Lyme Disease: A Look at Challenges and Treatments in Delaware

As Delaware grapples with high rates of Lyme disease, patients and healthcare professionals illuminate the diagnostic hurdles, treatment controversies and pressing demand for preventive measures.

When Centreville resident Bri Brant began experiencing flulike symptoms, she blamed herself. “I had a ‘heat rash’ on my stomach and was very tired. I assumed it was because it was a hot July and I was working too much,” she says. Months later, Brant received a surprising diagnosis: Lyme disease. “I had always spent lots of time in the tall grass along Brandywine Creek, but I never found a bull’s-eye rash. I was lucky my doctor did assume Lyme and blood tested me right away.”

Many Lyme patients suffer for years or even decades without a timely diagnosis. This is particularly concerning for First State residents because, according to the Centers for Disease Control and Prevention (CDC), Delaware continually has one of the highest incidence rates of Lyme disease of any state. Additionally, the Northeast megalopolis—including bordering states Pennsylvania and New Jersey—repeatedly occupies an overwhelming majority of that list’s top 10. The odds of encountering a poppy seed–sized parasite in Delaware are daunting.

One fundamental problem is that Lyme symptoms mimic those of other common diseases. Another is that standard treatment plans have become the subject of heated debates. The discourse surrounding conventional norms of diagnosis and treatment has been so contentious that one medical source opted for anonymity while contributing to this article.

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Diagnostic Dilemmas

First identified in the town of Lyme, Connecticut, in 1975, the disease’s origins trace back to the bite of infected black-legged ticks carrying the bacterium Borrelia burgdorferi. Initial cases presented a mysterious cluster of arthritis-like manifestations, prompting investigations to identify a link between tick bites and subsequent symptoms. This pivotal discovery led to the recognition of Lyme disease as a distinct entity. Understanding of the zoonotic infection has evolved to identify a range of indicators beyond joint pain, including neurological and cardiac expressions.

One of the biggest hurdles for patients is the variability and nonspecific nature of symptoms, which often leads to delays in diagnosis and treatment. Many, like Lisa Torbert, owner of Heather’s Holistic Health in Dover, become ill without witnessing a bite or the telltale, target-like erythema migrans rash. “[My late husband, daughter and I] all developed Lyme disease and babesiosis—that’s a coinfection of ticks,” she says of living in the Dover woods for a decade. “None of us remember getting a bite or a bull’s-eye. It was chronic for all of us because none of us knew we had it.”

John Beatty, who resides on 5 wooded acres in Chester County, Pennsylvania (arguably ground zero), had several tick bites over the years, but his real trouble began when a small wound appeared on his hip. Because he never saw a bite, it went untreated for months, until one event demanded his attention. “I was trying to write a simple star and couldn’t control my hand enough to do so. I typically have very neat handwriting, so this was a real eye-opener,” he says. Soon, his whole body hurt everywhere, 24 hours a day. “It was a monstrous endeavor to get out of bed,” he says. “I have vivid memories of wishing I could unzip my skin and crawl out of this vessel that did not work.”

Henry Childers IV, MD, FAAO—one of the only Lyme–literate medical doctors (LLMDs) in the region—has developed his own diagnostic criteria at Delaware Integrative Medicine in Georgetown. “I tell people if they don’t have brain fog and chronic fatigue, they don’t have Lyme,” the board-certified cardiothoracic surgeon says. “But I also require a story, where someone says they were completely normal until [one day] they suddenly get sick—and they stay sick. Then it just drags on [until] you feel like you’re not going to survive. We know it’s not genetic, because you were fine before.”

Physical manifestations can include every neurologic symptom, from facial palsy to twitches to headaches to neuropathy, Childers explains. They can be musculoskeletal, leaving joints, muscles, tendons and ligaments vulnerable to impact. It also often migrates: “One day it’s in one place and the next day, it’s in another,” he points out. The main issue, he says, is that it’s immunosuppressant.

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Treatment Debates

Even after a diagnosis, treatment can be precarious. According to the Johns Hopkins Medicine Lyme Disease Research Center (hopkinslyme.org), the standard first line of care for adults with Lyme disease is doxycycline, a tetracycline antibiotic. Other classes of oral antibiotics, such as amoxicillin, may be considered, and in severe cases, intravenous antibiotics can be used.

One of Delaware’s leading infectious disease physicians, who asked for anonymity and who we’ll call Dr. X, explains the intricacies of doxycycline. “It’s sort of an anti-inflammatory antibiotic. If someone gets better, it may just be that it’s tempering inflammation.” Considering the American Autoimmune Related Disease Association (aarda.org) estimates nearly 50 million Americans live with autoimmune diseases, it would not be unusual for a Lyme patient to have an overlapping inflammatory condition—a problematic Venn diagram, as Dr. X describes. Antibiotics can also upset the gut microbiome, potentially impairing the immune system and creating opportunities for otherwise nonthreatening microbes to thrive.

Erythema migrans, more commonly known as the bull’s-eye rash, is often the initial indicator of Lyme disease; however, “Most people have not seen a tick or a bull’s-eye,” Henry Childers IV, MD, FAAO, says.
Erythema migrans, more commonly known as the bull’s-eye rash, is often the initial indicator of Lyme disease; however, “Most people have not seen a tick or a bull’s-eye,” Henry Childers IV, MD, FAAO, says. Adobe Stock/ androsov858.

