Full Transcript Podcast Introduction and Guest Welcome 0:06 Welcome to the Doctors Making a Difference podcast, where we help physicians to be empowered with the tools they need to successful in medicine, 0:13 in finance, and in life. 0:15 Join us as we highlight doctors and other professionals around the world who are making a difference. 0:26 Today I'm pleased to welcome Dr. 0:28 Susan Mara. 0:29 Dr Marra is a naturopathic doctor who has done extensive work in Lyme disease and she has more information on this for us as physicians and I am really 0:39 excited to hear about it. 0:40 And it sounds like she's done a lot of work and am pleased welcome you. 0:43 So Dr Mera, would you mind introducing yourself to our audience and telling them a little bit about your journey? 0:48 Sure. 0:49 So my name is Dr. 0:51 Susan Merrill, and I've been practicing for 27 years. 0:56 I have a bachelor's and a master's in psychology, but not the Freudian psychology. 1:03 More like psychobiology, the way that the mind and the body interact. 1:07 I had thought that I was perhaps interested in going into neuroscience. 1:11 And so my first real job was working under Tom Insel at the NIMH in Bethesda, Maryland. 1:17 This was way back in the 80s. 1:19 So then when I got there, I I thought, I'm not sure that the lab is the best place for somebody like me because I am a little bit of an introvert,
Dr. Marrau2019s Background and Path to Naturopathic Medicine 1:31 but I too bubbly for the Lab bench. 1:34 I was a pain in the neck to the people. 1:37 They just wanted to do their work. 1:40 Well, you found where you belong. 1:42 That's great. 1:44 And then I happened to come out to Seattle to visit my sister Lauren. 1:48 She told me of this naturopathic school, Bastyr, which at the time was the premier natural medicine school really in the world. 1:57 And I went to look at it and I loved it. 1:59 I thought, this is who I am. 2:04 So I applied and got in and did the four years. 2:08 Then I got out and joined a practice in West Fort, Connecticut. 2:15 and I started seeing all these patients and they had strange symptoms. 2:20 They had migratory joint pain, migraine headaches lasting for seven days, severe, SEVERE PMS, gut dysbiosis, all kinds of things. 2:32 they weren't isolated. 2:33 So in a single patient, you saw disturbances in more than one organ system. 2:39 And I thought to myself, something is wrong here, I know something's wrong. 2:44 I also tend to be very intuitive. 2:47 So for me, if something doesn't feel right, it's not right. 2:54 So I called doctors all over the area and I asked them, you know, are you seeing this? 3:00 What are seeing? 3:01 I finally found a doctor, Dr. 3:03 Bernie Raxlin, who happened to be a pioneer in the field of clinical diagnosis of Lyme disease. 3:09 And he said to me, he says, You're right. 3:11 He said these patients have chronic infection. 3:14 They have Lymedisease and co-infections. 3:17 And I thought, you know, from school, we only had maybe three sentences about Lyme disease, about vector-borne illnesses. 3:24 It wasn't emphasized at all. 3:27 And that was in the mid-90s, so like 30 years ago. 3:35 yikes, you know, I don't really know anything about Lyme disease. 3:39 And I started testing all my patients, and I would say nine out of 10 patients came back positive for Lyne. 3:47 Now remember, Westport, Connecticut is about 40 miles south of Lyde, CT. 3:53 Lymed Connecticut, is where it really sort of blossomed. 3:56 So I said, oh, All right. 4:00 Well, I got to get trained. 4:02 So I joined ILADS, the International Lyme and Associated Diseases Organization, which is not the IDSA.
