More on the Lake Mead story...
- From: the 3rd Man <derdrittemann2003@xxxxxxxxx>
- Date: Mon, 23 Jun 2008 10:56:07 -0700 (PDT)
And..by way of explanation, (as it now seems to be getting hopelessly
tangled and confused)...
....I simply noted that the time of PROBABLE exposure as one factor
(among several others) had been overlooked in evaluating the
LIKELIHOOD that this case could be possibly be Lyme disease.
I did not intend this as determinative...that is, that it could
EXCLUDE the POSSIBILITY in its entirety. I do think, however, that
most authorities would tend to agree that it would seem that it is
unlikely in this particular instance. The longer the time of
attachment. And in this case...unknown...but seemingly, not within the
parameters of conventional wisdom.
In my opinion...Lyme diagnosis is almost ALWAYS a question of
PROBABILITIES. (Even a "CDC positive" does not indicate active
disease...but merely possible exposure).
HOWEVER...
again, in my opinion, this incident as well as similar inquiries, have
a history of being misunderstood...and mishandled...and it is
important to phrase and address the issue properly.
In my opinion...what you are talking about, here, is ultimately
PROBABILITY and trying to address that PROBABILITY in terms of a type
of risk analysis...risk comparison.
The CONSEQUENCES...the adverse consequences...are what you are trying
to AVOID. They are the impact of treatment-resistant late-stage Lyme.
THIS IS NOT THE "RISK", here...as I see it.
The "risks"...are attributable to two alternative courses,
options...namely, to treat immediately...or to wait...and oberve...and
evaluate this later IF symptoms appear (note that this option does NOT
exclude later treatment). You are doing this, still, theoretically,
within the successful "window" of early stage.
==============================================================
SO...what you need to know are what are the possible impacts of
possibly unecessary antibiotic usage on a six-year-old child...
....weighed against the possible impact of delaying treatment while
waiting for confirmatory symptoms to appear. You need some sense if
waiting exposes the child to a greater possibility, risk, of the
CONSEQUENCES of treatment-resistant late-stage Lyme.
You are really talking about evaluating the associated RISK of the
options.
===============================================================
Notice that we are really talking about evaluating two possible
treatment options...different from the adverse consequences that we
are trying to avoid...upon which there is general agreement. The
child's parent actually seemed to grasp the issue perfectly well. We
don't want the kid to go tertiary on us.
What I BELIEVE I said...was simply that these are properly questions
for medical professionals...and not online self-designated "experts".
That being aware of the controversy will help aid a good discussion
with medical professionals...so that he could evaluate their advice.
The problem here, I think...is that internet pundits simply advise
against the "wait and see approach" without ANY sense of what the
risks of that approach are...and really don't seem to be able to even
address them...but instead, point to the CONSEQUENCES, as if that,
somehow explains it.
And...I do NOT think this is the correct way to address the issue.
But what I was trying to get a sense of...and am still baffled...is
from whence this blanket justification for immediate antibiotic
treatment stems from?
In other words...well, what ARE the risks of waiting and seeing
within the "early stage"?
In this particular instance, and not wanting to "play doctor"...I
think you have to realize the odds are really not particularly good
that this was Lyme. Not IMPOSSIBLE. But unlikely.
(And the noted rash does not magically convert it to Lyme. It is,
however, properly, of course, a cause of concern).
I am still waiting for an explanation...
.
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