Re: Blue Cross assessment of LD and their medical admission of all three stages SAVE AND FAX TO BCBS or your local investigative scam reporter

[Guest guest]

Does anyone know the incidence of bilateral Bell's Palsy in stage two?

> >

> >

> >>

> >>Subject: Fw: AH HA! I found it! SAVE AND FAX TO BCBS

> >>To: dclaesson@...

> >>Date: Thursday, February 17, 2011, 3:42 PM

> >>

> >>

> >>A fellow lyme patient found this from Blue Cross and Blue Shield, and it

sounds

> >>drastically different from what they actually do......

> >>

> >>

> >>

> >>>LymeNet Law Pages

> >>>Case History Document

> >>>

> >>>Logan, et al V Empire Blue Cross and Blue Shield

> >>>

> >>>Entered By: Ira M Maurer/LymeNet Date Created: 2-15-98

> >>>Document Type: Other

> >>>

> >>>Title:

> >>>Empire Blue Cross And Blue Shield Managed Care Medical Guideline:

> >>>Treatment of Lyme Disease dated 10-1-90

> >>>

> >>>The following document was obtained during a recent pre-trial

> >>>deposition of an in-house doctor employed by Empire Blue Cross and Blue

> >>>Shield. The document reveals a far more reasonable and fairer approach

> >>>to Lyme Disease back in 1990.

> >>>

> >>>EMPIRE BLUE CROSS AND BLUE SHIELD

> >>>MANAGED CARE MEDICAL GUIDELINE

> >>>

> >>>TOPIC: Lyme disease, Lyme borreliosis or borreliosis, is a recently

> >>>recognized sphirochetal infection. It is transmitted to humans by

> >>>Ixodid ticks. Evidence indicates that the disease may have been present

> >>>in this country for many years; it is also found worldwide. There has

> >>>been discussion as to the need for hospitalization of patients who

> >>>require IV therapy. An alternative procedure has been promoted for home

> >>>IVtreatment. The present guideline addresses this issue.

> >>>

> >>>BACKGROUND: As with syphilis, findings of Lyme borreliosis have been

> >>>divided into 3 stages. Stage I (acute) is manifested by a spreading

> >>>skin lesion (erythema migrans), a flu-like illness, regional

> >>>lymphadenopathy or absence of these signs. Stage II (subacute) includes

> >>>more extensive skin involvement, musculoskeletal/joint pain, and

> >>>neuropathic entities, such as meningitis, encephalitis, mono-or

> >>>polyradiculapathy (Bell's palsy bilateral), cardiac involvement (A-V

> >>>nodal block), pancarditis, panophthalimitis, ARDS, hepatitis, and

> >>>orchitis. Constitutional symptoms of malaise and fatigue are prominent.

> >>>Stage III (chronic) disease includes chronic prolonged arthritis,

> >>>keratitis, indolent acrodermatitis with or without periostitis or joint

> >>>subluxation, chronic neurological syndromes (ataxic gait, paraparesis,

> >>>psychological disturbances, dementia, encaphalomylitis,

> >>>polyradiculopathy).

> >>>

> >>>The diagnosis of Lyme borreliosis is established by symptomatology,

> >>>clinical findings and measurement of serum IgG and IgM antibodies, the

> >>>latter indicating recent onset. However, spirochetes can persist in

> >>>body tissues even with negative serum titres.

> >>>

> >>>Treatment of Stage I illness calls for oral antibiotics such as

> >>>doxycycline, tetracycline, amoxicillin (or erythromycin if the patient

> >>>is penicillin-allergic). These are given for 10-30 days.

> >>>Hospitalization is not warranted. Similarly, oral therapy is indicated

> >>>for mild Stage II entities, i.e., headaches, (without meningeal signs),

> >>>musculoskeletal pain, mild to moderate arthritis, radiculopathy such as

> >>>Bell's palsy, first degree A-V block as long as P-R interval is <0.3

> >>>seconds.

