3 ms·

I'm stunned that you think people in this thread are promoting needless antibiotic use or "endorsing chronic lyme's existence." Please - do link the paper dispr

I'm stunned that you think people in this thread are promoting needless antibiotic use or "endorsing chronic lyme's existence." Please - do link the paper disproving the existence of chronic Lyme. Say you were diagnosed (via ELISA or Western blot) a few months/years ago with Lyme borreliosis. You take antibiotics for the recommended course, and your health has returned, but your tests are still quite positive. Your doctor(s) recommend continuing the antibiotic therapy. Would you rather that they terminate treatment despite (a) blood tests turning up positive and (b) symptoms continuing? Are doctors no longer permitted the last word in treating their own patients?

NikolaNovak 7y ago
>> link the paper disproving the existence of chronic Lyme. I mean, regardless of the "side" or "stance", this is kind of the oldest, least honest logical fallacy in the book [1] - you're requiring somebody else to disprove existence of something? How, exactly? Typically, the burden of proof is on the entity making a claim. >>Are doctors no longer permitted the last word in treating their own patients? erm... no? I'm assuming there's a more profound intent behind this statement, but as it reads, no absolutely not. Doctors are not researchers, they are (to simplify, for purpose of this discussion) expert [and hopefully experienced] appliers of knowledge gained by others, over generations of hard work. "In case of discrepancy between sticker and system, the system price will be held correct": in case of discrepancy between some random doctor and accumulated body of knowledge, body of knowledge wins. For example, if my doctor tells me to ingest my own urine twice a day, and CDC & NIH tell me that is bollocks, the doctor empathically does not hold the last word. ---- As to the particulars of your claims when it comes to Lyme, observationally, people actively "shop" for a doctor that will prescribe them the treatment the patient desires. So the last word here is actually typically the patient's. :| 1: https://en.wikipedia.org/wiki/Russell%27s_teapot https://en.wikipedia.org/wiki/Russell%27s_teapot
- eigenloss 7y ago
  > I mean, regardless of the "side" or "stance", this is kind of the oldest, least honest logical fallacy in the book [1] - you're requiring somebody else to disprove existence of something? How, exactly? > Typically, the burden of proof is on the entity making a claim. I would argue here that hycaria is the entity making a claim here: he's arguing that chronic Lyme is nonexistent and essentially fraudulent. The point is that the existence of chronic Lyme cannot be disproved. I'd congratulate you for knowing the concept, but Russell's teapot is completely irrelevant here; if long-term treatment with antibiotics or other therapies is helpful for those who say they have CL, who are you to stop them? > erm... no? I'm assuming there's a more profound intent behind this statement, but as it reads, no absolutely not. Doctors are not researchers, they are (to simplify, for purpose of this discussion) expert [and hopefully experienced] appliers of knowledge gained by others, over generations of hard work. This is pretty much completely wrong. Physicians and doctors are a crucial component in the development of new medical knowledge; case studies of patients at family offices and hospitals inform decisions going as far up as the leadership at the CDC. Medicine is a two-way street. > "In case of discrepancy between sticker and system, the system price will be held correct": in case of discrepancy between some random doctor and accumulated body of knowledge, body of knowledge wins. I don't know how you drew this analogy, but the logic is a complete farce. Doctors are not robots. If it turns out my appendix is on the opposite side of my body from the medical norm, they don't just chop my intestines off halfway so as to adhere to the "accumulated body of knowledge." Nowhere in science and medicine do you discard real-world data when it disagrees with theory; any doctor will tell you this. > As to the particulars of your claims when it comes to Lyme, observationally, people actively "shop" for a doctor that will prescribe them the treatment the patient