i
ChecklistsforBartonella,BabesiaandLymeDisease
2012Edition
J.L.Schaller,M.D.,M.A.R.andK.Mountjoy,M.S.
ii
INTERNATIONALACADEMICINFECTIONRESEARCHPRESSBankTowers•NewGateCenter(305)Highway41[TamiamiTrailNorth]
Naples,FL34103
Copyright©2012byJamesSchaller,MD,MARAllrightsreserved.
CoverDesign:NickBotnerResearch:RandallBlackwell,LindsayGibson,KimberlyMountjoy
LibraryofCongressCatalogingDataSchaller,J.L;Mountjoy,K.
ChecklistsforBartonella,BabesiaandLymeDiseasebyJ.L.SchallerandK.Mountjoy
ISBN978-0-9840889-5-9
1.Tickinfections2.Fleainfections3.Diagnosis
Note on Citation Style
Thestyleofthesereferencesvaries.Makingthemuniformwouldnotaddto the ability to locate a citation.Mostwere left as theyappearedwhenuncoveredfromawiderangeoflocations.
ManufacturedintheUnitedStatesofAmericaFirstEdition
iii
To those working to restore real and concrete liberty to the United StatesSpecifically, as the world’s top jailer, with 25% of the world’s
inmates in the USA, we are not the freedom nation, we are the PRISON NATION.
May God, conscience or peers, help sheriffs, police, child protectionworkers, judges and attorney generals to have real integrity,
balance and a heart of service.
In America the abuse of power in law enforcement and child services is now routine, and character, humility, kindness and wisdom
need to be restored.
If you are working to restore the rights of the poor, weak and falsely accused—this text and my affection are dedicated to you.
iv
Contents
BARTONELLAIntroduction...........................................................................1.Checklists...............................................................................3
Psychiatric.and.Neurological........................................3Dermatology.or.Skin......................................................5Eye.....................................................................................6Heart.................................................................................7General.Medical..............................................................7Possible.Laboratory.Findings........................................9Environment..................................................................10
Bibliography........................................................................13
BABESIAIntroduction.........................................................................65Checklists.............................................................................67
Psychiatric.and.Neurological......................................67Heart.and.Circulatory.System.....................................67Major.Organs.................................................................68General.Medical............................................................69Lab.Results.....................................................................71Reactions.or.Changes.in.Body.....................................73Environment..................................................................74
A.Word.on.Manual.Blood.Examinations........................76Bibliography........................................................................79
v
LYME.DISEASEIntroduction.......................................................................105Checklists...........................................................................107
Laboratory.Testing—Indirect.and.Direct.................107Body.Examination.Results.........................................109
Sample.Neurological.Exam.................................. 110Patients’.Reported.Physical.History......................... 111
Psychiatric.and.Neurological............................... 111Major.Organs......................................................... 113Skin.......................................................................... 114Musculoskeletal..................................................... 114General.Medical..................................................... 115Environment........................................................... 117
Final.Words........................................................................ 119Bibliography......................................................................121
Dr..Schaller’s.Sample.Publications.................................159Disclaimer.and.Safety.Issues..........................................167Contacting.Dr..Schaller....................................................169
vi
The Bartonella ChecklistIncreasing Suspicion of an Emerging Stealth Infection
James L. Schaller, M.D., M.A.R.
Introduction
In2011anewhumanBartonellaspecieswasaddedtotheoverthirty-fiveBartonellaspeciescurrentlypublicallypublishedinGeneticDatabanks. Itwasdiscoveredandhighlightedby the talentedveterinarianresearcherEdwardBreitschwerdt.HehassaidthingsmoreclearlythantheideasIwasponderingin2005,whiledoingmostoftheresearchformyBartonellabook.Hesaidsimply,butwithdevastatingandhighlyusefulclarity, thatBartonella testing is terrible, the treatments are poor, it is typically found on the outside of red blood cells, and thecurrentresearchonBartonellaispathetic—onestudyatNIH.Ifthiswasnotenough,hesaidin2011, “Bartonella is carried by more vectors than any infection on the earth.” So it is hardly a backdoor “co-infection.”PerhapsLymeisthe“co-infection.”
Recently, the German researchers Kaiser and Riess summarizedBartonella research in this manner: after 2 decades of Bartonellaresearch,knowledgeontransmissionandpathologyofthesebacteriaisstilllimited.Bartonellaspecieshaveemergedtobeimportantpathogensinhumanandveterinarymedicine.
Whycreateachecklistwhenaphysiciancanjustorderanantibodytest?First,Ihavefoundattimes,Bartonellacanturnoffitsownantibodies,andthosecausedbyothertickandflea-borneinfectionsinhumans.Inastudyofsixty-oneBartonellainfecteddogs,PerezandMaggireportedrecently thatmostBartonella infected dogsdid not have detectable Bartonella antibodies.
ThecriterialistedbelowmayhavecausesunrelatedtoBartonella.Forexample,eachyearmorestudiesshowthepresenceofpolyinfections,andthisraisestheproblemofwhichinfectioniscausingwhatsymptom,sign or lab test change. For example,most tick infections can cause
1
2 BartonellaChecklist•SchallerandMountjoy
headacheorfatigue.Knowingwhichinfectionisthecausedoesbecomeclearifyouaredoingveryadvancedtreatmentsthataredesignedtokillonlyoneinfection.Thelimitationofthesepolyinfectionstudiesisthattypicallythetestingdetectionrateforeachtickorflea-borneinfectionisnotover95%forallpossiblespeciesandstrainspossiblyinfectinghumans.
However, since Bartonella can disable and kill healthy people, thechecklist below is set to catch virtually every infected patient.Thisis neither right nor wrong. Philosophy, sociology, presuppositions,medicalfashionandpsychologyusuallyallplayaroleinsettingcutoffsforadiagnosis.Allscienceisguidedbypresuppositions,andthatiswhyevenmathresearchisguidedbyawiderangeofvariables.In medicine, psychology, philosophical assumptions and sociology control all of medicinebutareunappreciatedduetoalackoftraining.See Kuhn’s The Structure of Scientific Revolutions exceptionally summarized at the following link: http://des.emory.edu/mfp/Kuhn.html
ChecklistsforBartonella,BabesiaandLymeDisease 3
THE BARTONELLA CHECKLIST
James Schaller, M.D., M.A.R.
(Please Check Any Symptoms That Apply)
PSYCHIATRIC AND NEUROLOGICAL
£Currentanxietythatwasnotpresentatageten
£Currentdepressionnotpresentatagesixteen
£Knee-jerkemotionalresponsesworsethanpastdecadesandworsening
£Brainfog
£Depression
£Depressionthatisnotfullycontrolledonroutine anti-depressant doses,orhighdoseantidepressantsarerequiredtocontrolmood[Improvement of moodorbeing“lessdepressed”isnotsuccessfuldepressiontreatment.]
£Anxietyispoorlycontrolledwithaveragedosing
£Depressionispoorlycontrolledbyreasonabletreatmenttrials.
£Suicidalfeelingsorroutinethoughtsofdeath
£Crying
£Obsessivethoughtsorfearinexcessofevent
£Obsessivethoughtsthatintrudeintothemindwhichareinexcessofnormal
£Adecreaseinpleasure
£Rageworsewithtime
£Irritabilityworsewithtime
4 BartonellaChecklist•SchallerandMountjoy
£Impatienceisgreaterwhencomparedtotenyearsago[inachild--anyirritabilityinexcessofwhatiscommonformostchildrenwithanidenticalage].
£Cursingorhostilespeechthatisworseovertime
£Increasedaddictionsthatareveryresistanttotypicalrecoveryranges
£Increasedimpulsivityincontrasttopastyearsorpastdecades
£Severeneurologicaldisorderswithoutaclearcause
£Severepsychiatrictroublesthatdonotseemtofitwiththediagnosticcriteriaorthereistroublecontrollingsymptomswithtreatment
£Newphysical,emotionalorverbalabuseinthehomewhichwasnotpresentinthepast
£Panicattacksthatwerenotpresentattenyearsofage
£Anxietymedicationhastobeincreasedtovery high levelstocontinuepastbenefit
£Diagnosedashavingbipolardisorder,butdonotfitthecriteriawell
£Anypsychiatricdisorderthatalsoshowsmedical pathology in laboratory tests
£Restlessness
£Combativebehavior
£Aparent,grandparent,childorsiblingwithsuicideattempts
£Aparent,grandparent,childorsiblingwhohasstartedphysicalorextremeverbalfights
£Intermittentconfusion
ChecklistsforBartonella,BabesiaandLymeDisease 5
£Seizures
£BrainlesionsseenonabrainscansuchasanMRIorCTofthehead
£Shorttermmemorydeficits
£Difficultyinlearningnewinformation
DERMATOLOGY OR SKIN
£Persistentrashesthatlastover3weeks
£Nodulesundertheskin
£Hyper-pigmentationordarkareasofskinwhichwerenotpresentatbirth
£Hypo-pigmentationorobviouslightareasofskin
£Unexplainedhairloss
£Spontaneousbreaksorholesintheskinassmallasamillimeter
£Skinulcerations
£Stretchmarksineccentriclocations,e.g.,arms,uppersideunderarmpit,aroundarmpitorontheback
£Stretchmarksfilledwithred,pink,purpleordarkbluecolorwhicharenotcausedbypregnancyorweightloss[remember,manywithmanypregnanciesorweightlossdonothave20stretchmarks]
£Anyskinmarkingsorgrowthsgreaterthanmostpeople
£Bloodvesselsorcoloronskingreaterthanmostpeople
£Redpapulesofanysize
£Skintagsincludingonesremovedbyadermatologistorshavedoff
6 BartonellaChecklist•SchallerandMountjoy
£Unusualbloodvesselsofanykindincludinginsideorganssuchasbladderorintestinalwalls
£Anyskinfindinginexcessof95%ofmosthumans
£Skinfindingsshowingincreasedbloodvesselsofanysize
£Skinfindingsshowingincreasedtissueformationthatisincreasedovertheflatnessofsurfaceskin[ThismaybeduetoBartonella,untreatedLymedisease,orbothinfectionsandsystemicinflammation]
£Skinshowingbloodvesselsthataretoolargeortoomanyforthe location of the blood vessels,e.g.,surfacethighandcalfskinwithverythicksurfacebloodvesselsorlegs,upperarmsorshouldershaveexplosionsofmanyfinebloodvessels
£Burningskinsensations[thismayhavemanycauses].
