Dear Lyme Warrior...Help!

Every few months, Jennifer Crystal devotes a column to answering your questions. Do you have a question for Jennifer? If so, email her at lymewarriorjennifercrystal@gmail.com.

I had a root canal and now my Lyme disease symptoms have flared. Is there a relationship between dental problems and Lyme?

I asked my Lyme Literate Medical Doctor (LLMD) the same question before I had my wisdom teeth removed a few years ago. I was worried that the procedure might cause my Lyme symptoms to flare. Because the oral surgeon was going to put me on antibiotics for a week after the procedure, in case of infection, my LLMD thought that medication would protect against a Lyme flare up. He was right. He did caution me, however, that a more invasive procedure like a root canal could exacerbate Lyme symptoms. Lyme is an inflammatory disease, and such a procedure can increase inflammation and potentially aggravate Lyme bacteria (spirochetes) living in the area. I recommend talking with your LLMD to see if you might need antibiotics or an anti-inflammatory regimen.

Patients experiencing oral or facial symptoms should consider whether tick-borne illness could be at play, as should their dentists. In the article “Dentists can help fight against tick-borne diseases” in the American Dental Association (ADA) News, Dr. Stacey Van Scoyoc, an Illinois dentist and member of the ADA Council on Dental Practice, states, “Sometimes the dental patient may present nonspecific orofacial pain and headaches that can mimic temporomandibular joint point. Dentists should consider Lyme disease as a possible cause if a patient presents these or related symptoms and has no specific oral health problem.”

Does having Lyme disease make it harder to recover from a concussion?

Having Lyme disease can make it harder to recover from just about anything. You have an underlying inflammatory infection that your body is already working hard to battle, and now it needs extra energy to heal from a significant head injury. If your Lyme has crossed the blood-brain barrier and you are experiencing neurological symptoms, those could certainly be exacerbated because you now have double inflammation in your brain—from the Lyme, and from the concussion (or the concussion may have caused previous Lyme inflammation to flare).

Moreover, Lyme disease bacteria (spirochetes) love to hide out in scar tissue. When I was recovering from ACL surgery on my knee, I diligently did all of my physical therapy, but my leg was very slow to regain muscle. “This is terrible,” I remember the surgeon saying, telling me I needed to work harder. In fact, the recovery was slow because I had undiagnosed tick-borne illnesses. The muscle did eventually come back, but it took much longer than it would for an otherwise healthy person. I’ve learned that my underlying conditions generally slow down my recovery from both illness and surgery. As those conditions have improved, though, recovery times have, too, so don’t give up hope. You may want to check out my recent blog post “What Helps Improve Cognitive Function for Lyme Patients” for some ideas on helping your body recover.

I’m thinking of starting graduate school, but the last time I make a big life change, my Lyme disease relapsed. I don’t want Lyme to prevent me from pursuing my dreams, but I also want to be realistic. Do you have any advice?

Your story sounds a lot like mine. The first time I achieved remission, I went off antibiotics, moved to another state and started a new job. Three months later, I relapsed completely. It took another two years to get back to remission, and when I did, I was terrified of facing another relapse (see my “Fear of Relapse” post). Then, an opportunity arose to attend graduate school. I weighed risks and benefits. Could I manage the work load, and live on my own in a new city? I had outgrown my life in my home state, where I’d moved to convalesce. I’d made good progress in physical therapy. I had volunteered, and then taken on freelance writing jobs. I’d joined social groups. I decided that I had paced myself well enough during recovery that I was truly ready to take the next leap.

This time, I made preparations before I moved. I lined up doctors. I found local practitioners for adjunct therapies. I spoke with the Disabilities Office at my graduate school to make sure I could receive accommodations (like extensions) if needed. I explained my situation to my professors. I got in touch with friends in the area. Most importantly, I accepted that tick-borne illnesses would be coming with me on the journey; during my first move, I’d hoped to leave them behind.

My suggestion is to talk candidly with your doctor about where you are in your recovery. Does s/he think you are well enough to take this step, or might it be better to wait another year or two? With tick-borne illness, you have to keep the big picture in mind. I know how badly you want to pursue your dreams, but it’s better to wait until you’re really ready than to get so sick that you can’t pursue them at all. If you do decide to take this step, ask your doctor how you can best support yourself physically during a transition. If you’re moving to a new location, make sure you get a support network in place before you go. I’ll be cheering you on!