No more minocycline and guilt over happiness.

The reason I have this blog is to keep track of my symptoms and occasionally share a ramble. I never imagined I’d be getting thousands of visitors… Thank you, for your views and your comments, and I sincerely hope the things I’ve written can help someone else. Many of you have shared that they have, and I will always feel blessed by it.

So yes, I need to update on a few things for future reference… The first one being: My brain fog. If I haven’t said it before, let me say it now: Flagyl gives me the worst brain fog ever. I’m glad I only take it four days a week. My typing has been fairly atrocious lately (sometimes worse than others) so I apologize in advance if this entry doesn’t come out right. I know some of you have to translate it into your native language and this one might not be.. erm.. see, I can’t even think of how to finish that statement! :\

My eyes have been hurting for weeks. I’m so sensitive to light, and I get stabbing pains in them. I’ve spent the past week in the dark. My nervous system has been very sensitive, in general, since I started treatment, however my eyes don’t usually hurt this much… I’m wondering if the Nasonex has anything to do with it. I’ve taken it for.. probably a decade, now? But I had a two year break, and I don’t recall it having an accompanying Glaucoma Warning in the past…? But it does, now. I’ve stopped needing it, so I stopped it two days ago. Today my eyes ARE better, but it’s impossible to draw any conclusions from that. It’s probably just coincidental timing and I’ll get a severe case of eye pain tonight like I did yesterday, aha. If in the future, however, I start Nasonex and get crazy eye symptoms, I’ll know something.

It would appear that warning-hive I got a few weeks ago held true to its title. On the 12th of May, I got very, very sick, and had to stop all antibiotics. Aside from the fact that I felt completely flu-ish with a severe headache, I’d gotten to the point that I could not eat anything, even drinking water was becoming difficult, and amassed in me shaking, becoming dehydrated, and needing Zofran three times a day to keep my nervous system from having a meltdown. These are the same things that the Doxycycline did to me last year before I was hospitalized for five days. We were worried that the minocycline might do this, too, which is why we’ve been easing into it for all these weeks… It’s clear now that I can no longer handle the tetracyclines. I’m just glad that (1) I knew what was about to happen so I stopped the medicine in time, and (2) that I basically had available to me the same medications that they gave me last year to pull me through it (except re-hydrating took a tad bit longer without an IV). After three “missed” doses of antibiotics I was able to eat a chicken sandwich, and it’s been a steady improvement since then…well, at least in regards to being able to eat and keep food in my system.

Wednesday I couldn’t breathe again, having much the same symptoms as two weeks prior. And I’m still having that problem: I cannot breathe when I sit up, but as long as I’m lying down, I’m pretty much okay, though I still have to gasp for air every so often.

Now, I’ve had flare-ups every two weeks for almost two years, now–since summer of 2010, I believe, when I took grapefruit seed extract (GSE) for a few weeks–so this isn’t too much of a shock. But I usually have Lyme symptoms during those flare ups. This time, I haven’t. At all. I’ve had lung pains, and coughing a lot, and an inability to breathe right. That can’t be Lyme disease?

The reason I assumed the GSE had woken up the Lyme disease when I took it, and gave me flares every two weeks instead of every four weeks, is because GSE is a supposed to be a destroyer of Lyme cysts (i.e., the cysts that the bugs were hiding in, open up and start causing symptoms, then you can kill them with antibiotics)… Well, I’m on Flagyl, which is THE cyst buster, so could that have anything to do with my minor Lyme symptoms during these flares? Or is this not Lyme disease at all, and is it Mycoplasma? My money is on the latter for this particular scenario, given the hive and the breathing problems and lung problems which are all the things that I was worried might happen. :\ Because I tell you, my other symptoms are very mild. Shockingly so. When I was off antibiotics this past week, my neuro symptoms barely even flared up! I’ve been having mild “hot foot” sensations in my right leg, and that’s about it. (My tags say I last had that.. well, let’s just say that every time I’ve mentioned it, I’m also talking about Mycoplasma… The evidence mounts!) Nothing went to attack my arms, nothing started quickly progressing like a starved animal waiting to pounce… That is very exciting, and makes me feel like we’ve at least done something the past four months. As I usually say, time will tell! I’ll keep updating on it, and hopefully a pattern will emerge.

Until then, we just make sure I’m on both Lyme and Mycoplasma antibiotics. So I started Biaxin today! I’ve heard great things about this one, and it treats borrelia burgdorferi and mycoplasma pneumoniae and even bartonella, in the event that some of those critters have survived and are saving up for a revolt. Also, the pills are bright orange!

Ah, and so far, I feel accomplished with my goal to not be advocacy-frenzied. I’ve reposted/retweeted a few things, but that’s about it. Life is good, despite everything. I’m happy, even though I feel like I have society and ten thousand other sources telling me I’m not allowed or shouldn’t be… I’m sick, I’m “supposed” to be complaining about everything, right? Ha. Last week I felt the urge to announce, “I’m so happy to be alive.” Because I was. Because I am. And afterward I felt so odd about it. One friend said, “You feel odd because society tells you to complain about your woes. You’re happy because you see what matters most.” Which is pretty dead-on. Another said that people see someone like me “who is thankful for another day and enjoys life as much as possible, and they make a hateful comment” because they’re trying every materialistic avenue available to them and still can’t feel happiness and appreciation.