£Itchingwithoutaclearcauseandwhichishardtocontrolandremove
£Skinerosionwithoutaclearcausesuchasafire,fallorchemicalburn
£Minorcutsorscratcheswhichhealslowly
£Veryslowhealingafterasurgery
£“Granulomas”orballsoftissue
£Formicationorfeelingsofbeingbittenbybugsorbugsensationsonskinwithnobugsontheskin
EYE
£Retinainfection
£Retinainfarctordeadtissueinthebackoftheeye
ChecklistsforBartonella,BabesiaandLymeDisease 7
£Neuroretinitisorinflammationoftheretinaandopticnerveinthebackoftheeye
£Uveitisorinflammationofthemiddlelayeroftheeyeortheinterioreye
£Papilledemaorswellingoftheopticnerveasitentersthebackoftheeyeduetoraisedintracranialpressure
£Stellatemaculopathy
£Acuteblurredvision
£Suddenand/orsignificantchangeinvision
HEART
£Endocarditisorinflammationoftheheart
£Heartvalvepathology
£Enlargementoftheheart
£Anyamountofdeadcardiactissue
£Arrhythmiasoftheheart
£Palpitationsunrelatedtopanicattacks
GENERAL MEDICAL
£Sleepmedicationstake90-120minutetotakeeffectinsteadof30minutes
£Insomnia[Ifprofoundfatigueispresent,thismightnotapply]
£Atemperatureunder98.3inasickperson.Atemperatureunder99.0ifLymediseaseorBabesiaisalsopresent
£Anuncomfortableinfectioninthebodywithnodiscerniblecause
8 BartonellaChecklist•SchallerandMountjoy
£Gastroesophagealrefluxdisease(GERD)
£Diarrhea
£Colitisoraninflammationofthecolon
£Liverenlargementwithnoclearcause
£Bloodvesselproliferationorincreasednumbersinanyinternalorgans
£Lesionsorwoundswithnoclearcause
£Asorethroatwithnootherclearreason
£Apersistentsorethroatinhumidityinexcessof45%[lowhumiditydriesoutthroattissue]
£Gingivitisorbleedingduringflossing
£Unusualdiscomfortonthesolesofthefeetespeciallyinthemorning
£Puffytissueoninsoleoranypartofankles
£Ankle“edema”orexpandedtissuethatdoesnotpitwhenpressed[becauseitisexpandedtissueandnotmerelyfluid]
£Bonepain
£Inflammationoftheouterbonesurfaceorosteomyelitis
£Jointpain[thiscanbealsoduetoLymediseaseandmanyothermedicalproblems]
£Musclepain[thiscanbealsoduetoLymediseaseandmanyothermedicalproblems]
£Medicalproblemsdescribedas“idiopathic”(ofunknownorunclearcause)
ChecklistsforBartonella,BabesiaandLymeDisease 9
£Presenceoftwotickorfleainfectionswithtwopositivetickorflea-borneviruses,bacteriaorprotozoa.
Aspreviouslymentioned,Bartonellahasmorethan30publishedspeciesin public genetic databases and has more vectors than possibly anyinfectionintheworld.Therefore,thepresenceofotherinfectionssuchastick-borneviruses,bacteriaorprotozoa,shouldraisesuspicion.SomeoftheseincludeBabesia,STARI(Masterson’sDisease),Neoehrlichia,Anaplasma, Lyme disease,Mycoplasmas,Q Fever, RockyMountainspotted fever (Rickettsia), tick-borne relapsing fever, Tularemia(bacteria),Ehrlichia,ProtozoaFL1953,andvirusessuchasCMV,HHV-6,CoxsackieBTypes1,2,3,4,5,6,ParvoB-19orPowassan.
POSSIBLE LABORATORY FINDINGS
£IL-6isverylow.
£IL-1Bisverylow.
£TNF-alphaisinlower10%ofnormalrange.
£VEGFisabovethenormalrange[however,ifBabesiaispresentorbeingtreatedtheVEGFwillfallintonormalorabnormallowlevels].
£X-rayofthebonemayshowareasofboneloss.
£BiopsiesoflymphnodesarenegativeforMycoplasmaandnoclearevidenceofotherinfectionsorillnessesarefound
£Biopsiesoflymphnodesappearingsimilartosarcoidosis
£Tissuebiopsieswhichareabnormalbutwithnoclearcauseoftissueproblems
£AswabofafreshscratchorbiteskinlesionispositiveforBartonella.
10 BartonellaChecklist•SchallerandMountjoy
ENVIRONMENT
£Exposuretocatsanddogsinexcessofveryincidentalrarecontact
£Exposure to cats and dogsthathavebeenstraysorgooutside[reviewsofhundredsofprofessionaljournalarticlesmakethisariskinanunknownpercentage]
£Ticksorfleasarefoundonanypetyoucontact
£Thepatient’smotherissuspectedofhavingBartonellabasedonnewerdirectandindirect testing.
£Asibling, father, spouse or childwithanytickorflea-borneinfectionwhosharedwiththepatientaresidenceorvacationlocationwithproximitytobrush
£Outdoorexposuretooutdoorenvironmentssuchasbrush,wildgrasses,wildstreamsorwoodswhichhappenedwithouttheuseofDEETonskinandPermethrinonallclothing(It only takes one exposure to get a bite.Ifyouusedprotection“mostofthetime,”youwerestillexposed.)
£Exposuretolice
£Fleabitesorfleaexposure
£Exposuretopetsthatareexposedtoticksorfleas
£Ascratchfromacat
£Abitefromacatordog
£Exposuretobitingflies
£Hunting,livingorvacationingneardeerorsmallmammals
ChecklistsforBartonella,BabesiaandLymeDisease 11
£Clearexposuretoanytypeoftick.[Bartonellaiscarriedbyahugenumberofcarriers,butfornow,thepercentthatcarryBartonellaisnotknown.Further,thecapacitytodetectallnewspeciesinthevectorsorinhumansinfecteddoesnotexistorisnotroutinelyavailableindirecttestingofallhumaninfectiousBartonellaorganismsinbothlargeorspecialtylabs].
£Ticksfoundonyourclothing
£Ticksfoundonyourskin
£Ticksfoundinyourhomeorcar,vacationspotorrecreationarea
IfonereadsthemajorityofBartonella journalarticles, itseemsclearBartonellaharmsthebodyinhundredsofways.Butforourpurposesindiagnosis, theabovecriteriashouldbeenoughtopreventamisseddiagnosis. More criteria exist. Certainty claims or criticism aboutBartonellapositionswithoutreadingatleastof1,000articlesisconfusing.HowisthispossiblewithnewBartonellafindingsandunderstandingseachmonth?Therearealsonewspecieswhosegeneticsequencesshowtheiruniquenessalmosteverymonthinpublicdatabases.Inthisspirit,thisscaleismeantmerelytoincreasesuspicionofBartonella,whichisasuperstealthinfectionthattakesperhapsfiftydaystogrowoutonsomebacteriagrowthplates,andfloatsinthebloodasitlowersfevers.Italsoclearlysuppressessomekeyimmunesystemfightingchemicals.Cureclaimsmadewithouttheuseofindirecttesting,markedlydocumentedinsuperiorjournals,shouldbeexaminedfurthertoproveeffectiveness.
Dr. Schaller is the author of 30 books and 27 top journal articles.His publications address issues in at least twelve fields of medicine.He has the most recent textbook on Bartonella. He has published on Bartonella under the supervision of the former editor of the Journal of the American Medical Association (JAMA), and his entries on multiple tick and flea borne infections, including Bartonella [along with Babesia and Lyme disease] were published in a respected infection textbook endorsed by the NIH Director of Infectious Disease.He has seven texts on tick and flea-borne infections based on his markedly unique full-time research and study practice, which is not limited to either finite traditional or integrative progressive
12 BartonellaChecklist•SchallerandMountjoy
medicine. Dr. Schaller has read on these emerging problems for many years.
Copyright © 2011 JAMES SCHALLER, M.D., M.A.R. version 19.
This form cannot be altered if it is printed or posted in any manner without written permission. Posting a negative evaluation is forbidden. Printing to assist in diagnostic reflections is encouraged, as long as no line is redacted or altered including these final paragraphs. Dr. Schaller does not claim this is a flawless or final form, and defers all diagnostic decisions to your licensed health professional. All translations are permitted.
ChecklistsforBartonella,BabesiaandLymeDisease 13
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ChecklistsforBartonella,BabesiaandLymeDisease 17
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ChecklistsforBartonella,BabesiaandLymeDisease 63
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ChecklistsforBartonella,BabesiaandLymeDisease 65
The Babesia ChecklistImproving Detection of A Common,
Emerging Stealth Infection
James L. Schaller, M.D., M.A.R.
Introduction
Below are examples of signs, symptoms and indirect ways to helpincrease the diagnosis of Babesia.An examination of public geneticdatabasesshowsthatwelloverthirty-fivespeciesexist,manyofwhichhavevariants.
