Sandy Salmon

The Iowa legislature has voted to let Iowa doctors prescribe more aggressive treatment for Lyme Disease than is currently allowed by the state’s Board of Medicine, but the state’s medical community opposes the move.

According to Representative Sandy Salmon of Janesville, the state Board of Medicine disciplined two doctors for prescribing antibiotics for more than 30 days as treatment for Lyme Disease.

“This has had the effect of quashing the willingness of Iowa medical providers to treat and even diagnose Lyme Disease,” Salmon said during House debate of the bill.

Senator Brad Zaun of Urbandale said legislators have been convinced by Lyme Disease patients that this move is necessary.

“Time and time again you can’t get treatment in the State of Iowa. They go to Missouri. They go to Minnesota. They go to different states. The people that have this disease, these doctors in Iowa just stay away,” Zaun said during Senate debate. “They’re just uncomfortable making that diagnosis.”

Left untreated, Lyme Disease can cause inflammation of the brain and problems with short-term memory. Three senators with personal experience urged their colleagues to act. Senator Mark Lofgren of Muscatine said his daughter went from doctor-to-doctor in Iowa and finally, last year, a Minnesota doctor diagnosed her with Lyme Disease.

“They figured out she’s probably had it more than five years and when you’ve had it that long, it’s very involved. She’s been through a lot of challenges with it,” Lofgren said. “…Unfortunately, by going all the way to Minnesota, it’s cost her a lot of money. Her insurance hasn’t covered a lot of it. She’s 26, so she doesn’t have a lot of money. She’s pretty much drained all of her savings. I support this bill. This will make it less challenging for others.”

Seventeen years ago, Senator Rita Hart of Wheatland was convinced her six-year-old son had Lyme Disease, but she could not convince an Iowa doctor that he had been sickened by a tick bite.

“We spent a month of hell going back and forth to doctors who kept telling us: ‘It’s just a virus,'” Hart said.

Hart said the boy ran a high temperature off and on for a couple of weeks, then as they were sitting in a doctor’s waiting room, her son broke out in large rashes that signaled “second stage” Lyme Disease.

“Usually that rash only happens with children and it doesn’t happen with every one, so we were so fortunate because as soon as the doctor saw the rash, he said: ‘Oh, yeah, that’s Lyme Disease,” Hart said. “…If he had not broken out with that rash in front of the doctor’s eyes, I don’t think we would have gotten the diagnosis.”

Senator Mark Chelgren of Ottumwa said several years ago he saw a red ring on his 11-year-old son’s back. The senator took his son to the doctor, it was diagnosed as Lyme Disease and the boy was quickly cured.

“We were lucky that I saw it when I saw him coming out of the shower,” Chelgren said. “…Many people in Iowa are not so lucky. This bill helps those individuals. Lyme Disease is a real problem and a real issue we can deal with today.”

The Iowa Medical Society and other groups representing physicians oppose the bill. The mainstream medical consensus is there’s no data indicating antibiotics should be prescribed long-term as treatment for Lyme Disease and no evidence Lyme Disease can become a chronic condition. However, the bill representing the opposing view won unanimous support in the Iowa House a week ago and the Senate yesterday.

Representative Salmon said action is needed because Iowa now ranks 17th among the 50 states for reported cases of Lyme Disease.

“This bill is about freedom of choice and access for Lyme patients and freedom for medical providers to work with their patients, to look at the options and provide them with the best treatment possible without fear of discipline,” Salmon said.

In 2010, lawmakers in Minnesota passed a moratorium on disciplinary action against doctors who aggressively treat Lyme Disease. The Iowa legislature’s bill now awaits review by Governor Branstad. It would still allow the Board of Medicine to review cases in which patients with Lyme Disease die or are seriously injured by treatment.