Re: More on Klempner's deceptiveness


GregGerber wrote:
> I agree that the NIH position is more liberal, but it stands ALONE,
and
> it recommends doctors use IDSA or CDC to diagnose --and those
> guidelines say what I have explained.
>
> I believe all these posts support my position that the overwhelming
> majority of guidelines in the peer-review instruct to clinically
> diagnose in a highly restrictive fashion and with almost iron-clad
> reliance on serology to confirm before treating except in the case of
> the rash --and yes, this includes the IDSA guidelines. For what it
is
> worth, Sigal is actually far less draconian in his approach than many
> of those who train other doctors in regular seminars --shapiro, for
> instance.

Sigal SAYS he is far less draconian. But in reality (as in if you went
to see him as a patient, something I would NEVER recommend to anyone I
like or even those I don't particularly like) I seriously doubt he is
any less draconian.

> But I KNOW that Shapiro tells doctors not to treat later lyme inless
> there is a late major ie objective manifestation and passage of the
> two-tier. He trains many hundreds of doctors a year.

Yes I think it is important to note that sometimes the writings are
actually caveated but the grand rounds lectures are NOT.

Some of the writings provide caveats but the practical reality is that
they don't.

Just like the strange conundrum when you read a paper where Steere or
Shapiro or Coyle or Dattwyler etc have documented some "strange"
presentation of Lyme, something along the "expanding clinical spectrum
of Lyme" for example, but then another patient goes to see them with
that same symptom, suddenly they are sure it is NOTLYME rather than
Lyme. So many of them put feathers in their caps by documenting
symptoms of Lyme in an article which they'll never acknowledge again in
clinical practice.

Just like a certain neurologist recommended by one of the Lyme
organizations. I heard him stand up and say "Ah yes I see interesting
case of Lyme once..." (he is Asian and that is word for word what he
said), well, he meant ONCE. Because every other patient who went to him
he was sure it wasn't Lyme.

> The idsa guidelines, finally, are treatment guidelines, not
diagnostic
> guidelines. The bible for diagnostic guidelines is the article
weisman
> has posted here --not the nih blurb.

Is that NIH or CDC, I thought it was a CDC blurb?\\

> You can see it instructs doctors to diagnose just as I described.
>
> It's caution against reliance on serology is only to caution to
IGNORE
> IT in two conditions:
>
> 1. if there is no exposure
> 2. if there is no late major manifestation.

Yes it is a caution to IGNORE it. Meaning the emphasis is (once again)
on FALSE POSITIVES NOT FALSE NEGATIVES.

When they talk about not relying on serology THAT IS WHAT THEY MEAN.

They aren't s'posed to use it to make OR BREAK the diagnosis but the
emphasis is on not MAKING it--they're perfectly happy to see it broken
on the basis of a negative.

The one article even says that a negative test might be helpful to rule
it out.

> Nowhere do any of these guidelines say to treat with a negative
> serology, except in the instance of an erythema migrans rash or
> attached tick, and the latter is one dose of doxy.Derdritteman, I
feel
> you are confused, are taking things out of context, are not aware of
> the situation, and are of the opinion that the majority of doctors
> should ferret out a minority opinion that is not even pubished in a
> journal.
>
> To most academics and to most doctors, clinical diagnosis of lyme
> disease means other than what you contend. GG

.

Relevant Pages

  • Re: More on Klempners deceptiveness
    ... it recommends doctors use IDSA or CDC to diagnose --and those ... guidelines say what I have explained. ... diagnose in a highly restrictive fashion and with almost iron-clad ... this includes the IDSA guidelines. ...
    (sci.med.diseases.lyme)
  • Spread of Lyme stirs medical rift - NY
    ... FOCUS: LYME DISEASE ... Doctors are divided over how to diagnose and treat the disease in chronic, ...
    (sci.med.diseases.lyme)
  • Re: More on Klempners deceptiveness
    ... Isn't it the case, and I admit I don't know, that doctors are ... responsibile for knowing the ... "Standard of Care" for the illnesses they diagnose and treat, ... would a doctor who diagnosed Lyme only when a Bullseye ...
    (sci.med.diseases.lyme)
  • Re: NIH Study
    ... Seems to me that the Problem is not what the Klemper study proves or ... makes to doctors, most of whom dont give a rat's ass about study ... prefering simple rules to diagnose and treat by. ... Lyme and their crappy Western Blots in making a diagnosis of Lyme ...
    (sci.med.diseases.lyme)
  • Re: IV ABX Study for Psychosis
    ... medical doctors with a speciality in psychiatry. ... thyroid meds had me all ramped up and emotionally liable and stressed ... The Lyme dx was clearly by chance. ... Took me a few months to get into an LLMD, who was recommended to me by ...
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