Please note that an unknownpercentage of people infectedwith thissinglecelledparasitehavenosymptoms,atleastformanyyears.
ThischecklistisnotmeanttobeusedasadefinitivetooltodiagnoseBabesia.Itismyexpertopinionthatnodefinitive100%oreven98%accuratetoolexists.
Mygoalismerelytodecreaseillnessinthosepeoplewhoarepositivebutdonotshowupaspositiveonabasicdirecttest(falsenegative).
Indeed,itisnotuncommonforapatientwithBabesiatopresentwithanegativetestresultovertentimes,regardlessofthelaboratory,andthentoshowupwithapositiveonDNAtestingwhenexposedtotwoorthreetreatmentsagainstprotozoaforthreedays,ortohavenewconversionfrom negative to positive antibody testing six weeks after a similarprovocationtrial.
I do not oppose or endorse such approaches, but feel it necessary tomentionthatthesameoutcomehasoccurredwith“Malaria-prevention”treatment.Additionally, there have been instances in which the useofherbs,suchasartesunate,forcancerprevention,hasresultedinanunintendedoutcome: theconversionofaBabesiaantibody titer fromnegativetopositive.
66 BabesiaChecklist•SchallerandMountjoy
Having authored four books on the topic of Babesia, I have createdthisscalebasedonyearsoffull-timereadingandapassiontoadvancedetection. Thischecklist ismeant toprevent falsenegatives: somepatients who appear to be negative may not actually be negative. Ihavedonethisbecausemyyearsoffull-timereadingandresearchhaveshownmethatmissingthisparasitefor5,10,30or50yearsisfarmoredangerousthancarefultreatment.Treatmentsideeffectsarelowifthetreatmentisstartedat20% of the suggested dose.
I would appeal to you that one cannot be considered an expert intreatingthispotentiallyfatalinfectionbymerelyreadingafewarticlesorguidelines.Norisexpertiseacquiredbydiagnosingandtreatingthehighlyobvious,immenselyill,sickest1%ofpatientsasthe“norm”inBabesiadiagnosis.Expertiseshouldrequireat least areviewof1500articlesover fiveyears.The fact thatparasite textbooksusuallyoffermerely1-2pagesaboutthisinfectionshowsthatitisnotmasteredorunderstoodevenbythoseinterestedinparasites.
ThecureofBabesiadoesnot fitaset formula,butnooneshouldbehopeless about reaching a full recovery. I have currently started anew, research-based, creative thinking textbook on optimal Babesia treatmentsforpublicationin2012.Itwilldiscussfamiliartreatmentsandofferideastomaximizetheseoptions,butIwillalsoadddiscussionsonneweroptionsforpatientsandclinicianswhoarenotsatisfiedwiththecurrentoptions.
Insummary,howcananycertainmedicalorscientificBabesiapositionexist, when new species, sub-species or variants that infect humansareroutinelyemerging,andforwhichthereisnotevenadirecttest—regardlessofsensitivity?
ChecklistsforBartonella,BabesiaandLymeDisease 67
THE BABESIA CHECKLIST
James Schaller, M.D., M.A.R.
(Please Check Any Symptoms That Apply)
PSYCHIATRIC AND NEUROLOGICAL
£Family,friendsorothersreportyoulooktiredorfoggy
£Slowedthinking
£Psychiatriclabel(s)giventoachildorrelativeforalltheirtroubleswhenclearmedicalproblemsexistasshownbyabnormallaboratoryresults(Iamnottalkingaboutbasicorganfailurelabs,buttheuseofwide testing which includes inflammation and anti-inflammation chemicals, hormones, nutrient levels, and other immune system chemicals)
£Enlargedlymphnodes(butalsoinLyme,Bartonella,otherinfections,highinflammation,tumorsandotherdiseases)
£Braintroublessuchastroublekeepingupwithpastroutinelifedemands,latenessduetotroublewithmotivationandorganization,andtroublewithconcentration[Anyofthesewouldbeapositive]
£Memorytroubles[thisisnotspecifictooneinfectionoronediseaseprocess.Forexample,exposuretoindoormold’sbiologicalchemicalscandecreasememorywithinanhourdependingonthespeciesmix.]
£Profoundpsychiatricillnesses[thisisnotlimitedtoasingleinfection.]
HEART & CIRCULATORY SYSTEM
£Asuddenlossofbloodpressure
£Transfusionsusingbloodthatisnotyourown
68 BabesiaChecklist•SchallerandMountjoy
£Anemiaevenifanon-infectiouscausehasbeenproposed
£Anemiawithoutaclearexplanation
£Severechestwallpains
£A“heartattack”beforetheageof55(whenyouhavethreeriskfactors)
£A“heartattack”orinfarctoftheheartbeforetheageof60yearsold,withonlyoneriskfactor.[Beingmaleisconsideredariskfactorformany.Menexperienceheartdamagesoonerthanwomen.Otherriskfactorsincludetobaccouseorexposure,suchassecondhandsmokeathome,diabetes,highbloodpressure,highlevelofstickycholesterolsuchasLipoprotein(a)orhightriglyceridelevels,familyhistoryofheartattacks,limitedphysicalactivity,Obesity(mightbedefinedaswearingpantsover39inchesifyouareamanandover34inchesifyouawomanorabodyfatorbodymassindexof30orhigher),excessangerorroutinepoorhandlingofstress,andabuseofstimulantdrugssuchascocaineoramphetamines.Iwouldaddahomocysteinelaboratorylevelover10,majordepression,novitaminK2supplementation,afreedihydrotestosteroneinthe10thpercentileorlower,fragmentedorpoorsleep[whichincreasesinflammation],ahighC4aRIA,aMMPIinexcessof300andalowVIPbloodlevel.
MAJOR ORGANS
£Ayellowhueoneyes,handsandskin(jaundice)withnootherclearcause
£Anenlargedliver(whichsitsunderyourrightribcage)
£Anenlargedspleen(underyourleftribcage).This is falsely believed to be a common human sign; actually it is very rare.
£Arupturedspleen[rarebutitgetsfastmedicalattentionandthereforeisover-representedinmedicalarticles]
ChecklistsforBartonella,BabesiaandLymeDisease 69
£Darkurine[thisisrarerthansomearticlesintimate]
£Aninabilitytourinate
£Shortnessofbreath[noclearasthma,pneumonia,COPDorothercommoncause]
£Pulmonaryedemawhichisahighamountoffluidintheairsacsofthelungs,whichleadstoshortnessofbreath
£Astrokeofanysizeorinanyorgan(thewordstrokemeanstissueisunabletogetoxygen).Thestrokeorinfarctcanbeinthebrain,retina,kidney,heartandmanyothertissues.
£AnMRI,CTorotherimagingstudythatshowsdeadtissueinanyorganwithnoknowncause
GENERAL MEDICAL
£Headacheswithnoclearcause
£Headacheswhicharehardtocontroland/orsevere
£Headacheslastingoverthreeyearsandwhichincreaseinpaindespitetreatments
£Weightgaininclearexcessofdietandexercise
£Weightlosswithreasonableeatingandaverageexercise
£Excessfatinlowerbellyareathatisinexcessoflifestyleandactivity
£Anorexiaoradecreaseinappetite
£Anydecreaseinappetite
£Apoorappetite
£Fatigueinexcessofthatexperiencedbymostpeopleinthesameagerange
70 BabesiaChecklist•SchallerandMountjoy
£Fatiguethatproducesneedforsleepinexcessof8½hoursdaily
£Fatiguewithongoinginsomnia[considerthepossibilityofbothBartonellaandBabesiainthiscase]
£Daytimesleepurgencydespitenighttimesleep
£Nightsweats
£Excessiveperspirationduringnormaldailyactivity
£Hotflashesinanormaltemperatureroom
£Intermittentfever
£Chills
£Anyfeverinexcessofthreedays
£Spikeofafeverover100.5afterapossibletickbite
£Listlessness
£Swellinginlimbsandotherpartsofbody
£Wavesofgeneralizeditching[thissignofinfectionandinflammationisnotlimitedjusttoBabesia.]
£Lumpsorothertypesoftissuecollectionwithnoclearcause[Othertickandflea-borneinfectionscanalsocausethesegrowths.]
£Wastingmuscles
£Thegeneralwastingawayofbodytissuethatisvisible
£Profoundbonelossinmarkedexcessofthatexpected at given age
£Excessbreasttissueinamanorboy
£Randomstabbingpains
ChecklistsforBartonella,BabesiaandLymeDisease 71
£Nauseaorvomiting
£Anyenhancedsense:sensitivitytolight,touch,smells,tasteorsound
£Asenseofimbalance
£Oneormoremedicalproblemswithunclearcause(s),withchangingorcontradictorydiagnoses,orwhichareeventuallycalled“idiopathic”
£Twotickorfleainfectionswithtwopositivetickorflea-borneviruses,bacteriaorprotozoa.Thepresenceofotherinfectionssuchastick-bornevirusesorbacteriaraisessuspicionofaBabesiainfection.
£Thepresenceofoneormoremysteryillnessesafteranevaluationbythreequalityphysicians
LAB RESULTS
£EosinophilCationicProtein(ECP)levelisintop15%ofnormal.Thisisalteredinperhaps15-20%ofBabesiapatients.
£TheECPlevelisabovenormal.(Otherthingscanincreasethislab,butitisanerrorthataBabesiainfectionisnotontheselists).
£TheECPlevelincreases30%ormoreinresponsetoaprotozoakillingmedicationinserialtesting.(Thistestisabout40-60%sensitiveandmanypatientshavenochangeinthislabevenwitheffectivetreatment).
£TheECPlevelisbelowdetectablelevels.
