I remember some of your posts about
your sister who I am truly sorry is still suffering. If it were me, I would find another doctor who understands the fact that travelling is difficult for her and make sure until your sister could tolerate travelling that all appt's have to be remote.
Remember, you or your sister pays the doctor so the doctor is the customer not the other way around. Why people bend over backward to see a doctor is beyond me. Yes, I get it that LLMD's (especially good ones) are hard to find.
That said if your sister has not improved by all this time then perhaps it's time to change up her meds, look into alternative medicine, read books by authors such as Buhner, Rawls, Jernigan, etc.
Connie Strasheim put together a book: https://www.amazon.com/new-paradigms-lyme-disease-treatment/dp/0988243784http://lymebook.com/new-paradigms-connie-strasheim-book/
I wish your sister much healing! You are a wonderful sister,