Recognizing Lyme Disease in Patients 4:10 The IDS is the Infectious Disease Society of America, Which is a more traditional way of looking at infections. 4:17 And I work in the more holistic... 4:21 I guess you'd call it alternative. 4:23 I don't call an alternative, but it's clearly not mainstream. 4:28 And then I arranged to work with Dr. 4:32 Richard Horowitz in Hyde Park, New York, because I got a preceptorship through Turn the Corner Foundation to sponsor me. 4:40 And I also did work for six years with Charles Ray Jones in New Haven, and he was the world-leading pediatric Lyme specialist. 4:49 So I basically did a residency, essentially, with both of them. 4:56 Now, obviously, A residency in a hospital is different, but I mean, being immersed, absolutely immersed in the topic for six years, 5:07 you come out the other end knowing something. 5:10 Absolutely. 5:12 Right. 5:13 So then where did your path take you after that? 5:16 Well, unfortunately, I lived in Westport, Connecticut, which is highly Lyme endemic. 5:22 There's probably a member of every household in Connecticut that has Lymedisease. 5:28 And I had a beautiful yellow lab and she would jump up on my bed. 5:32 I'm pretty sure that a tick got on her. 5:37 And then it jumped onto me and that's how I got Lyme because I already knew about LyME. 5:43 I was already practicing LyMe. 5:45 But it's so prevalent there that you just can't stay away from it. 5:48 2000, I got Lyme disease and also Bartonella, which is a co-infection. 5:59 And I lost the vision in my right eye for six months. 6:05 I had to go on IV antibiotics and oral high dose prednisone because the pressure in the eye was so high, they were afraid it was going to burst. 6:16 They did these therapies and then I came off the prednisone. 6:20 I went on to oral antibiotics and I got much, much better. 6:25 My vision returned. 6:26 It's not as good as my left eye, but it's fine with glasses. 6:33 I would say that it is not cured in me. 6:36 I am in remission. 6:39 And what I mean by that is if I have a really big stress, like a move or a death of a parent or death a sibling or anything like that, 6:49 I will relapse and symptoms will slowly creep back in. 6:53 But I know what they are, so I right away, okay, we've got to get this under control. 7:00 This is very typical of tick-borne illness. 7:02 And it's most likely because in a stressful situation, and I mean like high stress, like losing your job, moving, you know. 7:11 The body becomes acidic. 7:14 It's largely in an acidic state. 7:16 And those organisms flourish in acid and sugar.
Personal Lyme Infection and Recovery 7:23 They love sugar, Bardnell loves sugar and spearketes, Raleigh-Bergdorferi, they like fats. 7:30 That's one of the reasons why there is neuro-lime and neurobart is because they cross the blood-brain barrier and get into the brain and cause encephalopathy 7:40 and causes a myriad of different cognitive issues like poor memory, brain fog, inability to make decisions, impaired executive function, 7:50 emotional ability, things like that. 7:54 You can speak the language of patients. 7:57 You could speak to the languages of caregivers and doctors. 8:00 Like you had studied it, then unfortunately contracted it yourself. 8:03 Obviously, you stayed engaged if you've done this for 27 years. 8:07 So, I'm just curious about what you have seen evolve over that period of time as far as recognition and diagnosis and treatment modalities. 8:16 So the recognition of tick-borne illness is far greater than it was 27 years ago. 8:22 In fact, just this past Sunday on 60 Minutes, there was an excerpt on some research that's being done on Nantucket Island, 8:30 which is on the East Coast, and just off of Cape Cod. 8:34 And they're doing research looking at genetically modifying the white-footed mouse. 8:40 because that is a very large vector on the island of Nantucket and the research hasn't started yet, but that's the plan. 8:48 Well, that a big deal. 8:50 Very, very big. 8:52 So Martha's Vineyard and Nanduckett are two of the most endemic places in the world for Lyme disease and tick-borne co-infections. 9:03 Well, like you say, we've gone from barely recognizing two words, three lines about it in your training to your job, you know, 9:11 became... 9:12 lots about it. 9:13 And now we're talking about genetic modification of the vectors. 9:16 Have you seen any other advancements in the world of, like I say, of diagnosis or treatment in line? 9:21 I have, yes. 9:23 Yes. 9:23 Why? 9:24 The tests have become much more sensitive. 9:27 The laboratory that I choose to use is called Digenics. 9:29 It's in Palo Alto, California, and they specialize in tick-borne illness. 9:34 That's all they do. 9:38 And the tests have become more and more sensitive as the instruments have became more precise. 9:45 And so you can do a myriad of different tests. 9:48 You can look at antibodies. 9:50 You can look at PCR, polymerase chain reaction, which actually identifies the DNA of the offending organism. 9:58 Or you can do a FISH test, fluorescent in situ hybridization, where you actually visualize the blood cells. 10:06 And if there is babesia in there, if they're spartanella in their, and if spirochetes in the, then you see that. 10:15 That's good to hear. 10:15 A lot of times we rely on older style tests, which it's nice that we have had all these different generations of tests.