£AbsoluteEosinophilsintheloworhighrange[thisisnotdefinitiveinanymanner,butisausefultool.]
£ApercentageofEosinophilsinlowrangeorhighnormalrange
£VeryhighEosinophils[rarewithBabesia,butotherfindingssuggestotherpossiblecauses]
72 BabesiaChecklist•SchallerandMountjoy
£AnormalorlowVEGFlabresultinthepresenceofBartonella
£ATNF-alphainexcessof1.0inthepresenceofBartonella
£ACD57orCD57/8levelthatdropsrightafterthestartofaBabesiatreatment,orwhichfallssteadilywithongoingBabesiatreatment
£Hemolyticanemiawithlabtestshowingpositivebloodproductsinyoururine[thisisnotaroutinefinding.]
£YourclinicianunderstandstheuseofindirecttestingandfeelsyourlabpatternissuggestiveofthepresenceofBabesia.ThisinvolvesmorethananECPspike.
£SincedirecttestingforBabesiabyanylabmissesmanyhumanspeciesandisofvariablereliability,andthecommonpresenceofBartonellasuppressessomeantibodytests,apositiveor“indeterminate”islikelyapositive.Haveyouhadan“indeterminate”or“borderline”Babesiaresult?
£Bilirubinabnormality[elevatedinperhaps5%ofpatients]
£Ironabnormalitiesinexcessofnormal[highorlowlevels.Thefindingofgeneticdiseasethatincreasesironpathologydoesnotnecessarilyruleoutthisfinding.TheironpathologycanbegeneticoracquiredillnessplusBabesia[SeemyHEScancercurepaperinMedscapeinwhichthecancer-likeeosinophilswereprimedbyBabesia].
£AfterBabesiatreatmentwithclearprotozoakillingagentsusedalsotokillmalaria,IL-6movesfromverylowtoanincreasedlevel.
£AfterBabesiatreatmentwithclearprotozoakillingagentsusedalsotokillmalaria,IL-1Bmovesfromverylowtoanincreasedlevel.
ChecklistsforBartonella,BabesiaandLymeDisease 73
£Babesiacreatesandprovokeschangesinthehumanbodychemistry.TestsarebeingdesignedtoidentifychemicalsonlymadebyBabesia.AsampleisBabesiamicrotisecretedantigen1(BmSA1).
£AnypositiveEpstein-Barrvirusoverthenormallowlevel.Youmayhaveaninfection,infections,orinflammation.ItisnotmerelyfoundinBabesia.[Thisisnotaroutinecauseoffatigue].
£Autoimmunitytestingispositive.Thisisastrongerpositiveiftherearetwoautoimmuneresults.Forexample,apatienthasapositiveANAandhasantibodiesagainsttheirthyroidsystem.
£Positivelaborskintestingplacingpatient’sfoodsensitivityintop5%ofpopulation
£Elevatedmonocytes
£Elevatedneutrophilswithnoclearinfectionsource
£ElevatedC-reactiveprotein
£ElevatedD-dimer
£AnabnormallyhighALTwhichisaliverenzymeincreasedbylivertrauma,toxinsorinfectionssuchasBabesia[ararefinding].
£Lymphocytopenia—lowlymphocyteswhichareatypeofinfection-fightingwhitebloodcell
£Thrombocytopenia—plateletnumberunder50,000
£AhighlactatedehydrogenaseorLDH.Thisenzymemeasurestissuedamageparticularlyfoundintheheart,liver,kidney,skeletalmuscle,brain,bloodcellsandlungs.
REACTION OR CHANGES IN BODY
£ReacttoanyderivativeofArtemisia(SweetWormwood).*Note:thereactiondoesnotneedtolastmorethanadayandanyimmediatestomachachesorloosestoolsdonotapply.
74 BabesiaChecklist•SchallerandMountjoy
£Reacttoamalariadrug.Forexample,ativoquone(Mepron),proguanilaloneorwithativoquone(Malarone),artesunate,day1-3ofartemesinin,anewhighdoseofartemesininDay1-2,artemeter,Alinia,clindamycin,quinineorazithromycinat2,000mg/dayorallyoratanydoseIVforfivestraightdays.(ItrequiresprofoundwisdomforacliniciantodistinguishbetweenasideeffectandareactioncausedbyaneffectiveBabesiatreatment.Forexample,insomniacausedbythesyntheticdrugLariumismeaningless,sinceLariumhasthisasasideeffectinuninfectedpatients.Butfatigue,insomniaorsevereheadacheresultingfromateaspoonofativoquone(Mepron)ondayoneareverysuspicioussymptomsforaknownprotozoanlikeBabesiaorMalariaorothersimilarinfectionsthatarenewlyidentifiedgenetically).
£MoodchangeswithanyherbordrugthatkillsprotozoalikeBabesia,withtheexceptionofLarium
£Muscleachesorjointaches/pain,especiallyworseafteruseofaprotozoakillingmedicinesuchasproquanil,Alinia,ativoquone,clindamycin,oroneofmanynewemergingprogressivenaturalmedicineorsyntheticmalariadrugtreatments
£Insomniaaftertakingamalariakillingherbordrug
£Anxietyand/ordepressionaftertakingamalariakillingherbordrug
£Rageortemporarypersonalityregressionrightafteruseofamalariakillingherbormedication,e.g.,ativoquone,Malarone,proguanil,artesunate,day1-3ofartemesinin,artemeter,Alinia,clindamycinorazithromycinat2,000mg/dayorallyoratanydoseIVforfivestraightdays.
ENVIRONMENT
£Pets,farmanimalsorlocalrelativeswithANYclinical symptomsofatick-bornevirus,bacteriaorprotozoainfectionwithoutacleardiagnosis
ChecklistsforBartonella,BabesiaandLymeDisease 75
£Thepatient’smotherissuspectedofhavingorhasbeendiagnosedwithBabesia,STARI(Masterson’sDisease),Neoehrlichia,Anaplasma,Lymedisease,Mycoplasmas,QFever,RockyMountainspottedfever(Rickettsia),tick-bornerelapsingfever,Tularemia(bacteria),Ehrlichia,ProtozoaFL1953,orvirusessuchasCMV,HHV-6,CoxsackieBTypes1,2,3,4,5,6,ParvoB-19orPowassan.
£A sibling, father, spouse or childwithanytickborneinfectionwhosharedaresidenceorvacationwithproximitytobrush(woodedarea)
£Exposuretooutdoorenvironmentswithbrush,wildgrasses,wildstreams,golfcoursesorwoodsin excess of ten minutes in any location lived in or visited
£Pet(s) or family animalsofanytype,e.g.,horses,havehadoutdoorexposurestoareaswithbrush,wildgrasses,wildstreamsorwoods.Ifthepetswereanimalssuchasdogs,whichcanbegivenanti-tickandfleatreatments,weretheseanimalsalwayson schedulewiththesetreatments?
£Clearexposuretoticksinyourcurrentorpasthomes
£Clearexposuretoticksduringvacationsorothertravels
£Haveyoueverhadanytypeoftickbite?
£Haveyoueverfoundatickonyourclothing?
£Haveyoueverfoundatickonyourbody?
£Haveyoubeenwithothersatalocationinwhichtheyhadticksontheirclothingorskin?
£Sexualcontactisadebatedformofcommunicationofsometickandfleaborneinfections.Ihavenoposition.Isolationinabodyfluiddoesnotmeanthatisaroutetospreadtheinfection.Ifyouandyourhealerfeelthisisapossiblerouteofinfection,hasthepatienthadintimatecontactwiththesharingofbodyfluidswithaninfectedperson?
76 BabesiaChecklist•SchallerandMountjoy
£Youliveinastatethathasreportsofanytick-borneinfectioninover40people.[Currently,thiswouldusuallybeLymediseaseonly].
£Youlivenexttoastatethathasreportsofanytick-borneinfectioninover60people.[Currently,thiswouldusuallybeLymediseaseonly].
£Manysmallmammalslivenearyourhome,exerciselocation,vacationlocationsorwork.
A WORD ON MANUAL BLOOD EXAMINATIONS
NobloodsmearwillbepositiveforBabesiaunlessyouhaveaprofoundnumberof infectedredbloodcells. This isveryrare. Therefore,no blood smear should be considered negative unless it has been examined for at least thirty minutes. While a 2-3minute examof largewhite blood cellsmaybe fully sufficient to identify cancersand other diseases, a search for over eighty Babesia red blood cellpresentationsunder1000x,as found inmybook,Hematology Forms of Babesia,requiresatleastthirtyminutes.Unfortunately,inpatientspositiveforBabesia,routinemanualredbloodsmearexamswithaclearrequesttolookforBabesiaunderamicroscopeat1,000xmagnificationhavemissedtheBabesiaatleast98%ofthetime.Inpapersreportingclearly visualizedBabesia in blood smears the patients tend to haveimmenseinfection,i.e.,over3%ofredbloodcellsareinfected.
However,ifoneprivatelycontractswithamicrobiologist,pathologistor can get a lab director to allow their staff to spend the extra time,thepositiveresultsonthebloodsmearincreasewithclearlypositivelyinfectedpatients. Iknowmostlaboratoriesareveryoverworked,butthenotion that ablood slide isgoing to showanobvious tetrador aclassicXpatternisanerror.Usingslidesfromrespectednationalorstatesources,Ifoundonlybyverycarefulexam,overfiftypresentationsofBabesiathatareusuallymissed.Indeed,inmytextbookonBabesiaimagesmostoftheshapeshadneverbeenpublished.Nooneinhistoryhadevertakenthetimetolookcarefullyat200slidesandrecordeach
ChecklistsforBartonella,BabesiaandLymeDisease 77
uniqueshape.Itisfairlystunningtowritethisandconfirmsthatmanytickandfleainfectionsareclearlyemergingandnotyetmastered.
