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Rare but serious complication of Lyme disease can attack the heart: doctor

A heart specialist in Kingston, Ont. is warning health care professionals across the country to be on the lookout for a rare but serious complication of Lyme disease in which the disease bacteria begin to attack the heart.

The condition is called Lyme carditis and it can do serious damage by disturbing the heart’s electrical system andrate. Cardiologist Dr. Adrian Baranchuk, from the Kingston General Hospital Research Institute, says that’s why it’s so important for Canadian doctors to recognize the symptoms early and begin treatment – even before they have a definite diagnosis.

Most Canadians know Lyme disease is spread by ticks carrying the bacteria. The illness those bacteria cause is marked by fever, fatigue, and joint pain as well as other symptoms.

But when Lyme bacteria travel through the blood to the heart, they can also cause inflammation that disrupts the organ’s electrical system. The result is a condition called “heart block” in which the heartbeat becomes too slow.

The most common symptoms are sudden dizziness, shortness of breath, and chest pain. Left untreated, the condition can rapidly progress to complete heart shutdown.

Adam Flisikowski was diagnosed with Lyme carditis last summer after the previously healthy teen ended up in hospital with an erratic and dangerously slow heartbeat that dropped to 30-40 beats per minute.

The 19-year-old had just returned from a camping and fishing trip near Kingston and though he had taken precautions against bug and tick bites, when he got home, he found a small tick on his heel. He removed it, but six weeks later, he began having heart symptoms.

“I woke up and I could feel that something was wrong in my chest,” he told CTV News. “I felt like I was running but I was sitting down.”

Doctors told the teenager he might need to be fitted with a pacemaker to normalize his heartbeat. After several tests, doctors finally diagnosed him with Lyme carditis.

Dr. Baranchuk says Flisikowskiwas just one of several patients who were admitted to the Kingston Health Sciences Centre’s cardiac unit over 18 months with heart block symptoms. All were males under the age of 50 – one was just 14 – and all had recently taken part in outdoor activities.

“One of the things we noticed was each one of them had attended a different ER two to three times before anyone thought about this condition,” says Dr. Baranchuk.

Diagnosing Lyme carditis is often difficult because not only is the condition rare, many patients don’t get the bullseye rash caused by the bite of a Lyme-infected tick. Many also don’t notice the other, vague symptoms of Lyme disease, such as fever and muscle aches, which are often mistaken for the flu.

With Lyme diagnoses on the rise and the deer ticks that spread Lyme being found in parts of the country, Dr. Baranchuck worries Lyme carditis cases are going to increase but get missed.

“We have the suspicion that there are way more cases than are reported, because doctors are failing to report it,” he said.

That’s why Dr. Baranchuk has just published a paper advising Canadian health care workers to treat young patients with unusual heart problems with antibiotics to kill off any Lyme bacteria that might be present, while they wait for blood tests to confirm Lyme infection.

“These patients may not require pacemakers to be implanted. They can be treated with IV antibiotics for 10 to 12 days and the electricity of the heart will recover completely forever,” he said.

As for Flisikowski, because Dr. Baranchuk was able to offer him a quick diagnosis, he received antibiotics in time and his heart has now recovered.

“I am doing pretty good now. I am back to normal, I can do normal activities,” he said, fully aware his story is now a cautionary tale.

Sue Faber, a former ER nurse who had Lyme disease and now works with Lyme Hope, said that when patients present with symptoms such as fever, fatigue and joint pain, Lyme disease should be on top of mind among possible diagnoses, even when there is no rash present.

“We can treat them with antibiotics and they can go on with their lives,” she said.

The Ontario government says the best way to prevent Lyme disease is to prevent tick bites by: covering up

  • using insect repellent
  • washing and drying thoroughly
  • checking your pets for ticks

With a report from CTV medical specialist Avis Favaro and producer Elizabeth St. Philip

A deer tick that can transmit Lyme disease is shown in this file photo.

A heart specialist in Kingston, Ont. is warning health care professionals across the country to be on the lookout for a rare but serious complication of Lyme disease in which the disease bacteria begin to attack the heart.