Advances in Testing and Diagnosis 10:23 But if it was exclusively antibodies, it is challenging because you have IgM, you IgG, and sometimes that doesn't reflect the chronicity of the disease 10:31 or you don't know how recent it. 10:33 You're correct. 10:35 isolate it from a PCR sample and say, hey, we have genetic material from these microorganisms that is still present somewhere in this person's body, 10:43 that certainly lends some specificity to your diagnosis. 10:47 So let me just say you're right with the exception of this. 10:52 There has been an argument that PCR is perhaps not the best test because you cannot tell if the organism is living or not. 11:03 Oh, that's a good point. 11:03 If the, if, the organ is dead, then you're going to pick up the DNA, right? 11:10 It's dead. 11:11 It is not pathogenic to your body. 11:13 Although then the other side says, oh, no, even the remnants of the bacteria have peptidoglycans on them that are sort of toxic to the body. 11:24 So there's a lot of need for research. 11:29 And I'm actually on the board of two organizations. 11:32 One is called Global Lyma Alliance. 11:34 and they're sort of the premier nonprofit organization. 11:39 And what they do is they raise money to then grant certain scientists research money, to look at certain questions. 11:48 Then the other board that I'm on is the board for Dr. 11:52 Horowitz's nonprofit foundation. 11:55 I've been on these boards for five or six years now, and we meet quarterly and talk about research and what do we think needs to be done. 12:05 So it's, I think, a really good thing to help continue to move the ball forward. 12:11 Oh, absolutely. 12:13 I'm a primary care doctor, so educate me a little bit. 12:16 What would you recommend ordering if I have someone who comes in with a multitude of symptoms and says, hey, think I may have been exposed to Lyme disease. 12:25 We've kind of got the traditional teaching of what we've done with antibody-based diagnosis, but I'm curious, what would you recommend if you say what's 12:32 the initial workup for somebody who comes in and says, do I have this or not? 12:37 Okay, so first of all, 27 years ago, when you would test a patient, more than 50% of them would only have Lyme. 12:48 Now, I only one patient in my practice who just has Lyne. 12:52 Everybody has a multitude of co-infections, and they can range from Bartonella, Babesia, Ehrlichia Anaplasma, Q fever, Tularemia Rocky Mountain spotted 13:06 fever Powassan virus, Heartland virus Bourbon virus I mean relapsing fever. 13:12 I mean, there's like 16 or 17 vector-borne illnesses that we know are a problem. 13:20 And so depending on the myriad of symptoms that a patient has, you would choose the correct test to look at that. 13:32 For example, If somebody came to you and they had night sweats, they have air hunger, and a pressure headache that felt like their head was in a vice, 13:44 those are all signs of a babesia infection. 13:48 I use the babesy antibody test and the Babesya fish test. 13:52 Okay, I used both of them. 13:54 And you just sign up for an account with Digenics. 14:00 And their phone number is 800-832-3200. 14:01 Sign up, they'll send you test kits and then... 14:10 You can take a look at all the different tests that you can order. 14:14 You order per pathogen or you order bundles. 14:19 And I typically order bundle just because of who I am. 14:22 I'm pretty heavily sought after for what I do because I've been doing it for so long. 14:30 So most of the people that come to me are really infected and really sick. 14:35 Like you said, most of your patients have this and you found co-infections with these precise tests. 14:41 So another question related to the practical part of it is patients come in and a lot of times they have limited insurance or things like that and they 14:51 don't have the ability to pay for expensive tests, how often are these tests covered by insurance? 14:57 It depends on the insurance company.