Pleaseappreciatethatstainshelpdefinewhetherasubstanceiswhatitappearstobe. Forexample,someinthealternativemedicineschoolfeelthatCandidaisabadpresenceintheintestinesandfeelitoftengetsintothebloodthroughdefectsintheintestinalwall.WhileCandidaisnotagoodpresencefortheintestine,IhavefoundthatsomebloodsampleswithitemsthatlooksignificantlylikepartsofCandidadonotstainforcelluloseandothercomponentsofyeasts.Mypointisthatinthelasttenyears,indiscussionsorstudy,excellentpathologistsandmicrobiologistshaveshownmetheclearreasonhumanityhasdevelopedhighlysophisticatedstainingtechniques--theycanbediagnosticandverycosteffective.AndsomemedicalscientistsareaddingnewtechnologytoBabesiaidentification(discussedinmyBabesia 2009 Update andmyHematology of Babesiatext).
Babesiaisanemerginginfection. AnycertaintyclaimsorcriticismaboutBabesiapositionswithoutextensiveresearchandover200hoursof reading ispremature. Again,newBabesia speciesareemergingeveryone to fourmonths. Indeed,evenanewprotozoanhasbeenfound that looks likeBabesia under a highpoweredmicroscope, butwhenitisgeneticallysequenceditisnotBabesiaorimmaturemalaria,whichcanlooksimilar. ItisanewinfectionandispresentlycalledFL1953andwasgeneticallysequencedbyDr.EllisandDr.Fry.ItlookslikeBabesia,butisnotBabesiagenetically.
Therefore,sincehumanBabesiaisanewemergingillness,thisscaleismeantmerelytoincreaseawarenessofBabesia,aninfectionthatcankillpatientsofanyage.WritingsinthepastfifteenyearshaveeitherseenBabesiaasamere“co-infection”orafootnoteofaspirocheteinfection[i.e.,Lyme].Anythingthatcanhideforacoupleofdecades,andthenpossiblykillyouwithaclot inyourheart,brainor lungsorbyothermeans,isnotacasualinfection.
Babesia cure claims should bemadewith the use of indirect testingbirthedfromextractsofsuperiorjournalsreadaminimumoffiveyears.Currently,thesemanywell-establishedindirectlabtestpatternsarenot
78 BabesiaChecklist•SchallerandMountjoy
usedorunderstoodby immenselybusyand smart cliniciansworkingfull-time.Whilethisisfullyunderstandable,Ihopeitmaychangeinthecomingdecade.
Dr. Schaller is the author of 30 books and 27 top journal articles. His publications address issues in at least twelve fields of medicine.
He has published the most recent four textbooks on Babesia.
He has published on Babesia as a cancer primer under the supervision of the former editor of the Journal of the American Medical Association (JAMA), and his entries on multiple tick and flea-borne infections, including Babesia [along with Bartonella and Lyme disease], were published in a respected infection textbook endorsed by the NIH Director of Infectious Disease.
Dr. Schaller has produced seven texts on tick and flea-borne infections based on his markedly unique full-time reading and study practice, which is not limited to either finite traditional or integrative progressive medicine. With a physician’s medical license, he has been able to sort through many truth claims by ordering lab testing. He does not casually follow the dozens of yearly truth claims, without indirect testing laboratory proof. He has read full-time on these emerging problems for many years. He is rated a TOP and BEST physician (in the top 5 percent of doctors) by both physician peers and patients.
Copyright © 2011 JAMES SCHALLER, M.D., M.A.R. version 49.
This form may not be altered if it is printed or posted, in any manner, without written permission. Posting a critical or negative evaluation is forbidden. Printing to assist in diagnostic reflections is encouraged, as long as no line is redacted or altered, including these final paragraphs. Dr. Schaller does not claim that this is a flawless or final form, and defers all diagnostic decisions to your licensed health professional.
ChecklistsforBartonella,BabesiaandLymeDisease 79
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HerwaldtBL,CacciòS,GherlinzoniF,AspöckH,SlemendaSB,PiccalugaP,MartinelliG,EdelhoferR,HollensteinU,PolettiG,PampiglioneS,Löschenberger,TuraS,PieniazekNJ.Molecularcharacterizationofanon-BabesiadivergensorganismcausingzoonoticbabesiosisinEurope.EmergInfectDis.2003Aug;9(8):942-8.PMID:12967491
HerwaldtBL,McGovernPC,GerwelMP,EastonRM,MacGregorRR.Endemicbabesiosisinanothereasternstate:NewJersey.EmergInfectDis.2003Feb;9(2):184-8.PMID:12603988
HerwaldtBL,NeitzelDF,GorlinJB,JensenKA,PerryEH,PeglowWR,SlemendaSB,
WonKY,NaceEK,PieniazekNJ,WilsonM.TransmissionofBabesiamicrotiinMinnesotathroughfourblooddonationsfromthesamedonorovera6-monthperiod.Transfusion.2002Sep;42(9):1154-8.PMID:12430672
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TonnettiL,EderAF,DyB,KennedyJ,PisciottoP,BenjaminRJ,LeibyDA.Transfusion-transmittedBabesiamicrotiidentifiedthroughhemovigilance.Transfusion.2009Dec;49(12):2557-63.Epub2009Jul16.PMID:19624607
TopolovecJ,PuntarićD,Antolović-PozgainA,VukovićD,TopolovecZ,MilasJ,Drusko-BarisićV,VenusM.Serologicallydetected“new”tick-bornezoonosesineasternCroatia.CroatMedJ.2003Oct;44(5):626-9.PMID:14515426
TorinaA,CaracappaS.AnaplasmosisincattleinItaly.VetResCommun.2007Aug;31Suppl1:73-8.PMID:17682850
TorinaA,VicenteJ,AlongiA,ScimecaS,TurláR,NicosiaS,DiMarcoV,CaracappaS,delaFuenteJ.Observedprevalenceoftick-bornepathogensindomesticanimalsinSicily,Italyduring2003-2005.ZoonosesPublicHealth.2007;54(1):8-15.PMID:17359441
ChecklistsforBartonella,BabesiaandLymeDisease 101
Torres-VélezFJ,NaceEK,WonKY,BartlettJ,EberhardM,GuarnerJ.Developmentofanimmunohistochemicalassayforthedetectionofbabesiosisinformalin-fixed,paraffin-embeddedtissuesamples.AmJClinPathol.2003Dec;120(6):833-8.PMID:14671971
TsujiN,MiyoshiT,BattsetsegB,MatsuoT,XuanX,FujisakiK.AcysteineproteaseiscriticalforBabesiaspp.transmissioninHaemaphysalisticks.PLoSPathog.2008May16;4(5):e1000062.PMID:18483546
TuoW,EstesDM,BrownWC.Comparativeeffectsofinterleukin-12andinterleukin-4oncytokineresponsesbyantigen-stimulatedmemoryCD4+Tcellsofcattle:IL-12enhancesIFN-gammaproduction,whereasIL-4hasmarginaleffectsoncytokineexpression.JInterferonCytokineRes.1999Jul;19(7):741-9.PMID:10454344
vanDuivenvoordeLM,Voorberg-vanderWelA,vanderWerffNM,BraskampG,RemarqueEJ,KondovaI,KockenCH,ThomasAW.SuppressionofPlasmodiumcynomolgiinrhesusmacaquesbycoinfectionwithBabesiamicroti.InfectImmun.2010Mar;78(3):1032-9.Epub2010Jan4.PMID:20048045
VanSolingenRM,EvansJ.Lymedisease.CurrOpinRheumatol.2001Jul;13(4):293-9.PMID:11555731
VannierE,GewurzBE,KrausePJ.Humanbabesiosis.InfectDisClinNorthAm.2008Sep;22(3):469-88,viii-ix.PMID:18755385
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VyasJM,TelfordSR,RobbinsGK.TreatmentofrefractoryBabesiamicrotiinfectionwithatovaquone-proguanilinanHIV-infectedpatient:casereport.ClinInfectDis.2007Dec15;45(12):1588-90.PMID:18190320
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WeinbergGA.Laboratorydiagnosisofehrlichiosisandbabesiosis.PediatrInfectDisJ.2001Apr;20(4):435-7.PMID:11332670
WeissLM.Babesiosisinhumans:atreatmentreview.ExpertOpinPharmacother.2002Aug;3(8):1109-15.PMID:12150690
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LYME DISEASE SYMPTOM CHECKLISTJames Schaller, M.D., M.A.R.
INTRODUCTION
The followingchecklist isnotmeant tobecompleteorauthoritative.InformationaboutLymediseaseisconstantlyemergingandchanging.Therefore any checklist is intended for use as a starting point. Intraditional medicine, a physician performs a complete history andphysical.Labsandstudiesassistinclarifyingthedifferentialdiagnosis.InLymedisease,muchdebateexistsaboutlaboratorykits,thealterationof kits to have fewer possible bands, and which labs are optimallysensitiveandspecific. Thischecklistisnotintendedtoaddressthatissueortreatment.
Over200animalscarrytheIxodestick,whichisthemostcommonlyknown insect spreadingLyme disease. With somany vectors, theunderlyingassumptionbehindthischecklististhatLymeisnotrareinNorthAmerica,Europe,SouthAmerica,Russia,AfricaorAsia.
WeknowLymediseaseishighlyunder-reported.Onestudyshowedonly1in40familydoctorsreportedit.
