Advertise on podcast: Tick Boot Camp

What if one blood test could detect Lyme disease, Bartonella, and Babesia at the same time—without relying on the body's antibody response? In this LIVE from ILADS interview, Tick Boot Camp co-host Rich sits down with Dr. Jennifer Miller, PhD, of Galaxy Diagnostics to discuss a new generation of direct detection tests designed to help doctors identify Lyme disease and other difficult-to-detect vector-borne infections. Recorded at the 2025 International Lyme and Associated Diseases Society (ILADS) Conference in San Antonio, Texas, the conversation explores why conventional Lyme disease testing can miss infections, how Borrelia may interfere with antibody development, and how digital PCR technology can search for Borrelia, Bartonella, and Babesia DNA in a single blood sample. Dr. Miller explains how Galaxy Diagnostics developed a digital PCR assay that divides a blood sample into approximately 26,000 individual reactions, increasing the analytical ability to detect small amounts of pathogen DNA. She also announces that the assay became commercially available in March 2025 and explains how patients can work with their healthcare providers to access testing. For patients who have experienced years of diagnostic uncertainty, this conversation offers an encouraging look at emerging technologies that could help improve the diagnosis of Lyme disease and associated infections. Meet Dr. Jennifer Miller, PhD Dr. Jennifer Miller, PhD is Vice President of Clinical and Scientific Operations at Galaxy Diagnostics, a laboratory specializing in diagnostic testing for difficult-to-detect vector-borne infections. Her work focuses on developing and validating diagnostic technologies for pathogens such as Borrelia, Bartonella, and Babesia. Dr. Miller has extensive experience researching vector-borne pathogens and translating laboratory discoveries into clinical diagnostic tools. During the interview, Rich mentions a previous conversation with Galaxy Diagnostics CEO Nicole Bell, who helped introduce him to the company's work. Dr. Miller discusses returning to Galaxy Diagnostics and working with its scientific team to develop more sensitive direct detection methods. Their shared goal is to provide clinicians with better diagnostic tools while helping patients avoid unnecessary delays, repeated testing, and prolonged uncertainty. Why Lyme Disease Testing Can Miss Infections Rich begins by addressing one of the most frustrating challenges facing the Lyme disease community: patients can experience significant symptoms while repeatedly receiving negative laboratory results. He asks Dr. Miller to explain why Lyme disease testing remains difficult and what researchers are doing to improve it. Dr. Miller begins by describing two fundamentally different approaches to infectious disease testing. Indirect testing looks for the body's immune response to a pathogen. Direct testing searches for material associated with the pathogen itself, such as its proteins or genetic material. Understanding the difference is important because these tests answer different questions. Indirect Lyme Disease Testing: Looking for Antibodies Most commonly used Lyme disease blood tests are indirect tests. They look for antibodies produced by the immune system after exposure to Borrelia, the bacteria responsible for Lyme disease. Dr. Miller uses a simple analogy to explain the limitations of antibody testing. An antibody is like a sign left behind by someone who visited a location. The sign says: “I was here.” But it doesn't tell you whether that visitor is still present or whether they left months or years earlier. Similarly, Lyme disease antibodies may remain detectable after an infection has been treated. A positive antibody test therefore does not necessarily establish that a person currently has an active infection. Conversely, someone with a recent infection may not yet have produced enough detectable antibodies for a test to become positive. This creates a diagnostic window during which early Lyme disease can be missed. For more information about testing limitations, explore Tick Boot Camp's Lyme disease testing resources. Sensitivity, Specificity, and Cross-Reactivity Dr. Miller explains that diagnostic tests are evaluated using two important measurements. Sensitivity describes how effectively a test identifies people who have a particular condition. A test with inadequate sensitivity may produce false-negative results. Specificity describes how effectively a test identifies people who do not have that condition. A test with inadequate specificity may produce false-positive results. She also discusses cross-reactivity, which occurs when an antibody recognizes a target that resembles something other than the intended pathogen. Dr. Miller compares antibody testing patterns to a barcode. Different parts of the barcode represent responses to different proteins. However, some proteins may be shared across related organisms or resemble proteins from other infectious agents. This can complicate test interpretation. She emphasizes that both the biological behavior of Borrelia and the design of the assay influence how well a test performs. IgM vs. IgG: Understanding the Immune Response Rich asks Dr. Miller to explain why different antibody classes matter when diagnosing Lyme disease. IgM Antibodies IgM antibodies are commonly associated with the early immune response. Dr. Miller describes IgM as a broad responder that can recognize certain targets before the immune system develops a more refined response. This broad recognition can be useful during early infection but can also contribute to cross-reactivity. IgG Antibodies IgG antibodies commonly develop as the immune response matures. Through biological processes known as affinity maturation and class switching, the immune system can produce antibodies that recognize specific targets more effectively. Dr. Miller explains that the timing and quality of these responses can affect the performance of antibody-based diagnostic tests. However, neither IgM nor IgG results alone can reliably determine whether Borrelia remains actively present after treatment. How Borrelia May Interfere With Antibody Development One of the most scientifically interesting parts of the conversation explores how Borrelia may influence the immune system. Dr. Miller discusses research suggesting that Borrelia infection can disrupt processes involving B cells, the immune cells responsible for producing antibodies. She explains that an effective antibody response involves several steps. First, the immune system recognizes a pathogen. Next, B cells begin producing antibodies. Over time, the immune response can become more refined, generating antibodies that bind more effectively to their targets. Dr. Miller describes how Borrelia may interfere with these processes. She uses an analogy involving rooms and doors. Imagine that a B cell needs access to different rooms to develop and improve its antibodies. In her analogy, Borrelia interferes with access to those rooms, disrupting the processes needed for antibody maturation. This may help explain why some immune responses to Borrelia develop differently than expected. Dr. Miller also discusses how these effects could influence the transition from IgM to IgG antibodies. These mechanisms remain an active area of scientific investigation, and experimental findings do not mean that every patient with Lyme disease experiences the same immune dysfunction. Direct Detection: Looking for the Pathogen Itself Rich then asks Dr. Miller to explain the alternative to antibody-based testing. Rather than measuring the immune response, direct detection methods look for evidence of the pathogen. Dr. Miller describes two approaches being developed or offered by Galaxy Diagnostics. Urine Antigen Testing An antigen is a molecule associated with a pathogen, often a protein. Dr. Miller explains that Galaxy has developed testing designed to detect certain Borrelia antigens shed into urine. The goal is to identify pathogen-associated material without relying on antibody production. PCR Testing Polymerase chain reaction, or PCR, detects specific sequences of genetic material. For Lyme disease, PCR testing attempts to identify Borrelia DNA. However, Borrelia can be difficult to detect in blood because the organism may circulate at very low concentrations. Dr. Miller explains that Galaxy's newer approach uses digital PCR, a technology designed to improve the detection of small amounts of genetic material. Direct detection has important limitations as well. A negative result does not necessarily exclude infection, and detecting DNA does not automatically establish that live organisms are present. Digital PCR: Finding the Needle in 26,000 Haystacks One of the interview's most memorable explanations involves searching for a needle in a haystack. Rich recalls how Nicole Bell described Galaxy's digital PCR technology. Traditional PCR can be compared to searching for a tiny needle in a large pile of hay. Digital PCR divides the sample into thousands of smaller sections, making it easier to identify a target when very little genetic material is present. Dr. Miller explains that Galaxy's assay partitions a sample into approximately 26,000 individual reactions. Each partition is analyzed for the presence or absence of specific pathogen DNA. Rather than analyzing everything in one reaction, the technology evaluates thousands of smaller reactions. This can improve analytical sensitivity under appropriate conditions. However, the technology cannot detect pathogen DNA that is absent from the collected sample or present below the assay's detection threshold. One Blood Test for Borrelia, Bartonella, and Babesia The biggest announcement in the interview concerns Galaxy's ability to investigate three major pathogen groups using one blood sample. Borrelia: L

After seeing approximately 22 medical practitioners, undergoing more than a dozen procedures, and facing a possible ALS diagnosis, Darlene DeBauer O'Connor finally received a Lyme disease diagnosis that changed her life. Today, she's helping other families overcome one of the biggest barriers to healing: the cost of care. In this LIVE from ILADS interview, Tick Boot Camp co-host Rich sits down with Darlene DeBauer O'Connor, Executive Director of the Northeast Lyme and Associated Diseases (NELAD) Resource Foundation, to discuss her family's experience with Lyme disease, the devastating consequences of delayed diagnosis, and a new nonprofit providing financial assistance for testing and treatment. Recorded at the 2025 International Lyme and Associated Diseases Society (ILADS) Conference in San Antonio, Texas, the conversation explores Lyme disease misdiagnosis, ALS-like symptoms, neurological complications, family-wide tick-borne illness, treatment costs, patient advocacy, and financial grants of up to $3,000 per person annually. Darlene shares how her diagnosis on October 16, 2013, led to other family members seeking answers, why her brother's death strengthened her commitment to advocacy, and how years of educational outreach revealed a critical problem: Knowing where to find help means little when patients cannot afford to access it. Her story is one of resilience, family, community, and turning personal suffering into practical support for others. From Possible ALS to a Lyme Disease Diagnosis In her 40s, Darlene was working as a public school teacher in Massachusetts when she began experiencing increasingly debilitating symptoms. What started as fatigue and headaches progressed into a frightening combination of physical, neurological, and psychological problems. Her symptoms included: Extreme fatigue and difficulty getting out of bed Severe headaches and recurring fevers Migrating pain throughout her body Muscle weakness, tripping, and falling Difficulty walking Bladder control problems Neurological and psychological symptoms Darlene consulted approximately 22 medical practitioners across multiple specialties, including cardiology, neurology, and infectious disease. She underwent more than a dozen procedures while searching for an explanation. Eventually, clinicians began considering amyotrophic lateral sclerosis (ALS), a progressive neurological disease. The possibility was devastating. Darlene remembers becoming increasingly frightened as her condition worsened and her independence disappeared. Ten Negative Lyme Tests Before Getting Answers Despite living in a region where Lyme disease is common, Darlene reports receiving approximately 10 negative Lyme disease tests during her diagnostic journey. On October 16, 2013, her sister brought her to a practitioner in Wilton, Connecticut. After reviewing her symptoms and medical history, the practitioner diagnosed her clinically with Lyme disease and investigated possible additional infections. Darlene describes that appointment as the turning point in her life. She calls the anniversary her personal “D-Day,” meaning Diagnosis Day. For the first time, she felt she had an explanation for the illness that had disrupted her life. She began treatment and gradually experienced improvements, although she also recalls difficult reactions during the process. Her experience highlights the importance of interpreting Lyme disease testing alongside clinical findings and exposure history. Antibody tests can produce false-negative results, particularly early in infection. However, repeated negative results later in an illness require careful consideration of other possible diagnoses as well. For more information, explore Tick Boot Camp's Lyme disease testing resources. When One Diagnosis Leads an Entire Family to Seek Answers Darlene's diagnosis had consequences far beyond her own health. She is the youngest of five children in a close-knit Italian-American family. After learning more about Lyme disease and associated infections, she began recognizing similarities between her experiences and symptoms reported by siblings, nieces, nephews, and other relatives. Family conversations increasingly focused on tick exposure, unexplained symptoms, and the possibility of tick-borne illness. Darlene describes a cascade of additional diagnoses among family members. She explains that relatives were evaluated by different healthcare professionals rather than a single practitioner. Over time, she reports that most affected family members experienced meaningful improvement. The family's experiences strengthened her belief that education and early recognition are essential. Importantly, similar symptoms within a family do not necessarily establish a shared infection. Tick exposure, other medical conditions, and individual diagnostic findings must be evaluated separately. Losing Her Brother and the Questions Surrounding Lewy Body Dementia One of the most emotional moments in the interview comes when Darlene discusses the death of her brother. She believes complications associated with vector-borne illness contributed to his neurological decline and eventual diagnosis of Lewy body dementia. She describes a period during which he appeared to improve, followed by worsening symptoms and rapid deterioration. His death remains a profound loss for the family. Darlene's experience raises questions about the relationship between infectious diseases, neurological inflammation, and neurodegenerative conditions. However, a causal relationship between Lyme disease or other tick-borne infections and Lewy body dementia has not been established. Her brother's story reflects the family's understanding of his illness and the grief that continues to motivate their advocacy. Why Tick Prevention Education Matters Before becoming ill, Darlene believed she understood tick prevention. She had worked as an education coordinator for Mass Audubon and was familiar with outdoor safety. However, she admits that her understanding of Lyme disease was limited. She believed avoiding heavily wooded areas and removing visible ticks would provide adequate protection. Her perspective changed dramatically after her diagnosis. Darlene also recalls a tick bite involving her son at a Massachusetts hospital and wishing the tick had been saved for identification. Rich and Darlene discuss the importance of recognizing that tick exposure can occur in ordinary environments, including residential yards, gardens, and recreational spaces. They also reflect on how little Lyme disease education they received during their school years in the Northeast. Their conversation emphasizes that prevention education should begin long before someone becomes ill. For practical guidance on tick checks, tick removal, and what to do after a bite, visit Tick Boot Camp's Tick Bite Blueprint. Turning Lyme Disease Into a Mission As Darlene began recovering, she and her sister became involved with Central Mass Lyme, a Massachusetts organization focused on education and awareness. Darlene served on its conference committee, while her sister participated on the organization's board. Together with other advocates, they helped organize four educational conferences. One conference attracted approximately 500 attendees. Speakers included prominent Lyme disease clinicians and researchers such as: Dr. Stephen Phillips Dr. Daniel Cameron Dr. Neil Spector Dr. Bill Rawls These events connected patients, caregivers, healthcare professionals, authors, and advocates. Darlene also began speaking publicly about her family's experience. Her presentations resonated with people who had spent years searching for answers. But as more patients approached her after speaking engagements, she noticed a recurring problem. People weren't simply asking what Lyme disease was. They wanted to know how to find a knowledgeable practitioner and how to pay for testing and treatment. The Missing Piece: Financial Assistance for Lyme Disease Patients Darlene and her sister realized that education alone could not solve the challenges facing many families. Even when patients identified a healthcare professional they wanted to see, financial barriers often prevented them from obtaining care. Some practitioners had long waiting lists. Others required out-of-pocket payments that families could not afford. Testing, medical appointments, medications, and supportive therapies could create substantial financial strain. Darlene and her sister decided to establish an organization that would combine education and emotional support with direct financial assistance. That decision led to the creation of the Northeast Lyme and Associated Diseases Resource Foundation, commonly known as NELAD. What Is the NELAD Resource Foundation? The NELAD Resource Foundation is a nonprofit organization focused on helping people affected by Lyme disease and associated illnesses. Its mission includes three interconnected areas: Education and awareness: Helping patients, families, and communities better understand Lyme disease and associated conditions. Emotional support: Connecting individuals and families through support groups and shared experiences. Financial assistance: Providing grants to help eligible patients access testing and treatment. Although NELAD is based in New England, particularly Massachusetts and Rhode Island, Darlene explains that its assistance is not limited to those states. At the time of the interview, the foundation had already provided funding to recipients in 10 additional states, including Texas. Darlene emphasizes that the organization focuses on families and does not impose an age limit on applicants. NELAD Grants: Up to $3,000 Per Person Per Year One of the most valuable parts of the interview is Darlene's explanation of NELAD's financial assistance program. At the time of recording, the foundation offered grants of up

