Notes from Burrascano's talk March 21, 2011

Tuesday, March 29, 2011

Joe Burrascano's March 21st talk in Santa Rosa, CA

PLEASE NOTE:  Because the presentation was so dense and rich with information, there may be some info that was left out. These notes offered by an anonymous contributor. 
Note also:

• You can download the Word (.doc) file of this info here

• You can download the PowerPoint slides from here

• Burrascano's complete guidelines for Lyme treatment can be found here

• Purchase DVD's of the event here .
  
  
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  For questions or to purchase the DVDs over the phone please call 707-396-5808 or email supplements@gordonmedical.com.
  
  

What About All Those
Unanswered Questions?

A note from Gordon Medical Associates, co-presenters of the event:

Doctor Burrascano had a lot of information to share, and his part of the program ran overtime. No one complained about hearing more from Dr. Burrascano, but it did make the panel section of the program shorter than planned. That, added to the large number of questions asked, meant very few people got a specific response. The physicians sitting on the panel did not want to disappoint those who attended, so they have promised to work their way through all of the submitted questions, and to post them on a new blog on CALDA's website.


Questions will be answered weekly, until all of the submitted questions have been answered. The doctors will rotate answering the questions, so you can hear different points of view. The first installment of answers should be up sometime this week.


Click here:  Putting Lyme Disease Behind You: Questions and Answers with Local Physicians


