Lyme disease is like no other bacterial infection. With most bacterial infections, you expect to take an antibiotic and be over the infection within a week to 10 days. Despite treatment, however, many people with Lyme disease often end up with more serious, widespread infection.
Borrelia burgdorferi: An odd bacterium
The Borrelia burgdorferi spirochete causes most Lyme disease in the United States. At least two other Borrelia species lead to Lyme in the rest of the world. Borrelia burgdorferi is a parasite transmitted by infected ticks from deer, mice, and other small rodents that harbor the spirochete. These animals can have huge numbers of the bacteria and not show any symptoms of disease. Yet when these same spirochetes are transmitted to humans, they cause problems in many organ systems.
Why does the Lyme bacterium affect humans and not the infected animals?
The primary difference is the way the spirochete is transmitted and the way the human immune system reacts to this invader. In humans, the Lyme organism has learned to survive brilliantly.
Evasion starts with invasion
Starting as early as the tick bite itself, Borrelia burgdorferi can evade the best efforts of the immune system in several ways. The tick has certain factors in its saliva that coat the invading spirochetes, protecting them as they enter the body through the skin. This prevents the immune system from “seeing” them. For weeks after a tick bite the immune system of someone infected with Borrelia burgdorferi may not produce antibodies against the bacterium.
Structure is important for evasion
Then there’s the unique feature of Borrelia itself, its flagellum. The flagellum gives the spirochete the ability to cause profound disease. A flagellum is typically an outside tail a bacterium uses to propel itself from place to place. In the Borrelia corkscrew-shaped spirochete, however, the flagellum is located inside the bacteria’s body, somewhat like the skeleton of a snake. The flagellum helps the bacterium invade tissues and thick mucus that would stop most bacteria in their tracks. The flagellum also excites the immune system. Although the immune system can now see the bacterium, it can’t effectively attack it. Instead it launches a massive inflammatory response that ends up damaging surrounding human tissue rather than killing the bug.
Evasion continues with metamorphosis
Once inside the body, the saliva-protected spirochete also starts to change the proteins on its outer cell wall. The immune system typically uses cell wall proteins to detect a foreign invader, develop specific antibodies to fight it, and mount a coordinated immune attack. But the Borrelia spirochete is like a spy who changes his disguise to blend into the crowd. The police have an initial description of the spy, but it’s no longer accurate.
Lyme symptoms and the immune system
The prolonged immune response, trying to fight Borrelia burgdorferi infection, causes most of the symptoms of Lyme disease, including joint inflammation, skin changes, and neurological problems.
Another aspect of Borrelia burgdorferi is that its changing outer proteins further stimulate the immune system. To return to our spy analogy, it’s as if the police know the spy is disguised and somewhere in the crowd. But because they can’t mount a focused attack, they send all available officers to the scene to destroy everything in the environment. In our analogy, Borrelia burgdorferi is the spy and the officers are immune system cells. The environment, unfortunately, is the tissues of the body.
Immune cells that try to fight the invaders include neutrophils, monocytes, macro-phages, and dendritic cells. None are very effective at clearing the infection, but they do wreak havoc when they are in places like joints. Massive numbers of immune cells that invade the joint tissue take up space and release toxic compounds in an attempt to destroy the spirochetes. These cells (particularly neutrophils) release proteins and small molecules such as cytokines, which further stoke inflammation. The result of all this immune activity is joint pain, inflammation, and persistent arthritis. The same principle operates in virtually all organs affected by Lyme disease.
Borrelia burgdorferi in the brain
In the central nervous system, the story is slightly different. The brain doesn’t have the same immune cells that most other body tissues have. In the brain and spinal cord, the de facto immune system is cells such as astroctyes and microglia. These cells are bad at detecting and eradicating infections. Moreover, they release substances (like quinolinic acid) that can be directly or indirectly toxic to nerves. Similar to elsewhere in the body, they kill human tissue in an effort to kill the spirochete. The infection persists and the brain is damaged as a result of the failed attack.
The unique way that the human immune system responds to the Borrelia spirochete infection causes more problems than it solves. The more that scientists discover about the human immune system and Lyme disease, the better equipped they’ll be to develop treatments that can modulate these painful immune system effects. The ultimate goal of course is reducing or getting rid of Lyme disease altogether.