Insurance, Costs, and Access to Specialty Labs 15:02 There are some insurance companies that pay really well. 15:05 Medicare will pay for igenex, but some also will not. 15:11 So it really depends on the person's type of insurance that they have. 15:16 What happens is they'll give you a super bill. 15:20 They'll give you a super bill for what you paid for in the test, and then you can submit that to insurance and see if your insurance company will pay for it. 15:28 Sometimes it does, sometimes it doesn't. 15:32 Ideally, patients with health savings accounts, could they use those funds to help cover uncovered tests in this regard? 15:39 Is that used as like a credit card? 15:41 You can. 15:42 I mean, health savings accounts come if you have a high deductible insurance plan. 15:46 And with that, you can put money aside that is earmarked for payment of medical bills. 15:57 various things that are kind of considered medical, but are not covered by May insurance. 16:00 And if you don't know the specific answer to that, it's okay. 16:03 I'm just curious because a lot of times when I start ordering, yeah, when they order PCR tests and things like that. 16:09 If they're not cover, my patients always come back and complain like this was a $900 test. 16:14 So I was curious, you know, if come across that much. 16:17 No, it's a huge problem, and unfortunately, you know, It's not accessible for everybody because of the cost. 16:28 But I'm not in charge of that. 16:30 If you run a person's blood through LabCorp or Quest, the likelihood of the test, which is an antibody test being positive, 16:40 is very low. 16:42 Because those labs, they don't specialize in the identification of tick-borne illness or pathogens. 16:52 They're a general lab, right? 16:55 And so, Hygenics has really perfected the precision which with, they can identify tick-borne illness. 17:04 And there are other companies as too. 17:06 Armin Labs is a really good lab. 17:09 T-Labs in Gaithersburg, Maryland, those are probably the two other ones that It might be useful to doctors, but the tests are expensive. 17:19 I mean, to run a comprehensive panel for tick-borne illness throughigenics, it's $1,970. Yeah. 17:28 And that's on par with what I've discovered on most PCR, you know, when you're getting down to that level and they're expensive. 17:34 So that is why I was asking because again, most of the people who listen to this are physicians and are saying, okay, I want to order this test because 17:41 I have somebody with these crazy symptoms, this constellation of symptoms that makes me think of a vector borne illness. 17:48 But then that becomes kind of rate limiting steps. 17:51 behoves you to either check insurance or have the patient check, insurance, or possibly like this health savings account deal for patients who have high 17:58 deductible insurance plans. 18:00 That's interesting to see that, and I bet that's kind of developed over the last 27 years. 18:05 So, you know, I have never taken insurance and there's a reason for that. 18:11 I didn't want to get into the controversy of whether or not what I was seeing was chronic Lyme because it's highly controversial, 18:19 highly. 18:21 And I didn't want to get into that. 18:23 That's not why I went into medicine. 18:25 I have no desire whatsoever to be convincing anybody of anything. 18:31 Right? 18:31 I want do the right tests. 18:33 And that's what I focus on. 18:48 Yeah, you're not going to be abrasive with somebody.
