{"id":7215,"date":"2015-07-06T07:55:53","date_gmt":"2015-07-06T12:55:53","guid":{"rendered":"https:\/\/wholehealthchicago.com\/?p=7215"},"modified":"2021-08-18T22:48:47","modified_gmt":"2021-08-19T03:48:47","slug":"they-crawl-under-my-skin-and-come-out-at-night","status":"publish","type":"post","link":"https:\/\/wholehealthchicago.com\/blog\/2015\/07\/06\/they-crawl-under-my-skin-and-come-out-at-night","title":{"rendered":"\u201cThey Crawl Under My Skin and Come Out At Night\u201d"},"content":{"rendered":"\n

Earlier this year, iconic folk singer Joni Mitchell was found unconscious in her California home and immediately hospitalized. Although she was subsequently discharged and seems to be doing well (in late June her spokesperson said she\u2019d experienced an aneurysm<\/a>), the hospitalization revealed that she\u2019d been plagued for years with Morgellons Disease<\/a>.<\/p>\n\n\n\n

She describes her experience with Morgellons in a 2010 LA Times<\/em> interview: \u201cI have this weird, incurable disease that seems like it’s from outer space.. I look scary under daylight… Fibers in a variety of colors protrude out of my skin like mushrooms after a rainstorm: they cannot be forensically identified as animal, vegetable, or mineral. Morgellons is a slow, unpredictable killer \u2014 a terrorist disease: it will blow up one of your organs, leaving you in bed for a year. In America, the Morgellons is always diagnosed as \u2018delusion of parasites\u2019 and they send you to a psychiatrist.\u201d<\/p>\n\n\n\n

And from her 2014 memoir In Her Own Words<\/a><\/em>: \u201cI couldn\u2019t leave my house for several years. Sometimes it got so I\u2019d have to crawl across the floor. My legs would cramp up like a polio spasm.\u201d<\/p>\n\n\n\n

What Morgellons feels like<\/strong><\/h3>\n\n\n\n

In addition to a creepy crawly sensation beneath the skin and those very peculiar fibers, Morgellons patients also have chronic fatigue, brain fog, and muscle aching, which are also common symptoms of fibromyalgia and chronic fatigue syndrome. Because various diagnostic test results are generally negative, people who struggle with fibro and CFS frequently hear \u201cWe can\u2019t find anything wrong. Your tests are normal. It\u2019s all in your head.\u201d<\/p>\n\n\n\n

For those with Morgellons, the situation may be even worse. They see white, blue, red, and black fibers among their itchy skin sores. But physicians, usually dermatologists, don\u2019t see anything. Doctors often say that the fibers are strands of clothing, or normal tiny pieces of shredded skin. Some physicians totally disbelieve their Morgellons patients and accuse them of implanting fibers or deliberately scraping their skin in order to be taken seriously. They advise them to seek psychiatric help, and label them as suffering from \u201cdelusional parasitosis.\u201d<\/p>\n\n\n\n

Once the word \u201cdelusional\u201d gets written into a patient chart, it\u2019s there forever.<\/p>\n\n\n\n

Our Morgellons patient<\/strong><\/h3>\n\n\n\n

Some time ago, I had a patient (we\u2019ll call her Laura) with Morgellons who traveled from another city after seeing dozens of doctors and being dismissed as a delusional neurotic. Laura actually arrived with an overloaded briefcase filled with negative test results (including multiple skin biopsies), a full-sized microscope, and several small glassine envelopes containing fibers she had picked off her skin. I was happy to look at these since I\u2019d never actually seen a patient\u2019s own samples.\u00a0 \u201cYou\u2019re the first doctor willing to even check these out,\u201d she said delightedly.<\/p>\n\n\n\n

I wasn\u2019t much help. What I saw under the microscope were exactly what\u2019s described in dermatology textbooks for Morgellons: different colored fibers that she told me had pushed up through her skin. To retrieve a fiber, Laura explained, she would grab one with tweezers and tug it free. From my examination under the microscope, I was unable to tell what these fibers actually were made of, whether they were inanimate pieces of cloth or organic bits of fibrous tissue. I suggested that an analytic lab might be able to offer more than our office.<\/p>\n\n\n\n

Laura told me that one doctor had prescribed the antibiotic doxycycline (Minocin) and she\u2019d been surprised at how much better she felt. Unfortunately, she couldn\u2019t get doctors to prescribe it for long-term use. I remember thinking at the time that long-term doxycycline was pretty safe (if taken with good probiotics), as it was given to teenagers for acne. I wondered if the antibiotics might be killing some unknown bug or whether she was experiencing a placebo effect, so convinced the antibiotics were killing whatever was crawling around that she simply felt better.<\/p>\n\n\n\n

I\u2019m pretty open to the \u201cwhatever works\u201d philosophy of medicine and since there were no more tests to order, I wrote her prescriptions for both doxycycline and the anti-fungal diflucan, both of which are relatively safe for long-term use. I encouraged her to find a local doc who would continue these. I never heard from Laura again.<\/p>\n\n\n\n

