic infection or a chronic immune process mimicking the infection? Do they need antibiotics or do they need more supportive treatment? As a doctor, you need to be in the question to help the patient with chronic Lyme."

Bock said that treating acute cases of Lyme is straightforward. "We don't test the tick anymore," he said. "There's a sixty percent infection rate of ticks in Dutchess County, so when a person knows they've been bitten by a tick, the key element is timing. If the tick hasn't burrowed into the skin, it hasn't had time to inject its saliva into the bloodstream, and the likelihood of infection is quite small. If the tick has been attached for more than six hours, then we treat it with antibiotics—for at least five to six weeks. Otherwise, we often see patients who took the three-week course of treatment return in five to six weeks with symptoms.

"If the patient doesn't want antibiotics right away, we test them in six to eight weeks, tell them to look for acute symptoms, such as an EM [erythema migrans] rash and flu-like symptoms, and if they appear, we treat."

Many people read in the New England Journal of Medicine that rather than taking doxycycline for three weeks after a tick bite, they can take one dose and kill the infection, Bock said. To him, a single dose of the drug is not a treatment option. "The virulence of the bacteria is really important for readers to be aware of. I can't stress it enough. If you get bit, you need the full dose of antibiotics to deal with the infection."

The problem with not treating and waiting for symptoms or a positive test, Bock said, is that the tests may be negative for up to five years after a bite. "Blood converts (from negative to positive) at different times in different people. We have to go on the clinical diagnosis. For example, I saw a 35-year-old patient who developed arthritis, joint pain, fatigue, cognitive dysfunction, and depression—the whole clinical picture of Lyme—who lived on Shelter Island. Despite his not remembering a tick bite, and no EM rash, I treated aggressively. And the patient improved. The blood converted to positive after that, five years after probable time of infection."

Bock is quick to admit that cases of chronic Lyme are enigmatic and difficult to treat. "A subset of people are really difficult. They may not have classic Lyme, but they still have part of the constellation. These patients cannot accept diagnoses from Lyme-illiterate doctors who practice HMO medicine or specialists who see only the elephant's ear and misses the big picture."

What does treatment consist of? "We have a whole spectrum of treatment, from antibiotics to homeopathy, herbs, vitamins and supplements, and acupuncture." Bock does not believe that Lyme can be treated with holistic medicine alone, however.

When does Bock, who practices acupuncture himself, use complementary therapies? "There is a subset of people I feel I have to detoxify neurotoxins, for example," he said. "I do that with acupuncture. I treat back pain, fibromyalgia, and excess symptoms with acupuncture. If the patient is weak, on the other hand, they may have to take herbal tonics for adrenal support. The point is, I look at people through multiple filters when deciding on treatment."

What's the hardest part of treating Lyme disease? "The hardest part is seeing the patient back (after they've been asymptomatic for a while). Then you have to wonder, what really is their diagnosis? Our medical system has failed us in that we practice five-to-seven-minute medicine. Doctors in this system do not have the time to fully evaluate, and patients are at the mercy of that.

"For example, a friend's wife recently became depressed for no reason. She had no history of depression and nothing to be depressed about. My friend had had Lyme and brought her to me. A regular doctor might have told her to take anti-depressants, but it turned out she had a positive Lyme test. There's a balance between not seeing every case that walks in the door as Lyme and knowing when to rely on clinical experience and instinct." DEB WALKER’S ‘REBALANCING MACHINE’That's how I first heard Deborah Walker's work described on the holistic health grapevine. It sounded odd, but Deborah Walker is a nice, normal registered physician's assistant who lives on 15 acres of woods in Dutchess County. She's had Lyme disease four times. "The first time was the worst," she said at our interview in her Rhinebeck office.

When she was first infected, Walker worked as a physician's assistant in a Dutchess County Lyme disease clinic, and her first attempt to deal with the infection was straight out of the allopathic medicine book—a six-week course of doxycycline following the appearance of a bull's-eye rash. When the medication worsened her Lyme symptoms, Walker followed that up with another four weeks on a different antibiotic. "I felt much worse on the medication, worse than without it," she said.

How bad were her symptoms? "I had mainly concentration and memory problems. I'd be in the car driving down Route 9 and would get completely lost, or I would drive through a red light. I thought I was going to have to stop driving. And then there was the deadly fatigue."

Rather than stop driving, Walker sought out complementary practitioners, including a homeopath. In the process she studied classical homeopathy and became a homeopath herself. But when homeopathy failed to completely relieve her symptoms, Walker proceeded to get involved in her own healing by using something called a BioMeridian machine, which is what she calls a "computerized kinesiology machine." Kinesiology testing is the muscle testing that chiropractors and other health practitioners use to determine responses from the body.

Walker's BioMeridian machine assesses the frequency of energy flowing through channels in the body to uncover physical imbalances. Based on the meridian and point theories of Reinhold Voll (which are somewhat different from the points used in Traditional Chinese acupuncture), the machine checks the frequencies of about 50 points on the hands and feet that may indicate channel imbalances. Once an imbalance is located, the computer lists remedies, out of about 3,000 possibilities, to help rebalance the meridians. She has also made remedies from ticks she has found on patients and family members, so current infections on ticks are in the system.