Treatment Options: Antibiotics, Antiparasitics, and Herbs 18:50 You're trying to help patients. 18:52 That's really what we're all committed to do is help patience. 18:57 But no, a lot of medical doctors, I've been called every name in the book, charlatan, fake, all kinds of things, because they don't understand what I do. 19:10 And so they get a little bit irritated when they don't understand. 19:17 And, you know, my response to that is, well, guess what? 19:20 I don' understand cancer, but I do call these people bad names, right? 19:25 Just because someone is looking at something a different way doesn't mean they're wrong. 19:32 That's been my experience, and I've been very grateful that I have been a little bit rebellious, silently though, not making a big ruffle, 19:41 but just trusting my gut and just seeing like, something just doesn't feel right here. 19:46 It's not right. 19:47 I know it's all right, I would say 99 percent of the time I'm right now. 19:55 Now remember, that's the only kind of patient that i attract. 19:59 i'm not a general practitioner. 20:01 So people will Google their lists of symptoms, right? 20:05 And then recently they've been putting it into chat, GPT, and perplexity, as somehow they're coming up with my name. 20:14 So now it's like the quickest route to me now is my website, drsousanmera.com and there's a plethora of information on that website, 20:30 which I've been working on for 27 years. 20:33 So it's got all kinds of stuff, videos, it has got financial assistance information. 20:39 There are some organizations like the Limelight Foundation that will grant money to pay for children's testing. 20:49 So there are some, they're on my website, there's lots of blogs and articles, things like that, to help patients familiarize theirself in a watered down fashion, 21:03 right? 21:04 So that they can understand it, because you have to meet the patient where they are or they'll not gonna get it. 21:10 Right. 21:11 Another question on this is, again, your career spans multiple decades. 21:15 What have you observed about the treatment changes? 21:19 Certainly we've had different antibiotics and different things that have been developed during that time. 21:23 Have you seen any more specificity toward treatment of vector borne illnesses develop over the past three decades? 21:30 Yes. 21:30 There's been a couple of, obviously, the antibiotics, doxycycline, minocyclin, amoxicillin, zithromax, biaxin clindamycin, 21:39 rifampin. 21:40 Yes, all of that. 21:42 But there's been in the last, I would say, 10 to 15 years, there was a drug called disulfiram, which is actually used in addiction. 21:54 It's shown to be very effective in some patients to kill the spherarchy. 22:02 The problem is that disulphiram has a lot of side effects, one of which, is pretty severe neuropathy. 22:09 And these people already have neuropathy, so why are you gonna do that? 22:14 But some people do well on it. 22:16 Another drug that I use a lot in my practice is methylene blue, which is actually a dye. 22:23 And I do get it from a compounding pharmacy, and it is rather expensive. 22:28 But that drug, for whatever reason, is very, very good at crossing the blood-brain barrier and getting to the crevasses, 22:39 I call, of where these organisms live. 22:42 It's especially Bartonella, but also lawn. 22:45 So Lyme and Bardenella are very much affected by the presence of methylene blue. 22:52 The downside of methylene blue is it will stain your toilet bowl bright blue, bright, blue and it's difficult to get off. 23:01 So that's another issue. 23:04 And then another drug called Dapsone, And Dapsone is a drug I'm pretty sure was used originally in leprosy. 23:13 And my mentor, Dr. 23:15 Richard Horowitz, is the person that identified its use in tick-borne illness. 23:20 It's wonderful at really treating Lyme and Bardenal and Babesia. 23:27 Especially Lyme and Bartonella, however, I don't like to use that drug. 23:32 People develop methemoglobinemia very easily. 23:35 They have folate deficiencies. 23:38 It's just, it's really risky. 23:39 So I do not like use the drug unless I absolutely have to. 23:44 There's another drug called tefenequin or ericota, which is an antiparasitic and it's very strong and works against babesia. 23:55 Babesias is intracellular red blood cell parasite and looks like a multi-cross in the red cell. 24:03 And, you know, things like mepron, malarum, coardom, Plaquenil, albenza, the anti-parasitic drugs can be very useful against Babesia. 24:14 However, Babiesia is becoming more and more resistant to medication because more people are getting it. 24:21 And it's an epidemic in New York. 24:24 New york, Marthas Vindert, and Nantucket, I think, have the highest incidence of babesia, second to Slovenia in the world. 24:33 In the World. 24:35 I mean, it's very bad there. 24:36 And anyways, of this drug, tefenequine, which has been on the market for a long time, but it has a new application now. 24:43 This one you also usually have to get from a compounding pharmacy and you start with a dose of a hundred milligrams twice a day for three days. 24:53 Then you do a 100 milligrams once a week. 24:55 So it is a really strong drug. 24:59 You have to measure the G6PD before that, same with methylene blue, make sure the glucose 6-phosphate dehydrogenous pathway is normal. 25:08 If it's not, you cannot use those drugs.
