Parkinson.Fahr vai Lymen Borrelioosi?

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Parkinson.Fahr vai Lymen Borrelioosi?

Viesti Kirjoittaja soijuv » Pe Maalis 30, 2012 16:05

Noin kaksi vuotta sitten Chris Harrissin kädet alkoivat vapista ja puhe muuttui puuromaiseksi. Hänellä oli myös voimakasta uupumusta, vaikeuksia kävellä portaita eikä hän kyennyt ajamaan autoa jne. Hän sai erilaisia diagnooseja mm. Parkinsonin taudin. Hänelle aloitettiin mm.dopamiini lääkitys.

Diagnoosi vaihtui myöhemmin Borrelioosiksi borreliatestien osoittauduttua positiivisiksi. Harriss sai armeijan lääkäriltä lyhyen antibioottihoidon Borrelioosiin. Koska oireet eivät hävinneet, sanottiin jäljellä olevien oireiden johtuvan bakteerin aiheuttamista kudosvaurioista yms. Borreliahoitojen jälkeen Harriss lähetettiin armeijan sairaalaan jossa hän sai uuden diagnoosin, Fahrin tauti. Fahr on erittäin harvinainen tauti jossa kalsiumia kertyy aivoihin. Tautiin ei ole hoitoa ja siihen menehtyy yleensä muutamassa vuodessa.

Harriss hakeutui Borrelioosilääkäri Jemsekin hoitoon. Tämä aloitti pitkät suonensisäiset antibioottihoidot. Kuuden antibioottihoidon jälkeen Harrissin tila alkoi parantua nopeasti. Vuotta myöhemmin Harriss oli lähes täysin kunnossa (95%).

http://www.fayobserver.com/articles/2012/03/11/1156612


Dolores Claesson, Patient advocate, FL

Editors note:
The Fayetteville Observer has monitored the progress of Chris Harriss for more than a year. A reporter and a photographer were present when Harriss began physical therapy, and, about a month later, when he got his first intravenous antibiotic treatment. Harriss' wife, Karin, has provided periodic updates throughout the year.

By Greg Barnes
Staff writer

A year ago, Chris Harriss' hands shook so badly that he couldn't consistently place a small ball into a big basket.
He could barely climb stairs and couldn't drive a car. His speech became so slow and slurred that it was almost incomprehensible.
A year later, after controversial treatment for Lyme disease, Harriss seems to have made an almost complete recovery.

At a physical therapy session last month, Harriss easily skipped across a rubber mat, taking the black squares two by two almost without falter.
His therapist, Becky Bliss, says Harriss has regained 95 percent of his physical abilities, the remaining impairment being mostly a little loss of balance.

Harriss, a chief warrant officer 3 at Fort Bragg, has improved so much that he has gone back to work. His boss at U.S. Army Special Operations Command, Col. Patrick V. Pallatto, said in a letter dated Jan. 17 that Harriss' work performance "has been nothing less of superior." Pallatto called Harriss "a talented and tested senior Mobility Warrant Officer" and a "great asset to this command."

Harriss, who is now assigned to Fort Bragg's Warrior Transition Battalion, wants nothing more than to remain in the Army. When he got sick, he said, he set a goal for himself and his family that he would complete 20 years of military service. He has less than three years to go.
But the Army - whose doctors have misdiagnosed Harriss with a dizzying array of illnesses - isn't allowing him to return to duty.

In January, an Army medical evaluation board disqualified Harriss.
That was followed last month by a ruling from an informal Army physical evaluation board in Washington that found Harriss unfit for the Army, his wife, Karin Harriss, said she has been told.
The latest ruling was made despite:
Col. Pollatto's memo saying Harriss is doing a great job at work, and U.S. Army Special Operations Command would welcome him there.
A report dated Jan. 31 from Harriss' commander in the Warrior Transition Battalion, Capt. Steven Jeffery Coon, saying Harriss is capable of making complex decisions, can solve logistical situations and can multi-task projects. Coon recommended that the Army retain Harriss.
Bliss' evaluation that Harriss has regained 95 percent of his physical abilities.

A medical reassessment by Womack Army Medical Center in November that rated his cognitive and speech abilities as superior.
Harriss said he wanted to stand before the physical evaluation board and show its members that he is almost back to normal. He wanted to jump up and down and do pushups and run in circles and do anything else to prove that he is fit for the Army.
But the board doesn't allow that. Harriss is expected to get his chance later, during a formal physical evaluation board.
For now, at least, the Army seems intent on discharging a man who has given more than 17 years of his life for his country.

Chris Harriss' physical condition began to deteriorate more than two years ago. What started as a slight hand twitch quickly became an illness so debilitating that Harriss could barely walk or talk.
Documents provided by Karin Harriss show that Army doctors initially thought he had encephalopathy. Then came a diagnosis of Parkinson's disease along with a combination of medications, including the neurotransmitter dopamine, that Karin Harriss believes did her husband far more harm than good.
The Parkinson's diagnosis was followed by a positive test for Lyme disease, a tick-borne illness that can attack the central nervous system if left untreated.

