As someone diagnosed with Lyme only after my primary care physician telling me that my fatigue, mental fog, and that big rash that marked the beginning of a definite shift in my physical and cognitive stamina and strength was not Lyme, I found a specialist. In one particular test we found visual evidence of bartonella. So I am quite biased towards the view that the "accepted" diagnosis and treatment guidelines from the IDSA and the CDC are inherently flawed. If I and my physician had followed those guidelines, I would likely be in treatment for chronic fatigue syndrome and we would never have found the co-infection.
As the standard line goes, long term antibiotic treatments with something like doxycycline are toxic and therefore dangerous if done over the long term. Yet strangely, one with acne problems can go to a dermatologist and take tetracycline (which is of a similar molecular structure) to get rid of zits and do so over years, even decades. Those doctors are not pursued by insurance companies and medical boards for wreck-less practice, yet doctors who risk their careers to heal victims of Lyme disease are pursued and put out of business.
Under Our Skin focuses primarily on the controversy between those doctors who believe that Lyme Disease can become a chronic illness if not aggressively treated for often several years and those who think that these doctors are putting their patients at risk, patients who are accused of psychosomatic issues that take on the term "Lyme" as an imaginary ghost disease. This film strikes a balance between the technical aspects of the disease in how it is transmitted, the controversies over its treatment, and the political battles that have raged between different philosophies regarding diagnosis and treatment. With a lean towards the chronic Lyme diagnosis as the correct one despite its marginalization from "mainstream" medicine, the film presents top voices from both sides in a rather compelling balance.
What anchors the technical information and the political struggle are the stories of Lyme sufferers who exhibit very different traits. Some stories are heartbreaking as children and adults look like they are in the midst of battles with MS or Parkinson's. Others have far less visible effects and suffer all the while looking quite well. By the way, some MS patients feel present in the same way. By and large, the film lets you decide which side of the debate is the most reasoned one. One side says that there is an infection that persists. The other insists it does not. The film follows patients as they undergo treatments. They go from debilitating cognitive and physical functioning to what can only be described as "normal" by the second or third year of their long term treatment. By the end, any rational person deciding between the two sides must decide with the marginalized and criminalized group of physicians who are working tirelessly on the hypothesis that Lyme is a chronic illness that takes a long series of aggressive treatments to heal.
Two things were missing. The first is that we follow one patient through her treatments and notice that she gets worse to a life-threatening degree before she gets better. The film does not explain why this is so. While we that the bacteria, which look like so many little corkscrews called spirochetes, burrow into various tissues and so hide from antibodies, what would have been stronger is to explain why people get worse before they get better. The problem is called a "Jarisch-Herxheimer" reaction. As antibodies are infused in the bloodstream, resistances from the bacteria breakdown and they dislodge from various areas in the body. As this happens the infectious bacteria spread around even more before they die off. The later stage you are in Lyme, the worse these reactions will be. The reactions we see in the film are visceral strongly suggesting that early and aggressive long-term treatment is safer and results in less damage for many many reasons.
Second, while a small piece mentioned co-infections, what would have been more helpful is to briefly talk about these as well since it is often the co-infections which result in rather awful symptoms. Moreover, sometimes these co-infections are more difficult to get out of the body than the bacteria that causes Lyme disease.
If you do not walk out of this film questioning not only how and why diseases are diagnosed and the "recommended" treatments versus the opinions of those who live and breathe the disease and its various manifestations, you probably did not see the same film as I saw. As a sufferer of this disease I have learned how flawed our health system really is since it is primarily a money making industry, not a healing industry. This film reveals the severe damage that the deranged philosophy of healthcare-as-money maker cantruly inflict on those who need help rather than be marked as risks to drain the pockets of the corrupt.
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