What if the biggest obstacle to diagnosing Lyme disease isn't a lack of symptoms—but the limitations of the tests doctors rely on? In this LIVE from ILADS interview, Tick Boot Camp co-host Rich sits down with Dr. Liz Horn, PhD, Principal Investigator of the Lyme Disease Biobank, a research program of the Bay Area Lyme Foundation, to explore why Lyme disease testing remains challenging and how new diagnostic technologies could change the future of patient care. Recorded at the 2025 International Lyme and Associated Diseases Society (ILADS) Conference in San Antonio, Texas, the conversation covers early Lyme disease testing, antibody detection, FDA-cleared diagnostics, persistent symptoms after treatment, tissue donation, and the research needed to better understand Borrelia and other tick-borne pathogens. Dr. Horn explains how researchers are using donated blood, urine, and human tissue samples to develop more accurate tests, investigate persistent symptoms, and study what tick-borne pathogens may be doing inside the body. She also shares encouraging developments involving IGeneX, emerging multiplex antibody tests, and a growing research network that gives patients meaningful opportunities to contribute to scientific progress. Her message is hopeful: Better Lyme disease diagnostics are possible, and patients can play an important role in making them a reality. Meet Dr. Liz Horn, PhD Dr. Liz Horn is the Principal Investigator of the Lyme Disease Biobank, a research initiative of the Bay Area Lyme Foundation. She began working on the biobank in 2013, with biological sample collection beginning in 2014. The program was created to address a major obstacle in Lyme disease research: scientists often lack access to well-characterized patient samples needed to develop and validate diagnostic tests. Dr. Horn explains that a survey conducted in January 2025 found that approximately 85% of participating researchers still lacked some of the samples they needed. Through the biobank, her team collects, processes, and distributes samples to qualified researchers investigating Lyme disease and associated infections. At the time of the interview, the program had enrolled more than 1,250 participants and supported over 115 research projects. Why Lyme Disease Testing Remains So Difficult Dr. Horn explains that most commonly used Lyme disease diagnostic tests do not directly detect the bacteria responsible for the infection. Instead, they measure the body's immune response. This distinction is especially important during early infection, when the immune system may not yet have produced detectable antibodies. She describes two major categories of diagnostic testing. Direct Testing: Looking for Borrelia Itself A direct test attempts to identify the pathogen or its genetic material. For Lyme disease, that means detecting evidence of Borrelia rather than measuring the immune system's response to it. Dr. Horn explains that researchers still need better direct detection methods. The development of reliable direct tests could provide new opportunities for diagnosing infection, particularly in situations where antibody testing is inconclusive. Indirect Testing: Looking for Antibodies Indirect tests, including commonly used Lyme disease serology tests, measure antibodies produced in response to infection. The challenge is that antibodies take time to develop. Dr. Horn explains that a person may have Lyme disease before their immune response becomes detectable through laboratory testing. This creates a diagnostic window during which an infected patient may test negative. A negative Lyme disease antibody test early after infection does not necessarily rule out Lyme disease. For more information about testing limitations, explore Tick Boot Camp's Lyme disease testing resources. Why Two Lyme Disease Tests Can Produce Different Results One of the interview's most revealing discussions concerns differences between laboratory assays. Dr. Horn explains that two FDA-cleared first-tier antibody tests may not identify exactly the same patients. A sample that tests negative using one assay may test positive using another. This means the specific test used by a laboratory can influence whether an infection is detected. Dr. Horn describes how the Lyme Disease Biobank's well-characterized samples help researchers evaluate these differences. Her work underscores why test sensitivity, specificity, timing, and clinical context all matter when interpreting Lyme disease results. New Lyme Disease Tests: IGeneX and Multiplex Antibody Technology Dr. Horn discusses several promising diagnostic developments supported by biobank samples. IGeneX and FDA-Cleared Lyme Disease Testing She highlights an IGeneX diagnostic assay that received FDA clearance with the help of clinical samples provided by the Lyme Disease Biobank. These samples allowed researchers to evaluate how the test performed in people with documented clinical histories. Dr. Horn emphasizes that access to carefully characterized samples is essential for developing and validating new diagnostic technologies. FDA clearance does not mean a test is perfect or appropriate for every clinical situation, but it represents an important regulatory milestone. Multiplex Testing: Looking at More Than One Antibody Target Dr. Horn also describes research involving InBios. Its experimental approach examines multiple Borrelia antibody targets rather than relying on a single target. She explains that Borrelia expresses different proteins, known as antigens, that may trigger different antibody responses. A multiplex test can examine several antibody targets simultaneously. Dr. Horn uses a simple analogy: Looking at one target is like taking one photograph. Looking at ten targets provides ten different snapshots. Researchers hope this broader approach may improve the ability to detect Lyme disease at different stages of infection. However, these approaches still require rigorous validation to establish their accuracy and clinical usefulness. Could New Lyme Tests Detect Infection Earlier? Dr. Horn discusses research involving two experimental single-tier serology tests. According to the findings she describes, these approaches showed promise for identifying Lyme disease earlier than some conventional testing methods. She references the possibility of detecting infection approximately one week after symptom onset in certain study settings. That would represent a meaningful advance for patients who currently face uncertainty during the early stages of infection. However, these findings do not mean that every patient can currently obtain a reliable positive test one week after infection. Larger studies, regulatory review, and clinical validation are necessary before new diagnostic approaches can become widely adopted. Why Some Patients Don't Develop the Expected IgG Antibody Response Dr. Horn describes research involving patients who received treatment for early Lyme disease. She explains that clinicians often expect an IgG antibody response to develop as time passes. However, her research found that some treated patients did not develop the anticipated detectable IgG response. This process, known as seroconversion, can be affected by the timing of infection and treatment. Dr. Horn explains that antibiotic treatment may change the development of measurable antibodies. This is particularly important when interpreting follow-up testing. The absence of a later positive IgG test does not necessarily mean an earlier Lyme disease diagnosis was incorrect. Likewise, antibody results alone cannot reliably establish whether an infection remains active after treatment. One in Five Patients Still Had Symptoms Three Months Later Dr. Horn discusses a study involving patients with early Lyme disease who were followed after treatment. She reports that approximately 20% continued experiencing symptoms three months later, despite receiving treatment early in their illness. These patients had been evaluated at clinical sites experienced in recognizing early Lyme disease. The finding raises important questions about why some people experience persistent symptoms even after timely diagnosis and treatment. Dr. Horn believes further research is needed to understand the biological mechanisms involved and develop better tools for evaluating patients who remain ill. Persistent symptoms after Lyme disease treatment are real and deserve appropriate medical attention, but they do not by themselves establish that live Borrelia bacteria remain present. For additional research and patient perspectives, explore Tick Boot Camp's Lyme Persists educational resources. What Is the Lyme Disease Biobank? Rich asks Dr. Horn to explain the biobank in practical terms for patients and caregivers. She describes it as a collection of biological samples donated by people who participate voluntarily in research. The program includes samples from individuals with early Lyme disease and people experiencing persistent symptoms. Depending on the study, participants may provide: Blood samples Urine samples Information about symptoms and medical history Follow-up samples over time Certain tissues collected during qualifying surgical procedures These materials are processed and made available to researchers developing diagnostic tests and investigating disease mechanisms. Dr. Horn explains that scientists benefit from knowing the clinical background associated with each sample. Without that information, it becomes much harder to determine whether a diagnostic test accurately identifies the patient population it is intended to serve. The Lyme Disease Tissue Bank: Studying Borrelia and Bartonella Inside the Body One of the most important initiatives discussed is the Lyme Disease Tissue Bank, launched in 2019. The program collects selected tissues donated after death by people who had Lyme disease or ot

Why do so many women with chronic Lyme disease struggle to get answers—and could stress, hormones, immune function, and medical gaslighting help explain their experiences? In this LIVE from ILADS interview, Tick Boot Camp co-host Rich sits down with Dr. Anne VanCouvering, ND, a Vermont-based naturopathic doctor who treats patients with Lyme disease, tick-borne infections, mold-related concerns, and complex chronic illness. Recorded at the 2025 International Lyme and Associated Diseases Society (ILADS) Conference in San Antonio, Texas, the conversation explores why women are so heavily represented in the chronic Lyme disease community, how prolonged stress may affect immune function, and why patients with multisystem symptoms are frequently dismissed by healthcare professionals. Dr. VanCouvering also shares her personal journey into Lyme disease medicine, including her son's seven-year struggle with unexplained symptoms, her family's experiences with tick exposure on Long Island, and how ILADS helped shape her clinical approach. Their discussion raises important questions about Bartonella, Babesia, neuroinflammation, autism-like symptoms, PANS/PANDAS, environmental exposures, nervous system regulation, and the limitations of conventional medical care. Throughout the interview, Dr. VanCouvering emphasizes a principle that every patient deserves to experience: The goal isn't for a doctor to be right. The goal is to help the patient get well. Meet Dr. Anne VanCouvering, ND Dr. Anne VanCouvering is a naturopathic doctor based in central Vermont who provides telemedicine services to patients in Vermont, New Hampshire, and Massachusetts. Her clinical interests include Lyme disease, tick-borne infections, mold-related illness, autism, PANS/PANDAS, and complex chronic health conditions. Before attending naturopathic medical school, she operated a massage therapy practice in the Hamptons on Long Island. Her interest in medicine developed partly from her desire to understand her son's health challenges. She began attending ILADS conferences in 2014, seeking additional education about Lyme disease and associated infections. Dr. VanCouvering describes witnessing the growth of integrative and naturopathic approaches within the ILADS community, including increasing discussions of herbal medicine and supportive therapies. A Mother's Search for Answers: Seven Years of Unrecognized Lyme Disease Dr. VanCouvering's journey into Lyme disease medicine began with her son. During his teenage years, he experienced a collection of symptoms that initially appeared unrelated: Excessive sleeping and debilitating fatigue Anxiety and behavioral changes Knee pain Persistent headaches Cognitive difficulties and trouble completing sentences Purple stretch-mark-like skin changes that she later associated with Bartonella She initially explored autism and other possible explanations for his symptoms. Despite consulting multiple healthcare professionals, she struggled to obtain a diagnosis that explained his overall condition. Eventually, a discussion with another physician about purple striae prompted her to reconsider his symptoms. She began investigating tick-borne infections and concluded that Lyme disease might be contributing to his illness. By that point, approximately seven years had passed since his symptoms began. His condition eventually became so severe that, while attending college in Oregon, he reportedly spent three months largely confined to bed. Dr. VanCouvering describes traveling to California for additional medical support at Gordon Medical Associates, although the financial burden made continued care difficult. She credits a combination of medical care and lifestyle changes with helping her son improve. Her experience highlights how difficult it can be for families to navigate complex symptoms, particularly when multiple body systems appear to be affected. Clinical context: Purple striae are not diagnostic of Bartonella infection, and symptoms such as fatigue, anxiety, and cognitive changes have many possible causes. Lyme disease requires appropriate clinical evaluation. From Long Island to Vermont: A Family History of Tick Exposure Dr. VanCouvering discusses her family's extensive history on Long Island, including time spent on Shelter Island. Her husband served as a Scoutmaster and experienced frequent tick bites over many years. She describes how repeated exposure shaped her awareness of Lyme disease and the practical challenges of tick prevention. Rich, also from Long Island, connects with her over the region's history of tick-borne disease research. Their conversation highlights how Lyme disease can affect families with extensive outdoor exposure, including hikers, gardeners, hunters, park employees, and other people who spend time in wooded or grassy environments. Repeated tick exposure increases opportunities for infection, but it does not mean everyone living in an endemic area has Lyme disease or carries Borrelia. For practical prevention and next steps after a tick bite, explore Tick Boot Camp's Tick Bite Blueprint. Lyme Disease, Bartonella, Babesia, and the Total Burden of Illness Dr. VanCouvering explains that she approaches complicated patient cases by considering more than one possible contributing factor. Her evaluations may include: Lyme disease and other tick-borne infections Bartonella and Babesia Environmental mold exposure Possible heavy metal exposure Chronic viral illnesses Stress and nervous system function Individual medical history and genetic factors She uses a memorable analogy involving The Godfather and his associates. In her metaphor, addressing one major infection may not resolve a patient's symptoms if other medical problems remain unrecognized. She believes clinicians should evaluate contributing factors methodically rather than assuming that every symptom has a single explanation. However, the presence of multiple symptoms does not establish multiple infections, mold toxicity, or impaired detoxification. Each suspected condition requires appropriate evaluation, and not every proposed testing or treatment approach is clinically validated. Chronic Stress, Fight-or-Flight, and the Immune System One of the interview's central discussions focuses on the relationship between stress and chronic illness. Rich asks whether prolonged stress could affect the immune system in ways that influence a person's response to tick-borne infections. Dr. VanCouvering explains the body's stress response using the familiar example of escaping a tiger. During a perceived threat, the sympathetic nervous system prepares the body for immediate action. Processes such as digestion and other routine functions may temporarily change as the body prioritizes responding to danger. She believes prolonged stress may complicate recovery for some patients with chronic illness. The conversation also explores the balance between sympathetic and parasympathetic nervous system activity. Scientific context: Chronic stress can influence immune signaling, sleep, pain perception, and overall health. However, stress does not simply switch off the immune system, and evidence does not establish that psychological stress causes persistent Borrelia infection or Lyme disease relapse. For a related discussion, listen to Tick Boot Camp's interview with Cathleen King about nervous system regulation and Primal Trust. Why Are More Women Represented in the Chronic Lyme Disease Community? Rich shares an observation from hundreds of Tick Boot Camp interviews: women make up a substantial majority of the patients and practitioners featured on the podcast. He asks Dr. VanCouvering whether biological differences, stress, or social expectations could help explain that pattern. She identifies several possible contributors. Women May Carry More Caregiving and Household Responsibilities Dr. VanCouvering discusses the additional responsibilities many women manage outside paid employment. These may include raising children, caring for aging relatives, and organizing household responsibilities. She believes these demands can contribute to prolonged stress and affect a person's overall well-being. Rich also raises the possibility that social media may increase stress for some women. Dr. VanCouvering cautions that the issue is more complicated than social media alone. Men May Be Less Likely to Seek Medical Care Dr. VanCouvering notes that social expectations may discourage some men from discussing symptoms or seeking help. She treats men who spend significant time outdoors, including gardeners, hunters, and people working in wooded environments. She estimates that her own practice serves approximately 60% women and 40% men. This observation raises an important distinction: The demographics of patients seeking treatment do not necessarily reflect the actual distribution of Lyme disease infections. Hormonal Changes and Medical Dismissal Dr. VanCouvering also discusses hormonal fluctuations and their possible effects on symptoms. She believes women may face additional challenges when reporting fatigue, pain, or other difficult-to-explain health problems. Both Rich and Dr. VanCouvering express concern that women's physical symptoms are sometimes attributed to anxiety or depression without adequate investigation. The discussion raises questions about how medical research, gender bias, and differences in healthcare utilization influence patient experiences. Importantly, the interview does not establish that women are biologically more likely than men to develop persistent symptoms after Lyme disease. Medical Gaslighting: When Patients Are Told It's All in Their Heads Dr. VanCouvering describes patients arriving at her practice in tears after repeatedly being told that their symptoms are psychological. She believes medical dismissal can result from limited education, insufficient appointment time, or

