Blood Smears for Babesia monitoring

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sierraDon
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Date Joined Aug 2016
Total Posts : 289
   Posted 2/17/2018 4:45 PM (GMT -6)   
Just curious if anyone had a hematology lab or microbiology lab do blood smears to gauge where they are in their treatment.

I realize that smears are subjective based on the tech. But i saw a few places talk about Giemsa or Wright stains or smears being utilized to gauge treatment progress.

was wondering if anyone had tried that. thanks a lot

TOOTY
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Date Joined Apr 2014
Total Posts : 269
   Posted 2/17/2018 5:21 PM (GMT -6)   
sierraDon said...
Just curious if anyone had a hematology lab or microbiology lab do blood smears to gauge where they are in their treatment.

I realize that smears are subjective based on the tech. But i saw a few places talk about Giemsa or Wright stains or smears being utilized to gauge treatment progress.

was wondering if anyone had tried that. thanks a lot


Hi sierraDon, there are a number of us on this forum that do this ourselves (namely MustardSeed, bluelyme, Jackss, myself, and perhaps GeorgiaHunter)!! We have our own scopes and find microscopy in general, and darkfield microscopy and Giemsa smears in particular, an insightful tool for our treatment. Jackss and myself have also delved into acridine orange staining for the detection of Bb and the coinfections.

Darkfield (and Phase Contrast) microscopy is THE BEST tool for confirming a Borrelia infection. And Giemsa and Acridine Orange smears are among the best detection methods when it comes to the coinfections. The distinct advantage with microscopy is that you are actually visualizing the organisms. And, having your own scope gives you the distinct advantage of unlimited viewing of your sample. Commercial labs look at your slide for no more than 15 minutes. There is an inherent drawback to that because in CHRONIC INFECTION, the number of (co-infection) organisms in the blood IS EXTREMELY LOW!!

Do a search of the "Microscopy" threads on this forum and you'll find plenty of info. Also, "The Microscopy Thread" on Lymenet.org has a wealth of info from DIY'ers and is more in-depth.

sierraDon
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Date Joined Aug 2016
Total Posts : 289
   Posted 2/17/2018 5:34 PM (GMT -6)   
OK thanks a lot.

so, there is no reliable lab that does it for say 30 minutes each, with multiple samples.

I will look into the threads. thanks again

TOOTY
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Date Joined Apr 2014
Total Posts : 269
   Posted 2/17/2018 8:29 PM (GMT -6)   
I'm not aware that ANY lab ANYWHERE looks at a slide for 30 minutes. The best test for Babesia screening and monitoring is Igenex's Babesia FISH test. The FISH test uses special fluorescent probes that bind to specific DNA (or RNA) in a sample. When objects in the sample glow under a fluorescent microscope, you can be sure you have a positive result.

VIEW IMAGE

BabsBunny
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Date Joined Mar 2017
Total Posts : 563
   Posted 2/17/2018 9:53 PM (GMT -6)   
my LLMD does Giemsa stains. We confirmed babesia, but so far haven't followed up. I haven't been able to stay on a good treatment regimen long enough, I keep getting sick/ having reactions.

I don't know where you could order a test though.
Lyme, Babesia, Bartonella. Symptoms began 5/2016, didn't start treatment until 9/2016. Slow but steady recovery.

*twitch twitch*

sierraDon
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Date Joined Aug 2016
Total Posts : 289
   Posted 2/18/2018 7:49 AM (GMT -6)   
Thanks, i am going to try to see if my LLMD knows someone, i would like to get a baseline stain done. maybe at some point i would get my own scope.

Tooty, i had babesia FISH and Bartonella FISH done at Igenex, both negative. at MDL, they were both IGG positive. maybe i could retry FISH at MDL.

i just feel more comfortable trying to track its progress with a real test, even if its somewhat suspect due to various reasons.

TOOTY
Regular Member


Date Joined Apr 2014
Total Posts : 269
   Posted 2/18/2018 9:32 AM (GMT -6)   
sierraDon said...
Thanks, i am going to try to see if my LLMD knows someone, i would like to get a baseline stain done. maybe at some point i would get my own scope.

Tooty, i had babesia FISH and Bartonella FISH done at Igenex, both negative. at MDL, they were both IGG positive. maybe i could retry FISH at MDL.

i just feel more comfortable trying to track its progress with a real test, even if its somewhat suspect due to various reasons.


Very interesting that Igenex was negative while MDL was positive. The MDL test was the ELISA (IGG/IGM tests for antibodies), while the FISH would have been a direct visual on a fluorescent blood smear. Could be that you cleared the infection already, although that is somewhat unlikely, especially if still having symptoms and you tested negative for other infections. But we all know that no test is 100% accurate (and I wanted to reiterate that earlier but forgot).

BabsBunny said...
my LLMD does Giemsa stains. We confirmed babesia, but so far haven't followed up.
That's right! Dr. J does them for $200 per slide if I remember right.

Fry Labs still does the smears too, and I think they are in the ballpark of about $300. But for $200-$300 you can get a decent used lab-grade microscope and do as many of the slides as you want. And, learn a skill doing it. Unfortunately the skill is not marketable (unless you are a qualified/licensed pathologist/doctor), but it can give a world of insight into your own treatment and can give helpful direction to friends and family. Your predicament is the very reason most of us got started with microscopy.

sierraDon
Regular Member


Date Joined Aug 2016
Total Posts : 289
   Posted 2/18/2018 9:56 AM (GMT -6)   
Thanks for your feedback.