desires. So the last word here is actually typically the patient's. :| Sure, some doctors will help treat patients who self-diagnose. Wouldn't you argue that this would lead to a higher standard of care, though? Is adherence to standards preferable to a high quality of care? Have you ever read the Hippocratic Oath? I predicted that I had Lyme after noticing I had Bell's palsy - facial paralysis - a common symptom of borreliosis. Every single test for Lyme, which arrived weeks later, was positive. Would you say that I "shopped around" for a doctor who would give me an "antibiotic fix"? Why is it acceptable for an aging person to request all sorts of painkillers from their doctor, or acceptable for a patient with late-stage cancer to request experimental and risky therapy from some pharmaceutical startup, but it's utterly abhorrent and should be illegal for someone with Lyme (or whatever) to request, at their own cost, long-term antibiotic prescriptions from their physician? Why specifically do people like you feel the need to antagonize sick people who are trying to get better? For the record - I do not have chronic Lyme. Those questions were directed at hycaria.
hycaria 7y ago
Chronic lyme disease is the controversial disease where no pathogen can be found anymore, yet the most classical "treatment" offered by some practicians (but not all) is months or years of antibiotics. It's a dramatic misuse of antibiotics, because you're probably not without knowing that resistances emerge from their use, and it has no efficiency. Two recent free access reviews summing up the issue. Tldr : the very unspecific symptoms are probably real (but not always ie cognitive dysfunction complain that test up normal for age range), probably not because of borreliosis though (since follow up of people who had acute lyme disease brings up a very low number of chronic affection), patients feel unlistened to (sadly always more common and ends up in such defiance towards modern medicine and resort to shady unproven sicknesses and their communities, see electrosensibility too in the same vein), antibiotics are useless. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4440423/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4440423/ Extract : As such, treatment of this symptom complex with antibiotics is unlikely to be helpful to patients but does incur substantial risk. This, combined with the impact of excessive antibiotic usage on the development of widespread antibiotic resistance among more potentially lethal pathogens, and the significant health care resource utilization and cost associated with prolonged administration of parenteral antibiotics, makes such treatment ill advised. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4477530/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4477530/ Extract : Three research groups have examined prospectively the effectiveness of prolonged antibiotic courses for post-Lyme disease syndromes.57–59,75 All trials had strict entrance criteria similar to the aforementioned definition of PLDS. The Klempner and colleagues58 study reported 2 parallel trials in which their cohort of 129 subjects was divided into seropositive (n = 78) and seronegative (n = 51) arms. Subjects randomized to treatment groups received 30 days of intravenous (IV) ceftriaxone followed by 60 days of oral doxycycline. Those randomized to the placebo arm received IV placebo for 30 days, followed by an oral placebo for 60 days. The primary outcome was health-related quality of life as assessed by standardized instruments (the Medical Outcomes Study 36-item Short-Form General Health Survey [SF-36] and the Fibromyalgia Impact Questionnaire). These instruments were administered at baseline, and then 30, 90, and 180 days. There was no difference in any outcome measure between placebo and treatment groups in either the seropositive or seronegative arm, or in a detailed battery of neuropsychological tests that was published subsequently.75 Although all patients had complained of cognitive dysfunction at baseline (and this was the primary complaint in >70%), objective measures of cognitive function, such as memory and attention, were normal compared with age-referenced normative data. Depression, anxiety, and somatic complaints improved in both the antibiotic and placebo arms groups between baseline and day 180.