After the Lyme diagnosis, Chris Harriss received powerful antibiotics for a month. His wife said the antibiotics seemed to be making a difference, but the Army, following federal Centers for Disease Control and Prevention guidelines, stopped the medication.
The Centers for Disease Control says "studies have shown that patients treated with prolonged courses of antibiotics do not do better than patients treated with placebo."

According to the centers, most medical experts believe symptoms that linger after a two- to four-week antibiotic treatment for Lyme disease are caused by residual damage to the tissues and the immune system that occurred during the infection. The centers said people with the lingering symptoms almost always get better, but it can take months or even years to feel completely healthy.

After the Army stopped the Lyme treatment, Chris Harriss was sent to Walter Reed Army Medical Center, where he received a new diagnosis: Fahr's disease. The rare disorder is characterized by calcium deposits on the brain. Fahr's is a degenerative and irreversible disorder for which there is no known cure.
The diagnosis came as a crushing blow to Karin Harriss, who had already endured so much.

"How would you like to be told that?" she said. " 'So sorry ... but your husband has an illness that will calcify his brain. There is no known treatment or clinical trials. We as doctors do not even know much about this illness. We believe your husband has approximately five years left. And each day is his last good one. Each day is a day downhill.' "
Two months after the Fahr's diagnosis, Karin Harriss drove home to Canton, Ohio, to say goodbye to her father. He died from Alzheimer's disease the day after her arrival.

Her father had suffered from the disease for seven years. When he died, she said, she couldn't help but think that her husband, just 35 at the time, was about to meet an even crueler fate.
About the same time that Chris Harriss received the Fahr's diagnosis, he was transferred into Fort Bragg's Warrior Transition Battalion for physically and mentally wounded soldiers. That's where the Army began its medical evaluation board process to put him out of the service.
The Harrisses were introduced to Dr. David Weitzman, who told them that he had once treated a Fahr's patient and did not believe Chris Harriss suffered from the disease. Its symptoms, he told the Harrisses, don't manifest themselves so quickly.
Karin Harriss said Weitzman told them something else: The way your husband's condition is deteriorating, he probably has only six months to a year to live.

Medical records dated Jan. 6, 2011, show that Weitzman paved the way for Chris Harriss to begin seeing a controversial Lyme disease specialist, Dr. Joe Jemsek, in Washington.

In 2006, the N.C. Medical Board suspended Jemsek's license for a year after finding that he inappropriately diagnosed and treated 10 patients for Lyme disease. The board found that Jemsek's method of diagnosing Lyme disease was not based on objective evidence and that his patients were not adequately told that his long-term treatment departed from the four-week standard.

Afterward, Blue Cross filed a $20 million lawsuit against Jemsek, accusing him of unnecessary antibiotic treatments. The lawsuit was later dropped, but Jemsek has said that it forced him into bankruptcy protection.
Jemsek left the state and eventually set up shop in the nation's capital, where Chris Harriss began undergoing monthly intravenous antibiotic treatment for Lyme disease.

As the Harrisses were told to expect, the first treatments did not go well.
"He hardly has any appetite," Karin Harriss wrote in an email dated March 4, 2011. "He is really hot when I am cold, and it is cold outside ... or cold when he shouldn't be. He says his head feels worse in a way he cannot describe. And he is emotional. He can cry for no reason. Or he can get upset very easily. He does not think this medicine is working at all. And for me, well, I am not sure either."
But just three weeks after that email, Karin Harriss wrote another one that was far more upbeat.

"We went and saw Dr. Weitzman yesterday. And Chris is improving!" she wrote. "He no longer stutters when he speaks, and forms sentences. He isn't falling all over the (place) either. He has more energy also. The dr. did an exam and found that the reflex in his right leg is returning."
For the Harrisses, the entire spring seemed to consist of major accomplishments followed by disheartening setbacks. But Karin Harriss refused to give up. Throughout her husband's illness, she has been a bulldog, complaining about Army doctors, writing her congressman, doing anything possible to get someone to help find a cure.
By July, after six antibiotic treatments, Chris Harriss' health started to rapidly improve.

"Chris is nearly recovered now! You just won't believe it!" Karin Harriss wrote July 21. She said her husband was going to take a road test the following week so he could get his driving privileges back.
The doctors at Womack, however, apparently weren't seeing the same signs of improvement. Either that, or they weren't looking for them.
In August, Karin Harriss became enraged because a review of her husband's condition for the Army medical evaluation board didn't include the substantial progress that she had seen in him. The summary, she said, was written by a doctor who had never even met her husband and had based his review primarily on medical records from January.
The summary, dated Aug. 4, said Chris Harriss suffers from "Fahr's Disease with early onset dementia, ataxia and tremor that is disqualifying for service."

