Patient's Query
Hi doctor,
Recently, I visited my primary doctor's office, but he was on vacation. I was seen by a nurse practitioner. My main complaint is leg swelling, joint pain, and stomach aches. She asked me to do a series of lab tests and to return a week and a half later. When I went back, she told me that everything came back negative. However, a trace of an old case of Lyme disease showed up but it was nothing to worry about. Then she carried on to give lecture on my weight, and that I need to lose weight. I do, but I am 5 ft 7 inches and 215 lbs with three children. I have a long history of bipolar depression.Now I began to think that the joint pain and depression may have some correlation with this "old case" of untreated Lyme disease. I need some advice on this, please.
Hi,
Welcome to icliniq.com. I assure you not to worry at all as things may get settled with proper care and follow-up. Yes, depression and the joint disease may definitely be associated with the untreated Lyme disease. There are a lot of things that need to be cleared right away in history. I have written just for you to alleviate your concerns, once for all. Do answer where I ask a question, send back in follow up along with all the laboratory results you just went through. There are three main stages of the Lyme disease. Stage 1 is 1-30 days after the tick bite. It comprises the vague febrile illness with a typical red rash named Erythema migrans (the rash that appears is usually in unseen areas like axillae, groin and areas at the back of the knee, almost after a week of the tick bite). I wish to know, if you got this rash sometime? If yes, can you please give me details as when? Any eye redness, tearing, neck stiffness at that time with mild fever, etc.? Stage 2 is early disseminated disease, which is 3-10 weeks after the tick bite. It includes fever and malaise, eye and vision problems, heart issues, joint pains mostly involving knees, ankles, and the wrist. There are also the neurological manifestations like meningitis, facial palsy, headache, neck pain or stiffness, photophobia. Also memory problems, mood changes, sleep and personality changes, depression etc., with some skin rash. Stage 3 is months to years after the initial infection which is latent or chronic Lyme disease. I have seen my patients get a latency period with no disease and again erupted with stage 3 after sometime. Facial palsy and joint pains are very important and common manifestations of the late disease. Bladder dysfunction, hearing loss, cognitive impairment, other neurological manifestations including depression are also common. Treatment plan can be decided on seeing the blood work in follow up along with the details in history.
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Answered byDr. Muhammad Majid Hanif
Medically reviewed byiCliniq medical review team
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