Lyme Disease

Description of Diagnosis- Lyme Disease, which is an inflammatory disease, is also known as

Lyme borreliosis. It is the most common vector-borne disease in the northern hemisphere
(Pearson, 2014.) The Virginia Department of Health defines vector-borne diseases as an illness
caused by an infectious microbe that is transmitted to people by blood-sucking insects or
arachnids; this most common of these are ticks.
Etiology- Bratton et al. explained that even though ticks are the transmitter for Lyme disease, the
original source of the bacteria is the white footed mouse. There has been cases of Lyme disease
in all 50 states, but the areas of denser reports are the Great Lakes and New England areas. In
both of these areas the deer tick is the transmitter of Lyme disease, and in the western states the
black legged tick is the main transmitter. When these ticks are in their early life stages, they feed
on the white footed mouse, and in their adult stages they feed on deer. The ticks usually transmit
the infection in 36 to 48 hours of feeding, but it can take a little as 24 hours for the disease to be
transmitted from tick to human.
Pathology- There is a higher chance for Lyme disease if you live in the New England or Great
Lakes regions (Bratton et al., 2008). Lyme disease of often divided into three stages. These
stages are early localized infection, Early Disseminated Infection, and Late Disseminated
Infection. In the first stage, about 75% of people infected develop a circular rash that expands
around the bite within 3 to 30 days. As the rash continues to expand, the center of the rash begins
to clear out giving it a bulls-eye look, this rash is called erythema migran. The second stage can
begin days to weeks after the initial tick bite. This is the stage where the infection spreads
throughout the body. Those who become infected may have many symptoms such as fatigue,
chills, fever, headache, swollen lymph nodes, muscle pain, and joint stiffness. Neurologic,
musculoskeletal, or cardiovascular symptoms and multiple erythema migrans lesions may also
develop. In this stage, individuals may present with facial muscle paralysis (Bells palsy),
peripheral neuropathy, meningitis with severe headaches and neck stiffness, and abnormal
heartbeat. Arthritis may begin with swelling, stiffness, and pain. The arthritis usually occurs in
large joints, most commonly in the knees. If the rashes go away without treatment, it usually
happens after 1 month. The third stage can begin weeks, months, or years after the initial
infection of those who did not seek medical attention in the early stages of infections or the
treatment did not completely eliminate the bacteria. Some untreated patients have chronic
neurologic complaints featuring motor and sensory nerve damage and brain inflammation.
During the late stages, the infected may develop neuropathy or encephalopathy which symptoms
may include shooting pains, numbness or tingling in the hands or feet, and problems with
concentration and short-term memory loss. There are also chronic symptoms such as rheumatoid
arthritis (RA); neurologic impairment with memory and cognitive loss, anxiety, and depression;
cardiac disease such as myocarditis and endocarditis causing palpitations, pain, bradycardia,
severe fatigue, and sleep disturbance (Meletis, Zabriskie, & Rountree, 2009).
Statistics- The CDC states that there are approximately 30,000 cases of Lyme disease in the
United States. In 2013 Lyme disease was the 5th most common Nationally Notified disease. Of
the 30,000 95% of the cases are from the following states: Connecticut, Delaware, Maine,

Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania,
Rhode Island, Vermont, Virginia, and Wisconsin. In 2013 Pennsylvania had the most confirmed
cases with 4,981, and Minnesota had 1,431. Lyme disease has been diagnosed more commonly
in males than females, and the most common age for males was 5-9 years old. The months that
Lyme disease was more prevalent was June and July. There has been more cases of Lyme disease
in whites than any other skin color.
Role of Occupational Therapy- Occupational therapy practitioners would not be able to do
anything to help heal the disease. However, a person affected with Lyme disease would attend
occupational therapy to help suppress the symptoms that come with the disease. In the middle
stages of Lyme disease, occupational therapy would be able to decrease the joint stiffness and
muscle pain by using range of motion, massage, and modalities. For the facial paralysis
occupational therapy could provide facial exercises and massages. Occupational therapy can help
with the memory loss my helping the client find techniques such as reminders to help them
remember what they have to get done. NDT techniques should be used for the motor nerve
damage. Group therapy could be provided for anxiety and depression to work on finding coping
skills for what the person is going through. Energy conservation and work simplification
techniques should be used to minimize fatigue. The client would be taught energy conservation
techniques like sitting on a shower chair while taking a shower, dress while sitting in a chair, and
use a cart to carry necessary items. Work simplification techniques like taking breaks when
beginning to feel tired, do tasks in order from hardest to easiest, and plan tasks ahead.