Immediatelyuponbiting,theticktransmitsapainkiller,anti-histamineandananti-coagulant.Basedonanimalstudies,itisalsopossiblethebulls-eyerashislesscommonthanassumed,inpartbecauseinjectionsof spirochete relatedmaterial in laboratoryanimalsonlyshowa rashwiththesecondinjection.Withthisbackground,Iwouldappeal,thatifayoungormiddleagedadultexperiencesabite,andhasprofoundsymptoms,isitpossiblethiswasasmallnumberofinfectiousparticlesignitingalargernumberfrom2,5or20yearsearlier?Iamnotaskingforananswer,justforthepossibilitytobeconsidered.
Thischecklistisofferedwiththesincerewishthatotherswillimproveonit.Itisthisauthor’spersonalbeliefthattickandflea-borneinfectionmedicine is as specializedasHIVandHepatitismedical science andtreatment.
106 LymeDiseaseChecklist•SchallerandMountjoy
Someofthechecklistmaterialsmightbenewtoyou,whichunderscoresthe need for another scale to add to the ones currently in existence.This list isbasedonamassive reviewof thousandsofpapersoveradecadeof full-timereading,2012sciencerevelations,and/ormassivechart reviews. SincemodernLymediseaseseemstofocuson tick-bornediseaseandotherlaboratorytesting,wewillstartwithlabtestingconsiderations. Ifalabtesthasavalueorapercentage,thenumberschosen are intended to avoid missing those positive patients whootherwisewouldbeoverlooked.Theconcernisaboutphysiciansandotherhealthcareworkersnottreatinganinfectedpatient,whoovertimecanexperiencedisabilityorevendeathatafrequencythatisimpossibletodetermine.
ChecklistsforBartonella,BabesiaandLymeDisease 107
THE LYME DISEASE CHECKLIST
James Schaller, M.D., M.A.R.
(Please Check Any Symptoms That Apply)
LABORATORY TESTING — INDIRECT AND DIRECT
£VitaminDlevelisinthelowest20%.Ifyousupplement,itshouldbeintop50%.
£CD57orCD58isinthelowest20thpercentile.
£Freetestosteroneisin10thpercentileorbelow.
£In5%ofpatientsthetestosteroneorfreetestosteroneisoverthenormalrange.
£DHEAisinlower20%.Orrarelyisitfullyoverthetoplevel.
£Freedihydrotestosteroneisinthelowest20thpercentileorwelloverthenormalrange.
£EpsteinBarrVirusisabnormalinanymeasure.[Thisvirusisbelievedtobepositiveovernormalpositivelevelsinthepresenceofinfectionsorhighinflammation.]
£OntheWesternBlot,IgGorIgManyspecies specificbandatanybloodlevel,e.g.,18,21,23,30,31,34,37,39,83,93.
£AfreeT3levelunder2.8[thenormalbottomrangein1990was2.6;theinfluxoflargenumbersofelderlypatientsresetthehealthy“normal”range].
£PositiveforvirusessuchasCMV,HHV-6,CoxsackieBTypes1,2,3,4,5,6,ParvoB-19orPowassanvirus
£PositiveforMycoplasma,e.g.mycoplasmapneumonia
108 LymeDiseaseChecklist•SchallerandMountjoy
£ThepatientispositiveforinfectionsotherthanroutineLyme,[thatisBorrelia burgdorferi sensu stricto,BorreliaafzeliiandBorreliagarinii].Someoftheotherinfectionsalsocarriedbyinfectiousticks,fleasorothervectorsincludeBabesia(duncani,microtiorother),Anaplasma(HGA),Ehrlichia(variousspecies/strains),Neoehrlichia,RockyMountainorotherSpottedFevers,Brucellosis,Q-fever,STARI(Master’sDisease),Malaria,andBartonella[e.g.,B.henselae,B.quintana,B.elizabethaeandB.melophagi].Oncetestsarecommerciallyavailablefortestingallformsofprotozoaaffectinghumans,includingFL1953,allBartonellaspecies,andBorreliamiyamotoiandotherLymespecies,reportingshouldincrease.
£IL-Bisinlowest10thpercentile.
£IL-6isinlowest10thpercentile.
£TNF-alphaisunder2,orinlowest20thpercentile.
£AWBCcountwas,oris,under4.5.
£EosinophillevelintheCBCmanualexamiseitherat0-1or6-7.
£TotalmanualEosinophillevelis140orless.
£X-rayorotherstudyshowscartilagedefectsinexcessofinjuryoragemedian.
£Ifafullauto-immunitypanelisrunwithatleasteightdifferenttests,twoarepositive;forexample,youhaveapositiveanti-gliadinandapositivethyroidperoxidase.
£Positiveornearpositive(borderline)ELISA,PCR,orapositivetissuebiopsy;oratickfromyourbodyispositiveforLymeorothertickinfection
£Labtestsshowhighinflammation,e.g.,ahighC4a,elevatedcholesterolandC-peptide.TheseareneverspecificjustforLyme.
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£LabtestsshowaMSHlevelunder30[thereferencerangeof0-40isduetotheincreaseofverysickpatientstested,and40-85isabetterreferencerangewhichwasusedbeforethefloodofthesickresettherangeofnormal].MSHisananti-inflammatoryhormone.
£VIPisunder20.Thisisananti-inflammationchemical.
BODY EXAMINATION RESULTS
£Weightlossorgaininexcessof20poundsin12weeks
£Aroundorovalrashwithadarkcenterwasorispresentinaloose“bulls-eyepattern”orothersizeandshaperashesthathavenoothercauseafterexposuretoticksandvectors
£Healingisslowafterscratchesorsurgery.Forexample,afteracatscratch,fleabiteortickbitethemarkisstillvisiblelater.
£Skinonarms,handsorfeethasatexturelikericepaper.
£Clearreactionandeffectisseenwithantibiotictreatment.Specifically,amarkedimprovementorworseningofaseriousmedicalproblemorfunctionisobservedwithaspirochetekillingtreatment,e.g.,doxycycline,tetracycline,minocycline,anypenicillinsuchasamoxicillin,azithromycin,clarithromycinorcefuroxime.
£Presenceofskintags,redpapulesofanysize,excessbloodvesselscomparedtopeers,andstretchmarkswithcolororinsignificantexcessofpeers.
£Molesandraisedorhardplaquesinexcessofthefewonnormalskin
£Areasofskinwithulcerationssuchasthoseseeninsyphilis,butatanylocationonthebody
£Areasofclearhypo-pigmentationandhyper-pigmentation
110 LymeDiseaseChecklist•SchallerandMountjoy
£PositiveACA(Acrodermatitischronicaatrophicans)whichisasignoflongtermuntreatedLymedisease.SomereportACAbeginsasareddish-bluepatchofdiscoloredskin,oftenofthehandsorfeet.Itmayincludethebackinsomepatients.Thelesionslowlyatrophiesovermonthstoyears,withmanydevelopingskinthatisthin,dry,hairless,wrinkledandabnormallycolored.Thecoloroftheextremitiessuchashandsandfeetcanbered,darkred,brown,darkblueorpurple.
Sample Neurological Exam
£Patient’sshort-termmemoryispoor.Forexample,ifaskedtorecallthesenumbers—23,5,76,43and68—thepatientcannotrecallthem.
£Patientcannotreversefournumbers,soifgiven—18,96,23and79—thepatientcannotdoit.
£Ifaskedtosubtract17from120,(collegegraduate),itcannotbedoneinatimelymanner.Ifahighschoolgraduate,subtract7from100andcontinuetosubtractby7fourtimesin20seconds.
£Lightheadednessuponstandingquicklyinexcessofpeers,andwithnoclearcause
£Dizzinessunrelatedtoposition
£DizzinessmadeworsebyLymekillingantibiotics
£Troubledoinganinestepheel to toe straight line walk testwithfingersslightlyinpockets[Thepatientshouldnotswayorneedtheirhandspulledouttopreventafall].Inpatientswithpastexperienceinskating,skiing,danceorballetthisshouldbevery easyandisrarelyachallengetosuchpeople.Ifitisnoteasy,itissuspiciousmedically,butnotonlyforLymedisease.
£Troubleperformingaoneleglift,inwhichonelegislifted15inchesoffthegroundinfrontofyou,asyoucount,e.g.,“oneMississippi,twoMississippi,etc.”
ChecklistsforBartonella,BabesiaandLymeDisease 111
£Positivenystagmus[youreyejerkswhenyoulookrightorleft]
PATIENT’S REPORTED PHYSICAL HISTORY
Psychiatric & Neurological
£Mildtosevereneurologicaldisordersorpsychiatricdisorders
£Averyprofoundneurologicaldiseasewhichdoesnotclearlyfitthelabs,studiesandcourseoftheillness
£Amoderateorseveremedical,psychiatricorneurologicalillness.[Manyseveredisorderscanbeassociatedwithspirochetessuchasthosecausingsyphilis,andsomeproposethatLymeisalsorelatedtoawell-knownseriousbraindisease.]
£Severemedical,psychiatricorneurologyillnesswithuncommonfeatures,suchasParkinson’sdisease,appearingatayoungage
£Facialparalysis(Bell’spalsy)
£Personalityhaschangednegativelyandsignificantlyfornoclearreason.
£Psychosisatanyage,butespeciallyafter40yearsofagewhenusuallyitwouldhavealreadymanifesteditself
£Severeanxiety
£Maniaorprofoundrage
£Depressionwithminimalgeneticrisk
£Depressionoranxietythatdidnotexistwhenyouwerelessthan25yearsofage
£Irritability
112 LymeDiseaseChecklist•SchallerandMountjoy
£Anyoneofthefollowing:paranoia,dementia,schizophrenia,bipolardisorder,panicattacks,majordepression,anorexianervosaorobsessive-compulsivedisorder
£AdultonsetADHD/ADD[PrimarypsychiatricbiologicalADDorADHDispresentat7yearsofage.Adultonsetisasignofamedicalcondition.]
