True.Originally Posted by trailmercury
In the same way someone who decides not to buy insurance made the “right” choice if he never got sick.
bloodletting persisted as a viable medical treatment for as long as it did because, in part, if the process didnt kill the patient a good many of them, by sheer coincidence, survived and became healthy again.
does that mean the drs who performed bloodletting on them did the right thing?
I have a rock that protects me from tigers. I know it works because I haven't been attacked by a tiger while carrying it.
Phlebotomy is still used in current medicine, look it up sir
Not following you here
FWIW...
I am a family physician in Lyme-heavy Wisconsin, and I do indeed consider myself "Lyme-Literate"
I am very confident in handling tick prevention, tick bites, Lyme prophylaxis, Acute Lyme infection, Lyme sequelae etc etc
The decision to prescribe Doxy (or other antibiotics that kill borrelia) is made on a case by case basis.
folks can PM me with specific questions if desired.
Sounds like something David Avocado Wolfe would sell.
Colorless green ideas sleep furiously.
there is no comparing modern phlebotomy to the ancient practice of bloodletting.
if someone gives you pills to take and you dont get sick that does not mean one can conclude the pills cured anything or that you would have gotten sick if you didnt.
and dont come back at me with "whats the harm of taking the pills just in case?"
how do you feel about giving hikers antibiotics to carry around with them to take if they find a tick attached and afraid it might be carrying lyme?
If a patient came to my clinic and made that request, I would most likely prescribe it after some patient education. Have you had the conversation with your doctor?
My opinion that both patients were treated appropriately won't change.
I never tell patients to take these pills just in case, that's unwise and poor practice.
Here's an article from 17 years ago that addresses that: https://www.nejm.org/doi/full/10.105...00107123450201 If you do a search on PubMed you'll find a lot more that are more recent and come to similar conclusions. So much for being "Lyme literate".
My own physician knows that I participate in a lot of outdoor recreation and suggested that I keep 200 mg of doxycycline in my FA kit in case of an embedded tick. He give me a new script at each annual physical.
nope. no interest in having it either. except perhaps as a way of vetting drs i might like to avoid
yet youd also prescribe them pills that they were to take at their own discretion, as per your other post?
i fail to see the difference.
would you take the doxy for any "embedded tick"?
Given the relative risks and my location in the heart of the Lyme hot spot, yes, I would for a black-legged tick. That said, I've never had to use it as I don't consider it to be a first-line defense because you may never realize that you've been bitten. I take a proactive approach to tick safety by wearing permethrin-treated long pants, long sleeve shirt, hat, socks and shoes. The doxycycline is there for a worst-case scenario.
My internist takes a different approach - that of a partner in healthcare. Instead of taking the "I'm the expert here, so do as I say", we had an intelligent conversation re: the pros and cons, and I came to a decision with his input. That's my decision to make and may not be right for everyone, but a blanket refusal to even talk about it in light of decades of peer-reviewed medical literature showing a benefit really is a disservice to a patient.
I am in agreement that a prophylactic dose of doxycycline is indicated in certain cases.
1. deer tick or tick not identified and
2. attachment time unknown or greater than 24-36 hours.
These folks are more likely to potentially benefit from the prophylaxis.
If a patient can assure me the deer tick was attached less than 36 hours or tick not engorged, (deer tick= ixodes scapularis), they are very unlikely to benefit from the 200 mg doxy.
let's not forget Babesia, Erlichia, Relapsing Fever and Rocky Mountain Spotted Fever as tick borne illness and disease to be aware of. Check the CDC website and talk to your private physician.
Offshore, I wish you the best of health and I'm glad that you are proactive about this important subject. I don't wish to further defend my training/experience/education on a public forum.
the most important post of the thread
make a shared decision with your doctor
they cant assure you of anything. theyre out in the woods carrying the drugs with them to use at their own discretion.
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