> >>>

> >>>For Stage II and III, particularly with involvement of vital organs

> >>>(CNS, heart), hospitalization with IV antibiotics is indicated:

> >>>Ceftriaxone (2 gms/day IV x10-21 days) Cefotaxime (2x3g/day IV x10

> >>>days) or Penicillin (20-40 million units/day IV x10-21 days). In less

> >>>clinically urgent cases, office or home IV administration has been

> >>>recommended. However, a number of patients experience Jarish-Herxheimer

> >>>reactions; still others demonstrate allergy to their antibiotics. It is

> >>>warranted to admit patients with serious Stage II and III disease for

> >>>at least 4-5 days for initiation of IV therapy. Thereafter, if no

> >>>complications ensue and depending on their disease status, outpatient

> >>>IVtherapy can follow. Treatment failures have occurred with all

> >>>regimens, and retreatment may be necessary. Slow recovery from subacute

> >>>or chronic Borreliosis can take years, even after treatment. This may

> >>>be due to the natural history of the disease or treatment failure. It

> >>>is known that autoimmune mechanisms in the later phases of the

> >>>infection prevent full response to antibiotics. As the present state of

> >>>knowledge expands, changes in diagnostic methodology and therapy will

> >>>occur.

> >>>

> >>>SUBMITTED BY: Weissman, M.D.

> >>>

> >>>APPROVED BY:

> >>>MEDICAL DIRECTOR

> >>>MANAGED CARE PROGRAMS /S/ 10/1/90

> >>>___________________-

> >>>

> >>>

> >>>

>

[Guest guest]

And does the bull's eye rash appear at tick bite site? Will latent Lyme errupt

and produce a bull's eye rash as well as the palsy? Sorry about all the

questions but this has become acute here.

> > >

> > >

> > >>From: Dolores Claesson <dclaesson@>

> > >>Subject: Fw: AH HA! I found it! SAVE AND FAX TO BCBS

> > >>To: dclaesson@

> > >>Date: Thursday, February 17, 2011, 3:42 PM

> > >>

> > >>

> > >>A fellow lyme patient found this from Blue Cross and Blue Shield, and it

sounds

> > >>drastically different from what they actually do......

> > >>

> > >>

> > >>

> > >>>LymeNet Law Pages

> > >>>Case History Document

> > >>>

> > >>>Logan, et al V Empire Blue Cross and Blue Shield

> > >>>

> > >>>Entered By: Ira M Maurer/LymeNet Date Created: 2-15-98

> > >>>Document Type: Other

> > >>>

> > >>>Title:

> > >>>Empire Blue Cross And Blue Shield Managed Care Medical Guideline:

> > >>>Treatment of Lyme Disease dated 10-1-90

> > >>>

> > >>>The following document was obtained during a recent pre-trial

> > >>>deposition of an in-house doctor employed by Empire Blue Cross and Blue

> > >>>Shield. The document reveals a far more reasonable and fairer approach

> > >>>to Lyme Disease back in 1990.

> > >>>

> > >>>EMPIRE BLUE CROSS AND BLUE SHIELD

> > >>>MANAGED CARE MEDICAL GUIDELINE

> > >>>

> > >>>TOPIC: Lyme disease, Lyme borreliosis or borreliosis, is a recently

> > >>>recognized sphirochetal infection. It is transmitted to humans by

> > >>>Ixodid ticks. Evidence indicates that the disease may have been present

> > >>>in this country for many years; it is also found worldwide. There has

> > >>>been discussion as to the need for hospitalization of patients who

> > >>>require IV therapy. An alternative procedure has been promoted for home

> > >>>IVtreatment. The present guideline addresses this issue.

> > >>>

> > >>>BACKGROUND: As with syphilis, findings of Lyme borreliosis have been

> > >>>divided into 3 stages. Stage I (acute) is manifested by a spreading

> > >>>skin lesion (erythema migrans), a flu-like illness, regional

> > >>>lymphadenopathy or absence of these signs. Stage II (subacute) includes

> > >>>more extensive skin involvement, musculoskeletal/joint pain, and

> > >>>neuropathic entities, such as meningitis, encephalitis, mono-or

> > >>>polyradiculapathy (Bell's palsy bilateral), cardiac involvement (A-V

> > >>>nodal block), pancarditis, panophthalimitis, ARDS, hepatitis, and

> > >>>orchitis. Constitutional symptoms of malaise and fatigue are prominent.