Some patients do experience quantifiable relief, but results vary. “I took an antibiotic for maybe six weeks and was better but never have been quite the same,” Brant reports. Beatty, on the other hand, required “the big guns” after 21 days of doxycycline didn’t work. A specialist prescribed a Rocephin IV for 30 days. “A nurse came to my house to show me how to administer the fluids every morning through a PICC line installed in my left armpit,” he says. “She warned me that I may feel worse for the first nine days, but that on day 10 I should start to feel better. That is exactly what happened.”

Childers has a different approach: “Antibiotics are lifesaving in some situations, but I find they cause more harm than good,” he says. His antibiotic-free methodology incorporates a rotation of health-boosting processes—including but not limited to major autohemotherapy (ozone therapy), ultraviolet blood irradiation, and intravenous vitamin and colloidal silver therapies. He also advocates for a “complete protocol to clean the gut up as much as we can, which is usually very successful.” In other words, he treats the patient, not the bug.

“Lyme disease exists in a dormant state, so it’s hard to treat,” Childers explains. “[An antibiotic] may kill what is circulating and symptomatic, but you’re not eliminating what’s under the biofilm.” (Think of the biofilm as a slimy, protective coating.) “You may feel a little bit better,” he continues, “but when you stop, what was underneath can be expressed again.” Another problem, he says, is that medications don’t boost the immune system. “You’ve got to get the patient better, not just get rid of the bacteria.”

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Measuring Success

Among Childers’ Lyme patients, international competitive dancer Bronislava Vrtalova stands out most. “She couldn’t walk into the office; she had a wheelchair. I thought, this is as bad as it gets,” Childers recalls. After Vrtalova’s symptoms began in 2017, she progressively grew more fatigued, immobile and depressed. Antibiotics provided marginal relief. “I tried everything,” she says. “Nothing really worked.”

Desperate for answers, the dancer turned to Delaware Integrative Medicine. “It is unbelievable, but a miracle came after the sixth treatment,” she says. “I woke up and felt like a different person. When I looked through the window, the colors were different.” Today, Vrtalova is back to competing onstage.

Childers says he has never had a patient “not respond” to his alternative methods. “One of the things about ozone is I have patients telling me, ‘My hair is growing’ and ‘This unrelated thing is getting better.’ When you optimize the immune system, you heal whatever is wrong—you surveil, you grow, you repair, you replace. The body takes care of itself. Lyme disease, fine—but everything else, too.”

Due to the subjectivity of patient responses, Dr. X admits measuring progress is difficult. “There are examples in literature where if you send 10 test tubes from one patient to 10 different labs, you get 10 different lab results,” he notes. “That’s confusing and frustrating.” Dr. X also points out that the placebo effect is a very real phenomenon. “The Lyme–literate doctors are listening to the patient, laying on hands and providing them with what sounds like a reasonable explanation. …If people are empowered in other treatment, they often feel better. It’s not to blow someone off to say they have a placebo effect. I have seen heart failure patients who say, ‘I feel better with antibiotics,’ but they have heart failure.”

Testing Limits

Despite ongoing debates regarding treatment, most doctors agree that testing options are, at best, subpar. This may be due to several factors, mainly timing. Antibodies made by the body in response to infection can take weeks to develop, so recently infected patients might not yet have produced enough for detection. In fact, if a doctor prescribes treatment too early, the individual might never mount a measurable response, Dr. X explains. While the CDC recommends a two-step testing process where a positive (or indeterminate) first test prompts a second test, diagnosis criteria are only met if the second test produces a like result. Harvard University’s Lyme Wellness Initiative (lyme.health.harvard.edu) points out this potential pitfall: CDC testing guidelines recommend a second test only if the first test is positive or unclear. Because the first test may not pick up antibodies soon after possible exposure…that means a person with Lyme disease might never get the second test.

Another limitation lies in the test’s screening only for antibodies of the Borrelia burgdorferi bacterium, leaving potential coinfections undetected. “There isn’t a single organism on the planet that has one species in its mouth,” Childers reasons. “So, when you get inoculated by a tick, and it has 12 different coinfections in its mouth, that’s what gets injected.” Lymedisease.org reports that a survey of more than 3,000 patients with chronic Lyme disease found that over 50% had coinfections, with 30% reporting two or more coinfections.

Preventive Medicine

Preventing tick-borne illnesses starts with avoiding bites, but education is crucial. Torbert, set to complete her doctoral studies in prevention science at Wilmington University this August, plans to launch her Blast Away Ticks program statewide post-graduation. The initiative aims to educate children ages 7 to 11 about effective tick-avoidance strategies. “I’ve created games for better retention,” she says. “They need to be able to remember when they go into infested areas.”

Although Blast Away Ticks focuses on youth education, Torbert’s tips are universal: “Prevention is looking for ticks when you’re in endemic areas, wearing clothes that are treated with permethrin, using an insecticide that has DEET, throwing your clothes in the dryer for 10 minutes after returning home, showering within 10 minutes, and treating your pets,” she advises. The CDC suggests making your yard less attractive to ticks by keeping lawns mowed, clearing tall grasses, placing play equipment in a sunny location and providing a 3-foot-wide barrier of wood chips between lawns and wooded areas.

Dr. X emphasizes that prevention must also be habitual: “The problem with Lyme disease is you [can] get it again. The antibodies you make are not memory antibodies. They don’t protect you against reinfection. So, I tell people, ‘If you have Lyme disease, we’ve got to take steps to prevent you from getting it again next year.’” Most importantly, Dr. X encourages patients to question their doctors. They are, after all, human beings. “I’ve learned that Western medicine does not know everything. There’s got to be balance. Yin and yang and caution.”

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