Does this sound like good advise from LLMD? Getting concerned....

Today I called the llmd because my husband is an the middle of a 3 week herx, very severe. Three weeks ago he could walk although very stiff in his joints. He is on azithromycin 500 mgs 1 t. a day and flagl 500 mgs 2 t. a day. His previous herxes were usually a day or two long since the beginning of treatment which has been almost 90 days now with no real improvement. He is now in a wheel chair and in the last two days can only walk about ten feet with assistance. Dr. said go off antibiotics for 4 days, if he becomes worse over the weekend, take him to the ER. Call him on Monday and let him know how he is. Does this sound reasonable? I know it is not good to herx for such a long period of time. We talked about adding mepron to his other medicines but he has not been tested yet for co-infections and I am wondering if that is why we are not seeing any real improvement. Doctor feels what he is presently taking should also work on co-infections, any advise? We would appreciate any input. Thanks, Bev

Flagyl and zith will not work in combo on co-infections.  Mepron is for babesia.  Zith is usually paired with rifampin for bartonella or there are other combos for bartonella.

hiker53 or anyone else:
We are fairly new to Lyme, are you saying that this combo is not appropriate to treat Lyme? or just co-infections? thanks, Bev

Forms of Borrelia
• Spirochete – has a cell wall. Penicillins, cephalosporins, Primaxin, Vancomycin
• L-Forms – has no cell wall. Tetracyclines and Erythromycins. (Azithromycin)
• Cyst – protected form. Difficult to kill. Use Flagyl, Tinidazole, and possibly Rifampin (Hope to Heal 2007 www.betterhealthguy.com)

These are suggested types of antibiotics for each for of Borrelia (Lyme). I believe hiker was referring to co infections.

I am taking Amox with Flagyl and azith.

I'm currently taking Mepron and zith. My LLMD says it's for possible babesia, but also definitely has shown to be a lyme cyst-buster. Meaning it is able to go after lyme in it's non-spirochete form. I can't remember precisely, but I believe he considers flagyl to be an alternative cyst-buster - I just don't know if he would have used flagyl alone or with something else...

Before this I was on tetracycline. I herx pretty much constantly on both tetracycline and mepron - I wouldn't worry about too much herx, it means you're killing lyme.

I do also see a holistic doc, who adjusts me with acupressure, etc. Among other things, he helps my body continually dump the toxins.

Best of luck.

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http://lymechronicles.blogspot.com

My LLMD says Flagyl is the cornerstone of his treatment.  He gives it down the road for the cyst form of Lyme, but he also says he's pretty sure it goes after babesia, too.  He's been seeing this in his practice. 

CherylSue

It sounds reasonable that he would get much worse before he gets better. My first flare up ever lasted for about 3 months and then I will still feeling badly for another 6 months before seeing improvement.

The herx definately shows he is killing the lyme BUT your doctor may want to consider a lower dose because clearly his reaction to this dose is not tolerable.

Thanks for all your input. He is still herxing.....His left foot and ankle are badly swollen this week, red and very painful. He can not put any weight on it. Speech is slurred a good part of the day. Dry cough is almost constant along with twitching. Low grade fever comes and goes. Dr. said to start pulsing, 4 days on and 3 days off. I want to have him detox more but he can't even stand, we are doing foot baths of epson salts and hydrogen peroxide. I know herxing is a good thing but we would like just a little improvement to keep us going. A few good days would be nice? We have contacted a new LLMD but can't get in until the 12th of Nov.

Hi mosiegotlyme, welcome to the board!

How are you doing on the Mepron and Zithromax?  Do you know how long you will be taking it?

Hi ticker,

I'm in week 4 of a 6 week course of Mepron/Zith. Weeks 1 and 2 were low-level herx, week 3 was tough! So far, week 4 is very benign.

I see Dr. P in Wilton, CT, and so far he's had me do 5 weeks tetracycline, 1 week off, and now this. Then another week off, and I'm not sure what. Perhaps back on tetracycline, but at higher dose.

The mepron makes me a bit shakey, but I like it better than the tetracycline. During the tet cycle I felt like I had a stone in my gut the whole time. Plus, I herxed the whole five weeks.

A bit of background:
I had a bulls eye Jul 2007, and wasted precious time when an IDSA doc said, after a short course of abx, I had post-lyme, and I needed to "just wait 3-18 months". He went so far as to say the LLMDs were all quacks, and to avoid them. Of course I never got any better, and by this Spring he said I was a head-case and needed a psychiatrist. Familiar sad story, right?

My LLMD thinks I probably have had lyme for several years, as I've had constant tick exposure (hiked the Appalachian Trail in 2005, sleeping out 120+ nights - yes, I used to be able to DO things) and some known, apparently non-reactive, tick bites. Also, twice in 2006 I was on 3 weeks doxy for "possible lyme", and I got better and thought nothing of it. This may explain why as of Aug 2007 it was acting like late stage chronic lyme with heavy neuro symptoms, even though I "just got bit" in July.

I'm very happy to be seeing Dr. P now. I expect it'll take a while, but I'm already showing some improvement.

As a way to get my mental skills back, I write about this in my blog: http://lymechronicles.blogspot.com

Cheers.

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http://lymechronicles.blogspot.com

I don't think a lot of herx is a good thing.   It means you are releasing a lot of toxins which will add to the inflammation.  So, detox, detox, detox.   Hiker53

Hi hiker53,

I drink a lot of water, and take a lot of fiber. My holistic doc uses acupressure to help organ detox. I've been warned against radical detox, as it'll weaken me too much.

What do you recommend for a gentle detox?

Thanks.

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http://lymechronicles.blogspot.com