Tick Boot Camp

Matt Sabatello and Rich Johannesen
  • 5.0 (79)
  • Alternative Health
  • Updated Daily

Tick Boot Camp is a Lyme disease and tick-borne illness podcast featuring interviews with leading doctors, researchers, scientists, patients, advocates, and experts. Explore Lyme disease symptoms, testing, diagnosis, treatment, recovery, chronic Lyme disease, coinfections, PANS/PANDAS, MCAS, neurological symptoms, emerging research, and the latest advances in tick-borne disease care. Through expert education and powerful patient stories, Tick Boot Camp provides hope, validation, practical information, and a community for people navigating Lyme disease and complex chronic illness.

  1. 7h ago

    The Art of Lyme Healing – Dr. Frank Song Jr., ND | LIVE from ILADS

    LIVE from ILADS: Can treating Lyme disease be both a science and an art? Tick Boot Camp sits down with Dr. Frank Song Jr., ND, a naturopathic doctor specializing in Lyme disease, tick-borne infections, and complex chronic illness at Placeres Integrative Medicine in New Milford, Connecticut. But medicine is only one part of Dr. Song’s story. He is also a professional musician and performer whose music brings together influences from his Chinese heritage, Appalachian and Americana folk traditions, R\&B, soul, and his more recent experiences working with Brazilian musicians. For Dr. Song, those worlds aren't separate. Medicine is an art. Music can be medicine. And healing requires understanding the individual human being in front of you. In this wide-ranging conversation, Dr. Song shares how his upbringing in a Chinese immigrant family influenced his path into naturopathic medicine, what he learned during his Lyme disease residency under Dr. Alexis Chesney, why treating chronically ill patients caused him to reconsider how he was living his own life, and why he believes conventional and naturopathic medicine should work together rather than compete. The conversation also takes on difficult questions about trauma, nervous-system regulation, spirituality, access to care, financial resources, hope, and the danger of reducing complex Lyme disease recovery to simplistic advice that every patient must “change.” Dr. Song’s message is more nuanced: Meet people where they are. Understand what is actually contributing to their illness. Give them realistic hope. And never forget that precision medicine means treating the person—not a generalized version of the disease. This interview was recorded live at the ILADS conference, so you may hear some of the energy and background activity of the event throughout the conversation. From Chinese Folk Traditions to Naturopathic Medicine Dr. Song was born in New Haven to a family that immigrated from Hunan in south-central China. He spent part of his early childhood in China and was raised by grandparents who were farmers. Food, herbs, seasonal changes, folk traditions, and what he describes as Eastern medicine were naturally woven into everyday life. Looking back, Dr. Song believes those early experiences helped establish the foundation for his eventual path into naturopathic medicine. After returning to the United States, he grew up primarily in Virginia and studied biology and anthropology on the pre-med track at the University of Virginia. He later attended the University of Bridgeport for naturopathic medicine. Training Under Dr. Alexis Chesney One of the most important influences on Dr. Song’s Lyme disease education was Dr. Alexis Chesney, ND, LAc. Dr. Song completed his residency at Sojourns Community Health Clinic in Westminster, Vermont, where he trained under Dr. Chesney. The clinic combined primary care with naturopathic medicine, pediatrics, chiropractic care, physical therapy, acupuncture, and a specialized tick-borne disease program. That exposed Dr. Song to both ends of the tick-borne disease spectrum: Acute tick bites Early infections Lyme disease Tick-borne co-infections Chronic complex presentations Patients requiring individualized combinations of conventional and integrative care His current professional bio confirms that his residency specifically focused on diagnosing and treating Lyme disease, tick-borne diseases, and complex chronic illness and included pharmaceutical, herbal, and holistic approaches. Dr. Chesney has also joined Tick Boot Camp for her own LIVE from ILADS conversation exploring Lyme disease, Babesiosis, and whole-person treatment. What Treating Chronic Illness Taught a Young Doctor About Life Dr. Song began his residency during COVID. At the same time that the world was confronting illness and mortality on an enormous scale, he was working directly with chronically ill patients who were temporarily—or sometimes profoundly—losing important pieces of their lives. Some couldn't work. Some struggled to parent. Some lost mobility. Many were confronting fear, uncertainty, illness, and questions about mortality. Listening to those patients caused Dr. Song to ask difficult questions about his own life. What am I doing with my time? What would I regret not pursuing? One answer kept coming back: Music. His patients' experiences helped remind him that life isn't only about professional achievement. People facing serious illness often think about relationships, experiences, passions, travel, creativity, and the things they wish they had made more time to pursue. So Dr. Song decided to listen to the lesson his patients were teaching him. Becoming Both a Doctor and an Artist After residency and additional practice at Sojourns, Dr. Song moved to Brooklyn and shifted toward part-time clinical medicine. He joined Placeres Integrative Medicine, where he continues to work with Lyme disease, tick-borne illness, and complex chronic illness patients. At the same time, he dove more deeply into music. He began performing, working with a producer in Brooklyn, touring internationally, and recording. His musical identity draws from several different worlds. His grandparents were East Asian folk singers, exposing him to regional Chinese folk and operatic traditions. Growing up near Virginia's Blue Ridge Mountains exposed him to Americana, Celtic music, and bluegrass. He also developed a love for R\&B and soul. More recently, working and recording with Brazilian musicians added another cultural influence to his art. He has also pursued samba dancing and describes himself in the interview as a semi-professional samba dancer. Can Music Be Medicine? Dr. Song believes being a musician has made him a better doctor. Music has been a tool for expression, emotional processing, self-soothing, connection, and preserving family and cultural history. As a physician, he can work intensely with one person. He can investigate a case, recommend treatments, adjust a protocol, and help that individual navigate illness. Music works differently. It can reach an entire room—or potentially an entire community—at once. Dr. Song sees art as a way to create connection and empathy and potentially contribute to larger shifts in how people think about themselves, each other, health, and the world around them. His professional bio similarly describes his belief that music can be medicine and a channel for connection and healing. Lyme Disease, Nature & Our Environment Dr. Song also sees connections between his medicine, his art, and the natural world. Much of his music is inspired by nature and humanity's relationship with it. In the interview, he connects the changing landscape of Lyme and vector-borne diseases with larger environmental and climate issues. For him, those aren't entirely separate conversations. Human health exists within an ecosystem. How we interact with the environment can influence how we interact with vectors, pathogens, food systems, stressors, and other determinants of health. That ecological perspective fits naturally with the broader whole-person framework Dr. Song brings to medicine. Why Naturopathic Medicine? The conversation then explores what naturopathic training contributes to complex chronic illness care. Dr. Song is careful not to portray naturopathic and conventional medicine as enemies. He explicitly acknowledges the tremendous value of conventional medicine, particularly in acute care. His concern is that highly reductionist or hyper-specialized systems can sometimes struggle when an illness spans multiple interconnected systems. Complex Lyme disease can live in those gray areas. A patient may be dealing with infection alongside neurological symptoms, immune dysfunction, environmental exposures, psychological stress, trauma, nutritional problems, and other factors. Breaking everything into individual pieces can provide valuable information. But eventually someone has to put those pieces back together. Dr. Song believes the future requires a marriage between conventional and naturopathic medicine, using the strengths of both rather than insisting that one philosophy must replace the other. Lyme Disease Is Not One Disease Experience One of Dr. Song's strongest cautions in this interview is against broad generalizations. Two people who both say they have “Lyme disease” may have very different clinical pictures. One may be dealing with Lyme and Bartonella. Another may have Babesia or another tick-borne infection. Another may have mold exposure layered into the picture. There may be differences in immune function, environment, stress, trauma, socioeconomic circumstances, access to care, and many other variables. That makes generalized instructions dangerous. Dr. Song repeatedly comes back to the importance of individualized, precision medicine. Healing Is More Than Killing an Infection Rich and Dr. Song explore a recurring Tick Boot Camp theme: For many people, recovery from complex chronic illness eventually becomes about more than targeting pathogens. Physical health matters. But so can emotional health, nervous-system regulation, environment, relationships, stress, trauma, beliefs, purpose, and lifestyle. Dr. Song has additional training in mind-body medicine and holistic counseling. He describes studying with Dr. Moshe Block and becoming a Vis Dialogue practitioner, a counseling approach within a naturopathic framework. That background has influenced the way he thinks about connections between emotional experiences and physical health. But this is where the conversation becomes especially nuanced. A Critical Warning About Blaming Patients Dr. Song strongly cautions against turning mind-body medicine into another way of blaming chronically ill people. Telling someone: “You just need to change.” “You need to regulate your nervous system.” or