I was tested with Igenex FISH tests before i started any type of treatment. When i tested with MDL i just started treatment, was on Ceftin only for about a week when all the lyme and coninfections tests were done. so, dont think its possible that the infection has been cleared. I dont have many babesia symptoms tho, mainly just low body temperature, cold hands and feet, mood/irritability. it made me question if it was a 'false positive', but believe that is unlikely as i have heard of a lot of people that don't exhibit symptoms

I would be willing to do 2 or 3 slides to see what the results are, i am going for an initial consultation at JSC at the end of the month, will request these. maybe look into a scope after that, i am scientific type, so woulnd't mind learning how to use it, tho i just want some results right now. would probably take me a bit to develop the expertise.

Aerose91
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Date Joined Feb 2016
Total Posts : 581
   Posted 2/18/2018 1:02 PM (GMT -6)   
This is crazy (and awesome) that you guys have to go this far because doctors can't figure this out.

How much did the intial setup cost? With dyes and everything

TOOTY
Regular Member


Date Joined Apr 2014
Total Posts : 269
   Posted 2/18/2018 3:23 PM (GMT -6)   
sierraDon, I just want to clarify that the Dr. J I'm referring to is the one in Rockville, Maryland. I'm not aware that J. Specialty Clinic does in-house smears. The Bart "guru," Dr. M, does in-house smears too, but they are $500 per slide!!!

Yeah Aerose91, it's pretty crazy isn't it? Most doctors are not allowed to do Giemsa smears because they don't have a certified in-house lab, so there are very few docs doing it. It's relegated to hospitals and commercial labs, and they almost never find these infections because the loads are really low unless it's at the onset of infection and you are running a fever. Even then, the amount of time they spend per sample makes it very unlikely they'll catch them.

I'm not a big fan of Dr. S in Florida, but he has published some helpful reference books regarding microscopic detection of these infections, mainly for Babesia.

It's very easy to do this yourself, once you get familiar with it.

In answer to your question Aerose91, a simple used brightfield lab-grade scope can easily be had on Ebay for about a $100. For $200-$500 you can get a really nice set-up for brightfield, darkfield, and phase contrast. But, I emphasize, you only need the cheaper brightfield scope to view a simple Giemsa smear. Darkfield and phase contrast are used for looking at wet or "live" samples.

You can still view spirochetes with plain brightfield (as long as you have 1000x), but it's more difficult. But 400x brightfield is not enough to do much of anything when it comes to blood, so it's important to get a scope with a 100x oil immersion objective lens. All lab-grade scopes should come with the 100x objective lens unless it's been removed for some reason.

I paid about $110 ($150 total with shipping) for my first (lab-grade) scope (used), and it was equipped for brightfield up to 1000x and dark phase contrast up to 450x. (A darkfield- or phase-contrast-equipped scope can easily view spirochetes at 400x).

But, I emphasize, a lab-grade BRIGHTFIELD microscope with 1000x is all you really need to get started. And, they are pretty cheap. The Giemsa stain I use I got as free samples from Astral Diagnostics. I got the Quick-1 "blue," and the Quick-1 "red." Getting some is as simple as calling and requesting a sample. Those are ready-to-use solutions. No fixative step needed. Very simple to make a stained smear once you learn the "sliding technique."

So Aerose91, to answer your question, the total price can easily be less than $200! No more than $100 if you get a good deal on a lab-grade scope and I've seen them go for as low as $100 with shipping on occasion!

TOOTY
Regular Member


Date Joined Apr 2014
Total Posts : 269
   Posted 2/18/2018 3:43 PM (GMT -6)   
Here is what you can see with a simple brightfield microscope (approx. $150) and the free Giemsa stain. It is my picture with my microscope showing a classic ringform Babesia parasite:

VIEW IMAGE


Here is a picture of my blood with my fluorescent microscope using acridine orange showing a pretty typical pyriform Babesia parasite:

VIEW IMAGE

TOOTY
Regular Member


Date Joined Apr 2014
Total Posts : 269
   Posted 2/18/2018 4:02 PM (GMT -6)   
And, no special photography equipment was needed for those pics. Believe it or not, I use my old Canon A540 (6mp) for my photomicrographs.

If you have a simple point and shoot camera, or even a phone camera, you can get pics just as good down through the eyepiece lens of the microscope!

In fact you can get universal adapters for microscopes to use with your camera or phone. They are about $20. But most of my pics are shot free-hand down through the eyepiece.

TOOTY
Regular Member


Date Joined Apr 2014
Total Posts : 269
   Posted 2/18/2018 9:26 PM (GMT -6)   
The one recommendation I have for viewing Giemsa smears is to use LED lighting. Kohler I think is fine (but I never used that personally), but halogen lighting makes the Giemsa smear appear off-color and gives an orange-brown coloring which makes it hard to pick out the Basophilic colors. Most older scopes came with halogen lamps so if you get a scope with halogen you'll have to improvise or refit with LED. Halogen works great for phase contrast and darkfield....just not for viewing Giemsa smears.

There are aftermarket retrofit LED lamps available for most scopes. You can also buy low-profile LED "saucers" that fit between your microscope condenser and the factory lamp housing. I bought a really nice one on Ebay a while back that was very low-profile. I also made my own with a heat sink, AC to DC adapter/driver, CREE LED chip, a lens, and a variable switch. It's pretty easy to do, but you have to know how to solder because you have to solder your wires onto your LED chip. The quickest and cheapest hack is to use one of these between the condenser and factory lamp housing (I did this until I made my own LED lamp with the heat sink):

/www.amazon.com/dp/B00JM72W6C/ref=twister_B00P648KIE?_encoding=UTF8&psc=1

Aerose91
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Date Joined Feb 2016
Total Posts : 581
   Posted 2/18/2018 11:22 PM (GMT -6)   
Tooty-

Thanks so much for that detailed explanation. It's impressive that you have gone to this step. Im seeing Dr M who did a blood smear for me and said he thought he saw protozoa but im interested in this now, to monitor my own path, as well as i think its really cool
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