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12. October 2011 at 3:52 pm
Hi Pam, I was diagnosed with Lyme back in early August 2011 and went on Doxy. Unlike 2 years ago when I fought it off with Doxy in 30 days, my symptoms weren’t getting much better after 2 weeks. I was sent to an Infectious Disease Specialist who put me on Ceftin. At the same time I was tested for Babesia and Ehrlichia and both were negative. I took Ceftin for 5 weeks and my fatigue improved over time to where it is very low now, but I still have aches, mostly minor, sometimes moderate, every day. I’ve been off of all meds now for 1 week and had a doctor’s visit yesterday. He does not think I need any more anti-biotics and to monitor my improvement. If I start to head downhill to let him know. I am much better, but what are your thoughts on no meds while I’m trying to compleely rid my body of Lyme? Also, can you send LLD info for NJ? Thanks!
13. October 2011 at 9:56 am
Mitch, were you bitten again back in August? if not, it is possible you didn’t get 100% rid of Lyme two years ago and it’s back. In which case you’ve got chronic Lyme. Yes, a course of Doxy here and Ceftin there will perk you up. But if it isn’t long enough, you’ll just keep yoyoing. Also, were you tested for Bartonella too? It would seem odd to test for Babesia and Ehrlichia and not Bartonella.
Tell me where you are in NJ and I’ll send Lyme info for nearest you. Thanks for asking.
12. October 2011 at 5:50 am
had 2 ticks about 2 years ago,had them taken out immediately by a chemist. doctor gave anti-biotics each time just in case.1 tick bite place emerged into a small egg-like thing,doctor operated to remove. i have had numerous colds & bad bouts of flu,anti-biotics since then. doctor did full blood tests 6 months ago thinking maybe glandular fever but all negative. seems immune system low.do u think could be Lymes? live in SW France which is by all account over-run by ticks. i want to try to re-build my immune system naturally. any advice please?
12. October 2011 at 11:35 am
It could be Lyme, W. If it is, it’s a complicated illness compounded by the fact that people usually get other tick-borne infections transmitted at the same time which also need to be treated. As such, it’s better to see a health practitioner. If you’d like to self-treat, I’m sending you info on how to contact Lyme groups in Europe so you can ask. Thanks for commenting here.
7. October 2011 at 2:34 pm
Was told today that that my normal yearly blood work tested positive for Lyme. I do not have any symptoms. I am not an “outdoors” person. Could this have been a false positive? Is there another test my Doc can do to make sure I do have Lyme disease before taking antibiotics. (Frankly I am 45, not on any medications, do not like to take unnecessary pills) Please advise. Thank you
7. October 2011 at 5:52 pm
False positive are possible, Joan, although there are far more false negatives. If you didn’t have the IGeneX test, it could give you a second comparison. I’m with you on not taking meds iif you don’t need to. FYI – you can get Lyme from other biting insects besides ticks (like mosquitoes, flies, and fleas), not something most doctors know about or will acknowledge. Thanks for asking.
6. October 2011 at 8:25 am
I am an avid outdoorsman and I typically get several tick bites every year. I typically remove the offending tick in a short amount of time. I have never seen the bullseye rash on myself, but I have had a myriad of odd symptoms over the last two months. Fatigue, ears ringing, sore throat/swollen lymph nodes, some joint pain, and canker sores which migrate around my mouth. I don’t have fever or skin rash either. I am normally healthy and I know something is not right. My doctor can’t seem to find anything wrong with me, so he prescribed penicillin. When taking the prescription, the outbreak of canker sores occured. I have take penicillin before with no side effects. I went to a ear/nose/throat specialist and he said that the inability to get rid of the canker sores was potentially due to immune system issues. Would lyme diesease compromise my immune system? Are my symptoms related to Lyme diesease or something else? I am located in Northeast Iowa, so any information would be appreciated. Thanks
6. October 2011 at 9:49 am
Lyme disease compromises the immune system big time, Darren. Any dormant pathogens you already have get stirred up, like all the herpes viruses, of which cold sores is one. Your symptoms could be Lyme or another vector-borne illness. I’m sending Iowa Lyme info. I’d suggest you find a Lyme-literate doctor. Lyme often comes with other co-infections that should be tested for and treated as well. Thanks for asking.
30. September 2011 at 7:32 pm
I suspect I have Lyme but am having problems finding a knowledgeable doctor in Nebraska. could you send me information please?
