Pediatric LLMD Boston area

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nic@nite
New Member


Date Joined Apr 2018
Total Posts : 6
   Posted 4/17/2018 3:44 PM (GMT -6)   
Hi,

My 7yo daughter got a tick bite with a bullseye rash just over a week ago. I’m looking for an LLMD that will treat her, who takes insurance. We are very low income, and we live about 20 minutes north of Boston.

Post Edited By Moderator (Girlie) : 4/17/2018 3:33:29 PM (GMT-6)


Girlie
Forum Moderator


Date Joined May 2014
Total Posts : 33798
   Posted 4/17/2018 3:59 PM (GMT -6)   
Hi nic - Do you have a Dr that would support treating your daughter since she has the bullseye rash which is diagnostic of Lyme disease.
It’s important for her to get abx ASAP and sometimes LLMD’s are booked for several weeks to months out.

Treating her now is giving her the best chance for it not become chronic .

Take a pic of the rash.

Your daughter will need several weeks of abx.

From ILADS Lyme Treatment Guidelines:



TREATMENT CATEGORIES
PROPHYLAXIS of high risk groups- education and preventive measures. Antibiotics are not given.
TICK BITES - Embedded Deer Tick With No Signs or Symptoms of Lyme (see appendix):
Decide to treat based on the type of tick, whether it came from an endemic area, how it was removed,
and length of attachment (anecdotally, as little as four hours of attachment can transmit pathogens). The risk of transmission is greater if the tick is engorged, or of it was removed improperly allowing the tick's contents to spill into the bite wound. High-risk bites are treated as follows (remember the possibility of co-infection!):
1) Adults: Oral therapy for 28 days.
2) Pregnancy: Amoxicillin 1000 mg q6h for 6 weeks. Test for Babesia, Bartonella and Ehrlichia.
Alternative: Cefuroxime axetil 1000 mg q12h for 6 weeks. 3) Young Children: Oral therapy for 28 days.

EARLY LOCALIZED - Single erythema migrans with no constitutional symptoms:
1) Adults: oral therapy- must continue until symptom and sign free for at least one month,
with a 6 week minimum.
2) Pregnancy: 1st and 2nd trimesters: I.V. X 30 days then oral X 6 weeks
3rd trimester: Oral therapy X 6+ weeks as above.
Any trimester- test for Babesia and Ehrlichia
3) Children: oral therapy for 6+ weeks.
Moderator, Lyme Forum
Symp started April/2013; Buhner's Lyme May 15-July24/14; Igenex pos. July 3/14
Doxy: July 4-Aug.24/14;Zithro July26-Aug24/14; Amox + Proben. Aug. 29/14;
added biaxin Sept. 26/14
Disc. amox,added Ceftin Nov. 20th.;
Disc. biaxin added Buhner bart herbs Dec/14;Jan/15 pulsing Tinda (w/ Ceftin);
Abx/herb break Apr-July/15; July-mino; Aug. added Rif;
Nov./15 mino - to biaxi

Post Edited (Girlie) : 4/17/2018 3:09:59 PM (GMT-6)


nic@nite
New Member


Date Joined Apr 2018
Total Posts : 6
   Posted 4/17/2018 4:05 PM (GMT -6)   
She is on amoxicillin right now, I managed to get 28 days worth. She already has PANDAS, so I’m worried about what this Lyme will mean for her which is why I’m trying to get in to see an LLMD asap. I have loads of pics lol

Girlie
Forum Moderator


Date Joined May 2014
Total Posts : 33798
   Posted 4/17/2018 4:14 PM (GMT -6)   
Check the dosage ;

*Amoxicillin- Adults: 1g q8h plus probenecid 500mg q8h; doses up to 6 grams daily are often needed
Pregnancy: 1g q6h and adjust.
Children: 50 mg/kg/day divided into q8h doses
Moderator, Lyme Forum
Symp started April/2013; Buhner's Lyme May 15-July24/14; Igenex pos. July 3/14
Doxy: July 4-Aug.24/14;Zithro July26-Aug24/14; Amox + Proben. Aug. 29/14;
added biaxin Sept. 26/14
Disc. amox,added Ceftin Nov. 20th.;
Disc. biaxin added Buhner bart herbs Dec/14;Jan/15 pulsing Tinda (w/ Ceftin);
Abx/herb break Apr-July/15; July-mino; Aug. added Rif;
Nov./15 mino - to biaxi

nic@nite
New Member


Date Joined Apr 2018
Total Posts : 6
   Posted 4/17/2018 4:15 PM (GMT -6)   
I’m sorry, I’m not sure what all that means. She’s 60lbs and on 600mg twice a day