Walker remarked that her clients with Lyme disease rarely need only a single remedy to affect significant results. "The chances are good that the person will need a different remedy on a regular basis, and I will have to keep 'zigzagging' through remedies to stay on top of the disease. I think this is because the organism changes so much in the body, it's hard to stay on top of it."

Has Walker seen positive results from the BioMeridian system? "Definitely," she said. She herself, healthy, happy, and symptom-free, is a case in point. She has also helped her children, husband, and pets deal with Lyme disease, she said, not to mention having helped a substantial group of Lyme patients who adore her and depend on her for regular rebalancing to keep their symptoms in check.

How long does an eradication of symptoms take using the BioMeridian machine and remedies? "It depends on how long the person has had the disease and how healthy they were to begin with," she said. "Children can take two months, but adults can take up to or more than a year. Adults often come with a wide range of underlying conditions and imbalances that take a long time to heal. Curiously, I have also found that the healing is quicker in someone who hasn't done antibiotics."

Perhaps the most important piece to the Lyme disease puzzle Walker has found is that once the body is healed from Lyme disease once, a re-infection takes less time to heal. "These remedies seem to give the immune system a memory that helps it click into gear, to tell it, 'This is what you have to do to heal this.' Now that I know I can help myself and my family, I'm not afraid of Lyme disease anymore." TREATING LYME WITH MODERN CHINESE MEDICINEDr. Qingcai Zhang, MD, LAc, is rapidly becoming one of the best-known experts in an area where expertise is few and far between: the complementary treatment of Lyme disease. Zhang, a practitioner of both Chinese and Western medicine for 40 years and an assistant professor at a Chinese medical school in Shanghai for 22 years, has been in the US since 1980, when he was awarded a WHO fellowship to Harvard Medical School. He has also been a visiting professor of medicine at the University of California, Davis. Currently Zhang conducts research, treats patients in Westchester and Manhattan, and lectures at medical schools throughout the US.

Zhang honed his Lyme protocols in Dutchess County as a member of Dr. Richard Horowitz's Lyme disease staff in Hyde Park. His practice continues to focus on Lyme treatment, along with Hepatitis C and autoimmune disease. Dr. Zhang claims that he has successfully treated more than 500 Lyme patients; he is writing a book about Lyme disease and modern Chinese medicinal treatment.

During a recent telephone interview, Dr. Zhang said he believes that Chinese herbs can help reduce or eliminate Lyme disease symptoms and that PCR tests have turned negative in patients undergoing herbal treatment of Lyme and its co-infections. "Particularly for people who are unable to take antibiotics," he said, "herbal treatment is a viable alternative."

Zhang is quick to point out that the extensive use of antibiotics for Lyme disease is controversial. In a long online article on Lyme disease, Zhang discusses his misgivings of the current antibiotic treatment of Lyme. Quoting Kenneth B. Liebner, a Lyme researcher, he writes that relapses may follow the use of potent antibiotics due to their inability to eradicate the pathogen from the body in some patients.

"This is a problematic situation," Liebner writes, "because intensive antibiotic treatment is costly, inconvenient, and carries associated risk for the patient." One such risk that concerns Zhang is the increased chances of creating antibiotic-resistant strains of spirochete. Another risk is the inevitable digestive disorders caused by yeast overgrowth, antibiotic-associated colitis, and abnormal blood counts and chemistries that occur with antibiotic intake. Furthermore, the drugs, when taken, for up to a year or longer, do not always seem to eradicate the bacteria.

Why don't antibiotics always work? According to Zhang, this question underscores the fundamental difference between Western and Chinese medicine. "In reality," Zhang said, "an infectious disease consists of two sides, the invading pathogen and the body's reaction to the invasion. To only use anti-pathogen treatment is insufficient; adjusting the body's reaction to the invasion of the pathogen is a more important aspect. To rely only on antibiotics to eradicate the bacteria without enhancing the body's immunity and repairing the damaged tissue is an incomplete strategy of treatment. Therefore the conventional allopathic medical approach is only partially efficacious. The eventual eradication of the pathogens is the role of the body. Antibiotics can only help the body accomplish this task."

Zhang explained that this fundamental difference in treatment is called fu zhen qu xie, literally, “dispel evil (the pathogen) by supporting the righteous (normal body functions).” Following this principle, Chinese medicine has developed therapies to regulate the immune system. Don't get him wrong—Zhang is not wholeheartedly anti-antibiotic. He simply defines healing differently than his Western medicine counterparts. "Drugs and procedures can help to heal," he said, "but they cannot replace the healing function of the body. If the aim is to restore health and the well-being of the patient, simple killing the infectious agents is insufficient."

Zhang argues that the Chinese medicine approach to healing is more comprehensive. He uses numerous herbs from the Chinese medicine pharmacopia that have antibacterial and antibiotic effects to kill the spirochetes. At the same time he uses other herbs to support and strengthen the immune system. This treatment "restores the inner balance of the patient." From there, "the balanced body can finish the task of eradication of the pathogen ultimately."

Zhang pointed out that his approach to Lyme also differs from traditional Chinese medicine approaches that rely on classical theories to treat patients. "In my experience, the classical approach has to be combined with contemporary knowledge of the phytopharmacology of herbs. I practice an integrative medicine, which means that I use basic Western medical and pharmacological knowledge with Chinese medical theory to enhance treatment and adapt it to Lyme disease, which is a new disease about which many uncertainties remain."