I suppose when it comes down to it, I was worried someone would take it in the wrong way, or find a way to interpret it negatively, or think I was just “saying it to be saying it” even though I really do mean it. Also, I didn’t want it to sound conceited? I know people going through minor troubles who are very bothered day in and day out, and I have.. erm, well, a lot of daily troubles and suffering and yet lately I have maintained happiness. It’s just a fact. So I don’t want it to sound like I think I’m better than anyone, or something. Because I used to be bothered by daily insignificant things, too! I’m just so happy to not be that person anymore, to have inner joy no matter what, and I want to keep that balance between expressing that happiness about it, but not rubbing it in everyone’s faces. Then again, I only have so much control over how other people interpret what I say, especially when I know my heart is in the right place: Again, balance.

a rainbow at night

Article: Evaluation of in-vitro antibiotic susceptibility of different morphological forms of [Lyme disease]

Source: Evaluation of in-vitro antibiotic susceptibility of different morphological forms of Borrelia burgdorferi

Background: Lyme disease is a tick-borne illness caused by the spirochete Borrelia burgdorferi. Although antibiotic therapy is usually effective early in the disease, relapse may occur when administration of antibiotics is discontinued. Studies have suggested that resistance and recurrence of Lyme disease might be due to formation of different morphological forms of B. burgdorferi, namely round bodies (cysts) and biofilm-like colonies. Better understanding of the effect of antibiotics on all morphological forms of B. burgdorferi is therefore crucial to provide effective therapy for Lyme disease.

Methods:
Three morphological forms of B. burgdorferi (spirochetes, round bodies, and biofilm-like colonies) were generated using novel culture methods. Minimum inhibitory concentration and minimum bactericidal concentration of five antimicrobial agents (doxycycline, amoxicillin, tigecycline, metronidazole, and tinidazole) against spirochetal forms of B. burgdorferi were evaluated using the standard published microdilution technique. The susceptibility of spirochetal and round body forms to the antibiotics was then tested using fluorescent microscopy (BacLight™ viability staining) and dark field microscopy (direct cell counting), and these results were compared with the microdilution technique. Qualitative and quantitative effects of the antibiotics against biofilm-like colonies were assessed using fluorescent microscopy and dark field microscopy, respectively.

Results:
Doxycycline reduced spirochetal structures ~90% but increased the number of round body forms about twofold. Amoxicillin reduced spirochetal forms by ~85%–90% and round body forms by ~68%, while treatment with metronidazole led to reduction of spirochetal structures by ~90% and round body forms by ~80%. Tigecycline and tinidazole treatment reduced both spirochetal and round body forms by ~80%–90%. When quantitative effects on biofilm-like colonies were evaluated, the five antibiotics reduced formation of these colonies by only 30%–55%. In terms of qualitative effects, only tinidazole reduced viable organisms by ~90%. Following treatment with the other antibiotics, viable organisms were detected in 70%–85% of the biofilm-like colonies.

Conclusion: Antibiotics have varying effects on the different morphological forms of B. burgdorferi. Persistence of viable organisms in round body forms and biofilm-like colonies may explain treatment failure and persistent symptoms following antibiotic therapy of Lyme disease. (Emphasis Added.)

Read as (what us “Lymies” have known for years): The bacteria change forms to evade the different classes of antibiotics, and none of the antibiotics they researched had greater than a 55% success rate at eradicating Lyme disease’s biofilm form. Rifampin supposedly treats the cyst form, I wonder why they didn’t test that? Granted, all of this was done in-vitro, and sometimes things react differently when in the human body.

First off, I have to say this makes me feel very good about my LLMD suggesting that I go on Tindamax after the Rifampin! If the Rifampin is killing the round/cyst form right now, and this study shows that Tindamax (tinidazole) eliminated up to 90% of both forms of the Lyme bacteria… Goodness, I could be cured at that rate! (Well, unless they’re making biofilms… The jury is still out on how to completely get rid of those.) I’m also impressed that tinidazole kills even more than its close-cousin Flagyl (metronidazole), because we all know how well Flagyl works for neuroborreliosis. From what I’ve looked at, Tindamax also has less side effects.

At first I was shocked to read Doxycycline actually increased the round/cyst form of the Lyme bacteria, but then I remembered Doxycycline does not kill, it only stops the replication process. So if the bacteria cannot reproduce one way, they will just morph and produce in whatever way enables them to survive. This study actually proves that.

I think this study was much-needed, and even a bit groundbreaking, if you ask me. But shhhh, “chronic Lyme doesn’t exist,” you know…

a rainbow at night

[ETA: This makes more sense today, so I had to edit a few things. I got confused into thinking that the biofilm and cyst form were the same thing, but now I remember from the Under Our Skin documentary that the biofilms are those little clusters of spirochetes stuck together in that gel-like substance. You can go here to read further explanation.]

Slowly but Surely: The Beginnings of Improvement, and Adding Azithromycin

…I think the pieces are coming together. I had several “episodes” since I last posted, and.. let’s be clear, that by “episodes,” I mean the thing that happens when my face and tongue go numb, my arms (or arm) goes numb, I shake and temporarily cannot swallow, which may or may not be precipitated by an urge to urinate. I’ve had lots of different types of numbness over the past several weeks, so I felt a need to clarify.

I eliminated several other things that had any timing whatsoever to do with these attacks and/or Migraines: Ensure, BOOST High Protein shakes, things with Vinegar, things with nitrates, caffeine, black tea (even decaf), coffee (even decaf), Truvia, Splenda, and Aspartame (which is the devil anyway).

Because anything and everything can give me a Migraine attack these days. I had something marinated in apple cider vinegar and my body had a general meltdown. I had green olives with half a protein shake and had another “episode” almost immediately, so I can’t tell which was the culprit. But, having done all this, I actually haven’t had a Migraine in two days. I can’t believe that’s an accomplishment, but I’d been getting them every day, otherwise. I even left the house yesterday, and didn’t get one! And in the mornings, I don’t have much numbness in my arms and face, but I can’t yet determine if it’s the absence of Truvia or just a well-timed symptom. I’m scared to find out the hard way, right now. The general battle is finding out what cluster of symptoms is the bartonella, what cluster has to do with my Migraines, and how do we prevent them both. One interesting thing though: It happened this morning, and I hadn’t any Truvia, or any.. anything! Which means it can’t be purely the Truvia, despite me having a decrease in overall numbness since ceasing it. (And there’s the kicker. None of this is purely anything, but it seems to be a lot of stuff happening wrong at the right time. Which is another characteristic of my Migraines: They don’t happen until a lot of triggers add up, and then just one more will push it over the edge.) Now, what affects me worse in the mornings? Bartonella. So, which is it? My conundrum should be apparent.