  2. 1d ago

    When the Doctor Becomes the Lyme Patient – Dr. Robin Ridinger | LIVE from ILADS

    LIVE from ILADS: What happens when a board-certified medical doctor develops debilitating symptoms — but doesn't recognize that she may have Lyme disease? Tick Boot Camp sits down with Dr. Robin Ann Ridinger, MD, a physician board-certified in both Family Medicine and Integrative Holistic Medicine who treats Lyme disease and other complex chronic illnesses at Premier Health and Holistic Medicine in Leesburg, Virginia. Before Dr. Ridinger became a Lyme-treating integrative physician, she became the patient. While going through a difficult period in her life, she began experiencing cognitive problems severe enough that she feared she might be developing early Alzheimer's disease and would have to retire from medicine. Then she attended a Lyme disease conference. As she listened to the symptoms being described, she remembers repeatedly thinking: "That's me." That experience changed not only her health journey but the way she practices medicine. In this conversation, Dr. Ridinger discusses why her conventional medical training didn't prepare her to recognize Lyme disease in herself, what she learned from becoming a patient, why complex chronic illness often doesn't fit into short medical appointments, and how lived experience helps her understand symptoms such as air hunger, profound fatigue, and brain fog. The episode also explores integrative medicine, nutrition, mitochondrial health, individualized treatment, and one of the hardest skills in chronic illness care: Knowing when a patient needs compassion and rest — and when they may need a gentle push beyond a plateau. This interview was recorded live at the ILADS conference, so you may hear some of the energy and background activity of the event throughout the conversation. A Doctor Who Didn't Recognize Her Own Lyme Disease Dr. Ridinger was already a trained and experienced physician when her own health began deteriorating. She describes experiencing cognitive problems so concerning that she feared early Alzheimer's disease. Yet Lyme disease wasn't on her radar. That changed when her employer encouraged her to attend a Lyme conference. Sitting in the audience and listening to the symptoms being discussed, Dr. Ridinger suddenly recognized herself in what she was hearing. She subsequently found an ILADS-associated physician who evaluated her and, because of the limitations and cost of testing at the time, treated her based substantially on her clinical presentation. Dr. Ridinger says she improved considerably after approximately nine months involving different antibiotic protocols. Her physician then told her about opportunities to mentor with doctors experienced in treating Lyme disease. She pursued that training and eventually began helping other patients facing the same kinds of problems she had experienced herself. Why Didn't Medical School Prepare Her for Lyme Disease? Rich asks an obvious question: How could a medical doctor fail to recognize Lyme disease in herself? Dr. Ridinger's answer is remarkably simple. She says Lyme disease was barely part of her medical education. During her Family Medicine residency in Columbus, Ohio, other emerging infectious diseases received considerable attention, but she recalls essentially no meaningful education about Lyme disease. Without that framework, her collection of symptoms didn't naturally lead her toward a Lyme diagnosis. Her experience illustrates a challenge frequently described by Tick Boot Camp guests: You can't easily recognize a pattern you've never been taught to look for. From Conventional Medicine to Integrative Medicine Lyme disease wasn't Dr. Ridinger's only reason for moving toward integrative medicine. Even before her own Lyme journey, questions surrounding her children's health had pushed her to look beyond conventional approaches. She describes struggling to reconcile symptoms and laboratory results and becoming frustrated when the medical system didn't provide satisfactory answers. That led her toward deeper study of nutrition, hormones, physiology, and eventually integrative medicine. Today, Premier Health and Holistic Medicine describes her approach as personalized care that considers the whole person rather than isolated symptoms. Her practice includes Lyme disease and co-infections, mold toxicity, chronic fatigue, fibromyalgia, hormone and thyroid disorders, digestive problems, autoimmune conditions, and cognitive and mood symptoms. Why Complex Chronic Illness Doesn't Fit Into a 15-Minute Visit One of the most interesting parts of the interview isn't specifically about Lyme disease. It's about the structure of modern medicine. Dr. Ridinger describes always wanting more time with patients. She didn't want to cut people off. She wanted to listen, investigate, research, and understand how seemingly disconnected problems might fit together. At one point, she viewed that as a weakness. She thought she was simply too slow. Eventually, she realized the opposite may have been true. For complex chronic illness, taking time can be a strength. Acute Care vs. Chronic Care The conversation makes an important distinction between acute medicine and complex chronic illness care. Conventional medicine can be extraordinary when someone needs emergency care, surgery, stabilization, or treatment for a clearly defined acute problem. But someone with years of multisystem symptoms presents a very different challenge. Dr. Ridinger describes how medical specialization and insurance-driven time constraints can fragment care. The cardiologist sees the heart. The neurologist sees the nervous system. The gastroenterologist sees the digestive tract. The psychiatrist sees mood and behavior. But who has enough time to ask how everything might connect? Dr. Ridinger argues that complex patients require a more integrated view. The Problem With Medical Silos Dr. Ridinger remembers an earlier period of medicine when primary-care doctors and specialists communicated more collaboratively about complicated cases. She believes increasing time pressure and changes in the insurance-driven medical model have contributed to greater specialization and fragmentation. That becomes particularly problematic when the illness doesn't remain inside one organ system. Lyme disease and other complex chronic illnesses may involve neurological, cardiovascular, gastrointestinal, immune, musculoskeletal, endocrine, and psychiatric symptoms. Treating each symptom as an unrelated problem can make it harder to see the larger pattern. For Dr. Ridinger, integrative medicine is partly about putting those pieces back together. What Changes When the Doctor Has Been the Patient? Dr. Ridinger's own Lyme disease experience gives her another kind of medical education: lived experience. She knows what certain difficult-to-describe symptoms actually feel like. That doesn't mean a doctor must personally have Lyme disease to become an excellent Lyme clinician. But Dr. Ridinger believes her own illness helps her recognize nuances that might otherwise be difficult to understand from a textbook. One example is air hunger. Understanding Air Hunger Air hunger is a symptom frequently discussed by people with Babesia and other complex illnesses. A patient may not walk into a doctor's office saying: "I have air hunger." Instead, they may say their breathing feels shallow or that suddenly they're unusually winded doing something that was easy days earlier. Because Dr. Ridinger experienced air hunger herself, she can sometimes recognize what a patient is trying to describe even when the patient doesn't have the vocabulary for it. She describes the strange experience of taking the same walk and being able to breathe normally one day, then becoming disproportionately winded another day despite no meaningful change in fitness. That lived experience helps her ask more precise follow-up questions. Lyme Fatigue Isn't Ordinary Tiredness The same distinction applies to fatigue. Someone without chronic illness may hear the word fatigue and think: "I'm tired too." Dr. Ridinger describes something very different. During severe illness, fatigue can reach the point where it feels physically difficult to make the body move. She contrasts that with the normal tiredness she may still experience today. The words may be the same. The experience isn't. That distinction can matter when a patient is trying to explain an invisible symptom to someone who has never experienced it. When Brain Fog Becomes Disorientation Dr. Ridinger also shares a frightening example of neurological dysfunction. She remembers being at a stop sign near a church she had attended for approximately 20 years and suddenly becoming disoriented: Where am I? Her children were with her. The experience frightened them. This was more than occasionally forgetting a word or walking into a room and forgetting why. It was significant cognitive dysfunction in a familiar environment. Experiences like these helped shape the physician she eventually became. Peel Back the Onion Dr. Ridinger describes complex Lyme disease care using a familiar metaphor: Peeling an onion. Not every problem can be addressed simultaneously. Treatment becomes a process of identifying layers, supporting the body, reassessing, and deciding what should come next. One practical tool she uses is asking patients: What are the top three symptoms you most want to improve? That question gives patients a voice in establishing priorities. It also helps turn an overwhelming list of symptoms into something more manageable. Progress can then be evaluated according to what matters most to that particular person. Nutrition Is Part of the Treatment Dr. Ridinger also places significant emphasis on nutrition. She says patients in her practice receive education about healthy eating, liver function, detoxification pathways, and ways of reducing toxic exposures. Her current practi