> > >>>Stage III (chronic) disease includes chronic prolonged arthritis,

> > >>>keratitis, indolent acrodermatitis with or without periostitis or joint

> > >>>subluxation, chronic neurological syndromes (ataxic gait, paraparesis,

> > >>>psychological disturbances, dementia, encaphalomylitis,

> > >>>polyradiculopathy).

> > >>>

> > >>>The diagnosis of Lyme borreliosis is established by symptomatology,

> > >>>clinical findings and measurement of serum IgG and IgM antibodies, the

> > >>>latter indicating recent onset. However, spirochetes can persist in

> > >>>body tissues even with negative serum titres.

> > >>>

> > >>>Treatment of Stage I illness calls for oral antibiotics such as

> > >>>doxycycline, tetracycline, amoxicillin (or erythromycin if the patient

> > >>>is penicillin-allergic). These are given for 10-30 days.

> > >>>Hospitalization is not warranted. Similarly, oral therapy is indicated

> > >>>for mild Stage II entities, i.e., headaches, (without meningeal signs),

> > >>>musculoskeletal pain, mild to moderate arthritis, radiculopathy such as

> > >>>Bell's palsy, first degree A-V block as long as P-R interval is <0.3

> > >>>seconds.

> > >>>

> > >>>For Stage II and III, particularly with involvement of vital organs

> > >>>(CNS, heart), hospitalization with IV antibiotics is indicated:

> > >>>Ceftriaxone (2 gms/day IV x10-21 days) Cefotaxime (2x3g/day IV x10

> > >>>days) or Penicillin (20-40 million units/day IV x10-21 days). In less

> > >>>clinically urgent cases, office or home IV administration has been

> > >>>recommended. However, a number of patients experience Jarish-Herxheimer

> > >>>reactions; still others demonstrate allergy to their antibiotics. It is

> > >>>warranted to admit patients with serious Stage II and III disease for

> > >>>at least 4-5 days for initiation of IV therapy. Thereafter, if no

> > >>>complications ensue and depending on their disease status, outpatient

> > >>>IVtherapy can follow. Treatment failures have occurred with all

> > >>>regimens, and retreatment may be necessary. Slow recovery from subacute

> > >>>or chronic Borreliosis can take years, even after treatment. This may

> > >>>be due to the natural history of the disease or treatment failure. It

> > >>>is known that autoimmune mechanisms in the later phases of the

> > >>>infection prevent full response to antibiotics. As the present state of

> > >>>knowledge expands, changes in diagnostic methodology and therapy will

> > >>>occur.

> > >>>

> > >>>SUBMITTED BY: Weissman, M.D.

> > >>>

> > >>>APPROVED BY:

> > >>>MEDICAL DIRECTOR

> > >>>MANAGED CARE PROGRAMS /S/ 10/1/90

> > >>>___________________-

> > >>>

> > >>>

> > >>>

> >

>

[Guest guest]

my kids never had the bulls eye till we treated

From: mbrookh

Sent: Thursday, February 17, 2011 9:55 PM

To: BorreliaMultipleInfectionsAndAutism

Subject: Re: Blue Cross assessment of LD and their medical admission of all three stages SAVE AND FAX TO BCBS or your local investigative scam reporter