The Grief Fog That Comes With Loss

February 5, 2020 By Katja Faber

“How could you forget?” he asks, looking at me incredulously. “Really? Again?”

He’s right. How could I forget? But then, these days, I forget a lot of things. “I’m sorry,” I say.

His irritation hurts me, as does my own frustration at not remembering the simplest of things. I seem to live in a perpetual cloud of distraction, unmindfulness being the witness to my every act. I believe I’m being attentive because I truly do listen.

But come a day, a week, a month later and realize that my mind did not retain the information and I stand, dismayed, before my abstracted state of mind.

Since my boy was killed, I make lists. To-do lists. Must-be-done-by-then lists. Which-bills-to-pay lists.

Discarded envelopes lie scattered on my desk as if it’s rained unwanted mail. Their every corner is covered in hastily jotted down words so as to remember to book appointments, answer messages, make a call.

When I tell friends I’ve lost my mind, it’s not in jest. I shyly explain it’s grief fog, a ‘thing’ you get when you’ve suffered a loss the magnitude of mine.

My doctor diagnosed a lack of sleep. “OK, so tell me something I don’t know,” I answered.

She smiled wryly. “It’s normal,” she replied. “It’ll get better with time,” and handed me a bag filled with bath salts and scented candles.

Grief fog. Funny how those words are meant to explain the fact that our brain cells no longer function how they used to.

Lack of concentration? Ah, it’s grief fog.

Regular lapses in memory? Well, what did I expect following a traumatic loss?

After Alex was killed, my brain felt scorched. I couldn’t think straight. It wasn’t until two years into my grief that I realized how affected I was. A good girlfriend showed me a photo of us together. I looked terrible, the ghoul eyes of the newly-bereaved staring out at me.

“Do you remember that day?” she asked.

She had to remind me that she’d stayed at my home for five days. Yes, five days. I had absolutely no recollection of her visit. It was as if it had never happened.

This wasn’t me being absent minded, this was amnesia.

The implications are multiple, that much is obvious. If you work, manage a family, or are having to deal with lawyers following the death of your loved one, you’re not going to be up to the mark. Unfortunately, few understand just how bad it can get.

You may look as if you’re taking it all in, and you probably are, on some level — but the minute you turn away your trauma may wipe your memory clean. For me, it’s a lottery what I actually get to remember.

Stress is the biggie here. Grief causes enormous stress which in turn floods our body with cortisol.

Research shows that the same parts of the brain are affected by emotional loss as by physical pain. It’s known that emotional traumatic brain ‘injury’ following the death of a child or loved one will most often lead to serious changes in brain function.

People talk of grief brain, which manifests in a multitude of ways, grief fog being one of the many symptoms the bereaved have to contend with.

Other indicators of grief brain can include disturbed sleep, fatigue, anxiety, and loss of appetite, and often, following a traumatic loss, PTSD.

It’s five years since Alex died. I’d love to report that I can now will my intellect back whenever I want – but I can’t. I’ve had to slowly learn what works for me, and what to avoid. I’ve done it the hard way by feeling exasperated with myself and annoying quite a few others.

When I’m rested I do see a difference in my ability to focus but I’m hopeless at establishing a good sleep routine, so it’s a work in progress. I also eat home-cooked meals and limit my alcohol intake.

I’m getting better at saying ‘no’ to people when I feel overwhelmed as this lowers stress levels. I’m learning to schedule my social life so it happens in small, gentle doses.

My ability to multitask is coming back, but it’s still a dangerous series of stepping stones that can slip me up when I’m not concentrating and feeling calm. Exercise helps, as does finding time for relaxation.

I’m not re-inventing the wheel here. By adopting a sensible, self-care approach, I can mitigate the effects of brain fog. I’ve learned to gift myself the space for downtime and I’ve lowered my expectations where my memory is concerned.

As the years have grated past, I’ve gradually increased my ability to retain information.

Yet to this day, grief fog remains one of the secondary losses that has come with the death of my son. I’ve had to accept that my memory repeatedly fails me, and probably always will.

You may look as if you’re taking it all in, and you probably are, on some level — but the minute you turn away your trauma may wipe your memory clean. For me, it’s a lottery what I actually get to remember. ]]>