My LLMD put me back on Rifampin as of the 17th since I didn’t have anything crazy happen after a month and a half on it. Then, instead of adding Doxycycline, which is driving me out of my mind with its effects and herxing and messing with my throat/vague nerve, we’re adding the Zithro! I’m pleased to report I can handle all temperatures of food and drink and have no trouble with food texture. :D I’m on just 250mg, but considering this lowest dose still makes me feel like I have the flu every evening, I’m glad we’re starting so small. I’m still on a normal dosage of Rifampin and therefore we’re killing the bartonella at a reliable level, so that’s great news for me. I will still improve at a fairly decent rate, and can expect a change in ability levels within just a few months. I’m also lucky to not have developed any reaction to Rifampin, which can happen when you stop and have to start it again. It’s apparently still working as well, because the bartonella flare I had after I restarted it (which happened to be the next day) was insane. As in, curled up in a fetal position in a dark corner of my room, sobbing hysterically, not knowing what’s going on, or even how I got there, insane. So… We definitely have to kill them bugs. Kill them dead. (This goes in the category of “things I’d never admit did I not know they happened to most people with chronic bartonella.”)


The Topamax is amazing and I’m at the full 25mg right now. My Migraines… Well, I’ve had them a long time. So I can identify when they’re coming on, but lately they have been so complex, it’s ridiculous. Usually, my migraines affect the right side of my face, with numbness and pain and temporary facial unresponsiveness; my speech slurs and I cannot tolerate any sound or light. Bartonella attacks the right side of my face too, though. :\ This recent development where my arm goes numb and my tongue goes numb? It’s anyone guess whether that’s part of a Migraine or part of a bartonella flare or herx. (It’s sometimes accompanied by this “zap” sensation as well, which I’ve never felt as part of any Migraine.) But after searching LymeNet I found out that other people with bartonella are experiencing numb tongue accompanied by numb arms. How strange is that?! One thread even talked about the general numbness that’s been creeping up on me since I started the Rifampin! And on that note, twice after taking Rifampin this time around, I couldn’t feel my legs, and all of my limbs generally have that “fallen alseep” feeling at various parts of the day now. Especially at night, when I wake up and notice my limbs are cold and numb. That’s a bit scary, but as long as the sensation returns, I can deal with it. So! The mystery of the random arm numbness and terrible headaches that often precipitated them, may be solved! My severely increased Migraines may just be an unfortunate consequence of treating bartonella. If this is true, then it makes sense why they gradually got worse throughout treatment.

In general, the “episodes” and my migraines are getting less severe and less frequent. I still have trouble when I eat sometimes, however. (Things that HAVEN’T been happening, barely at all? No dystonia, no air hunger, and no troubles with low oxygen.) I will be sticking to this “Migraine diet” until I feel safe enough to come off of it. The Ensure drinks are once again off-limits, but that’s okay because my appetite is very healthy and I’m not losing weight! I’ve been gradually adding back my supplements and herbs as well, and I’m able to tolerate them again. I’ve actually been walking around more in the past few days than I have.. possibly since January, which is amazing. As long as I don’t overdo it, I think I’m finally at a stable point again. I’m not tired, so I’m having to force myself to rest and not do more than is necessary, which is.. well, it’s annoying. It’s like sitting a healthy person in front of an amusement park with unlimited tickets and telling them they can’t get up. :| But if I’m good now, in the future I shall be able to be active without dire consequences, so I must be patient. God’s given me the best opportunity for having rest, so I need to take advantage of it. On the scale right now I’d say I’m at, 20% physical, 30% cognitive, and still 7% symptom severity. The symptom severity is definitely the worst part of this right now. They are still terrible and flare so easily, but I do have a lot more cognitive functioning so I can at least use my brain more. :)


I saw my primary physician. I had to update her on everything that’s happened during the past three months. She says not to be too worried with the brain lesion unless it changes…which is good advice, right? It’s there, it’s done; it’s if it changes that will be cause for concern. She also wants me to see another cardiologist in case something else is contributing to the mitral regurgitation. Which is, again, sound advice. Just because I have things that affect my heart doesn’t mean nothing else can be going on. So for peace of mind, my mother is taking me to one Tuesday to get a bunch of tests run, just to make sure there’s nothing there we can potentially fix.

I’ve had the same doctor for ten years. She’s seen me from the moment I started going downhill, and through the M.E., and through the remission, and then through the relapse and these infections… So her advice means more to me than any other doctor. She briefly mentioned to me something that.. sort of startled me, in a strange way. She said something to the effect of:

“I know you’re at a race against time to treat these infections, but you know, even in cancer patients, if the chemo is going to end up killing them… Sometimes it’s wise to just let things take their course, if the treatment is going to be just as bad or worse than the disease, so I really hope you can get on something that will work, soon, because it pains me to see you continuously going downhill like this.”

Hearing her say that just sort of drove everything home for me, I think. These past three weeks–goodness, nearly a month!–since ‘all of that’ happened, have just been one big blur and me taking it one hour to the next, to not upset the delicate balance that my body is struggling to maintain. Consciously I do realize what I’m up against, but there’s something about talking to your doctor for twenty minutes and having her sum it up all into that

It was never a surprise that things might get this bad. Even in my old journal from the past year, I found where I’d written things like this:

December 5, 2009
“Two weeks ago I couldn’t make it down my hallway. Tonight I shuffled around in the yard, and made a snowman. No, I wasn’t exactly running around, but I was STANDING UP and doing so for more than two minutes…
I’m making this post now because if what I feel right now is any comparison, tomorrow is really going to suck. No one wanted to come out in the yard and make a snowman with me. They walked outside for a minute then watched from the door as I shuffled about, but… Hell, I have no idea what condition I’ll be in next time it snows, especially if that’s a year from now. I could be better, yes, I hope, but I could very well be bedbound yet again, or worse; anyone faces these risks for some reason or another, but that knowledge is always in my mind because of.. you know.”

