(gentle music) – Lyme disease affects the
patient in many different ways. It depends on which stage of
the disease we’re looking at. (gentle music) The first stage is the
early stage that occurs about seven to 10 days after a tick bite. Lyme disease affects the skin
where the tick bit the person. The skin is infected with the bacteria and it causes a round
or oval red skin lesion called erythema migrans,
and that may or may not be associated with flu-like symptoms, like feeling flu-like… Achy, chills, sweats, fatigue, malaise. And that combination of the skin lesion and those flu-like symptoms
are the primary manifestations of the first stage of Lyme disease. (gentle music) If you don’t treat the
first stage of Lyme disease, then in many patients,
probably more than half, the bacteria leaves the skin where it was initially inoculated and
goes through the bloodstream to other areas of the body. And then the manifestations change because now other areas
of the body are infected, primarily the nervous system,
the joints, and the heart. So those manifestations are different. If it affects the nervous system it may cause what’s called a Bell’s palsy, or a drooping face. It can cause meningitis with
headache and stiff neck. And it can cause heart problems if the bacteria goes to the heart. Those heart problems are
usually a slow heart rate that may cause the person to pass out or feel like they’re gonna pass out. (gentle music) The symptoms of second stage Lyme disease are probably, often, the
most difficult to ascertain. They are symptoms such as fatigue, generalized achiness of
the muscles and joints, and sometimes patients also note what they call a brain fog
type cognitive symptoms where they have trouble
with short-term memory and trouble multi-tasking. These symptoms, though, again, are not specific for Lyme disease and sometimes can make the diagnosis of second stage Lyme
disease very difficult. Now if we have objective signs such as facial palsy
or heart abnormalities or meningitis then we can more easily make the diagnosis of
second stage Lyme disease. But in the absence of those outward manifestations of disease,
relying on the symptoms alone is often problematic. Physicians may not think of
second stage Lyme disease in somebody who has fatigue
or generalized achiness. And so, you will have to think about it and then order the appropriate testing to make that diagnosis. (gentle music) The third stage doesn’t occur for months or even years later and
that stage is called late Lyme arthritis. That’s where a joint,
usually a knee joint, swells up and has fluid
accumulation and pain. And that’s actually the way the disease was discovered in Lyme, Connecticut. There was an outbreak of joint
arthritis in young children. So the symptoms vary a lot depending on what stage we’re talking about. (gentle music)