The Lyme Times

Volume 30

Front Lines

by Virginia Sherr, MD

Dad lay in bed or was propped up in a chair. He walked in great pain, feebly, and only with assistance. Everyone said that's what happens when you get to be 99 years old. But I could not understand it. For 90 of those years, he was vital, vigorous - a determined biologist and active gardener. I thought that surely something specific must account for his symptoms and his suddenly appearing to have given up.

Not depressed a day of his very zestful life, the change in him impelled me to search for an unrecognized melancholia. He wouldn't have any of it:

"It's the All-overish-ness, Virginia, the All-overish-ness."

A cadre of medical specialists thought his might be a case of polymyalgia rheumatica but the usual blood work was normal. With a sense of finality he insisted that I be satisfied with his version of a diagnosis whenever I asked him what was wrong. He always spoke as if I, a physician, certainly should understand as meaningful, this obvious, accurate label. At that time I could not; 10 years later I believe I do understand because I have experienced the All-overish-ness, myself.

Checked out again by a battery of medical specialists as he approached the century mark, there were no logical answers to the question of Dad's diagnosis. He was pronounced a remarkably healthy male with normal blood pressure, no major cardiac problems and looking especially good for his age. He made it to the century mark and beyond by nearly a year. Those last 10 years were a nightmare for him, however, because of pains that relentlessly incapacitated him.

A man who was raised never to acknowledge any discomfort, he eventually screamed with pain at every attempt to move or to be moved. It also was heart rendering to his family and to his attendants.

Ticks are a part of the way of life for people who live on the rural Eastern Shore of Maryland. And he was a biologist; ticks are considered by biologists and birders there to be common occupational nuisances. He picked them off himself without a thought. One dog belonging to the family had a known total of 300 ticks on him when my sister undertook the task of counting them.

I remember the first time after 1991 when Dad died that I thought about the All-overish-ness Syndrome again. I had been sure that the new mattress that my husband and I had purchased was defective. It was so firm, I thought, that it made my hips ache. But when the aching spread to my hands and to my ankles, it became more difficult to blame the mattress.

Soon after that, as I hurried to get my purse to pay a delivery man, I suddenly collapsed on the steps leading upstairs. The doctor who I consulted then for weakness and joint pains tried to reassure me that my lab work generally was OK and I looked just fine for my age. I thought, "I have heard this somewhere before and I know this drill!" But I never knew another name for it until an additional 6 years had come and gone. That was when my new family doctor recognized the symptoms and applied a scientific label to my version of Dad's excellent clinical description, "the All­overish-ness". Of course, that syndrome was in him more than likely the same syndrome that later developed in me.

My doctor identified it as chronic Lyme, co-infective with other tick-borne diseases, verified many months into treatment with positive borrelia and babesia DNA testing.

Dr. John Drulle wrote in 1991: "Polymyalgia rheumatica (PMR) is a common disease of elderly people characterized by pain and stiffness in the muscles of the upper arms and legs, fevers, malaise and weight loss... In classic form, the cause of the condition is unknown... I have personally seen three cases of Lyme-induced PMR, ...".

Polymyalgia rheumatica sounds a lot like "chronic Lyme All-overish­ness" to me. However, I may rename it for myself. It could just as well be called chronic "Overall-ish-ness" - tyrant that it is.

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