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We have a vaccine for it, but for various regulatory & market reasons it's no longer available

https://www.historyofvaccines.org/content/articles/history-l...

I received a shot of the vaccine when it was available. Unfortunately the projected longevity of the immunity conferred was only 3-5 years. By the time that period had passed for me the vaccine was no longer available.

> There is no evidence to suggest that the Lyme disease vaccine ever caused Lyme arthritis, but it was taken off the market largely in response to lawsuits alleging exactly that.

Your dog can get a vaccine but you can't.

https://www.pbs.org/newshour/show/dogs-can-get-lyme-disease-...

...is this surprising or unusual to you?

> So, don't be a fool like me: if you get a tick, go immediately to the doctor and get it sorted. Trust me the symptoms are just awful.

I'm glad to hear you're on your way to a full recovery given the severity of Lyme.

Your advice to "go immediately to the doctor" is not only important with regard to ticks but to all manner of infection. Most infections have similar symptoms and distinguishing between something discomforting and something deadly is a matter for a health care professional.

Stoicism with regard to maladies is practically a cliché among strong-willed people (men especially). Always consult a doctor with unusual infections, and seemingly usual ones, too, if you can.

If you remove a tick within a few hours you're likely to be fine especially if you don't see the telltale red circular rash.

Running to the doctor for non-issues is part of why our medical costs have increased so much the last few years. There's so much marketing to "ask your doctor" about this and that and the other thing these days. And when you go, of course the doctor is obligated to run a battery of tests to cover his ass.

Yeah, Lyme disease is not a "non-issue", it is an issue, and a serious one, and you don't wanna fuck with it.

So, learn to spot the symptoms, and go get it sorted with a doctor. Like you would with any parasite.

Depending on what part of the country/world you're in, there's also a wide variety of tick-borne illnesses with very scary mortality rates if untreated.

I didn't say anything that conflicts with this. If you have symptoms of Lyme, such as the circular red rash, definitely get it checked out.

Rentier syndrome and fraud has more to do with high healthcare costs than utilization.

Unfortunately there is not always a rash present and even if there is one it's not always the bullseye rash. The other early symptoms are feeling like you have the flu, fever, and being tired. So it can sometimes be hard to catch early on your own.

You are correct in that the longer a tick is attached the more likely you are to get Lyme. Mayo Clinic says it's unlikely to happen if it'as attached less than 36-48 hours. But some of the ones that can give you Lyme are about the size of a poppyseed and you don't notice them right away. You should always check for ticks after being outside and remove them ASAP.

More info on what to do: https://www.uptodate.com/contents/what-to-do-after-a-tick-bi...

I'd like to think that the reason I don't see a doctor is because I'm tough and stoci, but mostly I don't go because:

a) I have no primary care physician because I don't typicaly go to the doc for any reason

b) although I can afford insurance, it has an insanely high deductible and is very difficult to predict what I will be charged for

c) going to the doctor involves triggering an expensive and difficult to predict system that will possibly bankrupt me.

So I (like a lot of folks) don't go unless there is either an obvious emergency or a horrible, hard to live with long term problem.

So yeah, the advice is probably good, but the reason that I don't tend to take it has little to do with my willpower.

> a) I have no primary care physician because I don't typicaly go to the doc for any reason

This is circular... you saying you don't go to the doctor because you have no PCP, and you don't have a PCP because you don't go to the doctor

> c) going to the doctor involves triggering an expensive and difficult to predict system that will possibly bankrupt me.

I'm having a hard time believing that a standard outpatient visit would bankrupt you. These are typically on the order of $100, and rarely more than a few hundred unless you're going in for specialized procedures, which you've already established you aren't.

Sure, if you go to the doctor, you might find out you have a more serious condition that would require future, longer-term care to address, and that future care may involve additional expenses and inpatient care which you may or may not be able to afford. But that's hardly a reason not to go to the doctor today and find out - at least you'd be able to make that decision on an informed basis.

Having grown up in India, even after I've spent almost my entire adult life in the US, I'm still reluctant to go the doctor here.

In India, the process is very simple: you call the doctor in the morning, you get an appointment for the afternoon, you show up, get looked at, pay the cost of the visit (usually less than $10-15), and you're done. It's basically like any other business transaction. So even if I had a minor seeming infection, going to the doctor was the right and efficient move.

Here, I call the doctor's office, and might not get an appointment for another two months, if I'm lucky. At that point there is some opaque process involving my insurance, and it just seems like a much weightier event than a simple visit should be.