  3. 2d ago

    Why Some Lyme Patients Don’t Recover – Dr. Cory Tichauer | LIVE from ILADS

    LIVE from ILADS: Tick Boot Camp welcomes back Dr. Cory Tichauer, ND, owner and lead physician of Bear Creek Naturopathic Clinic in Medford, Oregon, and a member of the ILADS Board of Directors. After years of treating Lyme disease and other complex chronic illnesses, Dr. Tichauer has become increasingly interested in a particularly difficult group of patients: The people who do many of the "right" things but still don't fully recover. Dr. Tichauer describes them as his "20%." While he says the majority of his chronic Lyme patients can achieve substantial improvement through individualized combinations of conventional and integrative treatments, another group remains stuck despite working with knowledgeable practitioners and trying numerous therapies. Why? Dr. Tichauer believes some answers may lie at the intersection of persistent infection, immune dysfunction, chronic inflammation, mitochondrial dysfunction, and the cell danger response. The conversation also explores his research into a 12-week high-dose IV vitamin C protocol for Lyme disease, including the improvements he reports in quality-of-life measurements, Horowitz MSIDS scores, CD57 levels, and other immune markers. This interview was recorded live at the ILADS conference, so you may hear some of the energy and background activity of the event throughout the conversation. Who Are the "20%" of Lyme Patients Who Remain Sick? After more than 15 years focused on chronic Lyme disease, Dr. Tichauer says his attention has increasingly shifted toward patients who don't respond as expected. He describes a broad spectrum. Some patients respond well to relatively straightforward treatment. Others require additional therapies and considerably more detective work. But then there is a group that may improve somewhat yet never regain the level of function they hoped for. Those are the patients Dr. Tichauer can't stop thinking about. Some have already seen five, six, ten, or even twelve doctors — including experienced Lyme-literate clinicians — before reaching his practice. Rather than assuming everyone before him got it wrong, he asks: What are we missing? Lyme Treatment Is Rarely One Thing For the patients who do respond well, Dr. Tichauer describes drawing from a large therapeutic toolbox. Depending on the individual, his approach may include: Oral antibiotics IV antibiotics Off-label medications Herbal medicine Biofilm strategies Immune support Peptides Mitochondrial support Nervous-system approaches Other integrative therapies The challenge is that there are countless possible combinations. That makes complex Lyme disease less like following one treatment recipe and more like finding the appropriate combination for the individual patient. Dr. Tichauer says that approach has allowed him to help many patients substantially improve. But it doesn't explain everyone. When Doing More Isn't the Answer One of the strongest messages in this episode is especially important for people who have spent years cycling through increasingly aggressive treatments: More isn't automatically better. If a patient has already worked with knowledgeable doctors and repeatedly tried reasonable approaches without recovering, Dr. Tichauer says it would be arrogant to assume that simply doing the same thing harder will produce a different result. That realization has pushed him toward studying the underlying biology of his most difficult cases. Among the patterns capturing his attention are: Immune dysfunction Mitochondrial dysfunction MCAS Hypermobility Chronic inflammation Cellular dysfunction Persistent infection Cell danger response Instead of simply asking what else can kill a pathogen, he is increasingly asking what prevents the patient's system from returning to normal function. Persistent Infection vs. Persistent Immune Dysfunction Dr. Tichauer pushes back against treating persistent infection and post-infectious dysfunction as necessarily competing explanations. They may coexist. He discusses the possibility that some organisms may persist at levels below a threshold that produces direct tissue damage while the immune system remains activated. In other words, eliminating every last organism may not always be the only meaningful goal. The clinical objective may sometimes be achieving remission — reducing microbial activity while helping the immune system regain appropriate tolerance and regulation. Tick Boot Camp has explored the science and debate surrounding persistence in many conversations. Learn more on our Lyme disease persistence resource page. "Getting the Genie Back in the Bottle" The interview develops a useful metaphor. Rather than assuming the body must become completely sterile of every potentially problematic microorganism, Dr. Tichauer discusses restoring a healthy relationship between microbes and the immune system. Our bodies already coexist with enormous numbers of microorganisms. The immune system must constantly determine what requires attack, what can be tolerated, and where organisms can exist without creating disease. Dr. Tichauer describes the goal as getting the genie back in the bottle. The pathogen burden matters. But so does the immune response to it. Immune Tolerance & Chronic Inflammation Dr. Tichauer is particularly interested in immune tolerance. A healthy immune system needs enough activity to protect us from infection without remaining chronically activated when that response is no longer helpful. He discusses several interventions he uses or studies in the context of immune regulation, including: Low-dose naltrexone Vitamin D Herbal medicine Peptides Dr. Tichauer has lectured extensively on low-dose naltrexone and Lyme disease, including its potential role in modulating inflammatory pathways in chronic and post-treatment illness. The broader goal isn't simply stimulating or suppressing the immune system. It is helping restore appropriate immune regulation. Vitamin D Is More Complicated Than a Number on a Lab Report The discussion of immune function leads into vitamin D. Most patients are familiar with having 25-hydroxy vitamin D measured during routine bloodwork. Dr. Tichauer explains that vitamin D metabolism is more complicated than that single measurement. He discusses active and inactive forms of vitamin D and his interest in how infections may potentially interfere with vitamin D metabolism. He has become particularly interested in calcitriol, the active hormonal form of vitamin D, and discusses its potential influence on macrophages, immune polarization, and inflammatory signaling. These are advanced clinical concepts, and prescription calcitriol requires appropriate medical supervision because altering active vitamin D metabolism can carry significant risks. The Cell Danger Response Another concept connecting Dr. Tichauer's difficult cases is the cell danger response. In simplified terms, cells exposed to infection, toxins, oxidative stress, or other threats can shift their metabolism toward defense and survival. That response is useful when danger is acute. The problem may arise when the system fails to return to normal. Dr. Tichauer describes patients whose cells appear to remain metabolically impaired, with reduced energy production and mitochondrial dysfunction. For someone experiencing profound fatigue, cognitive dysfunction, exercise intolerance, and other persistent symptoms, this creates another possible piece of the puzzle beyond simply measuring whether an infection is present. Mitochondria & the Patients Who Stay Sick Mitochondria produce the energy required for cells to function. Dr. Tichauer sees mitochondrial dysfunction as one potential common denominator among some of his hardest-to-treat patients. This connects directly with the cellular-health conversations Tick Boot Camp had at ILADS with Dr. Melanie Stein and Dr. Vy Simeles. The question becomes: Even if microbial burden is reduced, can a patient fully recover if cellular energy production and immune regulation remain severely impaired? For Dr. Tichauer, helping restore mitochondrial and cellular function may be an important part of moving some patients from illness toward remission. Rethinking Antibiotic Treatment Dr. Tichauer still uses antibiotics. But his thinking about how to use them has evolved. Rather than relying exclusively on prolonged courses, he discusses circumstances in which he may use IV antibiotics more intensively for a shorter period, followed by pulsing, herbal therapies, mitochondrial repair, or other individualized strategies. He also mentions daptomycin in the context of approaches intended to address persister forms. His objective is not simply more antimicrobial treatment. It is finding a strategy that appropriately addresses infection while limiting unnecessary collateral effects and supporting the patient's overall physiology. High-Dose IV Vitamin C & Lyme Disease Research One of the most significant parts of this interview involves Dr. Tichauer's research into high-dose intravenous vitamin C in Lyme disease. At ILADS, he discusses a research project examining a protocol involving high-dose IV vitamin C. The study initially needed to establish safety and tolerability, but Dr. Tichauer says the research team was also able to collect exploratory clinical and laboratory measurements. The protocol involved: 12 weeks of treatment, 24 infusions, and 75 grams of IV vitamin C per treatment. The protocol also incorporated DMSO and calcium EDTA. Dr. Tichauer explains the rationale for these additions in terms of tissue penetration and biofilm-related strategies. Why Add DMSO & EDTA? Dr. Tichauer discusses DMSO as a compound used in the protocol with the intention of increasing membrane permeability and potentially helping vitamin C reach tissues where Borrelia may be difficult to target. He also describes adding calcium EDTA based partly on earlier laboratory