What happens when an Emmy-winning documentary filmmaker turns his camera toward one of the fastest-changing tick problems in the Northeast? In this episode of the Tick Boot Camp Podcast, Matt Sabatello, Tick Boot Camp Co-Founder, sits down in person with Emmy-winning filmmaker Reece Robinson, director of the upcoming documentary Ticking Point, to explore the rise of lone star ticks, Alpha-Gal Syndrome, Lyme disease, and what communities can do to fight back. For Reece, the story is personal. His older brother experienced severe chronic Lyme disease, including Bell’s palsy, cognitive problems, significant pain, intravenous antibiotics, and a period of being bedridden. Years later, Reece watched another tick-related threat begin transforming life on Martha’s Vineyard: the rapid expansion of lone star ticks and growing concern about Alpha-Gal Syndrome. Now he is documenting it. From Chronic Lyme Disease to Ticking Point Reece shares how watching his brother struggle with Lyme disease left a lasting impression on him long before he became a professional filmmaker. His career eventually led him into character-driven documentary storytelling and work on National Geographic’s The First Wave, which documented healthcare workers and patients during the earliest months of the COVID-19 pandemic. During the summer of 2025, Reece noticed something happening on Martha’s Vineyard that he could no longer ignore. Conversations about ticks and Alpha-Gal Syndrome seemed to be everywhere. That experience became the foundation for Ticking Point, a feature-length, solutions-focused documentary examining how communities are responding to expanding tick populations and Alpha-Gal Syndrome. What Is Ticking Point? Rather than creating what Reece describes as a “doom and gloom” documentary, Ticking Point focuses on people trying to solve the problem. The film follows residents, scientists, hunters, public health professionals, and advocates as communities confront questions surrounding: Lone star tick expansion Alpha-Gal Syndrome Deer populations and tick ecology Community-wide tick management Tick-bite prevention Emerging scientific research Public health policy Ecological interventions The challenges of balancing competing community priorities Martha’s Vineyard provides a fascinating case study because it combines a significant tick problem with an engaged year-round community actively searching for solutions. The question behind the film is much bigger than one island: If Martha’s Vineyard can find ways to meaningfully reduce its tick problem, could those lessons help other communities? Alpha-Gal Syndrome and the Lone Star Tick Much of the conversation focuses on growing concern surrounding Alpha-Gal Syndrome (AGS), an allergy associated in the United States primarily with bites from lone star ticks. Reece discusses stories he has encountered while making the documentary, including people whose reactions extend far beyond simply avoiding steak or hamburgers. For some patients, mammalian-derived ingredients, dairy products, medications containing certain animal-derived ingredients, or even exposure to cooking fumes can become concerns. The unpredictable nature of Alpha-Gal Syndrome is one reason Reece believes more research is urgently needed. Two people can experience tick exposure and have dramatically different outcomes—and researchers are still working to understand why. The Rise of the Lone Star Tick Reece describes the lone star tick as a particularly formidable challenge. Unlike the more passive questing behavior people often associate with blacklegged ticks, lone star ticks can actively move toward potential hosts. The conversation explores their behavior, expanding presence across parts of the Northeast, and what that expansion could mean for communities already dealing with Lyme disease and other tick-borne illnesses. Alpha-Gal Syndrome is also only part of the discussion. Matt, Rich, and Reece discuss other conditions associated with lone star ticks, including ehrlichiosis, tularemia, and Southern Tick-Associated Rash Illness (STARI). Filming a Long Island Tick Drag with Monica Cipriani This interview was recorded at the end of an extraordinary day in the field. Before sitting down for the podcast, Reece joined Tick Boot Camp and researcher Monica Cipriani on Long Island to film tick-dragging footage for Ticking Point. The results demonstrated just how significant local lone star tick populations can become. The team encountered large numbers of lone star ticks, including dense clusters of larvae commonly called “tick bombs.” Reece filmed the fieldwork and plans to use footage from the day in his documentary. See what we discovered during our Long Island tick drag with Monica Cipriani and Reece Robinson. Searching for Solutions to the Tick Problem One of the most important themes of Ticking Point is that there probably won't be one solution to the growing tick problem. Reece is documenting approaches that address the issue from multiple directions, including: Deer population management Habitat and landscape management Tick-bite prevention Scientific research Public education Community-based interventions Research into the human immune response Potential future technologies designed to interrupt tick-borne disease transmission The conversation also explores the social and political challenges surrounding interventions such as deer management and controlled burns. Solutions that may appear straightforward scientifically can become much more complicated when implemented across real communities. Can We Prevent Tick-Borne Disease Before the Bite Leads to Illness? Reece also discusses scientists exploring entirely new approaches to tick-borne disease prevention. That includes research involving genetically modified mice designed to interrupt the transmission cycle of Lyme disease, as well as investigations into immune responses that could someday help researchers better understand how the body responds to tick feeding. These ideas remain areas of research rather than immediate solutions, but they illustrate a broader question driving Ticking Point: Can we change the environment, ecology, or transmission cycle in ways that prevent people from becoming sick in the first place? A Filmmaker With a Personal Connection to Lyme Disease Although Reece does not identify as a tick-borne disease patient himself, his brother's experience gives him a perspective familiar to many families in the Lyme community. He remembers his brother experiencing Bell’s palsy, severe pain, memory problems, prolonged illness, IV antibiotics, and numerous approaches to treatment. That experience now intersects with Reece’s career as a documentary filmmaker. His goal with Ticking Point isn't simply to show how frightening ticks can be. It is to document people trying to understand the problem, challenge it, and build solutions. Support and Follow Ticking Point Ticking Point is currently an independent documentary project, and Reece is looking for people affected by Alpha-Gal Syndrome, researchers, advocates, communities working on tick-control initiatives, and others with meaningful stories to share. The project is also accepting tax-deductible financial support through its fiscal sponsor. Learn more about Ticking Point, watch the documentary teaser, join the mailing list, or contact Reece Robinson. Learn More About Reece Robinson Reece Robinson is an Emmy-winning documentary filmmaker whose work focuses on human stories and social issues. His credits include work as a field producer on National Geographic’s The First Wave, documenting the earliest months of the COVID-19 pandemic inside a New York hospital. Learn more about Reece Robinson and explore his filmmaking work. More From Tick Boot Camp Want to continue learning about Lyme disease, Alpha-Gal Syndrome, ticks, and the people working to solve these complex problems? Explore more Tick Boot Camp Podcast interviews with patients, doctors, researchers, and advocates. If you've recently found a tick or experienced a tick bite, start with the Tick Boot Camp Tick Bite Blueprint. And don't miss our behind-the-scenes look at the fieldwork featured in Reece's documentary: Long Island Tick Drag: Tick Bombs, Lone Star Ticks & an Invasive Tick.

Could Lyme disease and other tick-borne infections be overlooked contributors to arterial inflammation, heart disease, and stroke risk? In this LIVE from ILADS interview, Tick Boot Camp co-host Rich reconnects with Dr. H. Thomas “Tom” Hight, MD, a board-certified internal medicine physician and clinical lipidologist specializing in cardiovascular disease prevention and arterial health. Recorded at the 2025 International Lyme and Associated Diseases Society (ILADS) Conference in San Antonio, Texas, the conversation explores a provocative question: Could certain infections contribute to cardiovascular inflammation in ways that conventional heart disease evaluations don't routinely investigate? Dr. Hight shares observations from his Atlanta-based practice, where he monitors arterial health using serial ultrasound examinations and cardiovascular biomarkers. He describes patients whose arterial measurements worsened despite improvements in traditional risk factors, prompting him to investigate additional possible contributors, including chronic viral infections and tick-borne illnesses. The discussion covers Lyme disease, Bartonella, endothelial inflammation, atherosclerosis, plaque regression, heart attacks, strokes, Lyme carditis, and emerging research into vascular health and dementia. Dr. Hight also explains why he believes cardiovascular prevention should look beyond cholesterol and blood pressure while emphasizing the importance of addressing all relevant risk factors. His observations raise important research questions, although a direct causal relationship between persistent tick-borne infection and coronary atherosclerosis has not been established. Meet Dr. Tom Hight, MD Dr. H. Thomas Hight, MD is a physician specializing in cardiovascular risk reduction, arterial disease, and clinical lipidology. Based in Atlanta, Georgia, he has spent years working with patients who have experienced heart attacks, strokes, and other serious cardiovascular events. Dr. Hight developed an ultrasound-based approach to monitoring changes in arterial health over time. His practice, CardioSound, focuses on identifying and addressing factors that may contribute to cardiovascular disease progression. His growing interest in Lyme disease began after observing unexpected changes in patients whose cardiovascular risk factors appeared to be improving. He attended an ILADS conference in Boston to learn more about tick-borne illnesses and their possible cardiovascular implications. This interview follows his earlier appearance on Tick Boot Camp, where he first discussed the potential relationship between Lyme disease and cardiovascular risk. Why Dr. Hight Started Investigating Lyme Disease in Heart Patients Dr. Hight explains that his practice regularly monitors patients who have already experienced cardiovascular events. These patients face increased risks of subsequent heart attacks, strokes, and other complications. His approach includes repeat arterial ultrasound studies approximately every three to four months, alongside laboratory testing and comprehensive risk-factor management. He looks for evidence that arterial disease is stabilizing or improving. However, following the COVID-19 pandemic, he noticed an unexpected pattern. Some patients who had previously shown improvements began experiencing worsening arterial findings. This prompted him to reconsider whether additional inflammatory or infectious factors might be contributing to their cardiovascular risk. He began evaluating selected patients for chronic viral illnesses and tick-borne infections. Dr. Hight reports that some patients subsequently showed improvements in inflammatory biomarkers and arterial measurements during treatment. These observations motivated his continued interest in the relationship between infectious disease and cardiovascular health. Lyme Disease, Bartonella, and Endothelial Inflammation A central theme of the conversation is the endothelium, the thin layer of cells lining the inside of blood vessels. Endothelial cells play important roles in vascular function, blood flow, inflammation, and clotting. Dr. Hight discusses how certain infections may affect vascular tissues and potentially contribute to inflammatory processes. He is particularly interested in Borrelia, the bacteria responsible for Lyme disease, and Bartonella species. Both infections have recognized cardiovascular manifestations under certain circumstances, although their mechanisms and clinical presentations differ. Dr. Hight believes further research is needed to determine whether some tick-borne infections contribute to the progression of atherosclerosis. Does Treating Infections Improve Arterial Health? Dr. Hight reports observing reductions in inflammatory biomarkers followed by improvements in arterial ultrasound findings among some patients receiving treatment. He emphasizes that infection management is only one part of his cardiovascular approach. His patients also receive attention to cholesterol, blood pressure, metabolic health, and other established cardiovascular risk factors. Because multiple interventions may occur together, these clinical observations cannot determine which intervention caused the improvements. Dr. Hight acknowledges that more research is necessary to establish cause-and-effect relationships. Understanding Atherosclerosis and Plaque Regression Atherosclerosis develops when plaque accumulates within artery walls. Plaque contains lipids, inflammatory cells, connective tissue, and other materials. Over time, atherosclerosis can restrict blood flow or contribute to events such as heart attacks and strokes. Dr. Hight explains that he uses repeated ultrasound studies to evaluate changes in arterial disease. He discusses plaque regression, which refers to a reduction in atherosclerotic plaque burden. He believes monitoring arterial changes over time provides valuable information about whether a patient's cardiovascular risk-management plan is working. Although plaque regression can occur with effective treatment, interpreting ultrasound changes requires appropriate measurement techniques and clinical context. Dr. Hight also describes strong survival outcomes in his own practice. These are self-reported clinical observations, not independently verified results from a controlled study. Beyond Cholesterol: More Than 20 Modifiable Heart Disease Risk Factors Dr. Hight argues that cardiovascular medicine should consider a wider range of potentially modifiable risk factors. He explains that many routine discussions focus primarily on: Cholesterol Blood pressure Diabetes Smoking Obesity These are important, well-established cardiovascular risk factors. However, Dr. Hight believes clinicians should also investigate other contributors when patients experience unexpected disease progression. He describes evaluating more than 20 modifiable factors in his practice. His broader approach includes inflammatory markers and, in selected circumstances, possible infectious contributors. The conversation emphasizes that patients who have experienced a heart attack or stroke benefit from comprehensive secondary prevention, including evidence-based medication, lifestyle management, and appropriate specialist follow-up. Cardiovascular Biomarkers: Troponin T, NT-proBNP, and IL-6 Dr. Hight discusses several laboratory markers that helped prompt his investigation into additional inflammatory processes. These include: High-sensitivity troponin T: A biomarker associated with heart muscle injury. Interpretation depends on the clinical situation and the degree and pattern of elevation. NT-proBNP: A biomarker commonly used in the evaluation of heart failure and cardiac stress. Interleukin-6 (IL-6): An inflammatory signaling molecule involved in immune responses and multiple disease processes. Dr. Hight reports seeing changes in certain markers alongside changes in arterial health. He believes these measurements may provide clues when investigating patients whose cardiovascular disease is not improving as expected. However, these biomarkers are not specific tests for Lyme disease, Bartonella infection, or infection-related atherosclerosis. Lyme Carditis vs. Coronary Artery Disease Rich and Dr. Hight discuss the distinction between established cardiac complications of Lyme disease and the broader possibility of infection-associated atherosclerosis. Lyme carditis is a recognized manifestation of Lyme disease that can affect the heart's electrical conduction system, sometimes causing atrioventricular block. Symptoms may include palpitations, dizziness, fainting, shortness of breath, and chest discomfort. Coronary artery disease is different. It generally involves atherosclerotic plaque buildup in arteries supplying the heart muscle. Dr. Hight believes more research should investigate whether tick-borne infections contribute to coronary artery disease in selected patients. However, Lyme carditis does not establish that Lyme disease is a common cause of atherosclerosis. For a related conversation, listen to Tick Boot Camp's interview with Dr. Medeya Tsnobiladze about the neurological and cardiovascular impacts of Lyme disease. Should Heart Attack Patients Be Tested for Lyme Disease? Rich asks whether tick-borne disease testing should become part of routine cardiovascular evaluations. Dr. Hight believes infectious contributors deserve more consideration, particularly when a patient's clinical history raises relevant questions. He acknowledges that evidence establishing the relationship between Lyme disease and atherosclerosis remains incomplete. Currently, routine Lyme disease testing for every heart attack patient is not an established standard of care. Testing decisions should consider symptoms, possible tick exposure, geographic risk, and the likelihood that results will meaningfully guide medical management. The disc