Thanks!
1. October 2011 at 12:14 pm
I”m sending you Iowa Lyme info, Lisa. So far I have nothing for Nebraska. Thanks for asking.
27. September 2011 at 12:11 pm
Pam, Could you send me info for doctors in Montana? I picked up a tick on the east coast this spring and after the first test came back negative and the symptoms went away I chalked it up to some unknown virus and went on with life. Now symptoms are cropping up without any explanation – except going back to the tick bite. Like the doctor, but want a second opinion. Thanks.
27. September 2011 at 2:30 pm
Montana Lyme info is on it’s way, Cathy. Thanks for asking.
23. September 2011 at 4:54 pm
Diagnosed with Lyme’s today. Started on doxycycline for 21 days. Typical symptoms of fever, headache, aching joints, large red spots. Curious about how long it will take before antibiotics kick in and I start to feel better? Are follow-up tests recommended?
24. September 2011 at 7:29 am
Debbie, the Doxy should “kick in” right away killing Lyme. Depending on how long you’ve had Lyme, you can expect a Herxheimer reaction (symptoms getting worse before they get better – normal for Lyme treatment). If your doctor hasn’t done so already, you should also be tested for the co-infections Babesia, Bartonella, and Ehrlicia, which commonly come with Lyme. In addition, most Lyme doctors also test for other bacterial, viral, fungal, and parasitic infections, among them all the herpes viruses, Chlamydia pneumoniae, Mycoplasma pneumoniae, parvovirus, toxoplasmosis, and others. Many of these usually lie dormant in your body, causing you no problems, but get exacerbated by Lyme. Good luck!
24. September 2011 at 10:31 am
Thank you. You were right. Since being diagnosed and starting the doxy, I had the worse night last night, including a fever of 103, headache, aching jaw & ear, and my red circle went from a 3″ diameter to over 4″‘s. Will follow up with my doc for testing of co-infections.
24. September 2011 at 6:18 pm
Pam, although my fever is more controllable today and less aching in my body, the circle or bulls eye is growing quite significantly. In two days it has grown to 5.5 ” diameter. Is this anything to be concerned about, but normal?
25. September 2011 at 11:26 am
A growing rash can happen when you first begin Lyme treatment, Debbie. It should eventually dissipate, although some people being treated for Lyme have a rash that comes and goes throughout their treatment.. If you’re concerned, call your doctor.
21. September 2011 at 1:53 pm
Can you please send info for doctors anywhere near louisville, ky?
thank you,
Lauren.
22. September 2011 at 7:14 pm
KY Lyme info is on its way, Lauren. Thanks for asking.
10. October 2011 at 6:30 pm
I used to live in Louisville. It’s a great place, although sometimes ticks would randomly appear in my hair. I never got Lyme though. My parents had a good doctor- I really don’t know who though. Surely you could find a good doctor.
18. September 2011 at 11:39 pm
I live in Northern Minnesota and last summer was bitten by 4 diff ticks. 2 of them were deer ticks, one I didn’t see until about 3 days later that was on the back side of my knee. I had a big red rash about the size of an orange. I showed my chiropractor at that time and he didn’t think it was lymes because of the way it looked since it wasn’t a bullseye. He now knows better. In the late summer My left hand started hurting from the wrist up and all across the back of the hand. A week after labor day I became sick and then began getting dizzy spells. I had a hard time standing up and finally went to dr. He was sure I had lymes, gave me doxycycline (spelling) for two wks and it took me over a month to get better. Tests came back negative for lymes and others. Later around Christmas I got real sick again and same symptoms. Was tested again and neg so dr said no lymes took me all winter to get better. Went to another dr who was supposed to be knowledgeble on disease. He wouldn’t test me again because he said test was reliable. I have since started having more symptoms my legs are weak and my left knee in the back hurts hands are bad and have a hard time holding things without having pain. My chiropractor thinks I do have lymes since he has really been studying the disease since I began having problems last summer. Could you please get me information on drs in Minn who are up to date on this disease. I appreciate your help.
ught I had the flu for 2 wks. I started to get better and then st
19. September 2011 at 2:03 pm
Sounds like you’ve really had a time of it, JoAnn. I’m sending MN Lyme info. Please find someone who knows how to diagnose and treat Lyme. Thanks for asking.