Of course, I'm guessing that an infection would speed up the process, but the psychological barrier is already up in my mind, and I'd rather just power through on my own.

But there seems to be some hope. Recently, my wife was able to go to an urgent care clinic to treat an infection, and the process was much more like what happens in India. Still, there is some intervention of insurance, though a bit more transparently so.

As I'm sure you know, there are urgent care clinics everywhere in the USA for minor ailments and injuries, where you can be seen on a walk-in basis and pay cash if you want to.

When my kid dislocated his hip, I took him to an urgent care clinic, and the process was similar.

They did refer me to an orthopedist and I ended up being out about $450 dollars after they looked at an some imaging and decided it was a growing pain.

That was with insurance, but hey, not wholly unpredictable and because there was nothing treatable I wasn't bankrupted.

A standard office visit tends to be about $100 in my area, sure. That'll get me to talk to the doctor. But if I want to test for Lyme that's a blood test. Now the lab is involved, they may or may not have their own billing department and they won't tell me for anything how much or even ballpark estimate of what it will cost so that they are covered if they need to do more.

So I talk to the doctor and they say XYZ tests need to be run. Okay, now I know what I need exactly and get a price, right? Nope. I just get the run around and "It depends on the insurance" and "We will bill you later" and "No it's probably not $5000" and straight up "I don't know"

Oh, okay, so I need to call the insurance company then, huh? Nope, they won't tell me either. I've tried. They just say "It depends". Even when I know exactly what labs they are going to run. I can say "I understand it might change if they need to run more tests." Nope. No idea.

Sometimes they can give you a straight answer but very often they will not.

It's hidden on purpose. It is confusing on purpose. Insurance companies don't want you to know what's going on. The doctors offices don't want to share "cash-only" info publicly because insurance companies will demand that price. The insurance companies don't want to share the info because people will complain. Etc etc it is not that easy when you go to the doctor for more than the really simple things.

As to the circularity of my first point, without a PCP and no proximate cause, the wait time and cost is.... difficult to predict. With a PCP it is better, but because I don't go to the doctor I don't have a PCP.

Health care in the US is fucked!

I am a man that often avoids going to the doctor, but it isn't out of any level of machismo (I could be deluding myself). Rather, I've had a lifetime of experiences demonstrating that doctors could do nothing for me time and time again.

Not necessarily their fault (medical science is trying to debug a program that you don't have the code for, do not control/know all of the inputs to, and you risk killing them if it crashes) but they've failed me time and time again in diagnosis, effectiveness, and availability, and in the US they were a financial burden until I was fortunate enough to reach the point my budget could take a hit.

This has built a habit of assuming that if I'm not in intense pain, visiting a doctor would be a waste of time and money.

I got pneumonia once. When the cough seemed serious I asked for an appt, but it took several days and by the day of I was struggling to breathe. Ended up going to an urgent care clinic hours before my appt because I was genuinely worried I wouldn't make it to said appt if I waited. The clinic agreed, given that as I walked in to their crowded lobby they heard me rasping and bumped me to the head of the line. I had four people on me at once, giving me oxygen, taking vitals, and one entering the numbers into their computer. I could see the screen, and saw that a few entries triggered a "the number indicates a critical problem, is it accurate?" warnings. They told me later that at 1 percent lower oxygen (i was 92%, which apparently low) they would have sent me to the emergency room. I'm glad they didn't, as their care beat any ER visit I've had, and was only $100, which included lung xrays. An ER visit would have been worse just walking in the door. Still worth it when they can help me breathe, but it demonstrates one reason why one can avoid doctors for seemingly non-serious ailments and conditions, particularly with all the times they've shrugged.

I'm allergic to most everything that won't kill you (pollen, mold, dust mites, cats, dogs, even rats). I have a list of issues with this, mostly constant sinus production/drainage, but only learned it was allergies when I self diagnosed in my 30s and went to an allergist to confirm. Even then, the cause that was dramatic enough to clue me in (rats) was not part of the standard panel. I had to specifically request it...and then point out that they hadn't added it as they said they would. That ended up being so severe that the tiny scratch swelled to the size of a half dollar despite me being on benadryl (i had missed the instruction to skip such meds for the test) AND the calamine lotion they slapped on it almost immediately. Had I not asked for and checked for that test, the specific problem of the moment (my girlfriends pet rats) would have remained undiagnosed (I had a list of potential causes of an uptick in problems, not awareness of any specific one). Not one doctor growing up suggested an allergy test, even though I can now look back and see obvious signs. Not one doctor asked if my symptoms occurred at specific times or places, not one ever mentioned the high constant drainage or inflamed ear canals. (Though doctors offices are pretty allergen free. As a kid I joked that their ugly paint made you feel better, since by the time a doctor came to look in on me my worst symptoms weren't there...in retrospect the repeat experience should have been a clue to them and possibly my younger self) Instead they called it mild asthma (asthma test was negative, but shrug. My guess is that they called it that just to make me feel they had a clue)

Machismo is a problem, but it isn't the sole problem.