Blaming the patient for her symptoms<\/strong><\/h3>\n\n\n\n

Based on the writing style alone, I\u2019m pretty sure the Wiki article on Morgellons<\/a> was authored by Stephen Barrett, MD, who runs quackwatch.com. The article dismisses Morgellons as another \u201csham\u201d diagnosis along with candida, leaky gut, and adrenal fatigue. Both the Mayo Clinic<\/a> and Web<\/a>M<\/a>D<\/a> websites are more empathetic, and they do emphasize the cause-unknown factor and offer some suggestions for symptom relief (mainly anti-itch creams).<\/p>\n\n\n\n

I was disappointed, but not particularly surprised, to see an undercurrent of medical sexism in many of the articles I\u2019ve been reading about Morgellons. There\u2019s frequent reference to the fact that most sufferers are middle-aged white women (MAWW). With psychiatric innuendoes lurking in the same paragraph, you finish the article with the sense that those MAWWs are always complaining about something.<\/p>\n\n\n\n

Obviously any prejudice grievously interferes with rational medical thinking. Those who hint at the MAWW vulnerability to chronic symptoms forget that this group generally has better access to the health care system. Anyway, women as a rule are more in touch with their bodies than men.<\/p>\n\n\n\n

Bad news, good news<\/strong><\/h3>\n\n\n\n

Bad news first. Spurred by letter-writing campaigns, the CDC actually did spend quite a bit of time and money trying to determine if Morgellons is an infection. They concluded that the skin lesions were induced by patients themselves and that the fibers looked like skin and bits of clothing. CDC was unable to say if Morgellons was a new condition or a delusional phenomenon. They also decided to do no further research on the subject. Case closed.<\/p>\n\n\n\n

Thanks a bunch, guys.<\/p>\n\n\n\n

Now some good news. Several years ago, dermatology researchers noted that a very specific organism, called a spirochete, had been found in the skin lesions of several people with Morgellons. Spirochete infections occur primarily in sexually transmitted syphilis (caused by Treponema pallidum<\/em>) and tick-bite Lyme disease (caused by Borrelia burgdorfi<\/em>.)<\/p>\n\n\n\n

Recently, using very sophisticated diagnostic research tools including electron microscopy, some (but not all!) research has linked Morgellons to Chronic Lyme (Borrelia<\/em>)<\/a> and a second tick-borne illness called Bartonella<\/a>.<\/p>\n\n\n\n

But doctors do disagree, and at this juncture, the CDC doesn\u2019t buy the Morgellons-Lyme-Bartonella link. The situation is certainly not helped by the fact that a majority of conventionally trained physicians still don\u2019t believe in the existence of chronic Lyme, many dismissing it, too, as an \u201call in your head\u201d condition.<\/p>\n\n\n\n

So here\u2019s where things stand<\/strong><\/h3>\n\n\n\n

If you have the horrible sensation of things crawling beneath your skin, see fibers popping from itchy skin lesions, and feel ill all the time, according to the conventional medicine viewpoint you\u2019re neurotic and need a shrink, especially if you\u2019re a MAWW.<\/p>\n\n\n\n

Comforting, eh?<\/p>\n\n\n\n

A minority of physicians, including us at WHC, would counter that you\u2019re not neurotic, your symptoms are real, and you should be tested for Lyme and other tick-borne illnesses. If your tests show even a hint of Lyme, you should be treated for it.<\/p>\n\n\n\n

This, by the way, would explain why Laura, the Morgellons patient I treated years ago, reported feeling better taking doxycycline.<\/p>\n\n\n\n

It\u2019s the mainstay of Lyme treatment.<\/p>\n\n\n\n

Be well,
David Edelberg, MD<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

Earlier this year, iconic folk singer Joni Mitchell was found unconscious in her California home and immediately hospitalized. Although she was subsequently discharged and seems to be doing well (in late June her spokesperson said she\u2019d experienced an aneurysm), the hospitalization revealed that she\u2019d been plagued for years with Morgellons Disease. She describes her experience […]<\/p>\n","protected":false},"author":2087,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2,531,3,104,62],"tags":[1762,1763,1764,106,1765],"class_list":["post-7215","post","type-post","status-publish","format-standard","hentry","category-blog","category-case-studies","category-knowledge-base","category-lyme-disease-morgellons","category-t","tag-bartonella","tag-borrelia","tag-joni-mitchell","tag-lyme-disease","tag-morgellons-disease"],"yoast_head":"\r\n\u201cThey Crawl Under My Skin and Come Out At Night\u201d<\/title>\r\n<meta name=\"description\" content=\"arlier this year, iconic folk singer Joni Mitchell was found unconscious in her California home and immediately hospitalized.\" \/>\r\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\r\n<link rel=\"canonical\" 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