Send questions to: PuttingLymeBehindYou@gmail.com 

~~~~~

Dr.  Burrascano has treated over 10,000 patients with Lyme since early '80s.

"It is up to you. Learn as much as possible. Do as much as possible. Have a positive attitude."

Dr. Burrascano's definition of Lyme Disease

"Lyme disease is the illness that results from the bite of an infected deer tick; it's not one germ."

 Stages of Lyme

Early Lyme – I

Disseminated Lyme – II

Chronic Lyme – III

-for one or more years – immune system breakdown and its consequences

-co-infections become important

-serologic tests less reliable

-treatment must be more aggressive and of longer duration

The sicker you are, the less reliable the tests; lyme burrows deeper and is no longer easily detected in blood

CD-57 test – the one test that shows how long Lyme has been present (See more blow regarding CD57)

Tick Bites

Only 17% recall having a tick bite (Texas Dept of Health)

Only 36% recall a rash

Only 50% have positive western blot

Co-infections: tests are even less sensitive

Ticks: nature's "dirty needles"; a tick lives for 2 years

Co-infected patients: more ill, more difficult to treat; Lyme treatments do not treat Babesia, Bartonella, or viruses.

**Dr. Burrascano says he has never seen a patient without co-infections. 

Sorting Out Co-Infections

Lyme, Bartonella, Babesia, Ehrlichia, Mycoplamsa

Lyme – Gradual onset, no sweats, 4 week cycles, multisystem, afternoon fevers

It is important to take your temperature several times a day (record in journal)

Babesia – Cycles every few days, makes everything worse

Ehrlichia – Sharp headaches behind eyes, low WBC, elevated liver function

Mycoplasma – Made worse with exercise, aka "Chronic Fatigue Germ", major fatigue, neurological disfunction, found in the sickest and poorest responding; have the worst CD-57 tests

ELISA test – mostly useless; use Western Blot

Spinal Tap – only 9% have + csf

PCRs – 60% sensitivity at best because germ doesn't stay in blood

LDA – 30% sensitivity

Why Igenex?

Dr. B has no affiliation with them, no professional relationship with them, etc…

If a test is commercialized to be sold as a test kit, it must follow narrow CDC restrictions and guidelines. (Ironically, these restrictions were a result of the Lyme vaccine debacle.)

Most Lyme tests are commercial. Commercial Lyme tests miss 75% of cases.

Based on double-blind government proficiency tests, IGenex did well.

CD-57 COUNT (tracks a type of white blood cell)

Lower counts seen in chronic Lyme

Only Lyme (not co-infections) makes CD-57 low

The CD-57 reading does not change *during* treatment … until Bb is controlled. Then it quickly changes.

Predicts a relapse if low when antibiotics end

The CD-57 test must be done by LabCorp's method (using the "normal is >200" scale)

<20 – severe illness

20 – 60 most common for chronic patients

> 60 Lyme activity minimal

> 120 – relapse not likely

Why Are Chronic Lyme Patients So Sick?

-High spirochete load (perhaps multiple bites)

-Protective niches in the body and biofilms allow Bb to evade the immune system and antibiotics

-Immune suppression and immune evasion

Biofilms are a protective layer

Lyme germs live in different forms:

Spirochete – surrounded by a cell wall

Spiroplast – balls up, has no cell wall

Cystic form – has hard outer shell

Lyme germs can live *inside* a human cell, inside the vacule

Doxycycline – can get into the cell

Erithromycin – can get into the cell

Rocephin – does not kill germs inside vacule 

Treatment - Back to Basics

Form a therapeutic alliance with your Dr.; should be able to have "meeting of the minds"

Pharmacology

-It is *critical* that you achieve therapeutic drug levels – this varies from patient to patient

-Antibiotics – you *must* have extra-cellular and intra-cellular meds as Bb can live in and out of cells

-Antobiotics – must act on blood & tissues

Spirochete forms:

Penicillins, Cephalosporins, Primaxin, Vancomycin,

Spiroplast/L form:  no cell wall

Tetracyclines, Erythromycin

Cyst:

Metronidazole, Tinidazole, Rifampin

Spirochete B. burgdorferi – needs sustained levels

L form – Tetracyclines, need a spike in blood levels

Cystic – Metronidazole, sustained levels for 2 weeks +

Antibiotic combinations are necessary

Intracellular and extracellular

Blood and tissue

Intravenous therapy is most effective

Intramuscular Penicillin effective as well

Indications For Intravenous Therapy

-illness for more than one year

-prior use of steroids

-documented immune deficiency

-abnormal spinal fluid

-synovitis with high ESR

-age over 60

-failure or intolerance of oral therapy 

Typical Regimen

Oral

Cefuroxime + Clarithromycin

Augmentin XR + Telithromycin

Injection

BicillinLA + Clarithromycin

Intravenous

Clarithromycin + Telithromycin

Vancomycin + Clarithromycin

-high doses needed

-combination usually necessary

-check for co-infections

-rotate treatments

Rate of recovery dependent on germ; stronger drug will not speed recovery.

Find a regimen that works and stick with it

Change when you've reached a plateau

Treatments: at least 4-6 weeks before changes

Relapses

-relapses occur; retreatment needed

-repeated and/or prolonged antibiotic therapy

Aggressive supportive therapy also necessary:

Sleep cycle

Food

Supplements

Detoxing

As symptoms wind down, DO NOT cut dosage! Resistance develops that way.

Progressively increase exercise program

-exercise is vital and required

-not exercising will increase risk of relapse

If CD-57 is not normal at end of treatment, continue treatment or there will be relapse 

  

Prognosis

-May not cure infections, may need open-ended maintenance therapy

What to Watch For:

Signs of persistence; continued fevers

Four week cycles of ailments