Be careful with this. There is a class of issues the medica system is more or less useless with (musculo-skeletal pain, digestive issues, fatigue, the uncommon source allergy symptoms you described)

Then there is stuff they handle extremely well: broken bones, bacteria, and a variety of easily treatable ailments.

I have a few health issues I know I basically can get no medical help on. And then, on the other hand, I had MRSA, and went to the doctor ASAP to get that cured.

Oh, absolutely. Despite my negative experiences I in no way endorse avoiding doctors. As noted in my story, doctors at the urgent care clinic saved me from a much worse time (possibly even death).

I'm just saying (with way too many words) that there are reasons other than stoicism or machismo that people avoid going to the doctor. Were I the OP, I too would have not gone to the doctor for seemingly mild symptoms, and would have suffered as he/she did.

Most of us have no good way of knowing which issues are medically treatable and which aren't.

Ah, I see. Agreed, definitely more than just machismo.

They also seem moderately good at heart and cardiovascular disease, it being insanely common in the US.

Those are much better off prevented than treated.

But you got a point: they suck at preventing CVD, which is a shame.

What magic combination of words did you utter to get the antibiotics you needed? I had a terribly painful bacterial infection once, and six urgent care clinics and ERs all refused to help me unless I had a CT scan first. After a month of this humiliation, I wound up smuggling Augmentin across the border and felt better within 24 hours.

I had an obvious lesion with a head, which the doctor swabbed. Though I did have to go to a second doctor - the first thought it was a less serious infection.

> but it demonstrates one reason why one can avoid doctors for seemingly non-serious ailments and conditions, particularly with all the times they've shrugged.

You didn't have breathing problems when you asked for an appointment; you had a cough. Then when you had breathing problems, you sought out emergency care and had that taken care of. But you blame your original doctor for... not predicting your breathing problems? Or not giving you lung x-rays the moment you diagnosed yourself with pneumonia? I'm confused what you would rather they have done.

The missed allergy sounds like a legit failure, though, but I'm not a doctor.

> I'm confused what you would rather they have done

Other than having more doctors in the world (thus higher availability) and/or lower prices, I don't think this is a solvable problem. My point was not that doctors are terrible, but that people may have decent reasons to suspect going to the doctor for a mild rash (as article had) would not be worth it. Reasons other than stoicism. When I have a cough now, I still don't go to the doctor because the last 4 trips have been "You have bronchitis, just wait it out". I've resigned myself to having a constant low-level cough between Nov-Mar every year.

I do think my allergies should have been detected, but at the same time I understand the reasons they weren't. My goal was not blame, though I can certainly see how my pity-party comment could sound that way.

i have the same problem. i called my primary care to say i hurt my neck in the shower, they said the earliest they could see me was 2 months into the future.

i had step throat, they refused me antibiotics because although i had all the classic symptoms, the strep test was negative. a bottle of penicillin i had at home cured me pretty quickly.

i had pnemonia, i told them this was the sickest i have ever been in my life. my whole body was in pain and i had trouble breathing, especially at night. they told me to drink water and rest. after 2 weeks i got another appointment, i was in really bad shape. they told drink water and rest. 3rd week same, but i refused to leave. i reminded them i lost 40lbs, only then did they take a real look at me.

> "Not necessarily their fault" I do put the fault on them. i think there is something around 'white male, send them home' mentality.

And yet, that is sometimes not enough. A good friend showed his obviously infected foot to a doctor who dismissed the circular rash left from a tick as a localized infection. Fast forward one year and my friend was having major health issues and difficulty making it through the work day. Eventually, it was the worrisome neuropathy in his arms that motivated him to get a full blood test which revealed... it was Lyme disease after all. And bonus! with a year's worth of disease development, a much harder infection to get rid of.

It may be worth lodging a complaint with whatever authority your country may have against that doctor that dismissed the bullseye rash.

> It may be worth lodging a complaint with whatever authority your country may have against that doctor that dismissed the bullseye rash.