For seven years, Anne Desjardins struggled with unexplained symptoms, medical dismissal, depression, and thoughts of suicide before finally receiving a Lyme disease diagnosis. Today, she's helping others find the hope she once desperately needed. In this LIVE from ILADS interview, Tick Boot Camp co-host Rich sits down with Anne Desjardins, a Pennsylvania Lyme disease advocate, Ayurvedic practitioner, support group leader, and host of The Silver Lyming podcast. Recorded at the 2025 International Lyme and Associated Diseases Society (ILADS) Conference in San Antonio, Texas, their conversation explores delayed Lyme disease diagnosis, neurological symptoms, medical gaslighting, mental health, integrative healing, financial hardship, and the power of sharing patient recovery stories. Anne opens up about losing her independence, struggling to remember people's names, and reaching a point where she no longer wanted to live. She also shares how her diagnosis, treatment, lifestyle changes, and supportive community helped her rebuild her life and discover a new purpose. Her story is a reminder that a difficult chapter doesn't have to be the final chapter—and that hearing someone else's recovery story can help make hope feel possible again. Seven Years of Symptoms Before a Lyme Disease Diagnosis Anne believes she contracted Lyme disease in Pennsylvania, one of the states most heavily affected by tick-borne illness. She began noticing symptoms around age 30, but her initial attempts to find medical answers were unsuccessful. Healthcare professionals repeatedly attributed her symptoms to stress, depression, or being overly emotional. Anne remembers trying to explain that she was becoming depressed because she felt physically ill every day—not the other way around. Over time, her symptoms became increasingly disruptive: Hearing loss in her left ear Heart palpitations and episodes of fluttering Severe dizziness, particularly when turning her head Memory loss, confusion, and difficulty concentrating Speech problems, including stuttering Overwhelming fatigue and reduced ability to perform daily activities Depression, social withdrawal, and suicidal thoughts She eventually became concerned that she might have a brain tumor. After years of unsuccessful medical appointments, a physician finally suspected Lyme disease and ordered testing. When the result came back positive, Anne felt an overwhelming sense of relief. She finally had a diagnosis that could help guide her next steps. Medical Gaslighting, Depression, and the Mental Health Impact of Chronic Illness Anne describes how repeated dismissal affected her confidence, relationships, and emotional well-being. When doctors told her nothing was wrong, she began questioning herself. She became embarrassed by her cognitive symptoms and increasingly avoided social situations. At one event, she introduced herself to the same person twice within minutes because she couldn't remember their first interaction. Daily activities such as showering, doing laundry, cleaning, or visiting friends became difficult. Anne also discusses using alcohol to cope with years of physical and emotional suffering. Eventually, she experienced suicidal thoughts and wondered whether she would ever regain her life. Rich asks whether those thoughts were driven by the illness itself, the prolonged diagnostic journey, or the hopelessness that developed along the way. Anne believes multiple factors contributed. She describes feeling disconnected from herself and eventually learning to recognize that distressing thoughts did not define her identity. Her experience highlights why mental health support and compassionate medical care are important for people living with disabling chronic symptoms. If you're struggling with thoughts of suicide, you deserve immediate support. In the United States, call or text 988 to reach the Suicide & Crisis Lifeline. For additional conversations about the psychological impact of Lyme disease, explore Tick Boot Camp's mental health and Lyme disease interview with therapist Christina Kantzavelos. Lyme Disease Treatment and Anne's Personal Healing Journey After receiving her diagnosis, Anne began antibiotic treatment through her family physician. She initially experienced significant improvement, describing the experience as finally feeling human again. However, some neurological and cognitive symptoms returned during treatment. She received additional antibiotics and eventually began working with a clinician experienced in treating Lyme disease. Anne describes approximately two and a half additional years of antibiotic treatment, alongside herbal supplements and other supportive approaches. One influential resource was Unlocking Lyme by Dr. Bill Rawls, MD. Unable to comfortably read at the time because of her cognitive symptoms, Anne listened to the audiobook and found encouragement in Dr. Rawls' recovery story. She gradually incorporated additional changes into her daily routine, including: Dietary adjustments and avoiding foods she personally felt worsened her symptoms Eliminating alcohol and caffeine Herbal approaches discussed with her healthcare provider Hot yoga and regular movement Mindfulness, spirituality, and self-reflection Exploring Ayurveda and holistic wellness practices Anne credits these combined changes with helping her regain function and improve her quality of life. She emphasizes that her transformation happened gradually over several years. Her experiences reflect an individualized recovery journey rather than a treatment protocol proven to work for everyone. In particular, hot yoga, restrictive diets, and herbal products have not been established as cures for Lyme disease, and prolonged heat exposure can pose risks for some patients. Discovering Ayurveda and a New Perspective on Health As Anne's health improved, she became increasingly interested in Ayurveda, a traditional system of medicine originating in India. She was drawn to its emphasis on daily routines, seasonal changes, nutrition, and the relationship between physical and emotional well-being. Anne eventually pursued formal education to become an Ayurvedic practitioner. She describes this experience as part of a broader personal transformation. Rather than viewing recovery solely as the absence of symptoms, she began exploring how her experience had changed her priorities, relationships, and understanding of herself. Anne acknowledges that she would never have chosen the suffering she experienced, but she now values the perspective and sense of purpose that emerged from it. Turning Pain Into Purpose Through Pennsylvania Lyme Advocacy As Anne regained her health, she became determined to help others avoid the isolation and confusion she had experienced. She began leading a support group through the PA Lyme Resource Network, a volunteer-driven nonprofit focused on tick-borne disease education, prevention, patient support, and advocacy. Anne is associated with the organization's Berks County region and has participated in community outreach and prevention education. She also discusses becoming involved in Pennsylvania's public education efforts connected to Act 83, the state's Lyme and Related Tick-Borne Disease Surveillance, Education, Prevention and Treatment Act. Her advocacy focuses on helping people recognize potential tick-borne disease symptoms, understand prevention strategies, and find supportive resources. The Financial Burden of Lyme Disease Anne speaks candidly about the financial challenges many patients face. Her own treatment journey was expensive, and she describes hearing from people who struggle to afford testing, appointments, treatment, housing, or basic necessities. She also raises concerns about insurance coverage and access to knowledgeable healthcare professionals. Rich and Anne agree that patients should not have to face financial devastation while searching for answers. For Pennsylvania residents seeking community support or practitioner referrals, the PA Lyme Resource Network's patient resources provide a starting point. The Silver Lyming: A Podcast Dedicated to Hope and Healing Anne eventually transformed her advocacy into a podcast called The Silver Lyming. The title reflects her belief that meaningful growth, connection, and purpose can sometimes emerge from extremely difficult experiences. At the time of this interview, Anne had recently released her 75th episode. Her podcast features people who share their experiences with Lyme disease, tick-borne infections, chronic illness, and recovery. Rather than focusing exclusively on symptoms and suffering, Anne seeks out stories that demonstrate different paths toward improved health and renewed purpose. She believes hearing from people who have made progress can help listeners feel less isolated and more hopeful about their own futures. Anne also discovered that podcasting benefits the guests themselves. Several have told her that sharing their experiences publicly helped them process what they had endured. For Anne, the podcast has become a place where people can speak openly, feel heard, and connect with others who understand. Listen to The Silver Lyming with Anne Desjardins on Apple Podcasts. Why Positive Lyme Disease Communities Matter Rich and Anne discuss the importance of finding supportive spaces during chronic illness. Both recognize that patients need opportunities to express frustration, grief, anger, and disappointment. However, Anne explains that when she was seriously ill, she actively searched for stories of people who had improved. She found those stories encouraging at a time when her future felt uncertain. Rich emphasizes the value of multiple patient-led podcasts and advocacy platforms. Different hosts bring different perspectives, ask different questions, and connect with different audiences. He explains that Tick Boot Camp wants peop

What happens when Lyme disease patients develop seizures, neurological symptoms, or serious complications—and the treatments they're receiving aren't working? In this LIVE from ILADS interview, Tick Boot Camp co-host Rich reconnects with Dr. Pamela Cipriano, DNP, APRN, a Connecticut nurse practitioner specializing in Lyme disease, tick-borne infections, and complex chronic illness. Recorded at the 2025 International Lyme and Associated Diseases Society (ILADS) Conference in San Antonio, Texas, their conversation explores neurological Lyme disease, persistent seizures, suspected autoimmune encephalitis, Bartonella, Babesia, chronic urinary tract infections, and the challenges of caring for patients with complicated medical histories. Dr. Cipriano shares two neurological case studies involving a 25-year-old man and a 14-year-old girl, discusses why some healthcare professionals hesitate to consider alternative diagnoses, and explains her efforts to improve Lyme disease education. She also reflects on her personal journey into tick-borne disease medicine, her son's illness, her training with Dr. Richard Horowitz, and her candidacy for the ILADS Board of Directors. Throughout the conversation, one message stands out: Patients with persistent, unexplained symptoms deserve continued investigation, compassionate care, and healthcare professionals willing to collaborate. Meet Dr. Pamela Cipriano, DNP, APRN Dr. Pamela Cipriano is a Connecticut-based advanced practice registered nurse with a Doctor of Nursing Practice degree. Her professional background includes hospital medicine, critical care, pharmaceutical sales, and the evaluation of patients with Lyme disease and other complex health conditions. She joined ILADS in 2018 and has attended nearly every annual conference since becoming a member. Dr. Cipriano explains that ILADS conferences expose her to research and clinical discussions involving tick-borne pathogens, immune function, environmental exposures, and different treatment approaches. She emphasizes her interest in integrative medicine and individualized patient care. Her decision to enter the field was deeply personal. After her son developed significant health problems, including chronic bladder symptoms, she began investigating Lyme disease and associated infections. That experience ultimately helped shape her professional focus. Neurological Lyme Disease: Two Patients With Persistent Seizures One of the most important parts of the interview focuses on two patients featured in Dr. Cipriano's ILADS poster presentation. The cases involve a 25-year-old man and a 14-year-old girl experiencing serious neurological complications. Dr. Cipriano describes both patients as having neuroborreliosis-related concerns. She explains that the patients developed seizures after beginning antibiotic treatment for Lyme disease. The cases became particularly challenging because the patients continued experiencing neurological symptoms despite receiving anticonvulsant medications. The 25-year-old patient, she reports, was taking three seizure medications and still experiencing seizures. Dr. Cipriano began questioning whether an inflammatory or autoimmune neurological process might be contributing to his symptoms. She discusses researching autoimmune encephalitis and sharing relevant literature with the patients' neurologists. Could Autoimmune Encephalitis Be Overlooked? Autoimmune encephalitis occurs when the immune system attacks components of the brain, potentially causing seizures, behavioral changes, memory problems, and other neurological symptoms. Dr. Cipriano raises concerns that clinicians may sometimes focus on controlling seizures without sufficiently investigating their underlying causes. She discusses corticosteroids as one possible treatment used for certain inflammatory neurological disorders. However, persistent seizures do not automatically indicate autoimmune encephalitis or neurological Lyme disease. Both conditions require careful diagnostic evaluation, and corticosteroids are not appropriate for every seizure disorder or infection. New seizures, prolonged seizures, or repeated seizures without recovery are medical emergencies. Patients should receive prompt neurological evaluation and appropriate treatment. When Patients and Families Find Support Through Shared Experiences Dr. Cipriano explains that the two neurological patients eventually met through their treatment schedules. Although they had not previously known one another, their families began connecting during appointments. They shared experiences, asked about each other's progress, and developed a sense of understanding. For families navigating severe neurological illness, these connections can provide meaningful emotional support. Their experiences also illustrate why community matters when patients face prolonged diagnostic uncertainty. Knowing another family understands the challenges can reduce isolation, even when their medical situations are different. Why Some Doctors Hesitate to Explore Unfamiliar Diagnoses Rich asks Dr. Cipriano why healthcare professionals sometimes resist investigating conditions outside their established areas of expertise. She believes medical training, professional expectations, and concerns about colleagues' opinions may influence clinical decisions. Dr. Cipriano reflects on her previous work as a hospitalist and explains that she has always been willing to question established approaches when patients are not improving. She believes clinicians should remain open to additional evidence and consultation when a treatment plan is unsuccessful. Rich also discusses the professional and regulatory pressures faced by physicians who treat complicated tick-borne disease cases. They reference the history of Dr. Joseph Burrascano, whose work in Lyme disease has been influential within the ILADS community. Their discussion highlights the importance of balancing professional responsibility, patient safety, scientific evidence, and clinical judgment. A Lyme Disease Education Survey With Only 26 Responses Dr. Cipriano describes an effort to understand how much local healthcare professionals know about Lyme disease. She distributed 300 surveys to physicians, nurse practitioners, physician assistants, chiropractors, and naturopathic practitioners. Only 26 responses were returned. That represents a response rate of approximately 8.7%. Dr. Cipriano found the limited participation discouraging. She also shares that a former colleague contacted her privately to express support for her educational efforts. The experience reinforced her belief that healthcare professionals need more opportunities to discuss Lyme disease openly and constructively. Although the response rate does not establish what clinicians know or believe about Lyme disease, it illustrates the challenges Dr. Cipriano encountered while trying to encourage professional engagement. Why Dr. Cipriano Ran for the ILADS Board of Directors During the interview, Dr. Cipriano announces that she is running for the ILADS Board of Directors. Her motivation is to expand membership, improve communication, and encourage more healthcare professionals to participate in Lyme disease education. She believes her previous career in pharmaceutical sales provides skills that could help. Before focusing on tick-borne disease care, Dr. Cipriano spent approximately 14 years in pharmaceutical sales and marketing. She describes working with hospitals and medical decision-makers to explain treatment options and develop professional relationships. One of the medications she represented was ceftriaxone, commonly known by the brand name Rocephin. Ceftriaxone is an antibiotic used for certain serious bacterial infections, including selected neurological and cardiac manifestations of Lyme disease. Dr. Cipriano believes her communication experience could help ILADS reach healthcare professionals who are unfamiliar with its work. Her goal is to build relationships rather than create confrontation. She wants clinicians to better understand the experiences of patients with complex tick-borne illnesses and the research being discussed within the ILADS community. From Her Son's Illness to Lyme Disease Practitioner Dr. Cipriano explains that she began treating Lyme disease around 2017. Her son's illness played a major role in that transition. Initially, she focused on Lyme disease after his testing identified Borrelia. When his symptoms did not improve as expected, she began considering other possible infections. She later pursued additional education through ILADS and trained with Dr. Richard Horowitz, MD. Dr. Cipriano credits that training with helping her develop a broader approach to evaluating patients with complicated symptoms. She also discusses her son's reported improvement after treatment that addressed suspected additional infections. His experience remains a personal clinical account and does not establish that every patient with persistent Lyme disease symptoms has Bartonella or Babesia. The Three Bs and Four Bs of Tick-Borne Illness Rich and Dr. Cipriano discuss how the Lyme disease community increasingly talks about multiple infections rather than Borrelia alone. They reference the three Bs: Borrelia: The bacteria responsible for Lyme disease Bartonella: A group of bacteria associated with several human infections Babesia: Parasites that infect red blood cells and cause babesiosis Dr. Cipriano also mentions a fourth category involving other Borrelia species associated with tick-borne relapsing fever. She reports encountering more patients with laboratory findings suggesting multiple infections. Rich asks whether this reflects improvements in testing, increased clinical awareness, or changes in tick-borne pathogen exposure. Dr. Cipriano believes several factors may be involved. However, the presence of multiple microorgani

