COVID-19 is certainly still with us. Last week, the U.S. death toll crossed the one million mark. Suburban Evanston returned to the high-risk zone for COVID transmission, yet much of Illinois, especially downstate, remains woefully unvaccinated (only 37% are VAXed and boosted). I receive at least three or four emails a day, variations on “flu-like symptoms, home-tested positive, what next?”.
The answer is rest, quarantine five days, treat symptoms (if you have them usually with Tylenol or ibuprofen, throat lozenges, cough syrup, etc.), and I can phone in the new antiviral, Paxlovid. If you have no symptoms, I wouldn’t use it; supplies are short. Paxlovid is not used to “keep on hand”, but rather to prevent mild COVID from becoming severe.
The Mayo Clinic website provides excellent guidelines for at-home COVID treatment including when to consider a trip to the emergency room.
Two years ago, the Federal Trade Commission warned all health care providers not to give any advice about COVID that had not been FDA approved. Literally overnight the word “COVID” was replaced by the words “Immune Support” and these have been our recommendations:
AND: If you can schedule an Immune Boost Infusion every 2-4 weeks, it would be helpful.
Now, As For The Ticks…
The combination of a warm climate, plenty of acorns for mice to feed on, plenty of mice for ticks to feed on, has now caused a real explosion in the tick population in Wisconsin, Michigan and northern Illinois and Indiana. 20% of the nymph ticks (newly hatched, and you can barely see them) carry Lyme Disease, as well as 50% of the more visible adults.
If you dare go camping or for a walk in the woods (I am beginning to think skydiving is safer.), wear long pants tucked in at the socks and a hat. Use a “tick defense” spray on exposed skin. Do a “tick check” of your skin; although, the nymphs are so tiny you’ll probably miss them. If you do see one, remove it, and have your primary care doc prescribe four days of doxycycline to prevent Lyme disease. The famous ‘bulls-eye rash’ only appears in about a third of Lyme cases.
Much more diagnostically useful is when a patient reports a flu-like illness (fever, muscle aches, fatigue) a few days after a vacation in a Lyme area. It will be too early for a blood test to show anything Lyme-wise (a home COVID test might be useful to different COVID from Lyme). If your COVID is negative, it is perfectly reasonable to assume Lyme is present and get a month of Doxycyline, because untreated Lyme (a/k/a “chronic Lyme”) can be a real bummer.
A Highly Recommended New Book
Early last week, one of my patients enthusiastically recommended, “The Invisible Kingdom: Reimagining Chronic Illness” by writer and poet Meghan O’Rourke. She describes the utterly horrible spiral down from being a happy, healthy and successful woman into lonely days, nights, months, then years of widespread pain, fatigue, and brain fog as everything she accomplished starts slipping away into chronic unexplained illness. “Tests” are endlessly “negative”. Doctors are sympathetic but helpless. “The Invisible Kingdom” is the clearest explanation of the web that connects autoimmune disease, chronic fatigue, chronic Lyme, long-haul COVID-19 and other “negative test” illnesses I’ve ever encountered.
What I do know is that, here at WholeHealth Chicago, we have taken care of hundreds of “Meghan O’Rourkes”. Users of e-readers will understand this: the “reveal” of her diagnosis is at the 47% point in the book. Being an amateur medical detective myself, I immodestly, correctly diagnosed her problem at the 10% point, but then inwardly chuckled (yes, people still ‘chuckle’), “probably most of our WholeHealth Chicago patients could have made her diagnosis at the 10% point, too.”
Good book, very highly recommended.
David Edelberg, MD