Girlie
Forum Moderator


Date Joined May 2014
Total Posts : 33798
   Posted 4/17/2018 4:17 PM (GMT -6)   
It would help if you added the location you are seeking one.

When you do call make sure you mention it’s a recent bite - so hopefully they can get her in within a few weeks.

If you’re near Washington, DC - they have a Pediatric practitioner there.
Moderator, Lyme Forum
Symp started April/2013; Buhner's Lyme May 15-July24/14; Igenex pos. July 3/14
Doxy: July 4-Aug.24/14;Zithro July26-Aug24/14; Amox + Proben. Aug. 29/14;
added biaxin Sept. 26/14
Disc. amox,added Ceftin Nov. 20th.;
Disc. biaxin added Buhner bart herbs Dec/14;Jan/15 pulsing Tinda (w/ Ceftin);
Abx/herb break Apr-July/15; July-mino; Aug. added Rif;
Nov./15 mino - to biaxi

nic@nite
New Member


Date Joined Apr 2018
Total Posts : 6
   Posted 4/17/2018 4:18 PM (GMT -6)   
Sorry! I thought I did 😔 I’m near Boston, MA. about 20 minutes north of Boston

Girlie
Forum Moderator


Date Joined May 2014
Total Posts : 33798
   Posted 4/17/2018 4:20 PM (GMT -6)   
nic@nite said...
I’m sorry, I’m not sure what all that means. She’s 60lbs and on 600mg twice a day


The dose is 50 mg/kg/ each day divided into three doses (approx 8 hours apart)

Give me a minute and I’ll do the math
Moderator, Lyme Forum
Symp started April/2013; Buhner's Lyme May 15-July24/14; Igenex pos. July 3/14
Doxy: July 4-Aug.24/14;Zithro July26-Aug24/14; Amox + Proben. Aug. 29/14;
added biaxin Sept. 26/14
Disc. amox,added Ceftin Nov. 20th.;
Disc. biaxin added Buhner bart herbs Dec/14;Jan/15 pulsing Tinda (w/ Ceftin);
Abx/herb break Apr-July/15; July-mino; Aug. added Rif;
Nov./15 mino - to biaxi

Girlie
Forum Moderator


Date Joined May 2014
Total Posts : 33798
   Posted 4/17/2018 4:22 PM (GMT -6)   
nic@nite said...
Sorry! I thought I did 😔 I’m near Boston, MA. about 20 minutes north of Boston


Sorry - I meant in the subject of the thread.

I’m typing on my phone so I’m a bit handicapped as this site isn’t mobile friendly.

I’ll do the math and post in a few minutes what the guidelines say is appropriate for a 60 lb child
Moderator, Lyme Forum
Symp started April/2013; Buhner's Lyme May 15-July24/14; Igenex pos. July 3/14
Doxy: July 4-Aug.24/14;Zithro July26-Aug24/14; Amox + Proben. Aug. 29/14;
added biaxin Sept. 26/14
Disc. amox,added Ceftin Nov. 20th.;
Disc. biaxin added Buhner bart herbs Dec/14;Jan/15 pulsing Tinda (w/ Ceftin);
Abx/herb break Apr-July/15; July-mino; Aug. added Rif;
Nov./15 mino - to biaxi

Girlie
Forum Moderator


Date Joined May 2014
Total Posts : 33798
   Posted 4/17/2018 4:29 PM (GMT -6)   
Okay - 60 lbs is 27 kg

She needs 50mg x 27 kg = 1350 mg per day - so 600 mg twice daily is close to that BUT it’s best to take it in three divided doses because that particular medications has a very low half life of approx one hour.