Could overlooked environmental bacteria, immune dysfunction, and mitochondrial health help explain why some Lyme disease patients remain sick despite years of treatment? In this LIVE from ILADS interview, Tick Boot Camp co-host Rich welcomes back Jacquelyn “Jacki” Meinhardt, DNP, FNP-BC, a nurse practitioner at Amen Clinics in Northern Virginia, to explore the complex relationship between Lyme disease, tick-borne co-infections, environmental exposures, inflammation, and persistent symptoms. Recorded at the 2025 International Lyme and Associated Diseases Society (ILADS) Conference in San Antonio, Texas, the conversation explores why some patients struggle to improve after seeing numerous healthcare professionals—and why listening, comprehensive evaluation, and patient-centered care are so important. Jacki discusses medical gaslighting, the growing recognition of Anaplasma and Ehrlichia infections, cardiovascular complications of tick-borne diseases, and an often-overlooked environmental concern: actinomycetes, a group of bacteria that can be found in indoor environments. She also previews her work on mitochondrial medicine, including cellular energy production, NAD metabolism, inflammation, and the possible relationship between mitochondrial dysfunction and chronic fatigue. Throughout the interview, Jacki emphasizes a principle that resonates deeply with the Lyme disease community: Patients deserve to be heard, believed, and thoroughly evaluated—even when their symptoms remain unexplained. Meet Jacquelyn “Jacki” Meinhardt, DNP, FNP-BC Jacquelyn “Jacki” Meinhardt is a doctorally prepared, board-certified family nurse practitioner whose clinical interests include neuroinflammation, immune dysfunction, tick-borne infections, environmental illness, and complex chronic health conditions. At the time of this interview, she had worked at Amen Clinics in Northern Virginia, outside Washington, D.C., for approximately four years. Jacki also teaches at Georgetown University, bringing her clinical and academic experience to discussions about medical education and emerging research. During the interview, she shares that she had been nominated for the ILADS Board of Directors. Since this conversation was recorded, Jacki has joined the ILADS Board, becoming its first nurse practitioner board member. Her involvement reflects her interest in expanding interdisciplinary collaboration, improving education, and helping healthcare professionals better understand patients with complex chronic illnesses. Learn more about her work through her Amen Clinics professional profile. Why Some Patients Remain Sick After Seeing 20 Doctors Jacki explains that many patients arrive at Amen Clinics after extensive medical journeys. Some have consulted as many as 20 healthcare professionals, including functional medicine practitioners, without achieving meaningful improvement. They may have undergone numerous laboratory tests, received multiple diagnoses, and tried different treatment plans. Rather than immediately recommending another intervention, Jacki begins by asking questions. She reviews previous testing, medical history, symptoms, treatment responses, and possible environmental exposures. Her goal is to identify what may have been overlooked. She also emphasizes the importance of treatment sequencing. Sometimes patients have received several reasonable recommendations, but Jacki believes the order in which interventions are introduced may affect how well they tolerate or respond to care. Her approach focuses on understanding the individual patient's circumstances rather than automatically adding more treatments. Medical Gaslighting, Medical Trauma, and the Power of Being Believed One of the most meaningful moments in the interview occurs when Jacki discusses the emotional consequences of prolonged diagnostic uncertainty. She describes patients who have repeatedly been told that their test results are normal or that nothing is medically wrong. After years of symptoms and unsuccessful treatments, some become fearful that another healthcare professional will dismiss their concerns. Jacki describes this experience as a form of medical trauma. She explains that one of the first things she tells patients is: “I believe you.” That reassurance can help patients feel safe enough to share their experiences and participate in a productive medical conversation. Rich asks whether medical gaslighting always involves intentional dismissal or whether some situations reflect limitations in medical education and diagnostic tools. Jacki emphasizes education rather than assigning blame. She believes healthcare professionals can improve patient care by communicating more effectively, remaining curious, and recognizing the limitations of their knowledge. The discussion reinforces an important message: Unexplained symptoms are still real symptoms, and patients deserve compassionate medical attention. Immune Dysfunction: Finding Common Ground Across Medical Specialties Jacki explains that she frequently uses the term immune dysfunction when communicating with clinicians who may be unfamiliar with some of the terminology used in Lyme disease and environmental medicine. Rather than beginning with a discussion of Borrelia, Bartonella, Babesia, mold, or other specific organisms, she focuses on how the immune system may be functioning. She believes this approach creates opportunities for collaboration across medical specialties. Jacki also discusses how the COVID-19 pandemic increased public awareness of immune responses, inflammation, and cytokines. She views the resulting research and medical conversations as opportunities to improve understanding of other complex illnesses. However, immune dysfunction is a broad concept, not a single diagnosis. Specific immune disorders require appropriate clinical evaluation, and not every chronic symptom is caused by an abnormal immune response. Lyme Disease Co-Infections: Beyond Borrelia, Bartonella, and Babesia Rich asks Jacki whether she is seeing changes in the types of infections identified among patients with Lyme disease. He describes Tick Boot Camp's observations of patients reporting combinations of Borrelia, Bartonella, and Babesia. Jacki explains that she has considered multiple tick-borne infections in her clinical evaluations for many years. She also discusses other pathogens that may be relevant depending on a patient's symptoms and exposure history. These include: Borrelia: Bacteria responsible for Lyme disease and certain relapsing fever illnesses Babesia: Parasites that infect red blood cells and cause babesiosis Bartonella: Bacteria associated with several human diseases Anaplasma: Bacteria responsible for anaplasmosis Ehrlichia: Bacteria responsible for ehrlichiosis Rickettsia: Bacteria associated with spotted fever illnesses, including Rocky Mountain spotted fever Jacki reports encountering more Anaplasma and Ehrlichia in her practice over the preceding two years. She acknowledges that she cannot determine whether this reflects changing infection patterns, improved diagnostic testing, or increased clinical awareness. Her experience highlights the importance of considering other tick-borne infections when a patient's history and symptoms warrant investigation. It does not mean that every person with Lyme disease has multiple infections. Cardiovascular Symptoms and Tick-Borne Disease Jacki discusses her interest in cardiovascular and circulatory health. She explains that when evaluating patients with certain cardiac abnormalities, she considers whether an infectious disease could be contributing to their symptoms. The conversation includes heart block, atrial fibrillation, and tick-borne infections that may require further investigation. Lyme carditis is a recognized complication of Lyme disease that can disrupt electrical signaling in the heart. Other tick-borne infections may also produce serious systemic complications. Jacki emphasizes reviewing which infections have already been investigated and whether additional testing is appropriate. New chest pain, fainting, significant palpitations, or suspected heart block require prompt medical attention. For another discussion of Lyme disease's neurological and cardiovascular effects, explore Tick Boot Camp's interview with Dr. Medeya Tsnobiladze. Environmental Actinomycetes: Could There Be More Than Mold in Water-Damaged Buildings? One of the most distinctive parts of this interview focuses on environmental actinomycetes. Jacki explains that patients investigating building-related health concerns frequently focus on mold. However, she believes certain bacteria present in indoor environments deserve additional attention. Actinomycetes are a diverse group of bacteria found in soil, water, and other environments. Some are also normal members of the human microbiome. Jacki discusses how these organisms can enter buildings through shoes, clothing, pets, and ordinary outdoor exposure. She explains that moisture and environmental conditions may influence microbial growth. Her clinical interest includes evaluating possible environmental exposures in patients with persistent symptoms and complex medical histories. Actinomycetes, Biofilms, and Indoor Environments Jacki describes actinomycetes as organisms capable of contributing to biofilm formation under certain conditions. She discusses how investigating bacterial contamination may differ from evaluating fungal contamination. She also references research she reports publishing with Dr. Ritchie Shoemaker in 2019 concerning environmental organisms and chronic inflammatory illness. According to Jacki, understanding these exposures may help clinicians investigate cases where patients continue experiencing symptoms after addressing suspected mold problems. She also describes considering culture results from different body sites when eval

