By David Cederstrom
Chronicle Staff Writer
“We need a better navigation system” to deal with tick-borne diseases such as Lyme, Dr. Ronald Stram told a crowd of about 60 people at SUNY Adirondack on Nov. 14. The topic of the talk was “From Tick Bite to Chronic Lyme Disease: A Better GPS to Bring Us to a Healthier Destination.”
Dr. Stram, who is board-certified in emergency medicine, founded the Stram Center for Integrative Medicine in Delmar.
Some of what he said was not encouraging. He said newer studies show that a tick biting a human can transmit Lyme bacteria, Borrelia burgdorferi, in less than four hours, contrary to the established medical guidelines that say it takes 24 to 36 hours.
He recommended aggressive antibiotic treatment for a month for any case in which a tick has been attached to a person for more than three hours, and possibly longer treatment using more than one type of antibiotic if symptoms do not improve. He said that relapses are frequent with shorter-term antibiotic treatment.
“We have to get over the current established guidelines for treatment, that don’t work,” Dr. Stram said.
He told the attendees, “This talk is geared for you, to give information back to your health care providers….Your mission, if you accept it, is to go out and inform.” Dr. Stram said the Lyme bacteria “is really a very advanced organism,” capable of shifting between spiral and L-form shapes, encysting itself, living deep in tissues and joints where many antibiotics don’t reach, living inside cells, and producing biofilms (a slimy layer that can protect the bacteria). He said the different forms require different antibiotics.
Co-infections by other tick-borne diseases such as Babesia or Bartonella (“cat- scratch fever”) can also be present, further complicating treatment, he said.
Lyme bacteria actually tend to be present in relatively small numbers and reproduce slowly, but they produce large amounts of debris in the form of sugar proteins, fats, and DNA, Dr. Stram said.
“Right now, we can’t change the beginning [of contracting Lyme disease], but what we can do is change the ending,” Dr. Stram said.
At the Stram Center, he said, “our approach is a whole-system, whole-person approach, and this means not only do we utilize judicious and sometimes prolonged and variable antibiotic therapies, and herbal and vitamin supplements, but we also include lifestyle modification, nutrition, and complementary treatments such as acupuncture and massage to assist you in your care.”
Dr. Stram said, based on their clinical experience, “this integrated approach, we believe, has the most effective outcomes.”
Dr. Stram said that a majority of sufferers do not remember getting a tick bite, and less than one third get the skin rash associated with Lyme disease.
“The ELISA test alone does not meet the criteria” of the Center for Disease Control, Dr. Stram said. He said it’s only about 30% accurate. He asked, what would you think if your mechanic told you he could test your car to see if it needed a new engine, but the test was only 30% accurate?
The Western Blot test is better, but is still only about 50% accurate, he said, calling it “a coin toss.”
A close look at the patient’s history, such as chronic fatigue and a myriad of symptoms that can come and go and change over time, is essential for diagnosis, Dr. Stram said.
A new “Advanced Care” blood test directly detects Lyme bacteria, but it’s not yet approved in New York State, Dr. Stram said. It also costs about $600, requires three or four blood test vials of blood, and results can take two months or longer, he added.
Asked about the safety of long-term antibiotic use, Dr. Stram said they can be used a year or even more, but in his practice it would be done in conjunction with a strictly controlled diet and judicious use of probiotics, which restore the population of beneficial bacteria that naturally occur in the digestive tract.
The diet would rely heavily on fruits, nuts, and vegetables, with very little meat and no processed foods, he said.
Copyright November 21, 2012, Lone Oak Publishing Co., Inc. All rights reserved.