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  • Writer's pictureMartha Calihan MD

Lyme is a Complex, Multifaceted Disease

Do you know someone who has had Lyme disease? It is endemic in this area of Northern Virginia, so we probably all have had some experience with it, either directly or indirectly.


Lyme disease, as we know, is transmitted by deer ticks, and can infect a human after a bite. Deer ticks are tiny, and many people have no recollection or awareness of having been bitten. The “bullseye” rash that we have come to associate with the disease occurs in fewer than half the people who have Lyme, perhaps as low as a third of them. Typical symptoms include:


• Fever and chills

• Body aches

• Headache

• joint pain

• fatigue

• brain fog


Oftentimes, it presents as a flu-like illness in the summer.


Lyme ticks can carry a variety of other infections along with Lyme, including Babesia, Bartonella, and others. Sometimes it is these other infections that cause the biggest problems for our patients as they are less likely to be identified and take more time to be diagnosed.


One of the reasons that Lyme disease can be so challenging is the large number of effects it can have on our bodies. It is a multisystem infection with the ability to affect the immune system in ways that can help it survive detection and resist treatment. People can present with neurological symptoms such as brain fog, mood disruption, and nerve pain, or physical symptoms such as joint pain, fatigue and digestive distress. It can become persistent, or chronic, leading to further challenges in treatment.


But it can be treated, and it is best to approach it with a full and complete assessment of all of its manifestations and affects, and approach it with a multisystem approach.


If you have had a tick bite and develop symptoms, or have symptoms that you don’t understand, it is important to get evaluated and tested for this disease. Here at Five Stones, we follow the International Lyme and Associated Disease Society criteria for diagnosis. ILADS states that Lyme Disease is "a clinical diagnosis dependent on history, and physical examination, and supported by appropriate laboratory testing. The elements of diagnosis are placed in the context of the activities and experiences of the patient, environmental exposures and risk factors, and consideration of other diagnoses that may explain or impact the patient’s symptoms."




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