I guess it’s sort of like when everything tumbled in July of 2010, and I ended up living with family again, barely having a spare moment to think because things had reached a new level of bad and it all happened so fast… It just happened again, I guess. And now I’m realizing it. (Granted, I’m back on my olive leaf extract, so I’m much more “aware” of everything again!) But somehow–and the media doesn’t help–you just imagine that with enough determination you won’t “let” yourself get this sick. Ahaha. Like it’s a choice…

a rainbow at night

Three ER Visits and a Hospital Stay: What Happened

In case anyone was wondering why I haven’t been around, it’s because I’ve been in the hospital. If you’re on my Facebook or Twitter then you already know this. I went to ER three times in less than 24 hours, so they eventually kept me. I was there from Sunday night (Feb 27th) to Friday (Mar 4th) from these “episodes” that acted like seizures, but weren’t. The antibiotics didn’t technically cause it, i.e. it wasn’t an adverse reaction, but the medicine killing the bacteria definitely woke something up, so everything entered into a sort of revolt and my body–particularly my nervous system–could not cope. I talked to my LLMD from the hospital, and he told me to stop all Rifampin and Doxy for two weeks, only using the Doxy to avoid another emergency room trip. (You cannot stop bartonella treatment “cold turkey” because THAT can land you in the hospital, as it has for me in the past.)

My body has been fighting a lot of things these past two weeks. In addition to what I already had, my labs suggested an unidentified virus lurking, for which I can do nothing right now; I’m anemic because of the infections that I can’t treat; my blood sugar has been high (because of stress reaction I think);  and I haven’t been absorbing proper nutrition OR essential vitamins, yet I’ve also been unable to handle my nutritional shakes, so it seems inevitable that I will lose more weight. When everything else went south, my liver decided it couldn’t deal with my antibiotics, either. However my body also cannot cope withOUT the antibiotics either, since bartonella comes back with a fierce vengence in a very small amount of time, so I may very likely end up in the hospital this weekend if things take a wrong turn. All I can do is pulse the Doxy on Saturday and Sunday, and hope for the best. I’ve officially run into a treatment failure, despite us being so careful to avoid it. I’ve been very, very ill and unable to handle ANY of my medicine, even my herbs. Things got.. pretty bad.

You know, I really should be more specific in my prayers. Like, instead of asking to “make it to Saturday” without an ER visit, I probably should have extended that to the whole weekend! Because leave it to me to feel in the clear on Saturday, and then end up in the hospital on Sunday!

I guess it all started Saturday evening/night, February 26th. I watched a lot of TV, including two movies without pause, which doesn’t sound like much, but for someone with M.E., watching four-five hours of straight television and actually paying attention? That’s a lot of energy. Too bad it doesn’t affect me then and there. It was fun, and worth it, but I should have rested after that. I didn’t.

So the next day a lot of bad things came together:

  1. The relapse from the previous night began hitting me.
  2. Doxycycline takes 10 days to build up to its highest levels in your nervous system, and it was day ten.
  3. I had a small argument with my mother which stressed me out further and I am not supposed to get stressed out.
  4. I overexerted further: I just wanted to lie down in the living room and watch two movies with my family… I didn’t think it’d get me as sick as it did.

So by 7pm Sunday, I was sick as a dog (why do people say that?), herxing severely, having a Migraine, and I guess my nervous system just.. had enough. I had been having severe tremors all day, but then my muscles began spasming and going numb interchangeably. I went to my mother’s room for safety. She looked at me and immediately started making a list of my current medications for the hospital staff. (Mother-premonition?) I then proceeded to have this seizure-like episode of my limbs going numb, my tongue going numb, an inability to swallow (though I could breathe all right), and uncontrollable convulsions. My stomach felt this “rising” sensation and my speech was slurred whenever I did try to talk. This happened three times between Sunday night and Monday evening, so by the third ambulance trip, and me failing the Pronator Drift test (a neuro test, indicating a upper motor neuron lesion) they kept me.

“It” proceeded to happen again that night, twice on Tuesday, and once on Wednesday. I was discharged from the hospital Friday morning (4th) and I had a minor attack that evening. Then another minor attack on Monday, and one on Tuesday (the 8th). They were getting less severe and.. more Migraine-like than seizure-like, but then I had another bad attack two days ago on Wednesday, complete with a few minutes of convulsions. :\ But for the most part, instead of full-on convulsions I get some muscle twitching, and the “main event” is now a tingling sensation in my stomach and chest, abrupt numbness of my arms, neck, face, jaw, tongue, all mostly on the right side, and sudden slurred speech. (I still suspect some nerve around there is really messed up, perhaps that vagus nerve that has been giving me so much trouble recently.)

There are some very odd happenings that make it nearly impossible to find the true cause. I’m not sure there is just one, really. The first time it happened after drinking an Ensure; the second after taking Rifampin; the third after eating a hamburger; the fourth after eating again; the fifth after an Ensure; the sixth-thru-whatever numbers were correlated with either Ensure drinks or Migraines. In fact I’ve had a Migraine on.. Sunday (Feb 27th), Tuesday, Thursday, Tuesday (Mar 8th), and yesterday. Also, during the first three episodes, I really, really had to pee before it happened. Like, an abnormal amount, but I wasn’t drinking that much, so it didn’t make any sense. Nothing makes any sense, besides my nervous system just went into some type of overload/failure. I’m sure the exertion worsened it, as did the antibiotics/herxing, and for a time I developed the same sensitivity to Ensure as I have to daily multivitamins. I cannot take vitamins because they cause this unusual, terrible reaction where I become in a paralytic-like state for about 8 hours. And because of the number of times this happened shortly after drinking an Ensure–even though I’ve been drinking them for weeks and it helped me stop losing weight–it looks like I’m having a similar reaction to the nutrition in them, after a certain point. But why it happened after I ate? I have no idea. And why did I have to pee so badly before them? What the hell?

