I am not sure how much help I can be but since your husband and I share horrific fatigue as a primary symptom I thought I would try. I know when I started abx they did nothing at all for me and I actually felt worse on them. When I was diagnosed with CFS I still worked although part time and I was still running. I was told to just do what you can and maybe it will go into remission. Okay that was what I would do. Then I started abx and within a few months could no longer run-had to cut my hours again and just really felt horrible and it wasn't due to herxing.
I began to question the Lyme diagnosis since I didn't have a positive test just some activity on 4 bands. Then I was tested for co-infections and came up with the pos bart titer. I guess I am trying to say that I only felt better on the Rocephin. Orals did nothing but give me side effects and make me feel really bad and I had even less energy. I do believe alot of the times it is side effects we have and not herxing. I have basically had it with orals because they have done zero for me.
I think if your husband can keep on the Rocephin a few more months he will see improvement. Sometimes it can take months especially where he has been sick for so long. I was only sick 2 years before diagnosis. I think when you see John you could talk with him about this. I am so sorry your husband has declined even further and sometimes I feel like I am heading that way too.
I had a bart rash on my stomach a couple days ago and took a picture of it for John. I am not even being treated for bart right now and that scares me too because I was on Rifampin for 8 months and apparently it isn't gone. Sorry I can't be of more help but I totally understand how you are feeling. Keep in touch okay.