Personalized and Epigenomic Approaches to Care 25:10 You will have a problem. 25:12 So there's goods and bads about all these drugs, but if you look in medicine, that's true about every drug. 25:20 That's about cancer drugs that true, about the satin drugs it true. 25:24 About antibiotics, it is true that every, every drugs has goods. 25:29 I'm just trying to sort of give you the playing field. 25:33 And you talk about the side effects with your patients and say, look, here's what we know can happen. 25:40 Then you help them make a decision about what they want to do. 25:44 Some people don't want go on antibiotics at all. 25:46 They want just do herbs. 25:48 And that's where being a naturopathic physician is really in my favor, is because we're well-trained in that. 25:56 And there are lots of herbs like teasel, Japanese knotweed, andrographis, oregano, thyme, wormwood, walnut that are very effective at killing these organisms. 26:10 The difference is that it takes much longer to treat a patient with multiple tick-borne illness or complex chronic illness with herbs than it does with 26:21 the antibiotics. 26:23 Well, I always tell patients little solutions for little problems and big solutions, for big problems. 26:28 And I think that's because a lot of patients, you know, buy all sorts of stuff, sometimes under the advice of some of the training and other times just 26:36 what they've Googled and purchased. 26:38 You know and most of time if it's harmless and I say, well, if a little solution for a problem, go for it. 26:43 If you're trying to treat stage three hypertension with something that is ineffective, like I'm not going to recommend that because you are going toast 26:51 your kidneys. 26:51 But we just kind of have to match the treatment to the disease. 26:54 And it sounds like you do that with your patients. 26:57 Oh, I do very, very personalized medicine. 27:00 Very. 27:01 I used to actually look at the genome. 27:06 Then what I found was that, let's say, for example, the patient had the histida gene or the HNMT histamine N-methyltransferase gene. 27:19 But they didn't have allergies. 27:20 They didn' have an MCAS response. 27:23 And I said, what's going on here? 27:29 And, I realized that what it is, is that in that particular patient, the antigen is not activating or not turning on the histamine genes. 27:42 So that's why I was talking to you earlier about how tick-borne illness is very much an epigenomic disease. 27:51 And epigeonomic meaning that the actual pathogenic organisms very and the phenotypic expression of a patient. 28:05 And that's why there's a plethora of symptomatology for complex chronic illness and multiple tick-borne illness. 28:13 You can have GI Lyme. 28:15 you can Have NeuroLyme, you could have Cardiac Lyne, You could Have Musculoskeletal Lymes, like issues with your jaw and dental issues. 28:25 It really is a very individual thing. 28:32 you really have to tailor your treatment to that particular patient because as you know, certain drugs treat certain things, 28:40 right? 28:40 So doxy and minnow are really good at, they're anti-inflammatory. 28:45 They'll calm down the Lyme arthritis a little bit. 28:48 Plaquenil will help with the autoimmune component. 28:51 So it's just like any other wing of medicine, you have know what you're doing.
