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Comment by dec0dedab0de | Hacker News Reader

Just to be pedantic, Bell's Palsy is the name of the condition not the cause. So it was Bell's Palsy caused by Lyme disease.

I have noticed that the line between condition and cause is often overlooked, even by doctors. For example this leads to people thinking Pinkeye/conjunctivitis is highly contagious, when it is still conjunctivitis if it is caused by getting something in your eye. I think that holds for everything that ends in -itis too Sinusitis, Arthritis, Tendonitis, etc.

I know that is a bit of a tangent, but you reminded me of someone who had bell's palsy telling me that it was actually shingles. I explained that just because it was caused by shingles doesn't mean it stops being Bell's Palsy, just like how it is still a cough if it's from the flu or from smoking. They ended up getting really angry at me about it, but I think hn might appreciate the semantics a bit more.

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Not a tangent! I certainly appreciate the semantics, and there seems to be some academic interest in the semantics alone! Some Lyme researchers would like to call it “Lyme Disease Facial Palsy” or LDFP to encourage practitioners to differentiate early. Not sure that would’ve helped me, I had no bullseye rash and no fever, just horrible fatigue and facial paralysis. The idea would be to encourage practitioners in Lyme-prone locations to see Bell’s, test for Lyme, which I think your point about overlooking the link between condition and the cause supports. Lyme showed up on a blood test my PCP ordered only after I completed a course of prednisone with no improvement and much misery. He didn’t even tell me he added a Lyme test, but I’m glad he did!

Here’s one paper on the topic I remember reading at the time: https://pmc.ncbi.nlm.nih.gov/articles/PMC8791801/

Much of being a physician is pattern recognition - the vast majority of Bell's Palsy is idiopathic (generally viral), and thus that's how we usually treat it. If we tested everybody for everything everytime the health system(s) would collapse.

It definitely helps as a patient to advocate, and add anything that a physician like myself maybe wouldn't always ask, like if you've been a tick-infested area and/or discovered a tick attached to yourself recently.

Yeah I agree that’s what happened to me. Alas, no tick, no rash, and I’m not sure my PCP in New York City sees a ton of Lyme. Still, I’m glad he caught it when he did!

> If we tested everybody for everything everytime the health system(s) would collapse.

Looks like Labcorp made over 3 billion dollars last year, so I think probably that number would go up instead of collapsing?

Labcorp is one of several labs and most hospitals have their own labs and only send out specialized tests.

It is true - you can’t test every patient for everything. There is an estimated 1B primary care visits in the US each year. Assume every patient get 5 tests at $50 a test and you just spent a quarter of a trillion just on tests.

The test itself for lyme must be inexpensive - The vet did a test for my dog as part of routine yearly office visit. I don't know if it's just in my area, or if it's common now.

I don't know why you're being down voted, of course you can't test for everything, and you're going to start with the most likely causes.

The frustrating part for me is when people think of the symptom as the cause. Like they understand that multiple things can cause a fever, but they don't understand that multiple things can cause bronchitis.

When I was a kid I had "sinusitis" multiple times a year, but my doctor never explained to me that it could be the same or different causes. When I learned that '-itis' just meant inflammation, it blew my mind. I have done my best to spread that knowledge ever since.

Do you have trouble reading other people's emotions?

No, I could clearly tell they were angry. I just never understood why some people get angry about minor corrections.

Maybe it's worth investigating

Do you?

No, you?

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