I’ve had intermittent arm numbness since I started antibiotics, which I’ve mentioned on here repeatedly. (And oddly enough, it was in conjuction or following severe headaches, remember? They didn’t seem like Migraines at the time, but now, I wonder…) So the antibiotics woke something up, I guess. And I also mentioned here, I’ve had increasing trouble swallowing for the past four weeks, which made it impossible to eat a lot of things. It cumulated into a full inability to initiate swallowing last Tuesday, and it was pretty scary for a while. I didn’t want to end up with a feeding tube. :( Other things of possible note are my more frequent arrhythmias and tachycardia, which annoyingly never happened during any of the three times they checked my heart rhythms! But they did run a LOT of tests of me, over twenty-five. Included was an EEG, and the results would insinuate I’m not having seizures, but the sad part is, you can still have seizures and have a normal test result. :\ So. Yeah. They ultimately found:

  • I have a rotated kidney! This has been present since birth and poses me no problem.
  • I now have moderate mitral regurgitation in my heart.
  • A spot on my brain, which made me very, very angry.

Because I’ve had three MRIs in the past two years. Three MRIs. I’ve had this lesion in my brain during the last THREE scans of my brain, and no one said anything about it! It wasn’t on my 2003 MRI, but it’s been there since at least 2009, and has gotten “minimally more prominent.” I got Lyme in 2006, and both Bartonella and Mycoplasma in 2008 (when my neuro symptoms really took off) so my best assumption is, they did it.

But speaking of brains, they had me see a shrink to make sure I wasn’t just causing these problems out of anxiety. And I can’t really blame them–my doctor mainly wanted to make sure anxiety wasn’t worsening my problems–because truly my symptoms were very anxiety-like; if I didn’t know me, I would have made the same assumption. But as you can imagine, the results of that were, “She’s sane,” which is the SECOND time I’ve had to see a psychologist to prove to my doctors I’m not just a stressed out female… So maybe now they’ll leave that alone?! An interesting fact, though: The psychologist knew what Rifampin was because he has two other patients who have been off and on antibiotics for Lyme and coinfections. You know, in this state where I live, where Lyme supposedly doesn’t exist? Just like the two patients my infectious disease doctor treated here? Yeah…

The area of my brain with the lesion is the Pons, which is part of the Brain Stem. All of your brain is important but that.. is.. very important. It’s the part that allows communication between the your brain and spinal cord, i.e., any signal your body gets or receives has to pass through it. Wiki says the Pons is about 2.5cm in length, so the fact that this “spot” I have is 1cm itself… A little frightening, that. It could have been caused by a particularly bad Migraine, but.. then why is it getting any bigger at all? Or if it’s demyelination caused by an infection, it’ll just be there forever. If it’s actually a Lyme cyst, it could disappear with antibiotic treatment, because it’s not nerve damage as much as it is a bundle of bacteria that appears as a lesion on an MRI. The worse case scenario is that these infections have triggered multiple sclerosis (MS), which Lyme, Bartonella, and Mycoplasma pneumoniae are all capable of doing. And truth be told, the spot is more MS-like than Lyme-like. But. That scenario seems less likely, because MS doesn’t improve on antibiotics; I did.

As for the valve regurgitation… Well, I guess I expected as much. MVR generally gets worse over time, so it’s a little scary that it went from mild to moderate in just a year and a half, but… I guess when you look at what’s currently happening, and also with me being unable to treat the bartonella for almost a year (bartonella really likes the heart), it’s not that shocking. As if having M.E. wasn’t enough of a predisposition to heart failure, this does not help.

I’ve been working on this entry since Tuesday, so maybe in another few days (hopefully sooner!) I’ll try to make a post about what’s happening now. Until then, wish me luck with my antibiotic pulse, that it’s enough to keep me from the ER! I’m sure they’re very sick of me by now!

a rainbow at night

[Note, Nov 17, 2011: Further developments as to what happened can be found in subsequent posts, or by clicking the “pings” (posts where I referenced this one) below. These attacks were eventually proven to be neuropathy of my vagus nerve.]

Symptom recap in the middle of my “Lyme week” (treatment update)

Let’s see. What do I need to update about… Ah, who am I kidding, this is going to be one big ramble!

I’ve been re-tagging my primary blog, the one that used to serve as my health diary until I decided to switch all those things to here and make it public instead of invite-only. That old one is still so useful to me. What’s even more useful are my daily symptom charts… But they are so taxing to fill out, I stopped doing them out after just one week on antibiotics. I used to be able to, but this time around it’s just impossible to keep up.

My intestines are no longer giving me any problem, so whatever was happening has resolved itself. I’m having daily air hunger ever since my Lyme flare started, and in fact, after skimming through my entire prior blog the past two weeks, I’ve realized my air hunger nearly always coincides with my Lyme flares (that may or may not be distinguishable from the mycoplasma pneumonia; I have yet to figure out if that infection has a pattern or not). Nonetheless I am in my typical Lyme week, and having air hunger. I am slighlty comforted by this, because it makes it less likely that this is happening because of babesiosis, something that I don’t think I have but won’t really know until we get rid of these other things. Also, I’ve realized repeatedly that oxygen does not help air hunger. It only makes it slightly less severe, but unlike for normal shortness/gasping of breath, it doesn’t truly relieve it. There must be some neurological component to it, I think, because my vagus nerve is also experiencing problems for the past several days. This happened in responsed to treatment last time as well.