  4. 3d ago

    Lyme, Extreme Sensitivities & Cell Membrane Repair – Dr. Vy Simeles | LIVE from ILADS

    LIVE from ILADS: Tick Boot Camp sits down with Dr. Vy Simeles, ND, LAc of Restorative Health Clinic to explore one of the most difficult situations in chronic Lyme disease care: What do you do when a patient becomes so sensitive that nearly everything intended to help seems to make them feel worse? Dr. Simeles works with complex chronic illness patients, including people experiencing Lyme disease, mold illness, MCAS, nervous-system dysregulation, mitochondrial dysfunction, and significant environmental or treatment sensitivities. In this short-form conference interview, she explains why her practice has been increasingly focused on cell membrane therapy and lipid replacement therapy as a foundational strategy for highly sensitive patients. The conversation explores phospholipids, omega-3s, plasmalogens, mitochondria, ATP production, the cell danger response, neuroinflammation, diet, SOT, and the relationship between cellular health and a patient's ability to tolerate treatment. This interview was recorded live at the ILADS conference, so you may hear some of the energy and background activity of the event throughout the conversation. When Lyme Patients React to Everything Dr. Simeles describes a particularly challenging group of patients arriving at her practice. They are very sick, highly sensitive, and may react negatively to interventions that would ordinarily be considered relatively gentle. She describes patients experiencing symptoms including: Severe brain fog Numbness and tingling Short-term memory problems Anxiety Depression Irritability Aggression Neuropsychiatric symptoms Extreme sensitivity to supplements Difficulty tolerating treatment Some even report feeling worse after taking supplements typically used for calming support, including L-theanine or holy basil. When that happens, Dr. Simeles asks a different question: Why is the body interpreting so many inputs as threats? Cell Danger Response, MCAS & Nervous-System Dysregulation There may not be one answer. Dr. Simeles emphasizes that these are complex chronic illness patients, so multiple factors may be interacting. She discusses possible contributors including: Mold and other toxic exposures Oxidative stress Mast cell activation Nervous-system dysregulation Chronic infections Cellular dysfunction What is often described as the cell danger response Within this framework, a chronically stressed body can become increasingly defensive and reactive. Interventions that should ordinarily be tolerated may suddenly produce unexpected responses. Even nervous-system programs such as DNRS, Gupta, or Primal Trust may initially feel overwhelming to someone who is severely ill, cognitively impaired, or highly reactive. That doesn't necessarily mean those tools will never be useful. It may mean the patient first needs a more tolerable entry point. For more on this aspect of recovery, listen to Tick Boot Camp's conversation about Primal Trust with Cathleen King. Looking at the Cell Membrane Dr. Simeles and Dr. Melanie Stein traveled to Atlanta for additional training in lipid replacement therapy and cell membrane therapy, building on approaches they were already using at Restorative Health Clinic. That training helped deepen their focus on a foundational question: Can the patient's cells properly receive, process, and communicate information? Cell membranes aren't simply walls surrounding cells. They are dynamic structures involved in signaling, transport, immune function, energy production, and communication. Dr. Simeles' clinical model asks whether damage or changes to these membranes could be contributing to some patients remaining stuck despite extensive antimicrobial and supportive treatment. The Cell Membrane as the Foundation The previous Tick Boot Camp conversation with Dr. Stein used a simple metaphor: Imagine the cell is a castle and the membrane surrounding it is the moat. The moat helps regulate what gets in and out while supporting the communication necessary to recognize and respond to threats. Dr. Simeles expands on that concept. If the cellular environment is dysfunctional, the problem may extend beyond the presence of an infection. The immune system itself is made of cells. Mitochondria contain membranes. Proteins involved in energy production and cellular communication are embedded in or associated with membranes. From Dr. Simeles' perspective, improving membrane health may therefore help create a better foundation for the body's other systems to function. Why Treating the Infection May Not Be Enough Dr. Simeles makes an important distinction: Antimicrobial therapy and cellular repair are doing different jobs. Her practice still uses antimicrobial therapies when clinically appropriate. But she describes seeing patients whose testing improves after infection-directed treatment while symptoms such as fatigue and brain fog remain. In her clinical experience, integrating cell membrane support earlier — rather than waiting until antimicrobial treatment is finished — may help some patients better tolerate treatment while simultaneously addressing aspects of their lingering symptoms. The philosophy is not necessarily: Antimicrobials or cellular repair. It can be: Antimicrobials plus rebuilding the patient's underlying physiology when appropriate. Phospholipids & Cellular Communication A central concept throughout this conversation is phospholipids. Phospholipids are major structural components of cellular membranes. Dr. Simeles explains that oxidative stress associated with chronic infections, toxins, inflammation, and other physiological stressors may affect membrane lipids. Within her model, restoring appropriate lipids can help support membrane structure and the cellular processes that depend upon it. This becomes particularly important when discussing the immune system and mitochondria because their functions also depend on healthy cellular structures. DHA, Omega-3s & the Brain Dr. Simeles discusses omega-3 fatty acids, particularly DHA, in the context of neurological and neuropsychiatric symptoms. She distinguishes DHA from EPA, noting that both are common components of fish oil but have different physiological roles. Because DHA is an important structural lipid in the brain and nervous system, Dr. Simeles describes using DHA-focused omega-3 strategies with some of her highly sensitive neurological patients. She also discusses carefully titrating treatment for people who react easily, including beginning with very small amounts and increasing based on tolerance. Importantly, she cautions that high-dose fish oil can affect blood clotting and may increase bleeding risk in some people. This is one reason high-dose supplementation should be individualized and discussed with an appropriately qualified healthcare professional rather than copied directly from another patient's protocol. Plasmalogens & Neurological Health Another major topic is plasmalogens, specialized lipids found in cellular membranes and present in significant concentrations within nervous-system tissues. Dr. Simeles discusses using a specialized omega-9 plasmalogen product with some patients experiencing difficult neurological or neuropsychiatric symptoms. Her interest is rooted in the role membrane lipids play in neural structure and cellular communication. The product discussed in the interview, ProdromeGlia, is marketed as an omega-9 plasmalogen precursor intended to support glial cell membranes, myelin structure, and normal cellular membrane composition. Dr. Simeles describes this as one tool within a broader cell membrane strategy — not as a standalone Lyme disease treatment. Mitochondria: The Powerhouse Still Matters Most people remember one thing from biology class: The mitochondria are the powerhouse of the cell. Dr. Simeles explains what that actually means. Mitochondria produce ATP, the energy currency cells need to perform their functions. When mitochondrial function becomes impaired, the consequences can potentially be felt throughout high-energy systems of the body. Dr. Simeles connects mitochondrial dysfunction with symptoms she frequently sees in complex chronic illness, including: Fatigue Brain fog Memory difficulties Muscle weakness Neurological symptoms Reduced stamina The brain is particularly energy-demanding, which helps explain why mitochondrial health is often part of conversations about neurological and cognitive symptoms. Why Membranes Matter to Mitochondria The cellular-health discussion gets even more interesting when Dr. Simeles connects cell membranes with mitochondria. Mitochondria have their own specialized membranes, and their structure is essential to the biochemical processes involved in producing ATP. Within Dr. Simeles' framework, membrane dysfunction can therefore influence mitochondrial function. This creates a possible chain: Cellular stress → membrane dysfunction → impaired mitochondrial function → reduced energy production → symptoms such as fatigue and brain fog. That simplified model helps patients understand why her practice is interested in repairing cellular structures rather than exclusively targeting microbes. Are Low-Fat Diets a Problem? The conversation then moves from supplements and therapies to something much more fundamental: Food. Dr. Simeles doesn't recommend a single rigid diet for every patient. She does, however, push back against diets that unnecessarily eliminate healthy fats. Some fatty acids are considered essential because the body cannot adequately produce them on its own. Omega-3 fatty acids are one example. She therefore emphasizes obtaining adequate healthy fats through food while recognizing that individual dietary needs and tolerances vary. Foods discussed in the conversation include: Fish and omega-3 sources Eggs Egg yolks as a source of phosphatidylcholine Plant-based fat sources Red meat in moderation The