What if treating Lyme disease is only part of the recovery process—and the next frontier is helping the body repair the damage left behind? In this LIVE from ILADS interview, Tick Boot Camp co-host Rich sits down with Dr. Todd Maderis, ND, founder of Marin Natural Medicine Clinic in Northern California, to explore what he calls “Lyme 3.0”—an evolving approach to complex chronic illness that looks beyond infections to consider immune function, environmental exposures, cellular repair, and long-term recovery. Recorded at the 2025 International Lyme and Associated Diseases Society (ILADS) Conference in San Antonio, Texas, the conversation explores why some patients continue experiencing fatigue, brain fog, and neurological symptoms even after receiving treatment for Lyme disease and associated infections. Dr. Maderis discusses the challenges of diagnosing multiple tick-borne infections, the possible roles of mold exposure and heavy metals, the relationship between long COVID and viral reactivation, and how his approach to treating complex chronic illness has evolved since 2012. The interview also examines emerging diagnostic technologies, including testing from IGeneX, T-Lab, and Galaxy Diagnostics, along with Babesia, Bartonella, alpha-gal syndrome, and practical strategies for preventing tick bites. His central message: Recovery may require more than identifying and treating infections. For some patients, understanding the factors contributing to persistent symptoms and supporting rehabilitation may be equally important. Meet Dr. Todd Maderis, ND Dr. Todd Maderis, ND is the founder and medical director of Marin Natural Medicine Clinic in Marin County, California, just north of San Francisco. He began focusing on Lyme disease and tick-borne infections in 2012. Over time, his practice expanded to include patients with complicated medical histories involving several overlapping health conditions. His areas of clinical interest include: Lyme disease, Babesia, Bartonella, and other tick-borne infections Mold-related illness and environmental exposures Mast cell activation syndrome (MCAS) Chronic viral infections, including Epstein-Barr virus (EBV) Long COVID Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) Autoimmune conditions Persistent fatigue, pain, and cognitive symptoms Dr. Maderis explains that his approach has evolved as he has encountered patients with increasingly complicated combinations of symptoms and diagnoses. He also shares research and educational information through social media to help patients better understand emerging developments in complex chronic illness. What Is Lyme 3.0? One of the most compelling parts of this conversation is Dr. Maderis's explanation of how Lyme disease treatment has evolved. He describes three stages in the development of his clinical thinking. Lyme 1.0: Focusing on the Infection Early treatment approaches primarily emphasized identifying and treating the infectious organisms responsible for Lyme disease and associated conditions. Dr. Maderis explains that clinicians initially focused heavily on reducing the infectious burden. Antimicrobial treatment remains essential when a patient has an active infection requiring treatment. However, he began questioning whether infection-focused interventions alone could explain every patient's ongoing symptoms. Lyme 2.0: Recognizing Additional Health Conditions As his practice evolved, Dr. Maderis increasingly evaluated patients for other medical problems occurring alongside tick-borne infections. These included mold-related concerns, mast cell activation syndrome, chronic viral infections, and autoimmune conditions. He describes learning about mold-related illness at an ILADS conference around 2013 as a turning point in his clinical career. That presentation encouraged him to consider environmental exposures in patients whose symptoms were not fully explained by their existing diagnoses. Lyme 3.0: Recovery, Repair, and Rehabilitation Dr. Maderis believes the next stage involves understanding what patients may need after appropriate treatment of infections and other identified medical conditions. He points to people who continue experiencing symptoms such as: Persistent fatigue Brain fog and cognitive difficulties Reduced physical endurance Neurological complaints Difficulty returning to previous activities He discusses cellular and mitochondrial health as areas of interest when considering why some patients struggle to regain their previous level of functioning. His concept of Lyme 3.0 emphasizes the importance of rehabilitation and recovery rather than viewing treatment exclusively as an effort to eliminate pathogens. This is Dr. Maderis's framework, not an established medical classification or a validated treatment protocol. Persistent symptoms after Lyme disease treatment can have multiple causes and require individualized medical evaluation. Why Some Lyme Patients Have Multiple Contributing Health Problems Rich asks Dr. Maderis why clinicians appear to be identifying more complicated cases involving several infections or overlapping medical conditions. Dr. Maderis believes several developments may be contributing to this observation. Diagnostic technologies have evolved, clinicians have become more aware of tick-borne co-infections, and geographic patterns of tick exposure continue to change. He also discusses environmental exposures and the possible effects of other illnesses on immune function. Dr. Maderis groups the factors he considers into three broad categories: Infectious factors: Tick-borne infections and other clinically relevant infectious diseases. Environmental factors: Mold exposure, toxic metals, and other exposures that may warrant investigation. Traumatic factors: Physical injuries, including head trauma, and psychological stress or trauma that may affect health and recovery. He explains that some patients arrive with several potential contributing conditions rather than one straightforward diagnosis. His challenge is determining which findings are clinically significant and which require treatment. The conversation highlights why complex cases benefit from careful differential diagnosis rather than assuming every symptom has the same underlying cause. Lyme Disease, Long COVID, and Epstein-Barr Virus Reactivation Rich and Dr. Maderis discuss whether COVID-19 can influence previously controlled infections. Dr. Maderis references research investigating the relationship between SARS-CoV-2 infection, immune changes, and Epstein-Barr virus reactivation. Some studies have identified associations between EBV reactivation markers and long COVID. He raises the possibility that changes in immune function following COVID-19 could also affect other infections. However, the extent to which SARS-CoV-2 may cause reactivation of Borrelia infection remains uncertain. The discussion illustrates an important research question: How do multiple infections and immune responses interact in patients experiencing prolonged symptoms? Dr. Maderis believes clinicians should remain aware of emerging findings while recognizing that the science continues to develop. Why a Positive Lyme Antibody Test Doesn't Always Mean Active Infection Rich and Dr. Maderis discuss the distinction between detecting an infection and detecting evidence of a previous immune response. Antibody tests measure the immune system's response to an organism rather than directly identifying whether that organism is currently present. Antibodies against Borrelia can remain detectable for months or years after successful treatment. This means a positive antibody test does not necessarily establish an active infection. Conversely, testing early in an infection can produce negative results before detectable antibodies have developed. Dr. Maderis believes clinicians must interpret results alongside symptoms, medical history, exposure risk, and other clinical findings. This distinction is particularly important for patients who undergo repeated testing while trying to understand persistent symptoms. Advanced Lyme Disease and Co-Infection Testing Dr. Maderis explains that he uses several specialty laboratories when evaluating patients for Lyme disease and associated infections. He discusses how different testing methods may provide different types of information. IGeneX: Lyme Disease and Co-Infection Panels Dr. Maderis describes IGeneX as one of the foundational laboratories he uses when evaluating patients for tick-borne infections. The laboratory offers testing for Lyme disease and several associated infections. He explains that he frequently orders comprehensive panels during initial evaluations when the patient's history supports investigation for multiple tick-borne pathogens. T-Lab: Direct Detection Methods Dr. Maderis also discusses T-Lab, which uses specialized microscopy and molecular methods intended to detect organisms more directly. He contrasts these methods with antibody-based testing. The potential advantage of direct detection is that it attempts to identify evidence of the organism rather than relying solely on the patient's antibody response. However, the diagnostic accuracy, clinical validation, and appropriate use of individual specialty tests must be evaluated carefully. Galaxy Diagnostics: Bartonella Testing Dr. Maderis identifies Galaxy Diagnostics as another laboratory he uses, particularly when investigating Bartonella infection. He discusses the laboratory's expanded Bartonella testing methods and describes a patient whose infection was detected after earlier testing through other laboratories had been negative. This experience reinforced his belief that different testing methods may sometimes produce different findings. For a deeper exploration of Bartonella diagnostics, Tick Boot Camp previously interviewed Nicole Bell of Galaxy Diagnostics about the challenges

What happens when a Lyme disease doctor realizes she can only help so many patients in her office—but millions of people need better information, more treatment options, and access to knowledgeable healthcare professionals? For Dr. Myriah Hinchey, ND, the answer has been to build something bigger than her medical practice. In this LIVE from ILADS interview, Tick Boot Camp co-host Rich reconnects with Dr. Hinchey to discuss how she is expanding Lyme disease education and patient support through her Connecticut naturopathic practice, LymeCore Botanicals, the LymeBytes Symposium, and a new educational course. Recorded at the 2025 International Lyme and Associated Diseases Society (ILADS) Conference in San Antonio, Texas, their conversation explores herbal medicine for Lyme disease and co-infections, integrative approaches to complex chronic illness, the importance of continuing medical education, and the challenges of making specialized healthcare accessible. Dr. Hinchey also shares why she created her own botanical medicine company, how her conference connects patients with nonprofit organizations and healthcare professionals, and why she believes education can reach people who may never be able to schedule an appointment with her. The conversation raises an important question: How can one healthcare professional help thousands of people without personally treating every patient? Meet Dr. Myriah Hinchey, ND Dr. Myriah Hinchey is a Connecticut-licensed naturopathic physician specializing in Lyme disease, tick-borne infections, and complex chronic illness. She is the medical director of TAO: Center for Vitality, Longevity & Optimal Health in Hebron, Connecticut. Her clinical work focuses on patients experiencing complicated, often infection-associated health problems. During the interview, Dr. Hinchey explains that her multidisciplinary practice includes: Naturopathic medicine Lyme-informed psychotherapy Acupuncture Massage therapy Support for patients with complex chronic illness She works alongside fellow naturopathic physician Dr. Marisa Hauser, who also focuses on Lyme disease, co-infections, and related health concerns. Beyond her clinical practice, Dr. Hinchey is the founder of LymeCore Botanicals and LymeBytes, an educational platform that brings together healthcare professionals, patients, researchers, and advocacy organizations. Her professional work reflects a philosophy of combining individualized patient care with broader educational initiatives intended to reach the Lyme disease community. Why Dr. Hinchey Continues Attending ILADS Rich begins by asking why Dr. Hinchey regularly participates in ILADS conferences. Her answer centers on the importance of continuous learning. Even though her clinical approach may differ from those of other practitioners, she believes healthcare professionals need to understand emerging research and the treatments their colleagues are using. She explains that patients frequently arrive having already tried different protocols or therapies. Understanding those approaches allows clinicians to evaluate previous treatments, identify potential problems, and make more informed recommendations. Dr. Hinchey also believes no practitioner has every answer. Even after years of clinical experience, she says she regularly learns something new from educational presentations that helps her reconsider a difficult patient case. For her, attending conferences is not simply about learning new protocols. It is about expanding the clinical knowledge available to patients who have complicated medical histories. Why She Created LymeCore Botanicals One of the most interesting parts of this interview is the origin of LymeCore Botanicals, the herbal medicine company Dr. Hinchey co-founded. She explains that the business began more than a decade before this interview because she was frustrated by inconsistent access to the medicinal herbs she used in her practice. Her primary concern was supply reliability. When a clinician develops an individualized treatment plan using botanical products, inconsistent availability can make it difficult to maintain that plan. Dr. Hinchey wanted greater confidence in the sourcing, purity, potency, and consistency of the herbs available to her patients. Over time, the project expanded into developing formulations based on her clinical experience and treatment philosophy. What began as a practical solution for her own patients eventually grew into a resource used by other healthcare professionals. The Role of Herbal Medicine in Her Clinical Approach Dr. Hinchey discusses botanical medicine as one component of her integrative approach to Lyme disease and co-infections. She believes herbal formulations may play a role in addressing different aspects of complex chronic illness, including infection-related concerns and broader physiological dysfunction. Her approach emphasizes considering the patient's overall condition rather than focusing exclusively on antimicrobial treatment. However, herbal products vary considerably in their ingredients, quality, evidence, and potential risks. Some botanical compounds have demonstrated antimicrobial activity in laboratory studies, but these findings do not establish that herbal protocols can cure Lyme disease in humans. Patients should review supplements with qualified healthcare professionals, particularly when taking prescription medications or managing complicated medical conditions. The LymeBytes Symposium: Bringing the Lyme Community Together Dr. Hinchey explains that she created LymeBytes after discovering that nonprofit organizations were helping patients pay for treatment, yet many people—including experienced clinicians—did not know those resources existed. She wanted to create an event that would connect several important parts of the Lyme disease community. Her vision included three major goals. 1. Connect patients with nonprofit resources Dr. Hinchey wanted organizations providing financial assistance, education, and other support to become more visible to people who might benefit from their services. She also wanted to create opportunities to raise money for these organizations. 2. Provide practical medical education Rather than focusing exclusively on research presentations, she wanted clinicians to leave with information they could apply in practice. Her goal was to bring together experienced speakers who could discuss clinical approaches, patient management, and emerging treatment considerations. 3. Introduce patients and practitioners to additional resources The symposium includes companies and organizations involved in diagnostic testing, nutritional supplements, and complementary interventions. Dr. Hinchey mentions hyperbaric oxygen therapy, red light therapy, far-infrared saunas, and other supportive modalities as examples of topics represented at the event. These therapies have varying levels of scientific support and should not be assumed to be effective treatments for Lyme disease. From a Lyme Conference to a Broader Chronic Illness Symposium Dr. Hinchey explains that LymeBytes initially focused on Lyme disease and associated tick-borne infections. Over time, she expanded its educational scope to address other complex health conditions and overlapping symptom presentations. These include: Long COVID Mold-related illness PANS and PANDAS Immune system dysfunction Complex chronic infection-associated conditions Neurological and inflammatory symptoms She believes clinicians benefit from examining these conditions together because some patients experience overlapping symptoms or multiple diagnoses. The symposium is designed for healthcare professionals as well as patients who want to become more informed participants in their medical care. 2026 event update: The next LymeBytes Symposium is scheduled for November 13–14, 2026, in the Fort Lauderdale/Pompano Beach area of Florida, with in-person and virtual attendance options. Why Education Matters When Doctors Have Long Waiting Lists Rich raises a challenge that affects many patients seeking specialized Lyme disease care: limited access to experienced practitioners. Dr. Hinchey shares that her practice once had a waiting list approximately 18 months long. She recalls receiving angry messages from people frustrated that they could not schedule an appointment sooner. While she understood their desperation, she also recognized that she could not personally treat everyone who needed help. She has a family and responsibilities outside her medical practice. Even working longer hours would not solve the broader problem of limited specialist availability. Rich uses her experience to explore how healthcare professionals can serve people beyond traditional appointments. Instead of relying exclusively on one-on-one care, clinicians can share knowledge through conferences, podcasts, educational courses, books, and other resources. These formats allow information to reach people who live far away, cannot afford specialized consultations, or face lengthy appointment delays. Although educational resources cannot replace individualized medical care, they can help patients prepare questions, understand available options, and seek appropriate evaluations. Reaching Patients Through Podcasts and Online Summits Dr. Hinchey explains that she participates in podcasts and educational events because she wants to reach people who are still searching for explanations for their symptoms. She describes her involvement in two Healing Lyme Summit events through DrTalks. At the time, she already had more demand for appointments than her practice could accommodate. Her motivation for participating was not to attract additional patients. Instead, she hoped someone listening might recognize a relevant symptom pattern or learn about an avenue of medical evaluation they had not previously considered. She believes accessi