For some reason Lyme disease have an affinity for the facial nerves (most commonly presented as bell’s palsy), I suspect because they are the closest connection to the brain, where the bacteria primarily reside. Except for the vagus nerve, that is, which not only goes from the brain to the face, but all the way to.. your stomach, I believe? It controls things such as heart rate, blood pressure, and gag reflex, and reacts to temperature changes. (Recall the term “vasovagal syncope”?) The last time I was in treatment I became unable to drink anything cold for three months–even water had to be heated to room temperature! And I was consistently nauseated for a very long time, which was only alleviated by an anticholinergic that happened to be used to treat a hyper vagus nerve. So now, something of that sort is happening again, and I’m unable to swallow a lot of my pills. There is a lot of synchrony involved in swallowing, and things just aren’t lining up. Either I just can’t initate the action, or I do manage to swallow but my throat spasms halfway through, or I for SOME reason try to BREATHE in the middle of it, which has forced me to hold my nose so that I don’t sporadically inhale! ‘Tis not been pleasant, to say the least.

My temperature made a spike to 99.6 on Thursday when I began taking my antibiotics at regular intervals (Rifampin 300mg + Doxycycline 100mg, both twice a day), and after that,  it went down to 98.9…where it has stayed ever since. Every now and again it’ll go to 99.2, and then drop back down to 98.9. Then maybe another slight jump, and back down. But it basically hasn’t changed: Before I go to bed it’s 98.9, when I wake up it’s 98.9, when I take it at random intervals, it’s 98.9. I’ve tried two thermometer and even asked my mother to be a control subject (98.2 for her), so it’s definitely something within me. It can’t be my menses because you still experience a normal temperature fluctuation, just with a higher baseline. I.. have no fluctuation, except for small spike after I take my antibiotics! But I’m almost a little glad about this because when your temperature lowers is when the bacteria can most-easily replicate. Maybe now that I’m on Doxycycline, whose (haha I speak as if it’s a person) entire purpose is to stop bacteria from replicating… Yeah.

I found out Rifampin can lower your Vitamin D levels, so I’m glad I take extra Vitamin D every day anyway. :|

…OH. Another thing bothering me more and more is food texture. Right now my diet subsists almost entirely of whole grains, raw fruit and vegetables, eggs, and Ensure drinks. Occasionally I eat chicken.

All things considered I think I’m dealing pretty well being on both antibiotics… Ah, well, of course I have excruitating headaches come nightfall (Lortab-requiring) but that’s a given. Headaches are my most prominent infection symptom and my most prominent herx reaction. I’m not having as much blatant dystonia lately as I am more parkinsonism symptoms. (I qualify so closely for a diagnosis of a “dystonia plus syndrome” I’ve actually considered getting evaluated by a movement disorder specialist to see if I’m showing signs of anything genetic; my dystonia first appeared in my left foot about four or five years ago.) But yes, recently there is more trouble with tremors, difficult initating and stopping movement, freezing movements, slow movements. Again, my facial spasms have died down. I still have the head shaking, but not as severe. I’m currently trying to determine whether it’s my neck or if I’m having nystagmus, which is where your eyes move and your head shakes to compensate. I know my left eye dances and has a mind of its own, especially during Lyme flares… So that may be it. Whatever the origin, it’s not as severe. My feet are beginning to hurt again… Is it time for a bartonella flare soon?

Speaking of which, I’m concerned for the end of this month again. Maybe not this next one, but the one after it, the dreaded “bartonella flare after the Lyme flare” that’s been repeatedly responsible for trying to hospitalize me. I’m only concerned because the chance of it happening becomes more frequent when I have stabbing lung pains (I’ve had pleurisy twice in the past eight months) and air hunger in the week prior… Both of which I’ve had this week. I’ve previously speculated that the mycoplasma might have something to do with it, too, since this happens every other month and mycoplasma replicate very slowly… But we’ll see. I haven’t been coughing yet–… Oh, wait. Yes, I have been, a lot… Ah, crap. :|

Well, hoping this is all just herxing and nothing akin to an ominous sign…! (If I start having random allergies and chest pain, then I’ll begin to worry.)

Oh, but speaking of headaches (which was a couple of paragraphs ago I think), since I’ve needed Lortabs nightly and had no arm numbness, I think that kills the medication-reaction theory about my arms randomly going numb.

My legs have been weak, but again, Lyme, so there’s nothing too unusual there; just need to mention it. I’m having arrhythmias as well but after repeatedly mentioning it during Lyme flares, I think it’s the cause of those, too…

And this concludes my recap of the symptoms I’m currently experiencing. :)

a rainbow at night

Lyme lyme lyme: An insane day of flaring

I awoke at eleven in the morning and went back to sleep. My father brought me coffee at noon. :) I “got up” (read as: halfway sat up, turned on my stereo, and stayed awake) because I had to take my Rifampin, having taken my Doxycycline dose an hour earlier. I did take my Rifampin, and… WOW. I could not have had a worse “Lyme day.” I may as well have been a spirochete! I am most definitely beginning my Lyme week. (Note: My Lyme week is what I call the time of month where the bugs are replicating and/or cause me worse symptoms for about 3-4 days.)

It started with a “head shake tremor” (and no that’s not a clinical term), or, the thing where it’s as if you are slightly shaking your head to tell someone “no,” but it happens on its own.

Then I started to have tremors in my limbs, as well. Visible tremors, not just the “internal tremor”/buzzing sensation so common in Lyme disease.

About twenty minutes after that, I had progressed into full-blown movement disorder mode, complete with more violent head shaking (which was more of a whipping back and forth at this point), “hand curling” (as a lot of us Lymies call it), and dystonia of various parts of my body; all on the left side, as per usual. Also as usual–and I only admit to this because it is a documented thing with dystonia–touching the back of my neck gave a momentary reprieve from the dystonia-related things. Ironically, my face wasn’t too involved this time, so not much involuntary grimacing.

This went on for quite a while–two hours, at least–but I’ve been doing this all day. The tremors have died dow, but my head and neck still have a mind of their own. I’ve made a few attempts to walk, but my left leg just drags because it freezes up. Or, on that one occasion, it went into the air all by itself! (I know you fellow Lymies know what I’m talking about!!)