£Increasedverbalorphysicalfightingwithothers
£Functioningatworkorinparentingisatleast20%reduced
£Patienceandrelationalskillsaredecreasedby20%ormore
£Amildtoprofounddecreaseofinsight,i.e.,aninfectedpatientdoesnotseetheirdecreasedfunction,failedtreatmentorpersonalitychange
£Aneweccentricrigiditytohearingnewmedicalorotherimportantinformation
£Difficultythinkingorconcentrating
£Poormemoryandreducedabilitytoconcentrate
£Increasinglydifficulttorecallnamesofpeopleorthings
£Difficultyspeakingorreading
£Difficultyfindingthewordstoexpresswhatyouwanttosay
£Inabilitytolearnnewinformationaswellasinthepast[receptivelearning]
£Repeatingstoriesorforgettinginformationtoldtocloserelations,suchasaspouse,roommate,sibling,bestfriendorparent
£Confusionwithoutaclearreason
£Anaddictionthatresultsinrelapseinspiteofsincere,reasonableandseriouseffortstostop
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£Fatigueinexcessofnormal,orfatiguethatisgettingworse
£Troublesleepingincludingmildtosevereinsomniaanddisruptedsleep
£Sleepinexcessof9hoursadayornight,orsleepinginexcessof9hourseverydayifallowed
£Troublefallingasleep
£Troublestayingasleep[Takinga5minutebathroombreakdoesnotcount]
Major Organs
£GastritisorstomachsensitivitynotcausedbyH.Pylori
£Intestinaltroublesthatareunabletobefullymanagedand/orwhichhavenocleardiagnosis
£Nauseawithoutaclearreason
£Earproblemssuchaspainorincreasedear“pressure”
£Any troublewiththesenses(vision,sound,touch,tasteorsmell).Theuseofcorrectivelensesorcontactsdoesnotcount,unlesstheprescriptionischangedmorethanexpected.
£Buzzingorringinginears
£Doublevision,floaters,dryeyes,orothervisiontrouble
£Conjunctivitis(pinkeye)oroccasionaldamagetodeeptissueintheeyes
£Bladderdysfunctionofanykind
£Treatmentresistantinterstitialcystitis
114 LymeDiseaseChecklist•SchallerandMountjoy
£Bloodclotsfastwhenyougetacut,oryouhaveadiagnosedproblemwithclotting.Thismayalsobeseeninblooddrawswhereblooddrawneedleclotswhenbloodisbeingremoved.Ifonabloodthinner,bloodthinnesslevelgoesupanddowntoomuch.
£Cardiacimpairment
£Chestpainwithalllabsandstudiesinnormalrange
£Occasionalrapidheartbeats(palpitations)
£Heartblock/heartmurmur
£Heartvalveprolapse
£Shortnessofbreathwithnoclearcauseonpulmonaryfunctiontests,examination,labtesting,X-rays,MRI’s,etc.
£Airhungerorfeelingsofshortnessofbreath
Skin
£Numbness,tingling,burning,orshocksensationsinanareaofskin
£Oneormoretroublesomeskinsensationsthatmoveovermonthsoryearsanddonotalwaysstayinonelocation
£Rashorrasheswithoutasimpleandobviouscause
£Rashesthatpersistdespitetreatment
£Eccentricitchingwithnoclearcause
£Hairlosswithnoclearcause
Musculoskeletal
£Musclepainorcramps
ChecklistsforBartonella,BabesiaandLymeDisease 115
£Musclespasms
£Musclewastingwithoutaclearcause
£Troublewithyourjawmuscle(s)orjointinsomnia(TMJ)
£Jointdefectsinonejointwithnoclearcauseif20oryounger
£Jointdefectsintwojointsormoreif35oryounger
£Jointdefectsinthreeormorelocationsifyoungerthan55withnocleartrauma
£Swellingorpain(inflammation)inthejoints[Mostpatientsneverhavejointdisease.]
£Jointpainthatshiftslocation
£Neckstiffness
£Chronicarthritiswithorwithoutepisodesofswelling,redness,andfluidbuildup
General Medical
£Gainingorlosingweightinamannerclearlyinconsistentwithdietandexercise
£Newormorefoodallergiesthantenyearsago
£Feelworseaftereatingbreads,pastaorsweets
£Nolongertolerateorenjoyalcohol
£Anti-histaminesarebothersome,moresothaninthepast.
£Reactiontomedicationsisexcessive(youarevery“sensitive”tomedications)
£Yourresponsetoantibioticsissignificantlypositiveandyoufeelmorefunctional,or you have the opposite reactionandfeelworse,feelingill,fatiguedoragitated.
116 LymeDiseaseChecklist•SchallerandMountjoy
£Chronicpaininexcessofwhatseemsreasonable
£Nervepainwithoutaclearcause
£Sensitivitytolights,sounds,touch,smellorunusualtastes
£Sensitivitytocleaningchemicals,fragrancesandperfumes
£Headachesthatdonotrespondfullytotreatment,orwhicharegettingworse
£Newallergiesorincreasedallergiesoverthoseofyourpeers
£Anyautoimmunity--Lymeandothertickinfections,overmanyyears,increaseinflammationanddecreaseanti-inflammationchemicals.Webelievethisleadstoincreasedfoodsensitivities,increasedautoimmunityandaheightenedsensitivitytovariouschemicalsandmedications.
£Daytimesweats
£Nighttimesweats
£Chills
£Flu-likesymptoms
£Abnormalmenstrualcycle
£Decreasedorincreasedlibido
£Increasedmotionsickness
£Fainting
£Aspinningsensationorvertigo
£Illnessesthatcomeandgoanddecreasefunctioningwithnocertaincause
£Seriousillnessesthatunderminefunctionwithnoclearcause,andwhichaffectmorethanonebodyorgan
ChecklistsforBartonella,BabesiaandLymeDisease 117
£Anabnormallabresult,physicalexamfindingorillnessthatisgivenmanydiagnosesorhasnoclearcause
ENVIRONMENT
£Someoneinyourneighborhoodwithin400yardsinanydirectionofyourdwellinghasbeendiagnosedwithatickborneinfection[Thisincludesvacationlocations].
£Youhavesomeonelivingwithyouwithanytypeoftick-borneinfection—thisassumestheywerenotmerelytestedforoneinfection.[ItisnotproventhatthesmallLyme-carryingticksonlycarryLyme,anditispossiblesomecarryotherinfectionswithoutcarryingLymeatall.
£Youhaveremovedanyticksfrom your bodyinyourlifetimeatanylocation.
£Youhaveremovedticksfrom your clothinginyourlifetimeatanylocation.
£Afteratickorbugbite,youhadafeverforatleast48hours.
£Afteratickorbugbite,youwereill.
£Grewuporplayedinareaswithmanysmallwildmammals
£Whenyouareinaroomthathasvisiblemoldorsmellslikemoldandyoustarttofeelill,youdonotreturntoyourbaselinehealthin24hours.
£Anydiscomfortwithin two minutesofbeinginamustyormoldylocation.Thismaybeasignofchronicuntreatedinfection,becauseamere30inhalationsofmolddebriscausessystemiceffectsinyourbody
£Pets or farm animalspositivewithANYtickbornevirus,bacteriaorprotozoa,orclinicalsymptomswithoutacleardiagnosisorcause
118 LymeDiseaseChecklist•SchallerandMountjoy
£Thepatient’smotherissuspectedofhavingorhasbeendiagnosedwithBabesia,Ehrlichia,RockyMountainSpottedFever,Anaplasma,Lyme,Bartonellaorothertickbornediseasebasedonnewerdirectandindirecttesting,orclinicalsignsandsymptoms.
£A sibling, father, spouse or childwithanytickborneinfection
£Casual or work-related exposure to outdoor environmentswithbrush,wildgrasses,wildstreamsorwoods(Examples-golfcourses,parks,gardens,riverbanks,swamps,etc.)
£Pets,e.g.,horses,dogsorcats,havehadoutdoor exposurestoareassuchasbrush,wildgrasses,wildstreamsorwoods.
£Youplayedingrassinthepast.
£Youhavebeenbittenbyfleas.
£Youhavebeenscratchedbyacatordog.
ChecklistsforBartonella,BabesiaandLymeDisease 119
FINAL WORDS
SomeoftheabovelistedsignsandsymptomsfitotherinfectionsthatmaybemorecommonthanLymedisease.Unfortunately,theresearchandexperienceindicatingdiverseinfectionscarriedbytheIxodesandotherticksisignoredsoasmallnumberofsymptomsandsignswereaddedtothischecklist..Further,“testing”usuallyinvolvesonetestforamono-infection--BorreliaorLyme. TicksandothervectorsshouldneverbeassumedtocarryonlyLymedisease.
PleasenotethatwhenwearetalkingabouttheIxodestickwearenotreferringtothisasa“deertick”sinceithasover200vectors(Ostfeld).Many of the tick reduction options presently suggested are not successful in accomplishing their goals.Reducingdeerpopulations,oncethoughttoreducetickpopulationsandincidenceofLymedisease,maysimplyincreaseticknumbersinmammalsandothercarriersthatliveclosertohumans.
All healers have their familiarway of thinking, testing and treating.Kuhnhasshownweareallbiasedandstruggle tobeobjective…andfail.Certaintyissimplyimpossibleinmedicalscience.Further,tickandfleainfectionshavealmostinfinitepathologicaleffectsbecausethehumanbodyandtheseclustersofinfectionsaresocomplex. Ihavenotsuggestedagridorasetnumberofsymptoms,becauseonewouldnotfitthislist.Simply,thegoalofthischecklististohaveyouthinkbroadly.
You cannot use this checklist to diagnose Lyme disease or to rule it out.
