georgia
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Joined: 06 May 2005
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 Posted: Wed Jun 29, 2005 5:43 pm Post subject:
Misdiagnosing Lyme disease - Michigan
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http://www.lenconnect.com/articles/2005/06/04/news/news01.txt
Misdiagnosing Lyme disease
Saturday, June 4, 2005 12:19 AM EDT
A mother and son battle to regain their health after contracting the
disease.
By Justin R. Kalmes
Daily Telegram Staff Writer
It all started for Andrew Emery in November 2003 with what seemed like
a bad
case of the flu. The then 12-year-old had the symptoms - diarrhea,
vomiting
and fatigue.
Without wasting time, his mother, Christina, took Andrew to their
family
pediatrician. After four visits, the physician diagnosed the illness as
a
virus and said it would go away.
About two months passed, but Andrew didn't recover. The illness became
so
serious, Christina and her husband took him to their family doctor who
then
referred him to a specialist. When that physician couldn't figure out
what
was wrong, he sent him to the University of Michigan Hospital in Ann
Arbor
in January 2004, the first of what would eventually be two visits to
the
facility.
Doctors there intravenously administered nutrients to Andrew because he
couldn't keep food down. In an attempt to correctly diagnose the
sickness,
they conducted several tests, but the results all came back negative.
The doctors in Ann Arbor suggested maybe Andrew's symptoms were caused
by
stress, even that he could possibly be faking his illness or had an
eating
disorder. Psychiatrists evaluated him, but still had no clue as to what
the
problem was.
Having done research on Andrew's symptoms with her mother-in-law,
Christina
suggested that maybe the illness was Lyme disease, a multi-system
bacterial
infection obtained through the bite of an infected deer tick. However,
she
said the doctors told her they had tested for it and the results came
back
negative.
The Emerys returned to Adrian disheartened, with several questions
unanswered and Andrew still sick, unable to attend classes as an
eighth-grader at Springbrook Middle School.
He returned to the U-M hospital in April 2004 because his condition
hadn't
improved. Not only were his previous symptoms still present, but his
sight
began failing to the point he was considered legally blind. A
frustrated
Christina asked to see the results of the Lyme disease test supposedly
administered in January, she said, but doctors were unable to produce
them.
They then conducted another test, but the outcome remained unchanged.
"At that point we didn't know what to do," Christina said. "We were
hoping
the doctors were knowing what they were doing."
| Quote: | From April to June, Andrew's condition worsened. His blood pressure and
heart rate skyrocketed from the steroids doctors prescribed for his |
sight
loss.
He lost his hair and 50 pounds. His concentration faltered, which
brought
his once stellar grades down as well. Despite his Lyme-like symptoms,
doctors declined to refer him elsewhere because of the two negative
tests.
Several trips to the emergency room left Christina desperate.
"He kept getting worse," she said. "S He had the symptoms (of Lyme
disease),
but no one wanted to admit it and talk about it."
After searching for specialists across the country, Christina scheduled
Andrew an appointment in June 2004 with Dr. Michael Ledtke, a Saginaw
physician who specializes in treating Lyme disease patients. Ledtke
clinically diagnosed Andrew with Lyme disease and immediately put him
on
antibiotics. His health improved after only a few months of treatment.
"(Ledtke) is wonderful," Christina said. "We're really thankful we got
into
him."
The experience suffered by the Emery family is unfortunately all too
common,
says Linda Lobes, president of the Michigan Lyme Disease Association.
She
said because diagnosing Lyme disease based on the Centers for Disease
Control and Prevention criteria is difficult, many doctors either
misdiagnose it or deny its existence in lower Michigan. She said most
health
professionals will say anyone with the disease obtained it in Menominee
County or out of state.
"It's not that the cases aren't being reported," she said, "they're
just not
being accepted as cases. They don't meet the criteria from the CDC's
standpoint."