14. September 2011 at 5:50 pm
had a tick bite 4 years ago and I have a lot of the symptoms of Lyme. I am finding it difficult to find a doctor in the uk that understands Lyme. Do you know of anybody?
Thank you
Dania
14. September 2011 at 6:32 pm
Dania, I’m sending you UK Info. You’ve got a great Lyme forum there that should be helpful. Thanks for asking.
14. September 2011 at 6:41 pm
Thank you for your help Pam, much appreciated.
4. September 2011 at 11:48 pm
I thought that I had found a Dr. in Sacramento, CA who could treat me for Lyme symptoms. He recommends that I have IV anti-biotic treatment which he does not do. Do you know of anyone else in this area who is LLMD? The one he recommended has moved out of state. thanks
5. September 2011 at 3:26 pm
Sending you CA Lyme info, Michel. Hopefully you be able to find an LLMD who does IVs. Thanks for asking.
3. September 2011 at 10:11 pm
I went to my doctor after finding the bulls-eye mark on my chest. He was skeptical that I might have contracted Lyme because its not real common in our area, but agreed to give me a two-week prescription for antibiotics just in case. Its only been a little over a week, but the severe fatigue, muscle aches, and occasional double vision has been rather scary. I definitely want to do anything and everything I can to get rid of this once and for all. Could you send me a list of specialists in the St. Louis, MO area just in case? Thanks.
4. September 2011 at 11:27 am
Ken, a bull’s-eye rash means Lyme. Too bad a lot of doctors don’t know that, or know that Lyme is in their area. The worsening symptoms you’re experiencing is known as a Herxheimer reaction, probably something else your doctor doesn’t know about. MO Lyme info is beng sent shortly. Thanks for asking.
5. September 2011 at 2:29 am
Hi I live in the uk (london) and have been told by a homeopath I have boreila bacteria in my nervous system, she is working with me to get rid of it, I gave up with regular doctors who kept telling me I got rheum arthritis and wanted me to take methotrexate, a powerful chemo drug. I felt much better for year but now am aching in my feet, knees, elbows, shoulders, and I feel like an old woman, r there any lymes specialists in the uk? I would really like to meet one.
5. September 2011 at 3:41 pm
Yes, there are Lyme specialists in the UK, Claire. I’m sending you info on how to find one. Thanks for asking.
23. August 2011 at 6:00 pm
I suspect I’ve had Lyme for years, despite my doctor telling me at the time that “those ticks aren’t around here”. Need I add, I’ve not been treated for Lyme? Do you know of any Lyme literate doctors in Kentucky, or southern Indiana? I’ve been quite ill for the last three years.
24. August 2011 at 3:58 pm
Dang doctors! I’m sending you KY Lyme info, Cheryl. You may have to travel to find a Lyme-literate doc. Do it. It’s well worth the time, money, and effort. Thanks for asking.
21. August 2011 at 10:41 pm
my daughter has been tested for Lyme disease and it was neg. She has all the signs and it has been quite a few years, Her immune system is weak and her red and white blood cells go up and down. Our family dog developed Lyme disease and I am very worried she gets tired more each day and has joint pain in her legs and arms on and off. I have heard of doctors in Rhinebeck, New York but not sure where I should turn. Things are getting worse and I am afraid what will happen if this keeps going untreated. Please help Thank you
Shelly
23. August 2011 at 11:44 am
Shelly, Lyme tests are unreliable. Most Lyme doctors treat on clinical symptoms first. Tell me where you live and I’ll send targeted info so you can find a Lyme-literate doctor near you. Thanks for asking.
27. August 2011 at 5:05 pm
I have a cousin in her late thirties in Hungary who apparently came down with Borrelia bacterium as diagnosed by a doctor there. She has no visible tick bites anywhere but suffers from muscle and joint pains, headaches, insomnia, etc. Blood test was negative after 10 days so antibiotics were stopped. Problems continue. Had high sugar level for 10 days. Feel nauseous and weak. Any advice?
Thanks
27. August 2011 at 5:17 pm
I’m sending the Lyme info I have for Europe, JCB. You’re a good cousin. Thanks for asking.