  5. 4d ago

    From Brother and Advocate to Lyme Doctor: Dr. James Bruzzese, MD

    When Julia Bruzzese became seriously ill and lost the ability to walk, her brother James was beginning his medical education. Rather than allowing his family’s experience to drive him away from medicine, it gave him a new purpose: to become the kind of doctor his sister and other complex Lyme disease patients desperately needed. In this deeply personal Tick Boot Camp Podcast episode, special guest co-host Nicole O'Donnell, co-hosts Rich Johannesen and Matt Sabatello welcome Dr. James Bruzzese, MD, founder of Bruzzese Medical. They are joined by returning guest and Lyme advocate Nicole O’Donnell, who brings her perspective as a patient, mother, and member of a family affected by tick-borne illness. Julia’s story reached people around the world in 2015, when Pope Francis approached and blessed her on the tarmac at JFK Airport. She later appeared in the Lyme disease documentary The Quiet Epidemic. Behind the public moments was a close-knit family navigating medical uncertainty, debilitating illness, insurance barriers, and the painful experience of watching Julia’s symptoms be misunderstood. James was present through it all. He attended appointments, accompanied Julia to hospitals, studied medical research, and advocated for her care. Those experiences shaped how he now listens to patients, evaluates complex symptom patterns, and approaches Lyme and tick-borne disease. When Lyme Disease Becomes Personal Dr. Bruzzese explains that he had already entered an accelerated medical program before Julia became critically ill. At the time, he was still questioning whether medicine was truly his calling. Watching his sister become paralyzed, lose her independence, and struggle to obtain answers removed that uncertainty. He describes how helplessness and anger became motivation to study Lyme disease, challenge incomplete assumptions, and advocate for patients whose experiences were being dismissed. The conversation also explores the effects of chronic illness on the entire family. While one person carries the physical burden of disease, parents and siblings may become caregivers, researchers, advocates, and witnesses to tremendous suffering. Why Doctors May Miss Lyme Disease Dr. Bruzzese offers an inside look at how Lyme disease is addressed during conventional medical training. He recalls receiving approximately two hours of Lyme education and being taught to consider other explanations before Lyme disease when evaluating symptoms such as a swollen joint. He argues that medical education relies heavily on pattern recognition. That can help physicians work efficiently, but it becomes dangerous when doctors were never taught to recognize the shifting, multisystem patterns that can accompany Lyme and other tick-borne infections. The result may be a patient whose fatigue, pain, neurological symptoms, dysautonomia, cognitive difficulties, or migrating symptoms are divided among specialists without anyone examining the complete clinical picture. Medical Gaslighting, Bias, and the Patient Experience Nicole O’Donnell shares what it felt like to remain sick while doctors and family members questioned whether Lyme disease explained her symptoms. The group considers whether clinicians deliberately gaslight patients or whether inadequate education, institutional pressure, limited appointment time, and rigid diagnostic frameworks produce an experience that feels like gaslighting. Dr. Bruzzese discusses how patients, particularly women with complex combinations of pain, fatigue, dysautonomia, neurological symptoms, or autoimmune diagnoses, can become labeled as difficult before their complete histories are investigated. Whatever the intent, the consequences are real. Patients may feel disbelieved, families may begin questioning them, and necessary evaluation or treatment may be delayed. Building a Different Model of Lyme Care Dr. Bruzzese describes his vision for Bruzzese Medical, a virtual practice focused on Lyme disease, tick-borne infections, and complex chronic presentations. His goal is to provide individualized, patient-centered care that considers: Lyme disease and common tick-borne co-infections Multisystem and neurological symptoms Mold exposure and heavy-metal toxicity Immune, inflammatory, hormonal, and nutritional contributors Medication and supplement interactions Chronic and neuropathic pain Dysautonomia and peripheral neuropathy Quality of life during longer-term treatment Rather than applying the same protocol to every person, Dr. Bruzzese emphasizes listening to the patient’s full story, studying how symptoms developed over time, and adjusting care according to individual response. He also discusses the value of coordinated treatment planning. His family once had to determine how to organize and separate the more than 80 pills Julia was taking each day. He believes patients experiencing brain fog, exhaustion, and neurological symptoms should not be left to navigate complicated medication and supplement schedules by themselves. Treating Pain While Addressing the Underlying Illness Pain management is an especially important part of Dr. Bruzzese’s vision. His anesthesia training and work as a pain medicine fellow give him a perspective that is not always incorporated into Lyme disease care. He explains that addressing an underlying infection and improving a patient’s immediate quality of life do not have to be competing priorities. Some people need relief from neuropathic pain, anxiety, sleep disruption, or other disabling symptoms while their medical team continues investigating and treating deeper contributors. The discussion includes neuromodulation, chronic pain signaling, neuropathy, and why every intervention must be selected for the individual rather than offered as universal advice. Expanding the Next Generation of Lyme-Literate Providers Dr. Bruzzese does not want his work to stop with the patients he can personally see. Bruzzese Medical uses a team-based model with nurse practitioners, allowing additional clinicians to learn how to care for people with Lyme and tick-borne illnesses while expanding appointment availability. His clinical perspective was influenced by extensive exposure to Lyme patients and training with physicians including Dr. Richard Horowitz and Dr. Somer DelSignore. His message to patients is simple but powerful: whether someone has experienced a recent tick bite or has remained sick after visiting numerous doctors, their story deserves to be heard and investigated. Key Topics Discussed How Julia Bruzzese’s illness affected James and his entire family Julia’s meeting and blessing from Pope Francis Her appearance in The Quiet Epidemic Why James pursued medicine and Lyme disease care Gaps in medical-school education about tick-borne disease The limitations of diagnosis through pattern recognition Why complex patients may feel dismissed or gaslit The effects of insurance and institutional pressures on care Clinical evaluation when testing does not provide a complete answer Lyme disease co-infections and environmental contributors Individualized treatment instead of blanket protocols Medication and supplement coordination Neuropathic pain and neuromodulation The role of anesthesia and pain medicine in chronic illness care Bruzzese Medical’s team-based virtual practice Training more healthcare professionals to serve the Lyme community Why patients need validation, communication, and continued hope Work With Dr. James Bruzzese Bruzzese Medical currently offers virtual appointments when appropriate and permitted by state regulations. The practice is private-pay and does not accept insurance for appointments. Patients can learn more, request an appointment, and access the practice’s booking portal through the Bruzzese Medical website. Additional Resources Find Lyme-literate doctors featured by Tick Boot Camp Learn about Lyme disease testing Explore the Tick Boot Camp Podcast Watch The Quiet Epidemic