What happens when a child spends 10 years searching for a diagnosis, sees 21 doctors, and continues getting sicker while medical tests come back negative? For author and Lyme disease advocate Terri McCormick, this isn't a hypothetical question. It's part of her family's story—and the experience that inspired her to help others navigate the devastating consequences of delayed and missed diagnoses. In this LIVE from ILADS interview, Tick Boot Camp co-host Rich sits down with Terri to discuss her book, Being Misdiagnosed: Stories That Reveal the Hidden Epidemic of Lyme Disease, which shares 12 real-life stories of people whose illnesses were initially attributed to other medical conditions. Recorded at the 2025 International Lyme and Associated Diseases Society (ILADS) Conference in San Antonio, Texas, the conversation explores the limitations of Lyme disease testing, the emotional toll of medical dismissal, neurological and psychiatric symptoms, and the importance of finding knowledgeable healthcare professionals. Terri also shares her experiences advocating for two seriously ill daughters, the challenges of navigating multiple medical specialists, and why families need to understand that a negative test doesn't always provide a complete answer. At the heart of this conversation is a message for patients and caregivers who feel unheard: Your symptoms deserve to be taken seriously, and you are not alone in searching for answers. Meet Terri McCormick: Mother, Author, and Lyme Disease Advocate Terri McCormick is an author, speaker, patient advocate, and ILADS Ambassador whose work focuses on improving awareness of Lyme disease and other tick-borne illnesses. Her advocacy began when her own children developed serious health problems that remained unexplained for years. Terri describes navigating countless appointments, researching possible explanations, and struggling to find physicians who could connect her daughters' seemingly unrelated symptoms. What began as a mother's determination to help her children eventually became a broader mission to support families facing similar challenges. Today, Terri helps people find educational resources and connect with healthcare professionals experienced in tick-borne diseases. She also serves as an Illinois State Co-Leader for the Center for Lyme Action and contributes to LymeDisease.org. Her experiences inspired her to write Being Misdiagnosed, a collection of patient stories intended to raise awareness about diagnostic delays and the human consequences of medical uncertainty. A Mother's 10-Year Search for Answers One of the most emotional parts of this interview is Terri's account of her daughters' illnesses. Her older daughter developed increasingly debilitating symptoms, including: Severe, recurring migraines Extreme fatigue and prolonged periods in bed Difficulty walking and dragging her legs Unusual rashes on her hands Significant swelling in her hands Symptoms that fluctuated unpredictably Terri explains that repeated Lyme disease tests came back negative. Despite her daughter's worsening condition, the family struggled to find a clear explanation. Some physicians recommended psychiatric evaluations, leaving Terri frustrated that her daughter's physical symptoms were not being adequately addressed. Her younger daughter experienced a different combination of symptoms, including cardiac concerns, skin problems, and similar hand rashes. Her illness eventually became so debilitating that she missed approximately 60% of a school year. Determined to continue her education, she listened to classroom lectures remotely from bed. Terri recalls consulting numerous medical specialists, including neurologists and rheumatologists. She describes seeing 21 doctors during the family's search for answers. Eventually, the family connected with a practitioner who ordered testing through IGeneX, which Terri says helped establish a Lyme disease diagnosis for one of her daughters. Their experience illustrates how difficult it can be for families when symptoms cross multiple medical specialties and no single clinician has a complete picture. Why Can Lyme Disease Be Difficult to Diagnose? Rich and Terri spend considerable time discussing one of the Lyme community's most persistent concerns: diagnostic uncertainty. Many commonly used Lyme disease tests measure antibodies produced by the immune system in response to infection. These tests can be useful, but their accuracy depends on several factors, particularly the timing of testing. Early in infection, a person may not yet have developed detectable antibodies. This means a negative test does not always exclude Lyme disease, especially when symptoms and exposure history strongly suggest an early infection. Terri describes her frustration when negative test results became the primary reason clinicians dismissed Lyme disease as a possibility. She believes doctors should evaluate the full clinical picture, including symptoms, medical history, possible tick exposure, and appropriate laboratory findings. The interview also highlights the challenges associated with interpreting specialized testing and evaluating patients who have been ill for extended periods. For additional information about available testing methods and their limitations, explore Tick Boot Camp's Lyme Disease Testing Guide. When a Negative Test Becomes a Barrier to Care One of Rich's central observations is that negative test results can influence more than medical decisions. They can also affect whether patients are believed. When a person continues experiencing serious symptoms despite inconclusive testing, they may encounter skepticism from healthcare professionals, family members, employers, or friends. Terri explains that this can be especially difficult for people whose symptoms fluctuate. Someone may feel well enough to participate in an activity one day but be unable to get out of bed the next. Without understanding that symptoms can change over time, others may mistakenly question the severity of the illness. Rich and Terri discuss how this dynamic can leave patients feeling isolated, discouraged, and uncertain about their own experiences. Their message is that persistent symptoms deserve thoughtful evaluation, even when the initial medical investigation does not produce a clear answer. A negative Lyme test does not prove that someone is healthy, but it also does not establish that Lyme disease is the cause of their symptoms. A comprehensive evaluation should consider both tick-borne infections and other possible explanations. Being Misdiagnosed: 12 Stories That Reveal the Hidden Epidemic of Lyme Disease Terri's book, Being Misdiagnosed: Stories That Reveal the Hidden Epidemic of Lyme Disease, brings together 12 real-life accounts of people who experienced prolonged diagnostic journeys. The book explores how symptoms associated with tick-borne illness may overlap with those of other medical conditions. Among the diagnoses discussed are: Amyotrophic lateral sclerosis (ALS) Multiple sclerosis (MS) Alzheimer's disease Chronic fatigue syndrome Sleep disorders Psychiatric illnesses, including schizophrenia Other neurological and complex chronic conditions Terri hopes the stories will encourage patients, caregivers, and medical professionals to ask additional questions when an illness remains unexplained or a diagnosis does not fully account for someone's symptoms. The book also addresses the emotional and social consequences of prolonged illness, including family relationships, medical uncertainty, and the importance of advocacy. Publication update: Although Terri discussed a planned January 2026 release during this October 2025 interview, Being Misdiagnosed has since been published and is available through her official website. The Story of David: Decades Without Answers Terri shares the story of David, one of the individuals featured in her book. According to Terri, David began experiencing serious health problems around age 10, when he received a diagnosis of spondylitis. As he grew older, his condition continued to deteriorate. He underwent repeated medical evaluations, yet his symptoms progressed. By age 42, Terri explains, David had accumulated an extensive list of diagnoses and was living with significant chronic illness. She wonders whether earlier recognition of an underlying tick-borne infection could have changed the course of his medical journey. David's experience raises an important question: What happens when physicians treat individual symptoms and diagnoses without reconsidering whether a broader explanation may be missing? His story reflects the book's emphasis on persistence, reevaluation, and the importance of listening to patients whose health continues to decline. When Lyme Disease Symptoms Resemble ALS or Other Neurological Conditions Another story Terri highlights involves a woman who received an ALS diagnosis. According to Terri, the woman was evaluated by neurologists, including specialists at Mayo Clinic, and was given a limited life expectancy. Her daughter subsequently researched other possibilities and helped her pursue an evaluation for Lyme disease. Terri reports that the woman received a positive Lyme test and underwent treatment. She describes substantial improvement, explaining that the woman later returned to working approximately 50 hours per week. Terri presents this experience as an example of why patients facing serious diagnoses may benefit from a careful review of their medical histories and potential alternative or coexisting conditions. Importantly, this individual story does not establish that Lyme disease causes ALS or that Lyme treatment reverses confirmed ALS. Neurological symptoms can overlap across conditions, and accurate diagnosis requires appropriate specialist evaluation. The story illustrates the importance of investigating potentially treatable condi

For more than four decades, Dr. Richard Horowitz has challenged conventional thinking about chronic illness. His work treating more than 13,000 chronically ill patients has led to one of the most influential clinical frameworks in Lyme disease medicine: MSIDS® (Multiple Systemic Infectious Disease Syndrome). Now, in his groundbreaking new book, Ending Chronic Illness: A Revolutionary New Program to Reverse Inflammation and Heal Persistent Disease, Dr. Horowitz expands that framework far beyond Lyme disease. He presents a bold new model suggesting that many of today's most common chronic illnesses—including Alzheimer's disease, Long COVID, autoimmune disorders, chronic fatigue syndrome, cardiovascular disease, autism spectrum disorders, psychiatric illness, and cancer—share common inflammatory pathways and root causes that can be identified and addressed. In this exclusive Tick Boot Camp interview, Matt Sabatello and Rich Johannesen spend more than two hours taking a deep dive into Dr. Horowitz's latest work, exploring the science behind chronic inflammation, the evolution of his MSIDS model, his precision medicine approach to healing, and why he believes medicine must shift from treating symptoms to identifying the multiple factors keeping patients sick. Whether you're living with Lyme disease, another chronic illness, or simply want to understand the future of personalized medicine, this conversation offers one of the most comprehensive discussions Dr. Horowitz has ever shared. You can purchase Ending Chronic Illness: A Revolutionary New Program to Reverse Inflammation and Heal Persistent Disease on Amazon Meet Dr. Richard Horowitz Dr. Richard Horowitz is a board-certified internist, internationally recognized Lyme disease specialist, researcher, educator, and New York Times bestselling author. After beginning his medical career as a traditional internist, he found himself practicing in one of the country's earliest Lyme disease epicenters in New York's Hudson Valley. Over the past 40+ years, Dr. Horowitz has become one of the world's leading clinicians treating chronic Lyme disease and complex chronic illness. His clinical experience treating more than 13,000 patients led him to develop the MSIDS model, a comprehensive framework that looks beyond a single diagnosis to identify multiple overlapping factors driving persistent illness. His previous books, Why Can't I Get Better? and How Can I Get Better?, transformed how many physicians and patients approach chronic Lyme disease. His newest book expands that framework to virtually every major chronic disease. In This Episode, You'll Learn: Why Dr. Horowitz Believes Chronic Disease Needs a New Model Rather than viewing illnesses as isolated diagnoses, Dr. Horowitz argues that chronic diseases often share common inflammatory drivers. He explains why treating a diagnosis alone frequently fails while identifying multiple underlying causes can dramatically improve outcomes. Understanding the MSIDS Model The conversation explores the evolution of MSIDS (Multiple Systemic Infectious Disease Syndrome), which identifies sixteen overlapping contributors to chronic illness. The six primary "drivers of inflammation" include: Chronic infections Environmental toxins Microbiome dysfunction Leaky gut and food sensitivities Vitamin and mineral deficiencies Sleep disorders Dr. Horowitz explains how these root causes create widespread inflammation that then produces additional downstream effects throughout the body. The Three I's: Infection, Inflammation, and Immunity One of the interview's central themes is Dr. Horowitz's "Three I's" framework. He explains how: Persistent infections trigger inflammation Chronic inflammation damages immune function Impaired immunity allows additional infections to thrive Breaking this cycle, he argues, is essential for long-term recovery. Chronic Inflammation: The Common Thread A major focus of the discussion is inflammation. Dr. Horowitz explains why inflammation—not simply infection—may be the underlying mechanism connecting: Lyme disease Long COVID Alzheimer's disease Autoimmune disorders Mood disorders Chronic fatigue syndrome Cardiovascular disease Cancer Autism spectrum disorders The 16 Inflammatory Pathways Building upon the MSIDS model, Dr. Horowitz discusses sixteen major inflammatory pathways that regulate immune function and chronic disease. He explains how pathways such as NF-κB, NRF2, the NLRP3 inflammasome, and prostaglandin signaling interact to sustain inflammation and why targeting these pathways may improve outcomes across numerous diseases. Precision Medicine Instead of One-Size-Fits-All Care Rather than treating everyone identically, Dr. Horowitz advocates for personalized medicine. Every patient presents a unique combination of infections, environmental exposures, immune dysfunction, nutritional deficiencies, hormone imbalances, mitochondrial dysfunction, and other contributing factors. The goal is to identify each person's unique inflammatory burden and systematically remove the factors preventing recovery. Dapsone Combination Therapy Dr. Horowitz explains how years of clinical experience led to the development of his Dapsone Combination Therapy protocols. The discussion covers: Persister bacteria and biofilms Combination antibiotic strategies Reducing Herxheimer reactions Supporting detoxification Managing treatment side effects The importance of antioxidants, probiotics, methylfolate, glutathione, and other supportive therapies He emphasizes that successful treatment involves much more than simply prescribing Dapsone. Lyme Disease, Alzheimer's Disease, and Neuroinflammation The interview also explores Dr. Horowitz's recent work investigating Lyme disease and Alzheimer's disease. He discusses how chronic infections, environmental toxins, and neuroinflammation may contribute to cognitive decline and why reducing inflammation may become an important future direction for neurodegenerative disease research. Emotional Trauma and Chronic Illness Drawing from Chapter 3 of his new book, Dr. Horowitz discusses the biological impact of trauma and chronic stress. He explains why unresolved trauma, limbic system dysfunction, and chronic stress physiology can perpetuate inflammation and why healing often requires addressing both physical and emotional health. Environmental Toxicity Chapter 4 of the book examines the growing role of environmental toxins. Dr. Horowitz discusses: Mold exposure Heavy metals Air pollution Plastics and endocrine disruptors Pesticides Water quality He argues that modern environmental exposures contribute significantly to chronic inflammation and should be evaluated as part of any comprehensive treatment plan. Prevention Matters Although much of the discussion centers on treating chronic illness, Dr. Horowitz emphasizes prevention. He shares many of the lifestyle practices he personally follows, including: Anti-inflammatory nutrition Exercise Sleep optimization Stress reduction Detoxification support Targeted supplementation Reducing environmental toxin exposure His message is simple: protecting health before illness develops may be just as important as treating disease after it appears. Key Takeaways Chronic illness often results from multiple overlapping causes rather than a single diagnosis Inflammation may be the common biological mechanism connecting many seemingly unrelated diseases. The MSIDS model provides a practical framework for identifying and treating these underlying contributors Personalized precision medicine may offer better outcomes than symptom-focused treatment alone Addressing infections, toxins, gut health, nutrition, sleep, immune dysfunction, and emotional health together may dramatically improve recovery Prevention through lifestyle and inflammation reduction should become a central focus of modern medicine. Why This Episode Matters For decades, Dr. Richard Horowitz has challenged traditional assumptions about chronic disease. In Ending Chronic Illness: A Revolutionary New Program to Reverse Inflammation and Heal Persistent Disease, he brings together thousands of patient experiences, years of clinical research, and an evolving understanding of inflammation into one comprehensive roadmap for patients and physicians alike. Whether you agree with every conclusion or simply want to better understand one of today's most influential voices in integrative medicine, this conversation offers an extraordinary look at how the future of chronic illness care may evolve. If you or someone you love is navigating Lyme disease, Long COVID, autoimmune illness, chronic fatigue, persistent inflammation, or another complex chronic condition, this is an episode you won't want to miss.