20. August 2011 at 7:44 pm
My wife got lyme after a tick bite in New York a month ago. I saw the bull’s eye rash after six days and we got her on antibiotics right away. Our doctor gave her a prescription for three weeks, assuring her it would be okay. Her prescription ran out six days ago and she is beginning to see the same achy, fatigue symptoms she had when I first saw the bull’s eye. A month after the bite, we are a little confused and scared as to what the next step is, any advise? thank you,
23. August 2011 at 12:38 pm
Obi, three weeks of an antibiotic for Lyme is rarely enough, although it’s what many doctors who know little or nothing about Lyme prescribe. Tell me where you live and I’ll send you information on how to find a Lyme specialist. Your wife needs longer treatment. Thanks for asking.
18. August 2011 at 2:20 pm
Can you please send MD info for MA, boston suburbs? THANK YOU!
20. August 2011 at 3:09 pm
MA Lyme info is on its way, Andrea. Thanks for asking.
18. August 2011 at 11:04 am
I was finally diagnosed with Lyme disease with Babesia n Bartonella co-infections after a year and half of test after test n everything “seemed” normal. I was hving severe pain in my pelvis, knees,and ribs. Then started hving severe nerve pain on R side n eventually had headaches, blurred, vision, loss of balance n was struggling with bouts of fatigue. Finally I went to a CFNP.. N she immediately suspected Lyme but admitted little knowledge of it..did Igg test which came back negative but she continued to pursue per believing thay is what it really was..PTL.. I was sent to Dr in Lousiana who immediately diagnosed me n began treating me.. What is long-term outcome for people with Lyme? Can u send me list of any other Dr in MS, LA, or Al area that specialize in this? My Dr overloaded n hv friend who has similar symptoms.. Thk u
20. August 2011 at 3:06 pm
Jennifer, the long-term outcome for people with Lyme depends on many factors. People who don’t get treated will most likely have a slow slide into total disability and death. People who get adequate treatment may have recurrences that can be handled with another course of treatment. LA Lyme info is on its way. Thanks for asking.
14. August 2011 at 11:11 pm
Pam,
Can you please send Lyme info for Idaho/Utah?
Thank you
15. August 2011 at 11:30 am
UT/ID info is being sent shortly, Michelle. Thanks for asking.
13. August 2011 at 3:26 am
Hi. I’m 27/f. I noticed a strange bite on my back last summer and seems like it looked like a bullseye. I’ve also had other issues. My bones ache so bad, especially in my legs. Lately, I’ve had hot sensations in my knees and both knees become very red and hot to the touch. The redness is under my skin, and maybe some slight swelling. My poor legs have horrible muscle twitches. The twitches are all over and are constant. The redness is my legs is splotchy and has white around the splotches, I wish I could post a pic
. I tested positive for a u.t.i back in December and despite numerous antibiotics, the leukocytes remain in my urine. I’ve had it for 9 months and had ct scan, ultrasounds and show no abnormalities. I have heart palpitations now. The pain in my legs is so bad sometimes I can’t sleep. I have mentioned Lyme tests but for whatever reason, the doc just never tests for it.. Anyone think it could be Lyme? Or any clue what it could be? The heat in my knees comes on spontaneously and usually disappears after about 30 mins and just keeps doing it over and over again thru out the days. I live in Cleveland, Tn. I’m so confused :/
13. August 2011 at 3:59 pm
What you have could be Lyme or another tick-borne illness, Heather. You should see a Lyme doctor to get tested. I’m sending you TN info shortly. As you’ve already found out, regular doctors know little or nothing about Lyme. Even if they tested you, they’d probably use a CDC test that’s very unreliable. Thanks for asking.
11. August 2011 at 1:32 pm
Can lyme be associated with repeated cases and long lasting cases of mono? Also could you send a list of LLMDs in MA or Southern NH? Thank you
11. August 2011 at 3:51 pm
Yes, Emily, Lyme is often associated with repeated and long lasting flare ups of the herpes virus Epstein-Barr, better known as mononucleosis. Once you have any herpes virus, it stays in your body, although usually quietly, not causing any problems. Lyme changes all that. MA/NH Lyme info is being sent shortly. Thanks for asking.
28. July 2011 at 8:42 am
Hi, Pam, I suspect I may have Lyme’s…can you send me a list of doctors in the south western NH or western MA regions. Thanks, Joe
28. July 2011 at 11:41 am
NH/MA info is on its way, Joe. Thanks for asking.
