Dear Akteacher -
What you've described sounds exactly like Lyme disease. Although Lyme disease is most prevalent in the northeast and midwest - where it's practically an epidemic in some areas - it has been found in all 50 states and can occur anywhere there are deer, mice, and ticks. About 50% of those with Lyme don't remember a tick bite and even fewer get the circular rash that you may have heard about.
Early Lyme disease symptoms are usually flu-like symptoms - heavy fatigue, achiness, sometimes fever. In its next stage, joint pain is very common, often with associated swelling. Sudden-onset joint pain plus fatigue makes Lyme very likely. You should immediately get tested for Lyme and other tick-borne illnesses.
Lyme is easy to treat with antibiotics when caught early but can be very difficult to get rid of in its later stages and can cause permanent neurological and joint damage if left untreated.
A few things you should know:
- Lyme testing is notoriously inaccurate - false negatives are very common. It's still important to get tested right away. That's the first step, and a positive result is completely accurate. Most doctors will start with antibody tests, including ELISA and Western Blot. If those are negative and your symptoms still persist, you should request a Lyme PCR test which looks for the actual DNA of the Lyme. This is still not fool-proof, since Lyme is not always present in blood - it often "hides" in tissues. Even more accurate - though still not 100% - is a Lyme PCR test done on fluid taken from one of the affected joints.
- If all tests are negative, but you still have symptoms that can't be explained by other diagnoses, then it's worthwhile to try antibiotics (doxycycline is used for Lyme). If you have Lyme, there will be an immediate effect from the abx - typically, you'll feel much better within a day or two and then will get much worse again (that's a sign that the antibiotics are killing off Lyme and it's entering your blood stream). If there's no effect from doxycycline (either better or worse), then it's unlikely that it's Lyme.
-Lyme that has been present for more than a week or two and has caused joint pain will require at least 30 days of doxycycline and often many months. I got Lyme last June or July, started antibiotics in August and have been on them for 9 months now. You have to stay on the doxy until you've been completely symptom-free for at least 2 months. If you stop too soon (as I have done twice now!), then you have to start again and go through the period of getting worse again.
- In addition to Lyme, there are about a half dozen other infections that are carried by ticks. Most of these cause fatigue and some also cause joint pain. Your doctor should test you for all of them, including erlichiosis, babesiosis, rocky mountain spotted fever, and mycoplasma. Some require different treatment than Lyme.
For more information, here are some accurate and up-to-date resources:
I don't mean to scare you, but it is essential that Lyme is treated as quickly and aggressively as possible, if that's what you have. Your doctor can help you to consider and eliminate other possible diagnoses as well.
Good luck and please let me know if you have any other questions or need further information -