About four hours after all of that, the pain started. Headache. Numbness in face. Various pain meds to counter it: didn’t work. Ended up taking half a Lortab, and once again got the effect of being less sick in general. Thank God. So there I was, headache thoroughly medicated, plugged up to my supplemental oxygen via my new 25 ft cord, sitting up in my wheelchair, and tidying things up around my room. Because tomorrow I start my full dose of Doxycycline! I’m both excited and nervous, but my mother found some sparklers for me! ;) I told her I wanted balloons again, to thoroughly celebrate starting “phase two” of my treatment–hell, to celebrate that I even made it to phase two of treatment!–as, God willing, this will be the regimen I’ll be on for the next five months. After that, I’m going OUT to celebrate!!!

What I can’t figure out, though, is why a bartonella-specific antibiotic accelerated my Lyme symptoms? Rifampin doesn’t have active killing-properties against Lyme, but my LLMD did say it works on the cystic form; i.e., it causes those latent tiger-in-waiting Lyme cysts to open up.

Or maybe this was just an especially potent herxheimer reaction because my bartonella flare was only yesterday. I also sometimes wonder, since Rifampin is also treating my Mycoplasma pneumoniae and myco symptoms can be insanely similar to Lyme disease–even down to similar replication cycles–if some of this is a mycoplasma herx. Or maybe it’s both. That might explain the severity, yes? (Doxycycline is also a primary treatment for Mycoplasma.)

Today I have had a lot of air hunger. I feel a constant need to yawn. It rarely helps. Fever. My back hurts. My legs shake when I try to walk to the restroom…which would concern me, but, Lyme week and all, right? Oh, and I remember mentioning to someone that yesterday my shins were hurting? My feet also began to hurt, all night. Today they are all right, and although my shins were still a little achy earlier in the day, they do not hurt anymore. I’m having arm numbness, and I’ve noticed whenever I have severe headaches, the numbness comes with it, so there’s that. Is it tomorrow yet?

a rainbow at night

Dissociation and Moodswings During Treatment for Chronic Bartonellosis

Today has been.. strange. Last night after the Doxy (and something that’s happened the past two nights, actually), I’ve gotten a neck ache and racing thoughts, most of them being paranoid or depressive thoughts. I know it’s because of the antibiotic, for example, before I took it last night I was thinking of how blessed I was to have so many people who care about me and offer their support… And then two hours after the Doxy I was an emotional wreck. I’m glad I’m able to sleep through it… At least until I start the twice-a-day 100mg on Thursday.

When I woke up, I was in a lot of pain (in the neck! haha), so a Fioricet was taken. It has caffeine in it, and so I used that to take a bath before taking my Rifampin at noon. It feels wonderful to be clean, and to have done it myself! A couple of hours later my oxygen became necessary. I got off of it about an hour and a half later, but when I wheeled to the kitchen to fetch myself a bottle of water, by the time I got back I became severely and suddenly exanimate. Like a FOOL I lied in bed for five minutes before realizing that wasn’t going to work, so I plugged in (oxygen) again. I was able to breathe again within minutes. My mother said my color had finally returned, so for another hour and a half I “oxygenated” and had a nice relaxing time… Or at least, I think it was relaxing.

I entered into this mental state of being very aware of my body’s condition, and those are honestly the only words I can think to describe it. I was comfortable, which was nice, and I could breathe, which was very nice, but I was also aware of every pain that entered my body, and every minor twitch. For instance, my shins are hurting today. I feel that I was borderline dissociative, because that type of sudden altered mental status isn’t normal. But again, today there was the strong possibility of a bartonella flare up, and it seems that it did happen, if my need of oxygen and volatile moods (from happy to angry to paranoid, to happy, to…you get the idea) are anything to judge by. I can usually tell the day is going to be “interesting” if I start thinking angry and resentful thoughts first thing upon awakening. That’s so unlike me, in every way, and I immediatley think, “Wow, what is wrong with me?!”

I got a migraine yesterday, but forgot to mention. It was the first I’ve had in a couple of weeks, I think…! Also yesterday evening, I had a temperate of 99.5, but I’m pretty sure that was only due to it being very warm. We had to turn on the air conditioning because I was about to pass out, being unable to handle heat at all. I’m a little depressed that winter is about to end; I hate Spring and Summer with a passion. My Lyme flare should be approaching soon… Not looking forward to that, but hey, I’ll be on Doxy this time so it will help STOP those bacteria that try to reproduce! And that makes me happy. :D

And another bit of good news: The Ensure Clinical shakes I decided to start drinking have helped me to stop losing weight! I haven’t gained any back, but I haven’t lost another two pounds, which is what would have happened, so I’m quite thrilled, really! So if anyone is losing weight because of infectious disease, I would highly recommend them. I’m sending a friend some of thes extra coupons I have (buy 2 get 1 free), so hopefully they will stop losing as well!

I’ll leave you with a picture of my view this evening, as the sun sets outside my window.

This is the time of day I used to sit on my porch with evening coffee, watch the birds fly home and listen to the bats chirp.

a rainbow at night

Small Improvements and My Current Pill Schedule

I’ve been on Rifampin for one month.

Last time I updated, I had just added 100mg of Doxycycline to the mix during the night. The Rifampin dose the next day caused a big herx. I haven’t had that severe a reaction since, which is good. I’ve actually felt relatively (relatively!) okay since then. But I do need to mention something that happened, yet again:

When the excruitating headache started, I needed hydrocodone. I know I’ve mentioned it repeatedly, because nearly EVERY TIME I need this pill I end up having to talk about how I randomly ended up feeling less sick in general, and thus I get excited to try Low Dose Naltrexone (LDN) all over again. My Lyme treatment needs to hurry on up, so in a few months I can start that potential therapy! I think it’s going to be awesome.