22. September 2011 at 3:39 pm
Hi Pam, I just came back from the doctors with the suspected diagnosis of Lyme. I started 21 days of doxycycline. Do you have the names of doctors in Southern NH or Northern MA that I can follow up with. According to what I read you don’t seem think 21 days of treatment is enough.
Thanks very much.
Susan
22. September 2011 at 7:47 pm
No one who knows Lyme thinks that 21 days of Doxy is enough, Susan. But congrats on your Lyme diagnosis; it’s a relief to know what you have. I’m sending you NH Lyme info. Thanks for asking.
26. July 2011 at 5:40 am
Hi Pam,
I was just diagnosed with Lyme. By my estimation of the time I have had symptoms I have had it for 2 months now and the pain is excruiating. Can you please send me physicians literate in treatment in Pittsburgh Pennsylvania. Thanks so much.
26. July 2011 at 10:54 am
Glad you know what you have, Kathy. PA/MD info is on its way. Thanks for asking.
8. August 2011 at 10:34 am
Pam, also looking for a Lyme doc also in or near Pittsburgh, PA. Thanks, David
8. August 2011 at 10:47 am
Western PA info is being sent shortly, David. Thanks for asking.
21. July 2011 at 2:29 pm
hello
I am a 30 year old female, I found a tick on my head 2 years ago, in the summer of 2009. Then in the winter of the same year, the joint pain and inflammation, on both knees started. I went to the doctor and the lyme disease test came back negative, the swelling went away, but now 1 year later, the inflammation is back. I feel really sick and the doctor thinks that I had inflammatory arthritis. Please send me the information for a doctor. I live in south new Jersey, close to Philadelphia. Thanks
21. July 2011 at 3:33 pm
Keny – NJ/PA info coming up. Thanks for asking. Good luck!
10. July 2011 at 1:18 pm
Pam, thanks very much. We are in Rochester NY.
10. July 2011 at 3:57 pm
Info coming up, Julie. Thanks.
28. July 2011 at 11:48 am
My 9 year old son was diagnosed with juvenile rheumatoid arthritis in Jan of last year. His symptoms came on very quickly. They tested him for Lyme disease. Came back negative. After reading more on your site, I would like to look further into the possibility of lyme disease. I have never seen a bulls eye, rash or any tick on him. We live in Northern California. Any information that might be helpful would be appreciated.
28. July 2011 at 2:51 pm
CA info coming up, Ida. Thanks for asking.
9. July 2011 at 6:26 pm
Hello, I pulled a tick out of my 10 year old son on May 30th. It seemed just slightly bigger, rounder and lighter in color than a deer tick. I was out of town at the time near the border of NY and PA and he had been in a wooded area with a pond. About 12 hours after visiting the pond, I got it out alive and it didn’t seem very engorged. I called the pediatrician and she said to call back if he got a rash or fever. I kept checking it for about two weeks then we had an illness and death in the family and I forgot all about it until I saw him dressing on June 30th and it look like it had a rash, like a mosquito bite size. Then, a couple of days later the rash was twice the size and the bite area was looking strange so I took him to a Dr. in FL (where we were for the funeral) and that Dr. said he thought it was Lyme and put him on 2 weeks of amoxicillin, 500mg 3x a day.
I am concerned that a whole month passed until he went on the medicine. He was fine all month. He got a fever, sore throat, and runny nose 3 days into the antibiotics but the doctor said that was unrelated (still odd for this time of year for him). Is a month enough for the Lyme bacteria to infiltrate his system? What can I do after the round of antibiotics to make sure they were effective? If he is symptom free can I assume he is ok?
10. July 2011 at 12:36 pm
Julie: Once a person has been bitten by a Lyme-infected tick, it takes only hours for the spirochetes to get into the bloodstream. If you son has Lyme, his fever, sore throat, and runny nose were probably a reaction to the antibiotics killing the Lyme. Sorry to say, 2 weeks of Amoxicillin rarely gets rid of Lyme, especially if someone has had it for more than a few days. Your son could be apparently symptom free for a few weeks and then get hit again when the Lyme builds up and comes back. Tell me where you live and I’ll send you info on how to find a Lyme doctor near you. Better safe than sorry. Thanks for asking.
27. July 2011 at 7:54 pm
Any doctors in Reno, Nevada that specialize in Lyme disease???
28. July 2011 at 11:04 am
NV Lyme info is on its way, Kathy. Thanks for asking.