Because Lyme's disease is regional - almost exclusively found in the Northeast and Minnesota/Wisconsin - most doctors won't have had much experience with it. Lyme's disease also presents with a lot of different symptoms that are very difficult to differentiate from other conditions (including other tick-borne diseases), which makes it difficult for doctors in those areas to diagnose.

The trademark "bullseye" rash of Lyme looks striking in pictures, but in most cases, it's less heavily pronounced, and it's harder to differentiate from many other possible sources of a rash or irritation. This is actually a problem for people who contract Lyme's disease more than once - after you've had Lyme's once, you will always test positive for the disease, even though you may no longer need treatment, so it's hard to identify patients who have been reinfected.

Just got back from a trip to Brazil and got several tick bites. I'm an epidemiologist, so of course I have the litany of things I'm now exposed to - and the incubation period for all of them sits right on my flight home.

Told my wife that I'm going to feel like crap because of 30+ hours of flying, but if I have a headache that doesn't go away, I need to go to the hospital right now. That was a fun conversation.

There is also a window of time between when a tick attaches and when it can transmit disease. The ticks don't transmit disease until they have spent some time feeding so if you catch the tick within the first 24hrs or so you should be fine.

EDIT: Fixed some incorrect information after I did some more reading on the specifics. Here's a full break down of it:

https://www.uptodate.com/contents/what-to-do-after-a-tick-bi...

And here's the process of a tick attaching: http://phenomena.nationalgeographic.com/2013/10/30/heres-wha...

Really? Why would they wait so long to start feeding? Seems like a bad evolutionary trait.

Actually they start feeding immediately, but the bacteria which causes lyme disease lives in the ticks intestinal system (not all ticks carry the bacteria). After the tick is done feeding (in general approx. 1-2 days but can be longer or shorter), or overfeeds, it can ’vomit’ back into the host and possibly spread the bacteria from its intestines. This is also why you want to be careful when removing the tick and it’s best to use special plyers, and avoid squeezing the ticks body.

Thank you for this clarification! I had just found some more information as well I had misunderstood what I was reading prior to this!

thanks, this makes more sense :)

I'm sorry I believe my initial understanding was wrong. The time frame is still correct but I thought it was feeding but after you asked this it made me doubt myself and upon looking it up it's a different reason.

They feed immediately but it appears that it is contingent upon when the tick starts having to get rid of excess water. Until the blood meal has started to engorge the tick, though, the organisms are not activated in the tick's gut. So until you see that the tick has actually engorged a slight amount, it's apparently not enough for you to catch disease from the tick.

https://www.uptodate.com/contents/what-to-do-after-a-tick-bi...

Again, sorry for the incorrect info initially!

Regarding watching out for the bullseye rash (ie. "EM rash"):

I didn't even notice mine (though it was 4" in diameter) until after I was diagnosed with Lyme disease (via blood tests), because the rash was on my back -- a place I don't regularly look or check. I also had no idea I was bitten by a tick, or even had any ticks on my body. My biggest mistake was probably just not wearing insect repellent while going in to the woods in an area that had a high incidence of Lyme disease.

Regarding antibiotic treatment -- my own treatment wasn't painful, but more annoying than anything because the antibiotics made my skin very light-sensitive, so I had to mostly stay indoors with the blinds drawn. It's the period before the treatment that was miserable, as I had all sorts of painful symptoms.

Lyme can cause very similar symptoms to multiple sclerosis. It's very serious. I know a person who has died fighting Lyme borreliosis.

Most Lyme disease doesn’t produce the rash, and ticks can transfer non-Lyme infections as well.

I agree with your post, I just wanted to clarify that people shouldn’t think they’re in the clear just because they didn’t get the rash.

Would you be able to describe the pains you felt? Also, would you mind saying where they were?

What antibiotic did you use? Doxycycline?

probably, my wife had it, and she received doxycycline. She felt terrible for days, not fun. Fortunately we discovered the tick, and later the "bullseye" quite quick, so we hope that it exterminated everything.

FWIW I have been treated for early-stage Lyme twice, both times with amoxicillin, which is often a little gentler on the body than doxycycline (and you don't have to give up alcohol or sunlight). Fortunately it seems like Lyme isn't (yet) too picky about which antibiotics should be used to fight it.

There's a doctor in Hungary specialized on Lyme who treats it with doxycycline or amoxacycline and azithromycin.

http://www.treatlyme.net/treat-lyme-book/lyme-disease-antibi...

Just don't take antibiotics by yourself, go to a doctor.