This is a big part of what Dr. Offutt does as she evaluates patients.  In the state of Texas, some doctors are trained to believe that diseases such as Lyme Disease do not exist.  In fact, Dr. Offutt was trained this way early in her medical career.  If a patient presented to her and said that he/she thought Lyme disease had been contracted, she politely repeated what she was initially taught in her medical training.  She would inform the patient that Lyme disease did not exist in the state of Texas so it had to be something else.  She always felt defeated as these patients left the appointment, though, because what they had was a mystery.  This was a significant part of what prompted her to go back to school.  It was one of her professors at George Washington University that first introduced the concept that patients with chronic illness and chronic inflammation should be checked for Lyme disease, among other chronic infectious agents.  This was intriguing because it seemed that the numbers of patients presenting with fibromyalgia, autoimmunity, and arthritis were steadily increasing.   He suggested that infection must be considered as a potential cause.  She started checking for it and found it to be much more prevalent than she had been taught.  A lack of education still exists in Texas for practicing physicians regarding Lyme disease.  ILADS (International Lyme and Associated Diseases Society) focuses on educating physicians and other healthcare providers about the presence of this problem.  Dr. Offutt attends their annual meetings and is a member as this organization has helped her to learn much more about Borreliosis and associated diseases.  Of interest, in 2013, a study was published in International Journal of Parasitology by a group including an author who is a professor at Texas A & M School of Veterinary Medicine.  The study demonstrates that 4.7% of the samples tested from 1,493 deer between 2001 and 2015 tested positive for the organism.  These originated in two eco-regions of Texas (Edwards Plateau and the South Texas Plains).  This was the first longitudinal study to demonstrate fluctuation in sero-reactivity of white-tailed dirt B. burgdorferi sense strict antigens in the southern United States.  Testing for this disease is suboptimal in humans which further perpetuates the debate, but clinically, there is no doubt that humans in Texas are suffering from this infection.  The difference is that we are much less likely to catch it in the acute phase because we are trained NOT to consider it as an acute diagnosis.  Therefore, we have some patients who suffer for years before getting the right diagnosis, when the disease becomes more difficult to treat.  We enjoy helping patients who have gotten lost in the midst of this problem to get back on track with a diagnosis and a plan for therapy.  It can take years to treat a chronic case, but as long as we are making steady progress, we persevere.  We are inspired by our resilient patients who fight to regain health.