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The occurrence of Lyme disease is rising steadily in the United States. The majority of health care providers are unfamiliar with this complex syndrome. Nurses lack accurate clinical information to provide comprehensive nursing care to these patients. The progression of Lyme disease is addressed through three stages. Untreated or poorly managed, Lyme disease may become a chronic, debilitating illness. The author's personal story is interwoven and serves to highlight the pathophysiology of the disease and the emotional and physical costs to the patient.
In 1996, the Centers for Disease Control and Prevention (CDC) reported a record high number of 16,461 cases of Lyme disease (LD) in 45 states - an increase of 41% from the 11,700 cases reported in 1995 (CDC, 1996). Lyme disease is becoming more prevalent in communities, yet many nurse practitioners and physicians are unfamiliar with the syndrome.
Personal Case Study
On a Saturday night in February 1995, I reported to an urgent care facility with complaints of severe jaw pain, left-sided Bell's palsy, occipital headaches, fatigue, low-grade fever of 99.4 F, and spontaneous bruising around my left eye. The triage nurse assessed my presentation and began to question my relationship with my spouse. "Has your husband ever struck you before? How did you get the black eye? Why did you come here alone? Do you have any other bruises?"
The physician ordered a full skull series to rule out present and past fractures. I kept insisting that I was not a battered wife and that I was ill, but the staff continued to look for bruising and question my social history. Finally, the staff listened to the fact that I had completed a dental preparation for a crown molar 5 days prior, and suspected that was the culprit. The physician gave me a prescription for amoxicillin and Tylenol with Codeine, and told me to see my physician.
I saw my physician on the following Monday, and that was the beginning of a long list of appointments. The antibiotics "cured" the symptoms, but I relapsed within 5 to 7 days after completing the course. My doctor continued to say my clinical presentation was not typical of a regular infection of the jaw. Bell's palsy does not usually resolve with antibiotic therapy....