Thomas Forschner, executive director of the Lyme Disease Foundation
Inc., a
Connecticut-based nonprofit organization dedicated to finding solutions
for
tick-borne disorders, said because the CDC uses stringent guidelines
when
counting Lyme disease, many cases go unreported.
"There's definitely (a problem) nationwide," Forschner said. "I know
there
has always been a problem in Michigan for recognizing Lyme,"
particularly in
southern Michigan.
"Lyme is underreported and has been for a number of years," he said.
Between
10 and 20 cases exist for every one reported, he said.
Many doctors are leery about reporting Lyme disease because of the
difficulty in producing a positive test, Forschner said. They often
don't
want to risk their credibility among peers and patients, he said, and
don't
want to fill out the necessary paperwork to be sent to insurance
companies.
"If their reporting is poor, (doctors) are going to second-guess
themselves," he said.
Dr. Arnold Markowitz, a Keego Harbor internist specializing in
infectious
diseases, said underreporting and underdiagnosing are occurring in
Michigan
because doctors aren't looking for Lyme disease.
"It's underdiagnosed because the physicians in the area aren't doing
the
testing to diagnose it.
"S They haven't looked for it, therefore they haven't found it."
Markowitz started diagnosing and treating Lyme disease patients in
1985, he
said. Each year, he sees about 30 new cases, and many come to him for
treatment because they can't get diagnosed elsewhere.
"(Lyme disease) is more difficult to diagnose than treat," he said.
"It's
hard to treat without a good clinical diagnosis."
Lyme disease-carrying ticks are most prevalent in the New England
states and
in heavily wooded Midwest states such as Wisconsin and Minnesota, a CDC
incidence map shows.
According to a CDC report, more than 300,000 cases of Lyme disease were
reported nationwide between 1993 and 2002, the most recent data
available.
However, the Lyme Disease Foundation estimates there may have been
between
1.5 million and 2 million cases in the United States since 1980.
In Michigan, CDC data as of May 21 show 661 cases reported between 1980
and
2005. The Michigan Department of Community Health acknowledged the
presence
of Lyme-carrying ticks in the Upper Peninsula and Berrien, Cass, Van
Buren,
Allegan and Ottawa counties in Southwest Michigan; however, it denied
their
presence anywhere else in the state. The organization reported no
infected
ticks in Lenawee County between 1985 and 2002.
However, Markowitz said he believes anywhere there are deer, there are
deer
ticks. With deer ticks, comes Lyme disease, he said. The Michigan
Department
of Community Health hasn't been vigorous in its attempts to find the
disease, he said.
"I've seen enough (cases) to know that they do exist in the state," he
said.
Several years of good clinical results show there is a prevalence in
Michigan, he said.
Mike Kight, health officer for the Lenawee County Health Department,
said
477 ticks from within the county were sent in for identification, but
none
tested positive for Lyme disease. He said three cases were documented
by the
CDC between 2001 and 2005.
"Is it possible to contract (Lyme disease)? Probably," he said. "The
chance
of it? Low, based on my experience."
As for Andrew Emery, he's now 14 and just finished his freshman year at
Adrian High School. He's doing better, but can't participate in gym
class
because of the risk of making his heart rate go up. He's still on
antibiotics and taking blood pressure medication, but he isn't throwing
up
every day and his eyesight returned.
About the time Andrew started getting better, Christine's health got
worse.
Her symptoms were similar to those afflicting Andrew, so Ledtke tested
her
for Lyme disease and results came back positive in September. She said
it is
unknown if she passed the illness to Andrew through birth, or if he was
bitten by a tick.
Her health improved after beginning treatment, but she still suffers
from
fatigue at times, she said.
"I'm definitely not vomiting every day, which is wonderful," she said.
Andrew said he's happy his health improved. After missing nearly an
entire
school year, losing his hair, 50 pounds and eyesight, he said he's a
new
person now that he's better.
"I'm doing a lot better," he said. "I can remember a little bit more. I
have
better concentration."
Copyright © 2005 Liberty Group Newspapers
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