ALymechecklistisverymedicallyimportant,sinceitisstillanemergingillnessandcansometimesdisableorincreasemortalityriskinpatientsofanyageifnotdiagnosedandtreatedearlyintheinfection.
Writings in the past fifteen years have either viewed Babesia andBartonella as mere “co-infections,” or a footnote of a spirocheteinfection[i.e.,Lyme].Either infectioncanhidefordecades,andthen
120 LymeDiseaseChecklist•SchallerandMountjoy
possiblydisableorkillapersonbycausingaclot,heartarrhythmiaorbyothermeans.
The detection of Lyme from stained tissue samples or blood is verydifficult. Currently, the well-established indirect lab test patternspresentedarenotusedorunderstoodbyallhealthcareprofessionals.Whilethisisfullyunderstandable,Ihopeitmaychangeinthecomingdecade.Tickinfectionshavesystemic impactsonthebody,andarenotlimitedtoeffectsreportedinjournalarticles,afewbooksoranynationalorinternationalguidelines.
Dr. Schaller has published the four most recent textbooks on Babesia and the only recent textbook in any language on Bartonella.His most recent book on Lyme, Babesia and Bartonella includes a“researchersonly”listofover2,600referencesconsideredtobea start forbasiceducationintickinfectionmedicine.
HepublishedarticlesonbothBabesiaasacancerprimerandBartonellaasaprofoundpsychiatricdiseaseunderthesupervisionof theformereditor of the Journal of the American Medical Association (JAMA). He also published entries onmultiple tick and flea-borne infections,includingBabesia,BartonellaandLymedisease,inarespectedinfectiontextbookendorsedbytheNIHDirectorofInfectiousDisease.
Dr. Schaller is the author of seven texts on tick and flea-borne infections. He is rated a BEST physician, an honor that is awarded to only 1 in 20 physicians by physician peers. He is also rated a TOP physician by patients, again ranking in the top 5 percent of physicians.
Copyright © 2011 JAMES SCHALLER, M.D., M.A.R. version 25.
This form may not be altered if it is printed or posted, in any manner, without written permission. It can be printed for free to assist in diagnostic reflections, as long as no line is redacted or altered, including the introduction or final paragraphs. Dr. Schaller does not claim that this is a flawless or final form, and defers all diagnostic decisions to your licensed health professional.
ChecklistsforBartonella,BabesiaandLymeDisease 121
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ChecklistsforBartonella,BabesiaandLymeDisease 147
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ChecklistsforBartonella,BabesiaandLymeDisease 159
Dr. Schaller has been published in:
Journal of the American Medical Association
Journal of Clinical Neuroscience
Medscape (Academic Journal of WebMD)
Journal of the American Society of Child and Adolescent Psychiatry
American Journal of Psychiatry
European Journal of Child and Adolescent Psychiatry
Compounding Pharmaceuticals: Triad
Fleming Revell Press (Four Languages)
Internal Medicine News
Family Practice News
Spire Mass Market Books
Internet Journal of Family Medicine
Greenwood Press
Child and Adolescent Psychiatry Drug Alerts
Hope Academic Press
Clinical Psychiatry News
Psychiatric Drug Alerts
Townsend Journal
OB/GYN News
AMA News
Currents
160 SchallerandMountjoy
A Sample of Other Books by Dr. Schaller
Thislargetextbookisclearandeasytoread.Itisreallythreebooks.Whilesomepointsarepartiallyoutdatedsince2006,muchwouldbeconsiderednewtomostreaders.
ChecklistsforBartonella,BabesiaandLymeDisease 161
TheOnlyHematologyBookExclusivelyDedicatedtoBabesia.
162 SchallerandMountjoy
TheMostUp-To-DateAcademicandPatient-CenteredBookonPracticalArtemisiaBabesiaIssues.
ChecklistsforBartonella,BabesiaandLymeDisease 163
Bartonella diagnosis is very complex. This current text creativelyused a new set of tools based on solid research of blood vessel andskinaugmentationchemicalscreatedbyBartonella.ItliterallycreatesafullBartonellaphysicalexam.Thisbookhelpswithlimitedbasiclabtesting,andpreventstheuseofroutinelyrelapsingorpoortreatmentspromotedinbothtraditionalandintegrativemedicine.Nootherbookonthistopicisbasedonoverathousandtopresearcharticles,andnoonehadpublishedanythingremotelyclose to replacing thiswork inoverfiveyears.
164 SchallerandMountjoy
Dr.SchallerisaCertifiedMoldInvestigatorandaCertifiedMoldRemediator.HereisAnotherPractical
andReadableMoldMycotoxinBook.
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TheOnlyCurrent,PracticalandAdvancedClinicalBookonthisRevolutionaryTreatmentfor
OpioidAddictionandModestPain.
166 SchallerandMountjoy
Themanymissedmedicalandneurologicalcausesofpoorfocusandbadbehaviorscannolongerbeignored.Thisuniquetextadvancesmedicineandshowshowmuchinyouthpsychiatryhasmedicalrootsthatareignoredorunknowneveninsolidchildandadolescentpsychiatrypractices.
ChecklistsforBartonella,BabesiaandLymeDisease 167
Disclaimer
Dr.Schallerisnotaspecialistininfectiousdiseasemedicine.Heisalsonot a pathologist.Both of these specialties have over 2,000 diseasestotreatandstudy.Dr.Schallerisonlyinterestedinfourinfectionsandhas readandpublishedononly these four.Themedical ideas,healththoughts,healthcomments,productsandanyclaimsmadeaboutspecificillnesses,diseases,andcausesofhealthproblemsinthisbookarepurelyspeculative,hypothetical,andarenotmeanttobeauthoritativeinanysetting.NocommentorimagehasbeenevaluatedbytheFDA,CDC,NIH,IDSAortheAMA.NeverassumeanyUnitedStatesmedicalbody,society,orthemajorityofAmericanphysiciansendorseanycommentinthisbook.Nocommentinthisbookisapprovedbyanygovernmentagency,medical body ormedical society.Nothing in this book is tobe used to diagnose, treat, cure or prevent disease. The informationprovidedinthisbookisforeducationalpurposesonly.Itisnotintendedas a substitute for the advice from your physician or other healthcareprofessionals.Thisbook isnot intended toreplaceoradjustanyinformationcontainedon,orin,anyproductlabelorpackaging.
Nopatientshouldusetheinformationinthisbookforthediagnosisortreatmentofanyhealthproblem,orforprescriptionofanymedicationorothertreatment.Youshouldconsultwithahealthcareprofessionalbeforedecidingonanydiagnosis,orinitiatinganytreatmentplanofanykind.Dr.Schallerdoesnotclaimtobeanexpertinanyillness,diseaseor treatment. In this book, he ismerely sharing one of his interests.Pleasedonot startanydiet,exerciseor supplementationprogram,ortakeanytypeofnutrient,herb,ormedication,withoutclearconsultationwithyourlicensedhealthcareprovider.
Babesia or Bartonella diagnosis or treatment comments and reportsof possiblepositiveor negative treatmentoutcomes arehypothetical.Notreatmentshouldberejectedorembracedbyanyone,basedonthepreliminaryresearchandstudyinthisbook.
In this book, Dr. Schaller makes no authoritative or proven claimaboutanydiagnosis, lab testingor treatment.Dr.Schalleronlyoffershypothetical ideas. Dr. Schallermakes no authoritative claims aboutmedications,nutrients,herbsorvarioustypesofalternativemedicine.
168 SchallerandMountjoy
Theideas in thisbookwillneed tobesubmitted toyour localexpertinallopathic,osteopathicorprogressivemedicine,ortootherlicensedhealthcarepractitioners.Thisbookisnotmeanttobeaninformalorformalguidelinebookthatpresumestocontrol800,000physicians,orthe300millionpatientstheyserve.Youareaskedtoletthewisdomofyourhealthcarepractitioners,andyourownstudy,beastartingpointtoguidetreatmenttailoredspecificallytoyourbody.Again,Dr.Schallermakesnoclaimtobeanexpertinanyaspectofmedicine.Hemakesnoclaimtoknowmorethanotherphysicians.
Additionally,Dr. Schallermakes no claim that any statement in thisbookiscorrect.
Sincethisappearstobethefirstbookexclusivelydedicatedtoadvancedmoderncutting-edgetickandfleainfectionexpandeddiagnosiscriteria,it isverylikelytocontainerrorsThisiscommonwithbooksthatarethefirstonsuchsensitivetopics.Everyreasonableefforthasbeenmadenot to try tooverstate findings.Further, it is important to realize thatanysinglelabfindingortreatmentoutcomecanhavemultiplecauses,and not all of thesemay be known to this author, or to other healthpractitioners. Therefore, all health care practitioners should look forotherconfirmationsoutsidethisbookbeforebeginningonanytreatmentplan,ifpossible.
ChecklistsforBartonella,BabesiaandLymeDisease 169
Contacting Dr. Schaller
Should you wish to talk to Dr. Schaller he offers individualized edu-cation consults, which can be arranged by calling 239-263-0133. Please leave all your phone numbers, a working email and a fax number. These consults are typically in 15 minute units and can last as long as you wish. All that is required is the completion of a short informed consent form.
If you would like a full diagnostic consult or to see Dr. Schaller as a patient, know he treats patients from all over the USA and from outside the country. He meets with you first and then does follow-up care with you by phone. He does require you to have a family doc-tor, internist or pediatrician, since he is only a consultant.
If you would like to fly in to see Dr. Schaller, his staff are very familiar with all the closest airports, and we have special hotel dis-counts.
I wish you the very best health!
Warm Regards,Rona C. MBAOffice Manager
170 SchallerandMountjoy