Can a multidisciplinary approach to Lyme disease treatment help patients better understand their illness, develop individualized treatment plans, and build a foundation for long-term recovery? In this LIVE from ILADS interview, Tick Boot Camp co-host Rich sits down with Dr. Francisco Ulloa, MD of Sanoviv Medical Institute in Mexico to explore the clinic's approach to integrative Lyme disease treatment, functional medicine, precision-oriented care, and patient education. Recorded at the 2025 International Lyme and Associated Diseases Society (ILADS) Conference in San Antonio, Texas, the conversation offers an inside look at how Sanoviv brings together physicians, nutritionists, psychologists, and other specialists to evaluate patients and develop coordinated treatment strategies. With approximately 17 years of experience at Sanoviv, Dr. Ulloa explains why he believes treating complex chronic illness requires understanding the individual patient, not simply following a standardized protocol. Rich and Dr. Ulloa also discuss the emotional challenges of chronic illness, the relationship between conventional and functional medicine, and why the habits patients develop during treatment may be important after returning home. For people researching Lyme disease treatment options in Mexico, this interview provides insight into Sanoviv's clinical philosophy, patient evaluation process, and residential care experience. About Dr. Francisco Ulloa, MD Originally from Mexico, Dr. Francisco Ulloa studied and worked in Guadalajara before joining Sanoviv Medical Institute. He first learned about the facility approximately 20 years before this interview through a professional relationship between Sanoviv and the university where he worked. During his initial visit, he was impressed by the environment and its approach to healthcare. He hoped to eventually become part of the medical team. Approximately two years later, he received an invitation to join the institute. By the time of this interview, Dr. Ulloa had spent approximately 17 years working at Sanoviv. His clinical philosophy emphasizes multidisciplinary collaboration, functional medicine, individualized medical planning, and helping patients understand their health. He believes one of the institute's greatest strengths is bringing healthcare professionals from different disciplines together to evaluate complex cases and coordinate patient care. What Makes Sanoviv's Approach to Lyme Disease Different? Located in Rosarito Beach, Baja California, Mexico, Sanoviv Medical Institute offers residential integrative medical programs for patients with a variety of health concerns, including Lyme disease and associated conditions. Dr. Ulloa describes Sanoviv as a functional medicine clinic built around collaboration among multiple healthcare disciplines. Rather than having patients visit specialists independently and attempt to coordinate recommendations themselves, the institute brings those professionals together within one facility. Its team includes medical doctors, nutritionists, psychologists, chiropractors, kinesiologists, fitness professionals, and biological dentistry specialists. Dr. Ulloa explains that the clinic's physicians have training associated with the Institute for Functional Medicine (IFM). Patients typically spend several weeks at the facility, although some extend their stays depending on medical needs, personal goals, and financial circumstances. During that time, the team works to understand each patient's medical history, evaluate current health concerns, and develop a coordinated plan. How the Multidisciplinary Evaluation Process Works One of the most revealing parts of the interview is Dr. Ulloa's description of Sanoviv's medical meetings. When patients arrive, different members of the clinical team evaluate their cases from their respective professional perspectives. The team then meets to discuss findings, compare observations, and determine treatment priorities. Dr. Ulloa explains that the most important issue to address first may not always be the symptom the patient finds most troubling. This is where collaboration becomes particularly valuable. Instead of making decisions based on one professional's perspective, the team considers the patient's broader medical circumstances. Rich describes this as a precision-oriented approach to medicine, where the treatment strategy is developed around the individual rather than applying the same protocol to everyone. Why Lyme Disease Treatment May Need to Be Individualized Dr. Ulloa emphasizes that people with Lyme disease can have very different medical histories, symptoms, and treatment needs. He discusses several factors that may influence the clinical picture, including immune system function, genetics, underlying health conditions, previous treatments, and individual susceptibility. His philosophy is that clinicians should evaluate these differences when developing a treatment strategy. For some patients, this may mean addressing sleep disturbances, nutritional concerns, physical limitations, or other diagnosed medical conditions alongside appropriate treatment for Lyme disease. Dr. Ulloa believes the goal should be to understand the patient as a whole rather than focusing exclusively on one symptom. This approach is especially relevant to people experiencing complex or persistent symptoms who may benefit from coordinated evaluation across multiple medical specialties. Importantly, Lyme disease is caused by infection with Borrelia bacteria. Individualized supportive care does not replace evidence-based diagnosis or appropriate antibiotic treatment. The Power of Helping Patients Understand Their Medical History Dr. Ulloa identifies patient education as one of the most meaningful aspects of the Sanoviv experience. People living with complicated chronic illnesses may arrive after years of searching for explanations. Some have consulted numerous healthcare professionals, undergone extensive testing, or tried multiple treatments without achieving the improvement they hoped for. Dr. Ulloa explains that the medical team works to review each patient's history and communicate its findings in a way the patient can understand. During the first weeks of treatment, patients may interact frequently with physicians and other specialists. These conversations provide opportunities to understand treatment recommendations, discuss priorities, and ask questions. Dr. Ulloa describes how meaningful it can be when a medical team helps patients make sense of their health history. For people who have struggled to feel heard or understood, having their experiences carefully evaluated can provide validation and a clearer path forward. Emotional Support, Hope, and Chronic Illness Rich asks Dr. Ulloa about the relationship between emotional well-being and the treatment experience. Chronic illness can affect much more than physical health. Patients may face uncertainty about their future, changes in employment, financial pressure, disrupted relationships, and the emotional exhaustion of navigating ongoing symptoms. Dr. Ulloa explains that psychological support is an important part of Sanoviv's multidisciplinary approach. He believes clinicians should recognize the emotional challenges associated with illness while helping patients understand their treatment options. The conversation also explores the importance of hope. When patients have experienced years of setbacks, a coordinated medical plan and supportive clinical environment may help them feel more confident about the future. However, emotional outlook does not determine whether someone will recover from Lyme disease. Patients should never be blamed for persistent symptoms or made to feel that they have failed because improvement has been difficult. Hope is most meaningful when accompanied by appropriate medical care, honest communication, and realistic expectations. Why Lifestyle Education Is Central to the Sanoviv Experience A major theme of this interview is what happens after a patient leaves a residential treatment program. Rich raises the concern that some people may expect an intensive medical experience to resolve their health challenges without requiring any changes to their everyday routines. Dr. Ulloa explains that Sanoviv emphasizes lifestyle education because the institute wants patients to continue applying what they learn after returning home. The discussion includes nutrition, sleep, physical activity, emotional well-being, and maintaining appropriate health practices. Dr. Ulloa believes these factors can influence general health and a patient's ability to manage certain medical conditions. He also acknowledges that not every patient is equally interested in a lifestyle-oriented approach. Some people seek a quick intervention, while others are willing to participate in a more comprehensive program. His goal is to help patients understand the reasoning behind recommendations so they can make informed decisions about their ongoing care. Lifestyle changes may support overall wellness and symptom management, but Lyme disease is an infectious illness—not a consequence of unhealthy habits—and these measures are not substitutes for appropriate medical treatment. Can Conventional Medicine and Functional Medicine Work Together? Dr. Ulloa challenges the idea that patients must choose exclusively between pharmaceutical medicine and complementary approaches. He describes encountering people with strongly held beliefs about different types of treatment. Some prefer to avoid prescription medications, while others are skeptical of nutritional or lifestyle-based interventions. His approach is to consider the available options according to the patient's clinical needs. He provides an example involving someone with longstanding sleep difficulties who may benefit from carefully selected short-term medication while ot

What happens when a healthcare professional suddenly loses the ability to walk, struggles to get answers from major medical institutions, and is told Lyme disease doesn't exist where she lives? In this LIVE from ILADS interview, Tick Boot Camp welcomes Dr. Kristi Hellenbrand, DC, a Georgia chiropractor, Lyme disease survivor, author of Let Me Tell You a Secret…She Makes It: A Lyme Survival Story, and Global Lyme Alliance ambassador. In the fall of 2020, Kristi experienced a devastating neurological decline. Within approximately 60 days, she could no longer walk. Migraines, tremors, memory problems, and episodes of disorientation followed. Despite evaluations at major medical institutions, she struggled to obtain a clear explanation for her symptoms. She recalls being told she might have multiple sclerosis and hearing that Lyme disease wasn't a concern in Georgia. Eventually, a local functional medicine physician helped her pursue a different treatment approach. Kristi reports achieving remission in 2021. But her journey didn't end with medical treatment. She also had to rebuild her physical health, process the grief of losing her chiropractic practice, navigate the emotional consequences of chronic illness, and discover a new purpose through Lyme disease education and advocacy. Her story offers a message for people who feel overwhelmed by their diagnosis: Healing is possible, and someone else's recovery story may help you discover questions, resources, and approaches worth exploring with your own healthcare team. When Lyme Disease Changes Everything in 60 Days Before becoming a Lyme disease advocate, Kristi was a practicing chiropractor, mother, wife, and horse owner living south of Atlanta, Georgia. Then, in 2020, her health rapidly deteriorated. Within approximately two months, she lost the ability to walk. Her neurological symptoms included: Severe migraines Tremors Memory lapses Cognitive dysfunction Disorientation in familiar surroundings Significant mobility impairment At one point, she became lost only two miles from home. Kristi describes the fear of watching her body and brain change while struggling to find a physician who could explain what was happening. Her experience became particularly frustrating when she was told that Lyme disease wasn't found in Georgia. For Kristi, the lack of answers became almost as frightening as the symptoms themselves. When a Healthcare Professional Becomes the Patient As a chiropractor, Kristi was already familiar with healthcare. But that didn't make navigating her own unexplained illness easy. She sought evaluations from major medical institutions, including Emory, Piedmont, and Mayo. According to Kristi, those encounters did not produce a clear diagnosis or treatment plan that resolved her illness. She ultimately connected with a local functional medicine physician who was willing to investigate Lyme disease as a possible explanation. That experience reinforced something frequently discussed on Tick Boot Camp: Patients with complicated symptoms need clinicians who listen, investigate, and remain curious when the first explanation doesn't fit. For more information about diagnostic challenges, explore Tick Boot Camp's Lyme disease testing resources. The Treatment Journey: Double-Dose Dapsone Kristi describes pursuing an intensive treatment approach influenced by research from Dr. Richard Horowitz, a physician known for his work with Lyme disease and other tick-borne illnesses. She specifically discusses the double-dose dapsone protocol. Although Kristi did not personally treat with Dr. Horowitz, she and her physician reviewed his published work and incorporated a related approach into her treatment. Kristi recalls that the protocol was challenging and that her physician was initially apprehensive about using such an intensive strategy. Nevertheless, Kristi reports that this period of treatment became an important turning point in her recovery. Her experience is a personal account, not evidence that double-dose dapsone is appropriate or effective for everyone. Dapsone-based multidrug protocols can involve significant medical risks and require careful clinical oversight. Learn more about these approaches through Tick Boot Camp's interviews with Dr. Richard Horowitz. Why Kristi Wrote Let Me Tell You a Secret…She Makes It Kristi's illness forced her to become a student of Lyme disease. While bedridden, she read extensively about the infection, associated conditions, available treatments, and recovery. She remembers needing approximately 20 books simply to begin understanding the basics. That experience inspired an important question: Why should every newly diagnosed patient have to do all this research alone? Her answer was to write a book that combines a personal recovery memoir with practical Lyme disease education. Let Me Tell You a Secret…She Makes It: A Lyme Survival Story was published in 2023. Kristi explains that the book includes educational sections addressing topics such as: Understanding Lyme disease Tick-borne co-infections Treatment options Navigating medical care Financial challenges Finding help Supporting the body during recovery Emotional health and grief Family relationships Rebuilding life after serious illness She began writing before she knew how her own story would end. Originally, part of her motivation was to preserve the experience for her children. Over time, the project became something larger: a resource for other patients and their families. Learn more about Kristi's book and advocacy through Lyme Lives Here. Learning the Language of Lyme Disease Rich and Kristi discuss one of the biggest challenges facing newly diagnosed patients: Lyme disease comes with an unfamiliar vocabulary. Suddenly, patients may be hearing terms such as: Borrelia Bartonella Babesia Co-infections Neuroborreliosis Biofilms Dapsone Herxheimer reactions Nervous-system regulation Rehabilitation Remission Understanding these terms can help patients communicate more effectively with healthcare professionals and evaluate the information they encounter. Kristi designed her memoir to help shorten that learning curve. Rich connects her educational approach with Tick Boot Camp's Tick Bite Blueprint, a resource developed to help people understand practical steps following a tick bite. Putting Out the Fire vs. Rebuilding the Body One of Kristi's central recovery concepts is distinguishing between addressing the active illness and rebuilding afterward. She describes the initial phase of treatment as putting out the fire. Once she felt the immediate crisis had been addressed, she shifted her attention toward rehabilitation. Kristi discusses working on: Digestive health Physical recovery Neurological symptoms Cognitive function Nutrition Emotional health Nervous-system regulation Her perspective is that treatment and rehabilitation are related but not necessarily identical phases. The body may need continued support even after the most severe symptoms improve. This leads to one of the interview's most important connections with Tick Boot Camp's broader healing framework. The Four Phases of Lyme Recovery Rich shares Tick Boot Camp's four-phase model, developed from recurring themes in patient recovery interviews. 1. Prehabilitation Preparing and supporting the body before intensive treatment. 2. Assist Supporting the immune system and addressing microbial burden through an individualized medical plan. 3. Rehabilitation Rebuilding physical, neurological, and functional capacity. 4. Maintenance Developing sustainable habits, monitoring health, and reducing the risk of future tick-borne infections. Kristi recognizes elements of all four phases in her own experience. The conversation illustrates how recovery may involve much more than a single treatment protocol. It also emphasizes that this is a framework for understanding recovery stories, not a universal medical sequence that every patient must follow. The Grief of Losing Your Former Life One of the most emotionally powerful parts of the conversation involves grief. Kristi didn't simply lose physical function. She also lost parts of her identity and independence. She was forced to close her chiropractic practice. She could no longer participate in many of the activities she loved. Her horses remained in the pasture while she recovered. Her children took on additional responsibilities. Her husband helped shoulder the financial burden. Kristi remembers experiencing denial, anger, sadness, loneliness, and fear. She describes the profound isolation that can accompany serious chronic illness, especially when someone feels their life is disappearing piece by piece. Her memoir explores these emotions openly. It also gives family members and caregivers an opportunity to better understand what a loved one may be experiencing. Why Caregivers Need to Hear These Stories Kristi explains that some readers have passed her book to spouses, relatives, and other caregivers. That has become one of its unexpected benefits. Someone living with Lyme disease may struggle to explain the full experience of losing mobility, employment, independence, or hope. A memoir can help communicate those experiences. Kristi's husband initially found the book difficult to read because he had lived through the events alongside her. For other families, however, reading her story has helped open conversations about illness and caregiving. Chronic illness affects the entire family, even when only one person has the diagnosis. Anger, Grief & Finding Hope Kristi is open about the role anger played in her journey. At one point, frustration with her declining health became a powerful motivation to pursue treatment. But she also describes eventually moving toward a quieter emotional place. Her experience wasn't simply about fighting harder. It involved grieving what she had