Research, Chronic Infection, and Future Directions 29:01 I've thought this often, Dr. 29:03 Mera, as I encountered patients, our interaction with our environment, and that includes microorganisms in our environments, 29:11 influences a lot of things, including, I think, the expression of genes, how our bodies respond to stuff. 29:16 And then also what your immune system happens to be up to fighting off these microorganism certainly has a big effect on the body in general and your ability 29:26 to respond other diseases. 29:28 We see people who gain, unfortunately, an infection in the setting of some other chronic heart disease or kidney or liver disease. 29:35 And then it really disturbs their ability to fight that. 29:37 I think that is true across the spectrum. 29:40 So our interaction with microorganisms is something our immune system often shields us from, but it is certainly something we encounter almost every day. 29:50 There's more interactions with micro-organisms, I believe, than we even recognize. 29:58 I 100% agree with you. 30:02 One question for you is, we're still at the level where we are trying to understand things at a molecular level of how these organisms are interacting 30:11 at cellular level, at DNA level or mitochondria level. 30:16 What way are they acting at that microscopic level of our bodies? 30:20 And I guess the question is, going forward, where do you see research going with this? 30:25 Are there any things on the horizon outside of the genetically modified vector mice? 30:30 I was wondering if there's any other research that you're aware of that's ongoing to try to change this. 30:36 Dr. 30:37 Horowitz is trying to work on a double-blind clinical trial on Dapsone. 30:42 So we're trying get that organized. 30:44 There's a couple of universities that are interested, and there is a drug that Kim Lewis, I believe he's at Northwestern University, 30:52 he found a drugs called hygromycin. 30:56 And the reason that it's wonderful is that doesn't disrupt the gut microbiome. 31:01 and it only targets Lyme, only Lyne. 31:05 So they're doing research on that as well. 31:07 It's called Hygromycin A. 31:08 Well, it is exciting to see some changes. 31:12 And like you said, your career has spanned enough time. 31:14 You've observed things changing a lot from the diagnostic side and even the treatment side. 31:20 Then going forward, hopefully as we understand things more at that DNA or molecular level, you'll be able to develop more things because A traditional 31:29 antibiotic treatment for an acute infection is the model we're taught, but you're observing that a lot of people have so many effects, 31:37 whether it be from the acute or the prolonged exposure and your immune system's interaction with that disease, it can create a chronic disease state, 31:46 which is really interesting. 31:49 It's not unlike strep or TB or syphilis or leprosy. 31:56 or HIV, they can all become chronic. 32:00 For the most part, all of them are chronic, right? 32:02 I think now HIV can be healed. 32:04 I'm not 100% sure about that, but I that there's a triple cocktail that is very effective and can either put HIV into great remission or it cures the patient. 32:19 That's not my area of expertise. 32:21 So take it with a grain of salt. 32:23 But I think it's something like that. 32:25 Well, even like we were talking before we hit record, my observation is that there's so much research being done. 32:31 And the example I shared with you is hepatitis C. 32:34 The screening, the recommendations for hepatite C screening weren't really in place because our treatments were kind of ineffective, 32:42 tons of side effects, really didn't work that well. 32:44 And so it was hard to recommend that. 32:46 Then a few years back, the treatment was developed that really, worked on hepatitis C, almost 100% cure rate. 32:53 They said, hey, let's screen everybody for hepatite C because we can remove it for an individual that has it. 32:58 You hope for that day to come with these tick-borne illnesses, if we say we could identify it, and not only can we identify, 33:05 but we have effective treatments so that we don't Ostracize people or make them feel like they are left out that there's no answer But rather we say we 33:14 we think we know what's actually going on here and help you find a way that treats your disease Let me tell you the two areas that I'm most concerned about 33:25 One is these organisms, they actually live deep in the tissue, but they come out into your blood. 33:30 And if you are a blood donor, They do not screen for Bartonella or Babesia or even Lyme. 33:37 They only screened for HIV and syphilis, I think. 33:42 I'm not positive about that, But I know the tick-borne illnesses they do Not screen four. 33:47 So if You receive a transfusion from somebody who had those infections and they lied dormant and nobody knew, then you're gonna get infected. 33:57 And I've seen that many times, many time. 34:01 The other place that I'm concerned is that Lyme and the other offenders, the vector borne infections, they cross the placenta. 34:11 So gestational Lyne, gestation Bartonella, Gestational Babesia is a real thing.
