In today’s podcast, Sarah explores Lyme disease from a nursing perspective with Nurse Practitioner Dr. Ginger Savely. Dr. Savely has specialized in the treatment of patients with tick-borne illnesses for the past two decades, and has authored and co-authored many articles in nursing and medical journals. Now living in Washington, DC, she first started researching Lyme while living in Texas, when her 16 year old daughter became very ill with the disease. Dr. Savely later became quite ill with the disease, eventually leading her to make it the focus of her own practice. She notes that many healthcare providers research and specialize in the Lyme after experiencing a personal encounter with the disease, which is much more complex than many other infectious diseases.
“Most of the people I know who specialize in treating Lyme and co-infections have the personal experience themselves, their spouse, their children.”Dr. Ginger Savely
Role of Nurses in Patient Care
Dr. Savely has written several articles that explore Lyme disease from a nursing perspective. She recognizes that nurses are able to pick up on more “subtle cues” or aspects of their history because they often spend more time with patients, and can develop a different kind of relationship with their patients. She also notes that the role of nurses and nurse practitioners is further expanded in rural communities. In many scenarios, nurse practitioners are the first line of patient care. Nurses who are well versed in the signs and symptoms of Lyme also have an important role in patient diagnosis. Dr. Savely sees Lyme treatment “as much an art as it is a science,” and emphasizes the importance of knowledge gained through experience and through fostering relationships with patients.
Nurses can learn to pick up the red flags, in other words, to notice little things…maybe even about the person’s history that the doctor might not have had time to go into in detail…people sometimes feel a little more comfortable, I’ve noticed, talking to nurses, and so they might even share some bit of information that’s really important.”Dr. Ginger Savely
Dr. Savely acknowledges that symptoms like sudden onset of headaches or severe insomnia can be indicators of some of these infections. She finds that doctors often don’t think of these infections when patients present with these types of symptoms, and emphasizes the importance of keeping these diseases in the differential diagnosis. She also stresses the importance of not ruling out these diseases due to a negative test. In the State of Virginia, physicians are required to inform patients that a negative Lyme test does not rule out Lyme disease.
Dr. Savely talks about some of the similarities between Lyme disease and COVID-19. She explains that both of these diseases can vary greatly from person to person. She describes some of the possible causes for this variability in response, such as genetic factors or immune status. She also touches on mast cell activation and multiple chemical sensitivities in Lyme patients and notes that certain genes can be activated by microbes, leading to a variety of physical reactions.
“It’s always important that (tick-borne diseases) be in the differential because it’s very often left out of the differential…also, it’s so important to not rule it out due to a negative test.”Dr. Ginger Savely
Prevention, Awareness and Education
Dr. Savely points out that nurses can teach about ways to prevent tick encounters, do tick checks, assess for the myriad of symptoms for Lyme disease, and share what they have learned wherever they go. In her own practice, Dr. Savely has learned how to efficiently review the often complex medical records that her patients arrive with, and discern important information for diagnosis and treatment.
Dr. Savely describes some of the classic co-infections such as Babesia and Bartonella. She notes once again that these diseases may present quite differently from person to person, and that blood tests are not reliable enough to rule them out. She describes some of the symptoms of Babesia and Bartonella, and touches on her approach to treatment. Dr. Savely also explains that quite often, symptoms overlap between infections. She talks about the role of inflammation and understands the importance of treatments that address the root cause, such as infection. In her experience of treating Lyme patients, she has found that the most effective treatment has been antibiotics, or herbal medicine in combination with antibiotics.
Although the Canadian and US healthcare systems are quite different, Dr. Savely believes that several changes need to be made on both sides of the border. She calls for better education for healthcare providers and heightened awareness of the limitations of blood tests. She also describes the frustration of treating patients in a healthcare system where treatment choices depend on patients’ financial status. Sarah encourages nurses who wish to further their education about Lyme disease to apply for CanLyme grants for the ILADS Lyme Fundamentals course. Thank you Dr. Savely for helping Lyme patients get their health back and for your insight into the role of nurses in the awareness, prevention, diagnosis and treatment of Lyme disease!