But it also said Chris Harriss believes he has Lyme disease, which would not disqualify him from military service. The doctor who wrote the review recommended further evaluation by a neurologist to get a clear diagnosis.
That recommendation led the Harrisses to the University of North Carolina's Department of Neurology, where another doctor found Chris Harriss to be "alert, oriented, with fluent speech, normal language and comprehension."

The physician wrote that a brain scan came back "normal so the suspicion for progressive neurodegenerative disorder in his case is extremely low, almost negligible."
The doctor also wrote that Chris Harriss' Lyme antibody appeared to be back to normal and that he didn't appear to be suffering any symptoms of chronic Lyme disease. The doctor recommended discontinuing the antibiotic treatments.

After that diagnosis, the Army sent the Harrisses to UCLA in November, where a Fahr's specialist painted a different picture. The neurologist found "potential sub-acute and acute cognitive impairment which fluctuates" and recommended that Chris Harriss be followed for the next several years to see if the impairment progresses.
The doctor also described Chris Harriss as having "increased fatigue, is tired by noon, increased stiffness, difficulty walking and increased slurred speech." Although the doctor seemed to exclude Fahr's as a diagnosis, he did say some brain calcification was apparent.

Two months later, Army doctors signed a medical evaluation board report saying Chris Harriss could not effectively fire a weapon, evade direct or indirect fire or live in an austere environment without worsening his medical condition. The board disqualified him, citing a central nervous system disorder.

The following day, Frank L. Christopher, deputy commander for clinical services at Womack Army Medical Center, wrote a memo to the president of the Army's physical evaluation board in Arlington, Va.
In the memo, Christopher, citing the UCLA findings, the medical evaluation board and other documents, concluded that Chris Harriss' central nervous system disorder is a disqualifying condition.
Karin Harriss was livid. She thinks the Army picked and chose from the UCLA findings and discounted the findings from UNC and elsewhere.
Christopher declined to talk specifically about Chris Harriss' case, despite Harriss signing a waiver that would allow him to do so.
Speaking generally, Christopher said, it is possible that a soldier's condition could improve significantly between the time he is diagnosed and when the medical evaluation board report becomes official. He said he has seen it happen.

Regardless, the board's decision cannot be reversed, he said.
So Chris Harriss' options are running out. If, as Karin Harriss asserts, the physical evaluation board has already ruled that her husband is unfit for the Army, he can appeal the decision to a formal physical evaluation board.
There, he can use all of his supporting evidence, including his physical therapist, his boss and his commander in the Warrior Transition Battalion. He can jump up and down and do pushups and run in circles and do anything else he can think of to demonstrate that he is almost back to normal.

The board will have two options: to find Harriss fit for duty or unfit. If he is found fit, he would be allowed to return to duty but would probably face restrictions.
Nine days ago, Dr. Jason Hawley emailed Karin Harriss with encouraging news. Hawley is the doctor at Walter Reed Army Medical Center who diagnosed Chris Harriss with Fahr's disease.
In the email, Hawley said the physician reviewing her husband's medical evaluation board had contacted him seeking clarification of Chris Harriss' diagnosis and current condition.

"With the diagnosis not being so clear, and Chris recovering both physically and cognitively, I would like to give him the opportunity to continue his military service if that is what he wants to do," Hawley wrote. "I don't know if that will be the final determination, but that was my input to the (physical evaluation board). I thought you'd like to know that."
In another email the next day, Hawley hinted more strongly that the physical evaluation board is re-evaluating Chris Harriss' condition and could return him to duty.
That is all Chris Harriss - a big, unassuming, aw-shucks kind of guy - has ever asked for.
Harriss said that was his goal from the moment he got sick, and he cannot understand why the Army didn't seem to believe him.
It was as if the Army's decision-makers thought, "No you are going to die, don't worry about it," he said.
But Chris Harriss didn't die, and his wife refused to stop fighting, no matter how sad, long and lonely the battle had become.
Karin Harriss still isn't convinced that her husband suffered from Lyme disease, even though she believes the antibiotic treatments helped him immensely. She has documents showing that the Army has spent more than $100,000 to treat him for Lyme disease.
She wonders whether her husband's illness could be linked to the anti-malaria drug mefloquine, which the Army banned because of adverse side effects. Chris Harriss had to take the drug whenever he deployed.

Whatever the cause, there is no mistaking that Chris Harriss' physical condition has improved dramatically in the course of a year.
Whether it has improved enough for the physical evaluation board to deem him fit for duty is likely to be known soon.
And this time, Chris Harriss will have plenty to say.
Staff writer Greg Barnes can be reached at barnesg@fayobserver.com or 486-3525.

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