And does the bull's eye rash appear at tick bite site? Will latent Lyme errupt and produce a bull's eye rash as well as the palsy? Sorry about all the questions but this has become acute here.> > >> > >> > >>From: Dolores Claesson <dclaesson@>> > >>Subject: Fw: AH HA! I found it! SAVE AND FAX TO BCBS> > >>To: dclaesson@> > >>Date: Thursday, February 17, 2011, 3:42 PM> > >>> > >>> > >>A fellow lyme patient found this from Blue Cross and Blue Shield, and it sounds > > >>drastically different from what they actually do......> > >>> > >>> > >> > > >>>LymeNet Law Pages> > >>>Case History Document> > >>>> > >>>Logan, et al V Empire Blue Cross and Blue Shield> > >>>> > >>>Entered By: Ira M Maurer/LymeNet Date Created: 2-15-98> > >>>Document Type: Other> > >>>> > >>>Title:> > >>>Empire Blue Cross And Blue Shield Managed Care Medical Guideline:> > >>>Treatment of Lyme Disease dated 10-1-90> > >>>> > >>>The following document was obtained during a recent pre-trial> > >>>deposition of an in-house doctor employed by Empire Blue Cross and Blue> > >>>Shield. The document reveals a far more reasonable and fairer approach> > >>>to Lyme Disease back in 1990.> > >>>> > >>>EMPIRE BLUE CROSS AND BLUE SHIELD> > >>>MANAGED CARE MEDICAL GUIDELINE> > >>>> > >>>TOPIC: Lyme disease, Lyme borreliosis or borreliosis, is a recently> > >>>recognized sphirochetal infection. It is transmitted to humans by> > >>>Ixodid ticks. Evidence indicates that the disease may have been present> > >>>in this country for many years; it is also found worldwide. There has> > >>>been discussion as to the need for hospitalization of patients who> > >>>require IV therapy. An alternative procedure has been promoted for home> > >>>IVtreatment. The present guideline addresses this issue.> > >>>> > >>>BACKGROUND: As with syphilis, findings of Lyme borreliosis have been> > >>>divided into 3 stages. Stage I (acute) is manifested by a spreading> > >>>skin lesion (erythema migrans), a flu-like illness, regional> > >>>lymphadenopathy or absence of these signs. Stage II (subacute) includes> > >>>more extensive skin involvement, musculoskeletal/joint pain, and> > >>>neuropathic entities, such as meningitis, encephalitis, mono-or> > >>>polyradiculapathy (Bell's palsy bilateral), cardiac involvement (A-V> > >>>nodal block), pancarditis, panophthalimitis, ARDS, hepatitis, and> > >>>orchitis. Constitutional symptoms of malaise and fatigue are prominent.> > >>>Stage III (chronic) disease includes chronic prolonged arthritis,> > >>>keratitis, indolent acrodermatitis with or without periostitis or joint> > >>>subluxation, chronic neurological syndromes (ataxic gait, paraparesis,> > >>>psychological disturbances, dementia, encaphalomylitis,> > >>>polyradiculopathy).> > >>>> > >>>The diagnosis of Lyme borreliosis is established by symptomatology,> > >>>clinical findings and measurement of serum IgG and IgM antibodies, the> > >>>latter indicating recent onset. However, spirochetes can persist in> > >>>body tissues even with negative serum titres.> > >>>> > >>>Treatment of Stage I illness calls for oral antibiotics such as> > >>>doxycycline, tetracycline, amoxicillin (or erythromycin if the patient> > >>>is penicillin-allergic). These are given for 10-30 days.> > >>>Hospitalization is not warranted. Similarly, oral therapy is indicated> > >>>for mild Stage II entities, i.e., headaches, (without meningeal signs),> > >>>musculoskeletal pain, mild to moderate arthritis, radiculopathy such as> > >>>Bell's palsy, first degree A-V block as long as P-R interval is <0.3> > >>>seconds.> > >>>> > >>>For Stage II and III, particularly with involvement of vital organs> > >>>(CNS, heart), hospitalization with IV antibiotics is indicated:> > >>>Ceftriaxone (2 gms/day IV x10-21 days) Cefotaxime (2x3g/day IV x10> > >>>days) or Penicillin (20-40 million units/day IV x10-21 days). In less> > >>>clinically urgent cases, office or home IV administration has been> > >>>recommended. However, a number of patients experience Jarish-Herxheimer> > >>>reactions; still others demonstrate allergy to their antibiotics. It is> > >>>warranted to admit patients with serious Stage II and III disease for> > >>>at least 4-5 days for initiation of IV therapy. Thereafter, if no> > >>>complications ensue and depending on their disease status, outpatient> > >>>IVtherapy can follow. Treatment failures have occurred with all> > >>>regimens, and retreatment may be necessary. Slow recovery from subacute> > >>>or chronic Borreliosis can take years, even after treatment. This may> > >>>be due to the natural history of the disease or treatment failure. It> > >>>is known that autoimmune mechanisms in the later phases of the> > >>>infection prevent full response to antibiotics. As the present state of> > >>>knowledge expands, changes in diagnostic methodology and therapy will> > >>>occur.> > >>>> > >>>SUBMITTED BY: Weissman, M.D.> > >>>> > >>>APPROVED BY:> > >>>MEDICAL DIRECTOR> > >>>MANAGED CARE PROGRAMS /S/ 10/1/90> > >>>___________________-> > >>>> > >>>> > >>>> >>