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Cure Unknown: Inside the Lyme Epidemic [Hardcover]

Pamela Weintraub
5.0 out of 5 stars  See all reviews (2 customer reviews)
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Review

“Pamela Weintraub's book is compelling, clear and troubling.”
–Patti Adcroft, editorial director of Discover magazine

 

“In Cure, Unknown, Pamela Weintraub has produced both the definitive book about Lyme disease and associated disorders and a survivor’s account of a grueling medical odyssey. Weintraub is a masterful science writer and storyteller, and she tackles the quarrels and quagmires surrounding this baffling illness with intelligence and pathos. This is an important and unforgettable book, destined to make a lasting contribution to the field of investigative health journalism.”
–Kaja Perina, editor in chief of Psychology Today

 

"A thoroughly researched and well-written account of the disease's controversial history."
--Jane Brody, New York Times
 
 
 
"Pam Weintraub, veteran science writer, weaves personal narrative with hard-hitting investigative journalism to bring the underground epidemic of Lyme and other tick-borne diseases up from under the
radar."
-Rebecca Wells, author of Ya-Yas in Bloom and Divine Secrets of the Ya-Ya Sisterhood.
 
 
 
"I sometimes wonder if the only investigative writers who will possess the necessary temerity to remove the white gloves and tackle these putative experts to the ground will be those, like Weintraub and the
late Randy Shilts, whose personal experience demands that they follow the rocky trail that leads to the truth."
-Hillary Johnson, author of Osler's Web: Inside the Labyrinth of the Chronic Fatigue Syndrome
Epidemic
 
 
 
"Millions suffering from symptoms of a mysterious disease need suffer confusion and loss no longer. If you want to know the real story behind Lyme disease and how to find your way back to health, read this book."
-Mark Hyman, MD, author of the New York Times bestseller, UltraMetabolism.
 
 
 
"Science journalism at its best."
--Amiram Katz, MD, Clinical Faculty, Neurology Department, Yale School of Medicine
 
 
 
"Weintraub turns a tragic yet eye-opening experience into a shocking exposure of what can happen when egos, greed, and peer pressure supercede objective evidence, allowing patients to suffer chronic,
disabling illness."
–Donna Chavez, Booklist
 
 
"Exhaustively researched and highly recommended."
–Tina Neville, Library Journal
 
 
 
"A tale of biological complexities, scientific turf battles, political intrigue, human egos and money – lots of it."
–Dorothy Kupcha Leland, Sacramento Bee
 
 
 
"Living with Lyme gave Weintraub both the insight and the dogged ambition to find out some truths ...  rather than remaining stuck at the pro-Lyme, anti-Lyme debate, Weintraub spent many hours
interviewing researchers who are experts in the ticks that spread Lyme, and the bacterial spirochete, Borrelia burgdorferi, that causes it. What she found is that these researchers -- at places like the
State University of New York at Stony Brook on Long Island, and the University of California at Davis -- are slowly figuring out how complex the bacteria and the disease are. And Weintraub said, these
researchers, by and large, confirm what many Lyme patients have learned through bitter experience -- the bacteria can cause a persistent infection that may not be treated easily by a couple of
weeks of antibiotics."
--Robert Miller, Danbury News-Times
 
 
 
"The view from inside the tick tornado: Sober but scary ...A science and health journalist, Weintraub writes clearly and passionately about a mysterious illness that has confounded physicians, patients and
scientists for more than three decades, while she tries to balance personal narrative and objective journalism... a comprehensive and compassionate guide to a dreaded illness named after a bucolic,
tick-infested town on Long Island Sound."
--Bill Williams, Hartford Courant
 
 
 
"In the war of information on Lyme disease, patient activist groups have started from a marked disadvantage to the medical establishment in terms of visibility and credibility. That may be changing, and science journalist Pamela Weintraub's new book, "Cure Unknown: Inside the Lyme Epidemic" (St. Martin's Press), could be one reason. Weintraub, a senior editor at Discover magazine, uses her family's protracted Lyme odyssey as the jumping off point for an exploration into the history, politics and, predominantly, the patient experience of the tick-borne disease."
--- Susan Morse, Washington Post

About the Author

Pamela Weintraub is an author and journalist who specializes in health, biomedicine, and psychology. She is currently senior editor at Discover Magazine and has previously held positions at Psychology Today and OMNI, where she served as editor in chief. Weintraub has written hundreds of articles for many national publications, including Redbook, Ms., McCall's, Audubon, and Health, to name just a few. She lives in Connecticut.