Migrating symptoms

Positive PCR or urine LDA

If you have not relapsed in 3 years, you never will.

What if you're not sure you're over it?

Low grade fever still present

Signs of recurrent four-week cycles

Migrating pain

Low CD-57 counts

  

Bartonella

The Bartonella co-infection with Lyme seems to be clinically different that "cat scratch".

Instead, they are Bartonella-like organisms; more prevelent that Borrelia in some ticks

Clinical Clues

Encephalopathy

Irritability

Anxiety

Stomach lining

Insomnia

Rashes

AM fevers

Night sweats

Tender skin nodules

Bartonella treatment:

Levaquin Fluoroquinolones

Erithromycins don't kill this

Rifampin & Metronidazole may be alternatives

1 – 3 months of treatment

Piroplasms – Babesia

Is a parasite

Symptoms

Night sweats

Air hunger

An occasional cough

Persistent migraine-like headache

A vague sense of imbalance without true vertigo

Encephalopathy

Fatigue

Babesia Treatment

Not treated with antiobiotics

Azithromycine & Mepron

Malarone

Coartem – Antimalarial for Babesia (new)

  

Ehrlichia

Headaches

Muscle soreness

Persistent leucopenia (low WBC)

Treatment

Doxycycline 1^st choice

Mycoplasms

"Chronic fatigue" germ

Ubiquitious in environment (in dust, for example)

Treatment is difficult

Worms

New species of nematodes in 63 – 75% of patients from Massachusetts

Fatigue

Lives in lungs mainly

(Dr. Eva Sapi, Dr. Larry Klapow – research)

An open mind is important!!

Biofilms

Dental plaque is an example

Gel-like substance in which germs can embed

Biolfilms in the gut are implicated in many digestive diseases & possibly food allergies and mal-absorption

Biofilm busters:

Banderol plus Samento

Enzymes

Methylation Cycle

Key component of metabolism

Need to bring up methylation cycle

This cycle can be blocked when chronically ill

75% of Lyme patients responded better after  treating

Crazy or Is It Lyme?

Cytokines – mediators of inflammation, are activated. 

When this occurs in the CNS, it triggers diversion of tryptophan into kynurenine

Result: depression, neuropathy, fog brain, "crazy" perception

Bornavirus

Autism-related?

Distant cousin to Rabies and distemper

Brain is the site of infection

Does not damage nerve cells but blocks cell function

Brain fog, fatigue leads to depression

Treatment: 

Antiviral Amantading

65 – 70% success rate

  

XMRV

Xenotropic Murine Leukemia Virus

Virus – is gamaretrovirus, 1^st isolated in prostate cancer

68 out of 101 CFIDS samples contained XMRV

XMRV is found on only 3% of healthy samples

XMRV is also found present in cases of: MS, ALS, Parkinsons, Autism, Fibromyalgia

Lyme patients who did not recover: 1005 of them had XMRV

Does it prevent a full recovery from Lyme?

Is it found in ticks?

Dr. Judy Mikovits

Treatment – XMRV

Retrovirus is cousin to HIV

-be sure there is not excessive cortisol and DHT

-consider adding antivirals AZT, tenofovir, raltegravir

Basic Advice

NO steroids or other immune suppressives!

No smoking at all

No alcohol (makes germs stronger, weakens immune system)

Clean diet: low carb, low glycemic index, high quality proteins

Maintain hydration (Lyme patients become dehydrated quickly, sense of thirst is altered)

May need mineral supplements

ENFORCED REST

You are NOT allowed to get tired

Take a break before afternoon lag

Work and school – Go in later, leave earlier, take a midday break, take Wednesdays off

Rest on days off

No caffeine, no stimulants

Home should be quiet, comfortable, non-toxic

Nap if needed!!

If you need to sleep late, do it!!

Exercise Program

Body sculpting

Gentle with free weights, exercising all muscles; very light or no weights

NO AEROBICS

Each body sculpting session 45 min; 60 minutes preferred

Begin with good progressive warm-up

Take a hot shower or bath afterward and go to bed. Lie quietly if you cannot sleep.

Never exercise daily

Total rest on off days

As strength improves, increase weight and resistance but maintain high number of repetitions

As stamina improves, exercise more, but NEVER daily.

Dr. B believes: spirochetes choose skin as their final hiding place.

  

Nutritional Supplements

Probiotics  

Multivitamins w/minerals

CoQ10 or ubiquinone

NT-factor or "ATP fuel"

ATP Fuel

Vitamin D – maintain upper-normal levels

Essential Fatty Acids

Magnesium

Methyl B-12 

http://www.mcguffpharmacy.com

B complex

Transfer Factors

Detoxify

FIR Saunas: Helpful to excrete organic toxins

DEET does not work!! Use Premethrin!

(Developed in cooperation with the U.S. Military, government agencies, universities and others; this Sawyer Clothing repellent offers superior protection from disease-carrying biting insects. The active ingredient, Permethrin is a synthetic molecule similar to those found in natural pyrethrum which is taken from the Chrysanthemum flower. Not only does this product repel insects, but will actually kill ticks, mosquitoes, chiggers, mites and more than 55 other kinds of insects. Sawyer Permethrin repellent is for use on your clothing, tents and other gear. A single application lasts up to six weeks and will remain effective even if you wash the garment once a week. Permethrin is odorless when dry, and during the drying process it tightly bonds with the fibers of the treated garment, it will not stain or damage clothing, fabrics, plastics, finished surfaces, or any of your outdoor gear. Try our two easy-to-use treatment methods: aerosol spray and NEW soak system. Both methods provide protection from mosquitoes and ticks through 6 launderings.)

And the most important part.......

Live with a healthy attitude; 

Lose "poor me", lose anger

Do not become "Lyme obsessed".

Pursue other interests and distractions.

Enjoy friends and family.

Cuddle with your pets.