  6. 5d ago

    Cellular Repair for Chronic Lyme Disease – Dr. Melanie Stein | LIVE from ILADS

    LIVE from ILADS: Tick Boot Camp welcomes back Dr. Melanie Stein, ND for an update on her approach to chronic Lyme disease and complex illness — and the release of her book, Breaking Through Chronic Illness: The Science of Cellular Repair and the Path to Lasting Recovery. Why do some people continue struggling after months or even years of Lyme disease treatment? Dr. Stein believes part of the answer may be found at the cellular level. In this short-form conference conversation, she explains her clinical model of repairing cell membranes, supporting mitochondrial function, reducing inflammation, calming an overactive nervous and immune system, and rebuilding the foundations of health so the body may be better prepared for treatment and recovery. Rather than waiting until the end of Lyme treatment to focus on repair, Dr. Stein makes a different argument: Repair may need to begin at the beginning. This interview was recorded live at the ILADS conference, so you may hear some of the energy and background activity of the event throughout the conversation. Why Can Lyme Recovery Stall? Dr. Stein begins with a familiar problem in the Lyme community. A patient is diagnosed with an infection. Treatment begins. Yet months or years later, that person may still experience fatigue, brain fog, neurological symptoms, immune dysfunction, or other persistent problems. Dr. Stein's clinical model asks whether focusing primarily on killing or reducing pathogens overlooks another important part of recovery: What condition is the body in while we're treating the infection? She discusses oxidative stress, mitochondrial dysfunction, impaired cellular communication, inflammation, and damage to cell membranes as factors she believes can help keep chronically ill patients stuck. Her book, Breaking Through Chronic Illness, expands on this idea by focusing on cellular repair as part of the recovery process. Treat the Body, Not Just the Bug This conversation connects directly with a recurring Tick Boot Camp observation. People who recover from complex Lyme disease often appear to need more than an antimicrobial strategy. Tick Boot Camp discusses its PARM framework: Prehabilitation Assist Repair Maintenance Dr. Stein agrees with the importance of repair but proposes an important modification: Don't wait until the repair phase to start repairing. She argues that improving the body's cellular environment earlier may help prepare patients for subsequent interventions and make treatment more tolerable or effective. It's a shift from asking only, "How do we kill the pathogen?" Instead, the question becomes: "How do we help the body become healthier while we're addressing the pathogen?" What Happens to Cells During Chronic Illness? Dr. Stein describes cell membranes as essential structures that help regulate what enters and leaves a cell and facilitate communication between cells. She discusses phosphatidylcholine and other lipids as important components of those membranes. Within her model, oxidative stress associated with infection can damage these fats and disrupt membrane function, cellular communication, mitochondrial function, and immune signaling. The science can become complicated quickly, so the conversation develops a much simpler metaphor. The Castle & Moat Metaphor Imagine the cell is a castle. Surrounding that castle is a moat — the cell membrane. The moat helps determine what enters and leaves while also participating in the castle's communication and defenses. Dr. Stein explains that when the membrane becomes damaged, the system may no longer operate normally. The drawbridge doesn't work properly. Communication systems can become impaired. Defenses may become less effective. The goal of cellular repair, in her framework, is to restore that protective environment so cellular communication and function can improve. It's an intentionally simple analogy for a complicated biological concept, but it helps explain why Dr. Stein places so much emphasis on cell membrane health. Phosphatidylcholine & Cell Membrane Support One intervention discussed in the episode is phosphatidylcholine. Dr. Stein describes phosphatidylcholine as an important fatty component of cell membranes and discusses replenishing healthy lipids as part of her approach to cellular repair. She also discusses butyrate, a short-chain fatty acid naturally produced by gut bacteria, within her broader cellular-health protocols. These therapies aren't presented here as universal Lyme disease treatments. They are components of Dr. Stein's clinical approach to patients with complex chronic illness and should be considered with an appropriately trained healthcare professional based on an individual's medical needs. ILADS has also featured Dr. Stein teaching on lipid replacement therapy and cellular restoration in tick-borne disease. (pathlms.com) Calm the Body Before Pushing Treatment Before getting into advanced cellular therapies, however, Dr. Stein emphasizes something more fundamental: Help the body feel safe again. Many chronically ill patients describe feeling stuck in a state of hypervigilance or fight-or-flight. Dr. Stein discusses several tools she uses clinically to address that state, including: Nervous-system regulation Limbic-system retraining Mast-cell support Anti-inflammatory strategies Sleep Breathing exercises Gentle foundational interventions She references programs including DNRS, Gupta, and Primal Trust while acknowledging an important reality: some severely ill patients may initially be too symptomatic or overwhelmed to participate in an intensive brain-retraining program. The approach therefore needs to meet the patient where they are. For more Tick Boot Camp conversations on nervous-system regulation, explore Primal Trust with Cathleen King. Sleep & Digestion Come First For all the sophisticated science discussed in the interview, Dr. Stein's first priorities for a new patient are surprisingly basic. Sleep and bowel function. She emphasizes sleep because the body needs restorative time to regulate, integrate, and recover. If someone isn't sleeping adequately, she argues that adding increasingly complicated interventions may accomplish little because the body isn't operating in an environment conducive to healing. Dr. Stein also discusses evaluating patients for sleep disorders rather than assuming insomnia is simply another unavoidable symptom of Lyme disease. That can include investigating: Sleep apnea REM sleep disorders Circadian disruption Cortisol dysregulation Poor sleep hygiene She notes that sleep apnea isn't limited to people who fit the stereotype of an older or overweight patient and says she refers patients for sleep studies when appropriate. Practical Strategies for Better Sleep Dr. Stein discusses several approaches she may use or recommend depending on the patient, including: Consistent sleep routines Reducing television and screens before bed Creating a dark sleeping environment Sleep masks Breathing exercises Meditation Gradually shifting a delayed sleep schedule Evaluating possible sleep disorders She also discusses L-theanine, GABA, magnesium, and low-dose melatonin within her clinical practice. The larger message is more important than any individual intervention: Don't overlook the foundations while pursuing advanced Lyme treatment. Nutrition as Cellular Medicine Food provides the raw materials cells need to function. Dr. Stein emphasizes nutrient-dense foods and healthy fats as part of her cellular-repair philosophy. She personally favors a lower-carbohydrate, ketogenic-style approach for many patients — not necessarily with the goal of maintaining nutritional ketosis, but as a way of emphasizing healthy fats alongside organic vegetables and nutrient-dense foods. Diet, however, should be individualized. The important principle in this conversation is that sophisticated therapies cannot replace the basic nutrients required for normal biochemical processes. As Dr. Stein explains later in the episode, everyday choices influence biochemistry. Movement Doesn't Have to Mean Exercise For someone severely ill with Lyme disease, the word exercise can be intimidating — and in some situations inappropriate. Dr. Stein instead talks about movement at the level a patient's body can currently tolerate. That could mean something as simple as moving the legs while lying in bed. Her goal is to gradually support circulation, oxygenation, mitochondrial activity, and energy production without demanding more from the body than it can currently handle. Recovery doesn't have to begin with a workout. It can begin with the smallest movement the body safely permits. Mitochondria & Energy Production Mitochondria produce ATP, the energy cells use to perform their functions. Dr. Stein connects mitochondrial dysfunction with common chronic illness complaints such as fatigue, poor stamina, cognitive dysfunction, and difficulty recovering from stress. But mitochondrial support can't exist in isolation. If a patient remains chronically stressed, poorly nourished, sleep-deprived, or otherwise physiologically dysregulated, Dr. Stein argues that even sophisticated mitochondrial interventions may have difficulty producing durable improvement. That brings the conversation back to the foundations: Sleep. Nutrition. Movement. Nervous-system regulation. Cellular support. The advanced protocols are built on top of those fundamentals — not instead of them. Cellular Repair Before, During & After Lyme Treatment One of the biggest takeaways from this interview is that healing doesn't necessarily have to follow a rigid sequence. The traditional mental model might look like: Kill the infection → repair the damage → rehabilitate the patient. Dr. Stein proposes something more integrated. Support the patient before antimicrobial treatment. Continue supporting cellular health during

  7. 6d ago

    Pediatric Lyme, Autism & Neuroimmune Dysfunction – Dr. Somer DelSignore | LIVE from ILADS