NikolaNovak 7y ago

>> link the paper disproving the existence of chronic Lyme. I mean, regardless of the "side" or "stance", this is kind of the oldest, least honest logical fallacy in the book [1] - you're requiring somebody else to disprove existence of something? How, exactly? Typically, the burden of proof is on the entity making a claim. >>Are doctors no longer permitted the last word in treating their own patients? erm... no? I'm assuming there's a more profound intent behind this statement, but as it reads, no absolutely not. Doctors are not researchers, they are (to simplify, for purpose of this discussion) expert [and hopefully experienced] appliers of knowledge gained by others, over generations of hard work. "In case of discrepancy between sticker and system, the system price will be held correct": in case of discrepancy between some random doctor and accumulated body of knowledge, body of knowledge wins. For example, if my doctor tells me to ingest my own urine twice a day, and CDC & NIH tell me that is bollocks, the doctor empathically does not hold the last word. ---- As to the particulars of your claims when it comes to Lyme, observationally, people actively "shop" for a doctor that will prescribe them the treatment the patient desires. So the last word here is actually typically the patient's. :| 1: https://en.wikipedia.org/wiki/Russell%27s_teapot https://en.wikipedia.org/wiki/Russell%27s_teapot

eigenloss 7y ago
> I mean, regardless of the "side" or "stance", this is kind of the oldest, least honest logical fallacy in the book [1] - you're requiring somebody else to disprove existence of something? How, exactly? > Typically, the burden of proof is on the entity making a claim. I would argue here that hycaria is the entity making a claim here: he's arguing that chronic Lyme is nonexistent and essentially fraudulent. The point is that the existence of chronic Lyme cannot be disproved. I'd congratulate you for knowing the concept, but Russell's teapot is completely irrelevant here; if long-term treatment with antibiotics or other therapies is helpful for those who say they have CL, who are you to stop them? > erm... no? I'm assuming there's a more profound intent behind this statement, but as it reads, no absolutely not. Doctors are not researchers, they are (to simplify, for purpose of this discussion) expert [and hopefully experienced] appliers of knowledge gained by others, over generations of hard work. This is pretty much completely wrong. Physicians and doctors are a crucial component in the development of new medical knowledge; case studies of patients at family offices and hospitals inform decisions going as far up as the leadership at the CDC. Medicine is a two-way street. > "In case of discrepancy between sticker and system, the system price will be held correct": in case of discrepancy between some random doctor and accumulated body of knowledge, body of knowledge wins. I don't know how you drew this analogy, but the logic is a complete farce. Doctors are not robots. If it turns out my appendix is on the opposite side of my body from the medical norm, they don't just chop my intestines off halfway so as to adhere to the "accumulated body of knowledge." Nowhere in science and medicine do you discard real-world data when it disagrees with theory; any doctor will tell you this. > As to the particulars of your claims when it comes to Lyme, observationally, people actively "shop" for a doctor that will prescribe them the treatment the patient desires. So the last word here is actually typically the patient's. :| Sure, some doctors will help treat patients who self-diagnose. Wouldn't you argue that this would lead to a higher standard of care, though? Is adherence to standards preferable to a high quality of care? Have you ever read the Hippocratic Oath? I predicted that I had Lyme after noticing I had Bell's palsy - facial paralysis - a common symptom of borreliosis. Every single test for Lyme, which arrived weeks later, was positive. Would you say that I "shopped around" for a doctor who would give me an "antibiotic fix"? Why is it acceptable for an aging person to request all sorts of painkillers from their doctor, or acceptable for a patient with late-stage cancer to request experimental and risky therapy from some pharmaceutical startup, but it's utterly abhorrent and should be illegal for someone with Lyme (or whatever) to request, at their own cost, long-term antibiotic prescriptions from their physician? Why specifically do people like you feel the need to antagonize sick people who are trying to get better? For the record - I do not have chronic Lyme. Those questions were directed at hycaria.

hycaria 7y ago

Chronic lyme disease is the controversial disease where no pathogen can be found anymore, yet the most classical "treatment" offered by some practicians (but not all) is months or years of antibiotics. It's a dramatic misuse of antibiotics, because you're probably not without knowing that resistances emerge from their use, and it has no efficiency. Two recent free access reviews summing up the issue. Tldr : the very unspecific symptoms are probably real (but not always ie cognitive dysfunction complain that test up normal for age range), probably not because of borreliosis though (since follow up of people who had acute lyme disease brings up a very low number of chronic affection), patients feel unlistened to (sadly always more common and ends up in such defiance towards modern medicine and resort to shady unproven sicknesses and their communities, see electrosensibility too in the same vein), antibiotics are useless. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4440423/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4440423/ Extract : As such, treatment of this symptom complex with antibiotics is unlikely to be helpful to patients but does incur substantial risk. This, combined with the impact of excessive antibiotic usage on the development of widespread antibiotic resistance among more potentially lethal pathogens, and the significant health care resource utilization and cost associated with prolonged administration of parenteral antibiotics, makes such treatment ill advised. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4477530/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4477530/ Extract : Three research groups have examined prospectively the effectiveness of prolonged antibiotic courses for post-Lyme disease syndromes.57–59,75 All trials had strict entrance criteria similar to the aforementioned definition of PLDS. The Klempner and colleagues58 study reported 2 parallel trials in which their cohort of 129 subjects was divided into seropositive (n = 78) and seronegative (n = 51) arms. Subjects randomized to treatment groups received 30 days of intravenous (IV) ceftriaxone followed by 60 days of oral doxycycline. Those randomized to the placebo arm received IV placebo for 30 days, followed by an oral placebo for 60 days. The primary outcome was health-related quality of life as assessed by standardized instruments (the Medical Outcomes Study 36-item Short-Form General Health Survey [SF-36] and the Fibromyalgia Impact Questionnaire). These instruments were administered at baseline, and then 30, 90, and 180 days. There was no difference in any outcome measure between placebo and treatment groups in either the seropositive or seronegative arm, or in a detailed battery of neuropsychological tests that was published subsequently.75 Although all patients had complained of cognitive dysfunction at baseline (and this was the primary complaint in >70%), objective measures of cognitive function, such as memory and attention, were normal compared with age-referenced normative data. Depression, anxiety, and somatic complaints improved in both the antibiotic and placebo arms groups between baseline and day 180.