Lyme Disease Case Study

Lyme Disease Background

“Lyme disease is a tick borne spirochete bacterial infection that is characterized by a rash in the area of the bite, headache, neck stiffness, chills, fever, myalgia, arthralgia, malaise, fatigue, and possible development of arthritis in large joints” (McCance, Heuther, Brashers, Rote, 2010). Lyme disease’s clinical manifestations occur in three stages: Localized infection, disseminated infection, and late persistent infection. Localized infection occurs shortly after the bite with erythema migrans (rash), fever, fatigue, malaise, myalgias (muscle pain), and arthralgia’s (joint pain). Within days to week the disseminated stage begins and manifests with secondary erythema migran, arthralgias, meningitis, neuritis,

or cardiovascular systems. The late persistent infection continues for years and presents with arthritis, encephalopathy, or polyneuropathy (CDC, 2015). In recent media Lyme disease has been described with a spectrum of details that have not necessarily portrayed the disease in the correct light but also brought out aspects of the disease that need to be considered in the medical field.

Articles in the Media
In recent media, The New York Times published an article titled “To Treat Lyme Disease, Focus on the Co-Infections”. This article goes into detail about how the co-infections from the tick bite can cause chronic illness after the initial treatment of Lyme disease. It explains that “testing for co-infections often go diagnosed” (The New York Times). It also focuses on the fact that the antibiotics that treat Lyme disease do not treat these co-infections which are listed as being mycoplasma, Rocky Mountain spotted fever, Q fever, typhus, and tularemia which also originate from the tic bite. This article focuses on individuals that have residual affects from Lyme disease, and hopes to encourage these people to get tested for the afore-mentioned diseases to appropriately treat the symptoms they are experiencing.
Medically these symptoms have been referred to as Post-Treatment Lyme disease syndrome, and the cause is thought to be that the autoimmune response continues to respond, doing damage to the body’s tissue, even after the infection has been cleared (Marques, 2008). It has also been proven that patients with PTLDS have a high likelihood of getting better with time, showing decreased symptoms over a period of months to years. This article affects occupational therapy because it brings awareness to the fact that Lyme disease can have residual affects but unfortunately relates the cause to co-morbidities only. It allows a different avenue for treatment that could decrease the therapeutic time a person undergoes if co-morbidity is the actual cause but it could also exacerbate the time due to a patient insisting on being treated for something they do not have.
Another recent article was published in the media by People magazine where Avril Lavigne discusses her battle with Lyme disease.

She describes being bedridden for 5 months and how she still currently recovering from symptoms from the disease she contracted a year ago. The magazine article then goes into further detail on how Lyme disease is a bacterial infection that causes symptoms ranging from moderate fatigue and muscle pain to debilitating dementia. It stresses importance on the fact that Lyme disease is “significantly underestimated because of factors including imperfect testing and symptoms similar to those of Parkinson’s, multiple sclerosis, and lupus” (People Magazine, 2015). This article accurately describes some of the symptoms of Lyme disease and accurately discusses how the disease is often overlooked as a diagnosis in individuals. Another article that correlates with People is a recent blog by Yolanda Foster from “Real Housewives of Beverly Hills”, she describes the disease personally stating, “I have lost the ability to read, write, or even watch TV, because I can’t process information or any stimulation for that matter. It feels like someone came in and confiscated my brain and tied my hands behind my back to just watch and see life go by without me participating in it.” These articles describe how impacting Lyme disease can be on an individual’s life and how it can affect their occupations. The demographic for this article include all individuals suffering from Lyme disease and those who may have a possibility of carrying the disease. The impact of the information was to inform the general population of how debilitating this disease can be and to increase knowledge so the disease will not be underestimated in the future. This article has a great impact in the occupational therapy field because it describes how individuals with disease have to put their life on hold and how they might hide themselves from society until they regain their health.

It also discusses some of the disparities the affected individuals might endure while dealing with the disease. It describes an area that occupational therapy can advocate for and it describes areas that are associated with the occupational therapy field. This includes helping patients regain their occupations and activities, educating them on modifications and adaptations that enable them to develop behaviors, habits, and routines specific to alleviating symptoms, and training them on skills that will empower them to keep living their life as independently as possible.

http://www.cdc.gov/lyme/signs_symptoms/index.html. Signs and Symptoms. Published March 4, 2015. Accessed April 4, 2015.

http://www.aldf.com/lyme.shtml#treatment. American Lyme Disease Foundation, Inc. Published January 1, 2006. Updated April 26th, 2010. Retrieved April 4, 2015.

Parsonnet J. Bacterial infection as a cause of cancer. Environmental
Health Perspectives. 1995;103(Suppl 8):263-268.

McCance, K.L., Heuther, S.L., Brashers, V.L., Rote, N.S. Pathophysiology: The Biologic Basis for Disease in Adults and Children. 6th Ed. Maryland Heights, Missouri: Mosby Elsevier; 2010.

Marques, A. (2008). Chronic Lyme Disease: An appraisal. Infectious Disease Clinics of North America, 22(2), 341–360. doi:10.1016/j.idc.2007.12.011