Well, that’s a relief!  I had my ultrasound scan and got the all clear.  Immediately after I had a follow-up with my super GP, and we discussed the interaction of Bromelain and other drugs.  I decided, against his advice, to resume the Bromelain – but only one a day (500mg) and only on the days I am not taking Amoxycillin.  I had been suffering quite  a lot with joint pain in my hands, wrists, and elbows but this suddenly eased after I started the Bromelain again – probably a complete coincidence.  I had also been getting a persistent swollen ankle and that cleared over the same time so I have been ruminating about this and my recent flare up of plantar fasciitis and imagined the following:

Bb is transmitted into the blood stream. It illicits an immune response but, in many individuals, manages to survive without doing that, so the host may not know they are ill until it is ‘everywhere’.  It has a slow reproductive cycle so I presume it prefers to stay in the blood where it ‘learns’ how to evade / protect itself against our natural autoimmune defence processes (using biofilms and cysts).  If we know we are infected we take the antibiotics (if we are lucky) but the bug does its escape and evasion thing so we take more / different ones that can get round the bug’s defences.

Now, I know the infective agent doesn’t ‘think’, but it helps to imagine that it does. What does it do next?  Does it retreat to where there is little, or no, blood supply: joints, tendons, ligaments, scar tissue – anywhere it can hunker down and wait for the environment to be less hostile and, maybe, adapt to the antibiotics because the exposure is limited?  So, what does it need to survive the wait?  Nutrients?  Oxygen?  What?  How long can it wait before it has to come out for supplies – or die?  A fellow Lymie suggested that she has more trouble with sites of former injury – Lyme related swelling, for example, in a formerly broken ankle.

I was thinking that the sudden appearance of multiple joint pain, after many months of progressively more intense treatment, may be evidence that the infection has retreated to sites where it is least exposed to the ABs, but inflammation at joints might be damage to tendons caused by the ABx: tendon rupture is a known side effect of some ABx, though not as far as I know of Amoxycillin, Azithromycin or Tinidazole, but in combination?

If the infection has localised in joints and tendons, how do I get it out of there and back into the blood?  One way would be to stop medication for a while.  Is there a way of getting antibiotics to ‘bind’ to medication that targets joints, tendons and bone (like Chondroitin and Glucosamine)?  Another might be to introduce an antibiotic ‘wash’ directly into the joints.  I don’t know if this is possible or could be effective (I’m sure it would hurt!).  My swollen ankle might be evidence of an overloaded lymphatic system trying to process infection, or the debris of infection.  It might also be an autoimmune response to accumulating debris rather than active infection.  Does anyone know if Bb can pass through into Lymph?  Could Bb be ‘screened’ out of blood, by a process like dialysis, for very sick patients?

Is there anyone ‘out there’ who has answers to these questions?