    LIVE from ILADS: Tick Boot Camp sits down with Dr. Somer DelSignore, DNP, BC-PNP, founder of Hudson Valley Integrative Health in Beacon, New York, for a wide-ranging conversation about pediatric Lyme disease, congenital tick-borne infections, autism spectrum symptoms, PANS/PANDAS, autoimmune encephalopathy, developmental delays, behavioral changes, and the importance of investigating potential biological contributors to neuroimmune dysfunction. Dr. DelSignore practices integrative pediatrics with a focus on children experiencing complex chronic illness and neuroimmune symptoms. Rather than stopping at a behavioral or developmental diagnosis, she describes a root-cause approach that asks a deeper question: What biological processes could be contributing to this child's symptoms? The conversation explores some challenging and evolving areas of medicine, including possible relationships among infections, inflammation, immune dysfunction, neurological development, and behavioral symptoms. Dr. DelSignore shares observations from her clinical practice and argues for more comprehensive biomedical evaluation of children with complex or atypical presentations. This interview was recorded live at the ILADS conference, so you may hear some of the energy and background activity of the event throughout the conversation. Looking Beyond a Pediatric Diagnosis Dr. DelSignore describes treating children who don't always fit neatly into one diagnostic category. Some arrive with: Autism spectrum diagnoses or symptoms Developmental delays Behavioral changes Cognitive difficulties Motor delays Speech and language delays PANS/PANDAS Autoimmune or neuroimmune symptoms Suspected congenital Lyme disease Other tick-borne infections A pattern she says sometimes catches parents' attention is an unexpected improvement when a child receives treatment for an unrelated infection. Parents may report that their child temporarily gains language, motor, behavioral, or other skills while taking an antibiotic, only to regress after treatment ends. For Dr. DelSignore, observations like these are clues that warrant further investigation rather than immediate conclusions. Root-Cause Medicine for Children Dr. DelSignore describes her work as a form of detective work. A diagnosis describes what clinicians are observing, but she wants to investigate why those symptoms are occurring. When a child presents with neurological, developmental, behavioral, or immune dysfunction, she evaluates possible contributors and works backward from the symptoms. That may involve extensive history-taking, laboratory evaluation, the child's medical history, environmental factors, immune function, infections, inflammation, genetics, and sometimes the parents' medical histories. Once potential contributors are identified, her goal is not only to address them but also to support the immune and neurological systems as the child progresses. Learn more about Dr. Somer DelSignore and Hudson Valley Integrative Health. Congenital Lyme & Tick-Borne Infections One of the most important subjects in this conversation is congenital or maternal-fetal transmission of tick-borne infections. Dr. DelSignore discusses evaluating both children and their parents when the child's presentation suggests that infection or immune dysfunction could have begun during pregnancy or early development. She specifically discusses Borrelia, Bartonella, and Babesia — the pathogens Tick Boot Camp often refers to as the Three B's — in the context of her clinical work. Dr. DelSignore also discusses another possibility: even when direct transmission isn't established in an individual case, maternal infection and inflammation during pregnancy could potentially influence fetal immune or neurological development. These are complex and evolving areas of research, and determining what occurred in an individual child requires careful clinical evaluation rather than assuming that every developmental or neuroimmune condition has an infectious cause. Why Family History Matters With very young patients, Dr. DelSignore says the parents' history can become especially important. She asks mothers questions such as: Were you exposed to ticks? Did you experience unexplained symptoms before or during pregnancy? Did you have unusual illnesses earlier in life? Did you struggle with immune dysfunction? Do you have autoimmune conditions? Were there infections or inflammatory problems during pregnancy? For an infant who cannot describe symptoms, family history may provide clues that aren't available from the child alone. Dr. DelSignore combines that history with clinical presentation and diagnostic testing when deciding what warrants further investigation. What Might Lyme Disease Look Like in a Young Child? Young children present a unique diagnostic challenge. They cannot necessarily explain that they are exhausted, experiencing pain, having temperature changes, or feeling neurologically different. Dr. DelSignore describes seeing infants with findings such as hypotonia — unusually low muscle tone — along with feeding and sleeping difficulties that extend beyond what would ordinarily be expected. As children grow, additional clues may emerge. Clinicians and parents can begin evaluating whether a child is: Sitting appropriately Crawling Developing speech Gaining words Building sentences Developing motor skills Interacting socially Meeting expected developmental milestones Dr. DelSignore emphasizes that none of these signs by themselves diagnose Lyme disease or another tick-borne infection. Instead, they may be reasons to investigate further when considered alongside medical history, exposures, physical findings, and other symptoms. Behavioral Symptoms in Toddlers & Children In toddlers and older children with tick-borne illness, Dr. DelSignore says the presentation can become heavily neurological or behavioral. She discusses symptoms including: Irritability Impulsivity Poor sleep Delayed speech Social difficulties Auditory sensitivity Visual sensitivity Anxiety Depression OCD-like behaviors Rage Fatigue Sweating Temperature dysregulation The difficulty is obvious: many of these symptoms overlap with other pediatric neurological, developmental, psychiatric, and medical conditions. A nonverbal child also may not be able to report fatigue, pain, headaches, sensory changes, or other physical symptoms. That overlap is one reason Dr. DelSignore argues against trying to identify tick-borne illness from behavior alone. Autism, Lyme Disease & an Important Distinction A substantial portion of this conversation explores autism and possible biological contributors to autism-spectrum presentations. This requires an important distinction. Autism is not synonymous with Lyme disease, and an autism diagnosis by itself does not establish the presence of a tick-borne infection. Dr. DelSignore's position is that some children diagnosed with autism or presenting with autism-like symptoms may also have infections, inflammation, autoimmune processes, or other biomedical issues that deserve investigation. She describes autism as a syndrome diagnosed from patterns of behavior and development rather than through a single definitive laboratory test. From her root-cause perspective, she therefore asks what potentially modifiable biological factors might coexist with or contribute to an individual child's presentation. This distinction is especially important because the scientific questions surrounding infection, immune activation, neurodevelopment, and autism remain complex and actively studied. Can Treating an Infection Change Developmental Symptoms? Dr. DelSignore shares clinical experiences in which she says children experienced substantial developmental and behavioral improvement after underlying infections and immune dysfunction were addressed. She discusses one case involving a nonverbal child with significant autism-spectrum symptoms whom she says tested positive for Borrelia, Bartonella, and Babesia in the context of suspected maternal transmission. Following treatment, she reports that the child progressed dramatically and was functioning much more typically by school age. This is a clinical case described by Dr. DelSignore, not evidence that tick-borne infections explain autism broadly or that antimicrobial treatment is an established autism treatment. What it illustrates is the central argument she makes throughout this episode: When a child's presentation is unusual or complex, clinicians should remain curious about potentially treatable medical contributors. The Neuroimmune Connection Dr. DelSignore encourages clinicians to think about some pediatric presentations through a neuroimmune lens. The nervous system and immune system don't operate independently. Infection can trigger immune activity and inflammation, and immune dysfunction can have neurological consequences. Dr. DelSignore discusses evaluating children for both infections and evidence of autoimmune activity when clinically appropriate. Rather than attempting to draw a clean line between a behavioral diagnosis and an infectious diagnosis, she looks at the entire clinical picture and asks what combination of processes could be affecting that individual child. PANS/PANDAS & Autoimmune Encephalopathy This same framework is relevant to Dr. DelSignore's work with PANS, PANDAS, and autoimmune encephalopathy. Children with these conditions can experience dramatic neuropsychiatric or behavioral changes associated with immune activation. Dr. DelSignore's clinical focus includes identifying possible infectious and inflammatory triggers and then addressing both the trigger and the downstream immune or neurological dysfunction. Her work therefore overlaps infectious disease, immunology, neurology, psychiatry, and developmental pediatrics rather than remaining confined to a single specialty. ILADS identifies Dr. DelSignore's a

  8. Sep 30

    From Lyme Patient to Practitioner: Compassion, Healing & Hope – Mindy Daigle | LIVE from ILADS