450 mg 3x day would be more effective.
Moderator, Lyme Forum
Symp started April/2013; Buhner's Lyme May 15-July24/14; Igenex pos. July 3/14
Doxy: July 4-Aug.24/14;Zithro July26-Aug24/14; Amox + Proben. Aug. 29/14;
added biaxin Sept. 26/14
Disc. amox,added Ceftin Nov. 20th.;
Disc. biaxin added Buhner bart herbs Dec/14;Jan/15 pulsing Tinda (w/ Ceftin);
Abx/herb break Apr-July/15; July-mino; Aug. added Rif;
Nov./15 mino - to biaxi

nic@nite
New Member


Date Joined Apr 2018
Total Posts : 6
   Posted 4/17/2018 4:30 PM (GMT -6)   
Ok! I’ll start giving her 3 doses a day

Girlie
Forum Moderator


Date Joined May 2014
Total Posts : 33798
   Posted 4/17/2018 4:31 PM (GMT -6)   
Here’s the guidelines :

www.lymenet.org/BurrGuide200810.pdf

Scroll down until you see antibiotic dosing - you could show it to your Dr.
Page 18
Moderator, Lyme Forum
Symp started April/2013; Buhner's Lyme May 15-July24/14; Igenex pos. July 3/14
Doxy: July 4-Aug.24/14;Zithro July26-Aug24/14; Amox + Proben. Aug. 29/14;
added biaxin Sept. 26/14
Disc. amox,added Ceftin Nov. 20th.;
Disc. biaxin added Buhner bart herbs Dec/14;Jan/15 pulsing Tinda (w/ Ceftin);
Abx/herb break Apr-July/15; July-mino; Aug. added Rif;
Nov./15 mino - to biaxi

Girlie
Forum Moderator


Date Joined May 2014
Total Posts : 33798
   Posted 4/17/2018 4:38 PM (GMT -6)   
nic@nite said...
Ok! I’ll start giving her 3 doses a day


But only 450 mg each dose.

It’s difficult to do the 3x dosing spaced out evenly - especially if she goes to bed early - just do your best

6:00 am

2:00 pm

9:00 pm (does she stay up that late?)
Moderator, Lyme Forum
Symp started April/2013; Buhner's Lyme May 15-July24/14; Igenex pos. July 3/14
Doxy: July 4-Aug.24/14;Zithro July26-Aug24/14; Amox + Proben. Aug. 29/14;
added biaxin Sept. 26/14
Disc. amox,added Ceftin Nov. 20th.;
Disc. biaxin added Buhner bart herbs Dec/14;Jan/15 pulsing Tinda (w/ Ceftin);
Abx/herb break Apr-July/15; July-mino; Aug. added Rif;
Nov./15 mino - to biaxi

Girlie
Forum Moderator


Date Joined May 2014
Total Posts : 33798
   Posted 4/17/2018 5:07 PM (GMT -6)   
Interesting you mentioned PANDAS. They're finding a link to Pans/PANDAS and lyme disease and coinfections.
There are Pediatric LLMD's who believe that it's an infection.

We have a member her whose daughter was diagnosed with it...and her symptoms resolved with extensive lyme/bartonella and babesia treatment.
Moderator, Lyme Forum
Symp started April/2013; Buhner's Lyme May 15-July24/14; Igenex pos. July 3/14
Doxy: July 4-Aug.24/14;Zithro July26-Aug24/14; Amox + Proben. Aug. 29/14;
added biaxin Sept. 26/14
Disc. amox,added Ceftin Nov. 20th.;
Disc. biaxin added Buhner bart herbs Dec/14;Jan/15 pulsing Tinda (w/ Ceftin);
Abx/herb break Apr-July/15; July-mino; Aug. added Rif;
Nov./15 mino - to biaxi

nic@nite
New Member


Date Joined Apr 2018
Total Posts : 6
   Posted 4/17/2018 5:25 PM (GMT -6)   
Yes, she's up at 9pm. She's had PANDAS for about 3 years, but only diagnosed for a few months so I'm still trying to figure that out. Now to add Lyme on top of it, my head is spinning lol
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