Key Takeaways for Physicians and Closing Remarks 34:18 And so the baby is sort of bathed in this infectious soup for nine months. 34:24 And then when it's born, it can have a myriad of issues, anything from colic to autism to heart defects, a Myriad things that are not well known, 34:37 right? 34:38 They're not Well known. 34:39 So you really have to look for it. 34:42 Thank you for sharing. 34:43 Obviously, you have a lot of passion, a drive and a knowledge on this. 34:47 As we wrap up here, I want to think about what are some things if you could pick two or three things you would want physicians to know about this who are 34:57 not Lyme experts. 34:58 What are the two of three takeaways that you want them to take away from this conversation to change how they interact as they recognize and treat folks 35:07 with potential disease or ones who have already been confirmed with disease? 35:11 So the first thing I would say is when you have a new patient come to you and they have laundry list of symptoms, the 1st thing you should be thinking 35:21 is some sort of vector borne illness. 35:23 And they probably have had it for a while. 35:25 Either that or they got a huge pathogen load at the time of the bite. 35:30 So that would be the 2nd thing. 35:31 When you see multiple organ systems that are dysfunctional or sick or diseased, you should immediately start thinking infection, 35:43 tick-borne illness. 35:43 Then of course, the questions I ask, have you ever been bit by a tick? 35:48 Did you do a lot of camping and hiking? 35:50 Because some of the ticks are nymphs and they're the size of a pinhead. 35:53 You can't see them. 35:55 So you got to look at their lifestyle. 35:59 Did they have an animal? 36:01 Do they hike and camp a lots? 36:02 What was their life like? 36:03 what was the risk of exposure? 36:07 So that would be the second thing is assessing risk of exposure. 36:12 And then I think the third thing would to make sure that you test for co-infections. 36:19 And to use a specific lab, you don't have to eugenics, that just happens to be the one that I'm using, but you can use Armin Labs or T-Labs are really 36:30 also really good labs. 36:31 So that would be my suggestion is to go to a specialty laboratory for those tests. 36:38 Now the downside of that is, is that you have pay upfront and then you submit the super bill to insurance and They will usually pay some amount, 36:48 but it depends really on your insurance carrier. 36:53 Excellent. 36:53 Thank you for sharing that. 36:54 I appreciate your information and your perspective. 36:58 And again, I can tell this is something you're very driven and passionate about. 37:01 You've been able to help, hundreds or probably thousands of people over those 27 years. 37:06 Nine thousand now. 37:08 Goodness gracious. 37:08 Well, thank you. 37:11 One more time, will you tell us the name of the website so folks who may want to follow your work and follow along? 37:17 My website is www.drsusanmera.com. 37:26 And you can go on there and you could read about me if you're interested in like, how does she know this? 37:32 Well, it'll tell you. 37:34 And then there's a lot of articles. 37:36 There's lots of blogs, there are videos, financial assistance information, books that you read. 37:45 I tried to be as comprehensive on my website as possible because there is not a whole lot resources for tick-borne illness patients. 37:54 My website, it's 27 years old. 37:57 I just keep adding stuff, adding stuffs, and also modifying it as things change because medicine is always evolving. 38:05 Absolutely. 38:06 Thank you for taking the time to record a podcast. 38:09 This will be tremendously beneficial to those who listen to it. 38:12 And I wish you the best in what you're doing and I look forward to following your work. 38:15 So thank you so much, Dr. 38:16 Mara. 38:18 All righty. 38:21 Thanks for tuning in to the Doctors Making a Difference podcast. 38:24 And thank you for what you do to help your patients and your community. 38:27 Your work truly helps so many people. 38:29 We produce this content to have the tools you need to stay in medicine and to highlight the amazing work being done by physicians around the world. 38:36 Please note that while I am a physician and many of the guests on this program are also physicians or other professionals, 38:42 the discussions on the podcast do not represent my employer or any professional organizations to which I belong. 38:48 This podcast is for your information and entertainment only, and should not be taken as professional advice. 38:54 You should seek appropriate professional advise pertaining to your own situation. 38:58 Please check out more of our content on our website, doctorsmakingadifference.com. 39:03 Also, please follow, like, or subscribe on your podcast player or YouTube channel, and give us a five-star rating. 39:09 It really helps to spread the message. 39:11 Finally, if you'd like to be a guest on the podcast, Or if would like nominate someone else to a be guest, Please visit the website or email admin at doctors 39:20 making a difference dot com. 39:22 See you next time.
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