    LIVE from ILADS: Tick Boot Camp sits down with Mindy Tobin Daigle, MSN, APRN-BC, a nurse practitioner whose approach to Lyme disease and complex chronic illness was profoundly shaped by her own experience as a patient. Before treating people with Lyme disease, Mindy lived it. After years of misdiagnosis, she was diagnosed with Lyme disease in 2010 following earlier tick exposures. Her illness became multisystemic and severe, affecting her heart, brain, joints, gastrointestinal system, bladder, skin, muscles, and more. At her sickest, she describes being bed-bound, wheelchair-bound, experiencing seizures and aphasia, and dependent on others for basic care. That experience gave her a mission: become the healthcare provider she needed when she was sick and searching for answers. This conversation goes far beyond Lyme disease treatment. Mindy and Tick Boot Camp explore medical gaslighting, listening to patients, compassion versus empathy, realistic expectations for chronic illness recovery, the importance of self-compassion, finding your physical and emotional "edges," and why progress is often measured in inches rather than feet. This interview was recorded live at the ILADS conference, so you may hear some of the energy and background activity of the event throughout the conversation. A Nurse Practitioner Who Became the Patient Mindy was already a trained medical professional when she became seriously ill. Her first reported tick bite occurred in South Africa in 1997, followed by additional exposures while she was working as a nurse in Minnesota and Wisconsin. Despite her medical training and access to healthcare, Lyme disease wasn't initially identified as the explanation for her growing collection of symptoms. Mindy describes repeatedly mentioning her history of tick bites only to have the possibility dismissed. Eventually, during a severe pain crisis, physician Dr. Ted Gillespie spent significant time listening to her history and asked a simple question: What about Lyme disease? Testing through Labcorp produced a positive Western blot, but Mindy says that even with that result, she continued encountering resistance to the diagnosis. Eventually, she found her way to Dr. Patricia Salvato in Houston and began treatment. Becoming the Practitioner She Needed Mindy made herself a promise during her illness: If she recovered, she would become the practitioner she had needed when she was lost and sick. That commitment eventually brought her to ILADS. At her first ILADS conference in 2013, Mindy heard the late Dr. Christine Green speak. The following week, she cold-called Dr. Green's office in San Francisco and asked if she could shadow her. That decision turned into a professional relationship lasting more than a decade. Mindy says her personal development as a Lyme patient became inseparable from her professional development as a clinician. From Sympathy to Empathy to Compassion One of the most powerful themes in this conversation is the evolution from sympathy to empathy to compassion. Mindy describes having sympathy as a young nurse and developing greater empathy with experience. After becoming seriously ill herself, she says she developed something deeper: compassion. Her definition of compassion centers on being willing to sit with another person's pain without judgment, interference, or adding to their suffering. For a Lyme patient who has spent years being dismissed, questioned, rushed, or told symptoms are unexplained, simply encountering a practitioner who genuinely listens can be meaningful. What Compassionate Lyme Care Looks Like Compassion isn't simply being nice to patients. For Mindy, it changes how she practices. When a patient arrives overwhelmed, crying, angry, frustrated, struggling with technology, or simply exhausted from managing chronic illness, her first goal isn't to rush through a checklist. She meets the patient where they are. She tells patients: We're not in a rush. The goal is to take the time needed to understand the person in front of her and determine what needs attention. That approach can be particularly important for patients with complex chronic illnesses who may arrive at an appointment carrying years of symptoms, medical records, failed treatments, fear, and frustration. Medical Gaslighting & the Importance of Listening Mindy also discusses the medical dismissal she experienced during her own illness and what patients often describe as medical gaslighting. The conversation explores why healthcare professionals may dismiss patient experiences even when a patient presents with a complicated history or evidence that warrants further investigation. Mindy emphasizes something deceptively simple: Remain curious. A practitioner doesn't have to immediately know every answer. But when something doesn't make sense, curiosity can keep the diagnostic process moving instead of shutting the patient down. For Mindy, listening and believing that a patient is genuinely experiencing what they describe are foundational to the therapeutic relationship. The Last Five Minutes Mindy has developed a practice she calls The Last 5 Minutes: 8 Concepts and Contemplations in Healing. After spending most of an appointment discussing symptoms, medical decision-making, treatment, and care planning, she reserves the final minutes for something different: Healing. It's a moment to put the metaphorical pencils down and talk heart-to-heart about what the patient is experiencing beyond laboratory results and treatment protocols. Her eight concepts and contemplations include: Keyhole Sunset Progress is made in inches, not feet Awareness, Acceptance, Compassion Pain is Information This is your Hero's Journey Healing is possible, with or without a cure Find a micron of joy and build on it Do what you need to do, rest when you need to rest, force nothing Mindy's original essay on the eight concepts offers a deeper exploration of the philosophy she discusses during this interview. Progress Is Made in Inches, Not Feet People with chronic Lyme disease are understandably in a hurry. They want their health back. They want their careers, relationships, independence, energy, and lives back. But recovery doesn't always move at the speed a patient wants. Mindy prepares patients for the possibility of a long process in which progress isn't perfectly linear. There can be improvements followed by setbacks. Instead of interpreting every setback as failure, she encourages patients to recognize that regression can sometimes occur within a larger pattern of progression. Mindy expands on this philosophy in Progress Comes in Inches, Not Feet. Self-Compassion During Lyme Recovery Chronic illness can create a destructive cycle of self-blame. Patients may think: Why aren't I better yet? Did I do something wrong? Why can't my body handle this? Why can't I do what I used to do? Mindy explains that even an excellent medical treatment plan doesn't automatically resolve the patient's relationship with themselves. Healing may also require learning to stop being at war with your own body. That doesn't mean giving up on improvement. It means learning how to pursue improvement without constantly punishing yourself for where you are today. Her writing on self-compassion and healing explores this balance between accepting present limitations and continuing to move forward. Finding Your Edges One of Mindy's most useful metaphors is finding your edges. After extensive treatment, she reached a point where she could no longer tolerate additional treatment in the same way. She learned to recognize the boundaries of what her body could currently handle. Rather than treating those boundaries as permanent walls, she describes living as well as possible within her edges — and periodically testing whether those edges can expand. If you can stand and wash dishes for five minutes, perhaps eventually you try seven. Small improvements matter. Progress in inches can eventually create meaningful change. Sometimes Progress Means Rest Pushing isn't always the answer. Sometimes the next productive step is doing less. Mindy distinguishes genuine restorative rest from simply lying down while remaining mentally stimulated by television, phones, scrolling, or other distractions. The challenge is learning when to push an edge and when the body genuinely needs recovery. That requires awareness, patience, and wisdom. For a practitioner, it also means understanding that two patients with similar diagnoses may need very different guidance at a particular moment. A Biopsychosocial Approach to Lyme Disease Mindy describes her clinical approach as biopsychosocial. That means considering the patient's: Biology Psychology Social environment Physical limitations Emotional health Relationships Stressors Daily circumstances Complex chronic illness doesn't occur in isolation from the rest of a person's life. Treatment may target infections and physical dysfunction, but healing can also involve how someone relates to their illness, themselves, and the world around them. Mindy's own experience as both patient and practitioner gives her a particularly personal perspective on those intersections. Can Having Lyme Disease Make Someone a Different Practitioner? The conversation explores a provocative question: Does personally experiencing Lyme disease change someone's ability to care for Lyme patients? Mindy says her own illness gave her an understanding she didn't have beforehand. She can recognize nuances between different kinds of fatigue, pain, and physical limitations because she has experienced them. At the same time, she points to her longtime mentor Dr. Christine Green as an example of an accomplished Lyme clinician who did not personally have Lyme disease. The distinction isn't that someone must have Lyme disease to become an excellent practitioner. Rather, lived experience can provide ano

See All (583)

5
out of 5
79 Ratings

About

Tick Boot Camp is a Lyme disease and tick-borne illness podcast featuring interviews with leading doctors, researchers, scientists, patients, advocates, and experts. Explore Lyme disease symptoms, testing, diagnosis, treatment, recovery, chronic Lyme disease, coinfections, PANS/PANDAS, MCAS, neurological symptoms, emerging research, and the latest advances in tick-borne disease care. Through expert education and powerful patient stories, Tick Boot Camp provides hope, validation, practical information, and a community for people navigating Lyme disease and complex chronic illness.

Information

  • Creator
    Matt Sabatello and Rich Johannesen
  • Years Active
    2018 - 2026
  • Episodes
    583
  • Rating
    Clean
  • Copyright
    © Copyright 2026
  • Show Website
    Tick Boot Camp

You Might Also Like