Works Cited
Bratton, R. L., M.D., Whiteside, J. W., M.D., Hovan, M. J., M.D., Engle, R. L., M.D., &
Edwards, F. D., M.D. (2008). Diagnosis and treatment of lyme disease. Mayo Clinic
Proceedings, 83(5), 566-71. Retrieved from
http://search.proquest.com/docview/216876601?accountid=40780
Lyme's Disease. (2013, December 6). In Centers for Disease Control and Prevention. Retrieved
February 15, 2015, from http://www.cdc.gov/lyme/stats/index.html
Meletis, C., Zabriskie, N., & Rountree, R. (2009). Identifying and treating Lyme disease.
Alternative & Complementary Therapies, 15(1), 17-23.
Pearson, S. (2014). Recognising and understanding Lyme disease. Nursing Standard, 29(1), 3743. doi:10.7748/ns.29.1.37.e9073
Vector-borne Disease Control. (n.d.). In Virginia Department of Health. Retrieved February 15,
2015, from http://www.vdh.virginia.gov/epidemiology/DEE/Vectorborne/

Name: John Olson

DOB: 5/16/1989 (25 years old)
John is a 25 year old engaged Caucasian, male that was born May 16, 1989
from Brainerd, MN. He was diagnosed with Lyme disease after removing a deer tick
that he believes he picked up on a camping trip just outside of Duluth, MN. When
John removed the tick he did not anything of it as he gets ticks all of the time, about
a two weeks later began to get a rash around the site of the bite. He decided to not
go to the doctor because he thought the rash was just irritation. Later side of his
face began to droop and he lost sensation and movement in his right side. He began
to experience extreme headaches accompanied by neck and jaw stiffness. He has
limited concentration abilities, confusion and mild short term memory loss. He
experiences tingling and numbness, poor balance, and tremors. He is also
experiencing rheumatoid arthritis, fibromyalgia, anxiety, depression, and severe
fatigue.
John is the oldest of 3 children and has a younger brother and sister. Both of
his parents are of Norwegian decent and attended the First Lutheran church in
Brainerd, MN. He graduated from the University of Minnesota with a Masters degree
in electrical engineering in 2013. He started working for Minneapolis- St. Paul airport
shortly after graduation. Since being diagnosed with Lyme disease he is having
difficulty getting to his 3rd story apartment as there is no elevators. He uses a walker
to help with his balance while walking. He can complete grooming independently,
but requires MIA for lower body ADLs and UE dressing. Before being diagnosed, John
was able to complete all areas of occupation independently. John enjoys hiking,
fishing, and hunting. He also enjoys watching the Minnesota Twins, Wild, Vikings,
and Timberwolves sporting events. John would like to be able to return to work and
live independently. He would eventually like to start a family with his fianc and
move into a suburb of Minneapolis.

Adult Diagnosis Assignment

Therapeutic Treatment Intervention/Media Part III

Diagnosis:
Lyme disease
Goals Addressed in this Intervention:
John will feed himself using his right hand in 7 weeks
Intervention:
Fishing and catching magnets than sorting the fish into categories.
Purpose of Intervention & Skills Worked on During Intervention:
The purpose of this intervention is to provide range of motion to gross and
fine motor joints that will help the patient with showering, dressing, and
eating. It will also work with UE coordination.
Skills worked on during intervention:
Bending and reaching, Coordinating body movements, Manipulation,
Anticipating or adjusting posture and body position, and concentration.
Time used during intervention:
5- 10 min: cutting out fish- Manipulation, Fine motor Coordination
5 min: putting the magnet on the line and on the back of the fishes Manipulation, Coordination
5 min: Putting out all of the fish- Bending reaching, Coordination,
Manipulation, Anticipating or adjusting posture and body position.
15 min: Play the game - Bending reaching, Coordination, Manipulation,
Anticipating or adjusting posture and body position.
Time and Supplies needed (needs to have a plan for a 30 minute
treatment):

Magnets
Scissors
Fishing pole
Fishing line.
Fish printed on paper.
Styrofoam.
Glue.

Tape

Steps of Intervention:
Before session:

Pictures of 3 different types of fish.

Gather all supplies needed.
Cut Styrofoam into desired sizes.

During session:

Have the patient cut out the pictures of fish

With a marker, have the patient mark the highest point of reach for the
left arm.
Place 1 piece of magnet on the Styrofoam
Tape fish on Styrofoam
Tie or tape a magnet onto the fishing line.
Spread 3x3 foot area
Have the patient cast the pool into the area where the fish are
Reel a fish in.
Put it into the right category.
Complete until all the fish are organized

Research Article to Support Intervention: (citation apa format)

Feys H, De Weerdt W, Verbeke G, Steck GC, Capiau C, Kiekens C, Dejaeger E,
Van Hoydonck G, Vermeersch G, Cras P. (2004). Early and repetitive
stimulation of the arm can substantially improve the long-term outcome
after stroke: a 5-year follow-up study of a randomized trial. Stroke,
35(4):924-929. DOI: 10.1161/01.STR.0000121645.44752.f7
This article talks about early repetition of movements and stimulation will
help improve patients use of arm after suffering paralysis.