Excerpt. © Reprinted by permission. All rights reserved.

Introduction
 
Navigating by Lymelight
 
Starting in the early 1990s, after we moved from a city apartment to a wooded property in Westchester County, New York, our family began to get sick. At first the illness was subtle: The vague headaches, joint pains, and bone-weariness seemed par for the course in our busy suburban lives. But as years passed, the symptoms intensified and multiplied, burgeoning into gross signs of disease.
 
My knees became so swollen that I descended the steps of my house while sitting. Swallowing my food, I choked. My arms and legs buzzed—gently at first, but then so palpably I felt like I was wired to a power grid. A relentless migraine became so intense I spent hours each day in a darkened room, in bed.
 
My husband, Mark, an avid tennis player with great coordination, began stumbling and bumping into walls. Formerly affable, he began exploding at offenses as slight as someone spilling water on the floor. He was an award-winning journalist with a love of literature and a vocabulary so vast he was our stand-in for the dictionary. But slowly he began struggling with memory and groping for words. Finally, ground to a halt, he left his job as editor in chief of the newsletter Bottom Line Health one day after realizing that he’d spent hours trying to read a single, simple paragraph.
 
Our youngest son, David, began to sleep—first so long that he could not do his homework or see his friends; eventually, so much (fifteen or more hours a day) that he could not get to class. Violating the strict attendance policy at his prep school, he was asked to leave.
 
Hardest hit was Jason, our oldest, who suffered fatigue and shooting pains starting at age nine, the summer we took up residence in our fairytale house in the woods. The doctors called these “growing pains” normal, but by age sixteen Jason was essentially disabled. He couldn’t think, walk, or tolerate sound and light. His joints ached all day long. On medical leave from high school, he spent his days in the tub in our darkened main-floor bathroom, drifting in and out of consciousness while hot water and steam eased his pain. As his condition worsened, as all sorts of lab tests came back negative, a raft of specialists at New York City’s top teaching hospitals suggested diagnoses from migraine aura (the dizzying buzz of a migraine) to fifth disease (a swelling of the joints caused by infection with parvovirus). Each diagnosis elicited a treatment, but none of them worked.
 
“What about Lyme disease?” I asked.
 
“There are too many symptoms here and he’s way too sick for Lyme disease,” responded the pediatrician, who declined to even test for it.
 
But by 2000, with answers still eluding us, the pediatrician drew fourteen vials of blood, testing for hormone imbalance, mineral deficiency, anemia, and a host of infections, including Lyme. A week later he contacted us, baffled. Just one test, a Western blot for antibodies against Lyme disease, had come back not just positive, but off-the-charts reactive. Jason was quickly reported to the Centers for Disease Control and Prevention (CDC) as an unequivocal case of Lyme disease. When the head of infectious disease at Northern Westchester Hospital put his imprimatur on the diagnosis, we had an explanation for Jason’s illness and an inkling as to what might be wrong with the rest of us, at last.
Our nightmare had just begun. As with the quest for diagnosis, almost everything about Lyme disease turned out to be controversial. From the length and type of treatment to the definition of the disease to the kind of practitioner we should seek to the microbe causing the infection (or whether it was an infection at all), Lyme was a hotbed of contention. It was the divisiveness surrounding the disease that had caused our pediatrician and the specialists we’d consulted to hold back diagnosis as Jason and the rest of us became increasingly ill.
 
For patients with early-stage Lyme disease the illness tended to be mild, and a month of antibiotic treatment usually offered a cure. But for those who slipped through the cracks of early diagnosis, for people like us, infection could smolder and progress, causing a disabling, degenerative disease that confounded doctors and thrust patients into the netherworld of unexplained, untreatable ills.
Despite the effectiveness of early treatment, withholding therapy had become increasingly common as a battle royal over Lyme’s essence spilled from medical centers and clinics into the communities where people got sick. The same doctors who routinely doused acne and ear infections with years of antibiotic often would not prescribe even ten days of such treatment for Lyme unless proof of infection was absolute. Meanwhile, the few doctors willing to treat the sickest patients with longer-term or higher-dose antibiotics could be called up for trial by medical boards, putting their practices and licenses at risk.
 