I’m seriously wondering whether my feeling so incredibly terrible last week could have been at all influenced by my headaches having temporarily died down from Lortab-level to Fioricet-level, which meant no needing opioids. And there’s that little fact that not only do opioids relieve severe pain, but they also alter the immune system. For instance, long term use of opiates is tied to immunosuppression and a greater risk of infectious disease, even the progression of infectious disease, including AIDS. And yet LDN, which also works with opioid-receptors to upregulate the body’s version of opiates (endorphins), has been shown to slow the progression of AIDS and auto-immune diseases. So really, there’s no telling what all is happening that makes me feel so much better. I just.. once again, really, really hope the improvement I see from opiates can also be given to me by LDN.

Symptom wise, my intestines still hurt. I can’t blame the Doxycycline because it started before I took it. I hope it’s something minor like inflammation or adapting to my new diet changes and that I’m not developing any major problems like a c. difficile infection, which is what WebMD suggested to me when I randomly ran through my symptoms. (Then again, it’s WebMD, which also means I could have a brain tumor, right? Haha.) I’d been having several episodes of intense nausea and motion sickness, but I haven’t had one since Friday night. (Which is unsual… To have your nausea stop when you start taking Doxy. Ha!) In case it starts up again, my anti-nausea ginger gum has arrived, which is amazing stuff. Oh, I also haven’t needed my oxygen since Thursday, either. I still require my wheelchair after taking the Rifampin, but I can get out of it earlier in the day than I had been when I first started it, and in fact yesterday I stood up for several minutes! It felt so strange, but it was nice. I did notice that today’s leg (foot?) dystonia was worse when I did try to walk, so it’s more because of that and POTS that I need it lately, instead of the horrible leg weakness. And.. I’ve had several episodes of arm numbess, which I know I’ve recorded in here before, but I’ve no idea what it’s from. I had it on January 31st that I last wrote down, and then I had it again last night. I think I remember another episode of it between there…

Today I organized my medication/supplement chart that I’ll be working with starting this Thursday.

11am: Coffee (half regular, half decaf)
12pm: Doxycycline 100 mg WITH FOOD; Olive leaf extract 500 mg; Vitamin C 1 gram; Aloe vera gel
1pm: Rifampin 300 mg
3pm: Probiotics; Antifungal (which changes every three days to prevent resistance)
8-10pm (dinner time): Olive leaf extract; Vitamin C; Ubiquinol 100 mg; L-carnitine fumurate 1 gram; Calcium/Magnesium/Vitamin D/Zinc; Vitamin D (extra 400 iu); Aloe vera gel
11pm: Doxycycline 100 mg; Rifampin 300 mg
1am: Probiotic; Antifungal

As far as I can tell, my father will be responsible for bringing me coffee and food to take with the Doxy in the “mornings,” then my mother will be responsible for food in the evenings/night. It’s “only” 22 pills per day, but these are all things I need, so I feel fine about taking them (compared to when I used to be on more that weren’t even guaranteed to lead to any improvement). I also supplement potassium throughout the day in my water, and add a safe amount of iodized salt to everything (including water); I do not know if the cysts on my thyroid stop multiplying because I increased my iodide intake, or because I finally started antibiotics, but I’d hate to stop the iodide supplementation and have them start up again! Time will tell.

a rainbow at night

Is there a right antibiotic for Bartonella?

I officially started the Doxycycline! 100mg last night made me dizzy…which is the first thing any new antibiotic does to me, I’ve learned. After my dose of Rifampin today, I developed tremors, dystonia (in my hands, of all places), facial grimacing, muscle spasms in my back, and a terrible headache with pressure in my skull, just half-an-hour later. Additonal pain medication has made me comfortable, and it’s safe to say this combination is looking to be very effective.

Today the technician came to evaluate my oxygen machine. I had to explain all the strange quirks I have, like why my oxygen reading was normal when he took it, why I change the output fairly often and how my various conditions impact what I require from this thing. I also got a new nasal cannula (the part that you wear on your face) and a 25ft cord so I can enter the bathroom (right around the corner) without having to take off the oxygen. That is going to be very helpful, because up until now I’ve had to practically race to get back to it before I felt faint. (I also have a 50ft cord/tube in case I want to go sit on the couch in the living room, which is just past my hallway!). Ironically I haven’t needed any oxygen yet today, haha.

After some research on bartonella. I’ve found the best way to eradicate it in someone with severe neurological involvement who is also immunocompromised seems to be, Doxycycline 100mg b.i.d. (twice-a-day) and Rifampin 300mg b.i.d. The latter is usually taken once-a-day (q.d.) for several other conditions–which is what I’ve been doing since my LLMD said it was okay–but ideally, the best results are obtained from spacing it out. Some claim that it makes it easier on the person, but given my circumstance, I don’t know. Nonetheless, I’m going to aim to take both the Doxy and Rifampin split into two doses, and see if it causes any candida problems (which is my main fear, besides the herxing). If it does cause problems, I shall try going back to Rifampin 600mg once-a-day and Doxy still 100mg b.i.d., and, if all else fails, I’ll just have to take them both once-a-day.

But of course right now I’m still at 100mg q.d. Doxy, so all of that other stuff begins next week.

The American Society for Microbiology recommends this regimen for at least 6 weeks in healthy individuals, but for longer if that person’s immune system is dysfunctional. They also warn of life-threatening herxheimer reactions in the immunocomprimised. Having already been hospitalized twice for severe reactions to things that shouldn’t have caused such a reaction in “normal” people, it really drives home the need to be very, very careful. *big breath*

Of interesting importance is that only Doxycycline, Rifampin, and Gentamicin have shown true effects against bartonella. This makes me wonder whether other antibiotics simply haven’t been tested enough to know (if you’ve never looked, how would you know?), or if they have been tested, and the others–such as Levaquin and Bactrim–just don’t stand up. I did find one study which claimed because Bartonella can so quickly develop a resistance, quinolone antibiotics (such as Levaquin!) should never be used aginst bartonella species! *gasp* Now doesn’t that blow everything else out of the water? Granted, it’s only one study.

a rainbow at night