The Herx

A Jarisch-Herxheimer reaction (aka a "herx") is, to put it simply, a miserable medical experience. But it's also a very good thing.

Herxing is specific to very few diseases, including syphilis and Lyme disease, which are both spirochetal infections. As I mentioned in my previous post, spirochetes are a type of microscopic organism that look like little spirals.

They are smart buggers, adapting to antibiotics and changes in your body.

It's hard to kill them, but it's pretty much the only way you can get better.

So a herx is what happens when you actually do start to kill them off with antibiotics. I'll explain how it works, but for a more detailed, scientific explanation, please either check it out here or here. So:

1. The antibiotics (if you're taking the right type or types, in the right dose, at the right times of day) start killing the spirochetes. This is good. But if the antibiotics are working particularly well, the spirochetes start to die off very quickly.

2. As they die, their cell walls burst, and the contents spill out into your body. Remember, spirochetes are living organisms--though I can't say I feel bad for killing them.

3. A herx happens if enough dying or dead spirochete material floods into your system, leading to an inflammatory immune response.

4. While you may have an acute, life-threatening allergic response, or a fever that rises quickly (I almost died this way, in 2003), it is more likely that you will just feel awful for a day or a few days.

Herxes come on quickly or take a while to appear, but either way, you will probably feel a worsening of the Lyme symptoms you already have. According to Pam Dodd's Lyme Disease Blog, symptoms could include:

• fever
• sweating and chills
• rapid heart rate or palpitations
• shortness of breath
• muscle and joint aches and pains
• headache
• brain fog
• insomnia
• swollen glands
• ringing in the ears
• sinusitis
• itching
• digestive issues
• unstable emotions
• general feeling of sluggishness

For me, when I'm not feverish, I'm experiencing unbelievable pain. That's how I know the antibiotics are working.

What can you do? You can eat well, drink a ton of water, take your vitamins, and get sleep. Take baths and drink tea. And call your doctor--he or she may want to reduce your dose or have you take a "drug holiday" until the herx has passed.

But remember--it will get better. And if you don't have a herx, the antibiotics are still probably doing their job. It's just one more weird, hardly-understood thing about Lyme disease.

Borrelia burgdorferi

I have a fantastic LLMD (Lyme-Literate Doctor) in Iowa, where I live. The doctor I was seeing before him lost his medical license (see video in preceding post) so I started seeing this doctor. He is very smart, and explains Lyme disease to me in a way no one else has before, and I want to share what I know with you.

Lyme disease is an infection by a spirochete known as Borrelia burgdorferi (Bb). A spirochete is an organism that looks like a spiral, a coiled spring. Syphilis is also a spirochetal infection, and in many ways, manifests similarly to Lyme.
The way to treat Lyme is to manage the symptoms while getting rid of the spirochete. To manage the symptoms, you might need any number of medications, since Lyme is known for its myriad presentations. For example, you will probably need medications to reduce your levels of pain. Some patients need medications for severe mood swings or cognitive deficits. You might need medications to manage cardiac problems, like blood pressure drugs. Or gastrointestinal support. On and on.

Each person’s Lyme disease is unique, with one aspect uniting all of us: symptoms come and go, they wax and wane, and many are not detectable with standard diagnostic testing. You can probably see what the challenge is here. With that type of symptomatic constellation, there are a whole lot of doctors who are going to think it’s in your head, a response to stress and not an actual disease.

Doctors are not perfect. They are people, biased and jaded like all of us.

The way to get rid of the spirochete is generally with the use of antibiotics. If you have Lyme disease that has become chronic, you’ll probably need antibiotics for months to years. Antibiotics can be unpleasant to take, for a few reasons. One is that they can bother your stomach a lot. Most antibiotics should be taken with a meal, but check with your pharmacist on this. Part of the reason they bother your stomach is because they eat up all the healthy organisms in your digestive tract, the ones that help you maintain a gastrointestinal homeostasis, so to speak. They can also do the same to women’s vaginas, leading to yeast infections. To deal with either of these problems, you should take a probiotic such as acidophilus, available in the vitamins section.
If you’re on intravenous (IV) antibiotics, you have to deal with a PICC line, a port in your chest, or some other way of getting the antibiotics into your blood once or twice a day. I have had a PICC line, and I did not enjoy it, because I found it a little scary to be injecting medicine directly into my blood stream, because it was very hard to shower with the PICC line (it should never get wet), and because I didn't know what to do with the line that dangled down my arm.
All the same, IV antibiotics can work very well, sometimes when oral antibiotics do not.

One other problem you run into with antibiotics is the Jarisch-Herxheimer reaction, colloquially known as a “Herx.” This is a central issue to Lyme disease, and I'll post on it soon.

Well, kids, this has been Lyme disease 101. I will continue to make posts that are educational, as well as very biased posts on the way I see the Lyme disease controversy, and autobiographical posts, about my own experience with it. If you'd like to submit your own story to this blog, please click on the "Share Your Lyme Story" link above. And please, comment, follow, and share this blog.