The war over Lyme had raged for twenty-five years when it swept us up in its madness. On one side of the fight were university scientists who first studied Lyme disease, initially writing it up in medical journals as an infection of the joints. The disease they described was caused by the spirochete Borrelia burgdorferi and transmitted to people by the bite of a deer tick. It was hard to catch and easy to cure no matter how advanced the case when first diagnosed. Late disease was rare, these academics said, because Lyme was recognized easily through a bull’s-eye rash and a simple, accurate blood test. Rarely was their version of the disease seen outside the Northeast, parts of California, and a swath of the Midwest.
 
To the horror of these scientists, the circumscribed disease of their studies had been hijacked by “quack suburban doctors” who saw Lyme everywhere, from Florida to Texas to Michigan, invoking so many signs and symptoms that they included every complaint under the sun. These heretical doctors, the scientists charged, were dispensing antibiotics like water, all the while raking in money from patients too deluded to realize they didn’t have Lyme disease at all. The patients had other things, the scientists said: sometimes mental disorders, but also chronic fatigue syndrome and .bromyalgia, illnesses with no known cause or cure.
 
On the other side of the fight, far from the ivory tower, the rebel doctors and their desperately sick patients insisted that Lyme and a soup of coinfections caused a spectrum of illness dramatically different from the one the scientists described. Knees didn’t always swell and the rash (rarely a bull’s-eye) often wasn’t seen. Instead the patients were mostly exhausted, in chronic pain, and dazed and confused. The mental condition they called “Lyme fog” robbed them of short-term memory, stunted their speech, and crippled their concentration. Brain infection could inflict a host of frank psychiatric problems from bipolar disorder and depression to panic and obsessive-compulsive disorder (OCD), they said, and Lyme could trigger autism or be confused with amyotrophic lateral sclerosis, known as Lou Gehrig’s disease, or ALS. Because their illness differed profoundly from the disease described in textbooks, because it often eluded blood tests, the patients went undiagnosed and untreated for years. As they struggled for answers, oncetreatable infections became chronic, inexorably disseminating, and causing disabling conditions that could never be cured. If treatment was to work at all, the heretic Lyme doctors said, it required high-dose antibiotics, often in combination or delivered intravenously, sometimes for months or years.
 
The patients, for their part, tried to comprehend why the academics dismissed their cases as false. The scientists were promoting an impossibly narrow version of Lyme disease to protect their early work and secure a windfall from Lyme-specific patents, some patients believed. A flow chart entitled “The Wall of Money” began circulating around support groups, connecting some of the researchers with U.S. patents and federal or industry grants. Other patients complained that university physicians consulted for managed care, making hundreds of dollars an hour dismissing Lyme diagnoses and advising rejection of their claims. The academics advanced their agendas, the patients charged, by reporting the doctors who treated them to disciplinary boards.
 
As medical tribunals swept through the Lymelands, primary care physicians became ever more cautious about treating or even diagnosing Lyme disease for fear of becoming targets themselves. Stepping into the breach, a few doctors—Ed Masters of Missouri, Charles Ray Jones of Connecticut, Ken Liegner and Joe Burrascano of New York—went to the mattresses for the patients, but with the Lyme war so brutal, thousands of cases were missed.
 
Lyme or not Lyme? Diagnoses could get mixed up. Dueling brain tumor stories make the point. A young woman from Australia went hiking in California. From that trip on her health declined. She eventually experienced such pain, disorientation, and inflammation that doctors thought she might die. She returned to the U.S. for treatment, and neurologists in Manhattan diagnosed a brain tumor. They actually operated, but when they opened her up, there was no tumor. It turned out the young woman had Lyme disease. She was treated with antibiotics and cured. A young man from New Jersey was diagnosed with Lyme disease and treated with antibiotics for months without impact. Finally he was sent to a local medical center, and further testing was done. Doctors discovered a brain tumor and operated to re...
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