Brief Answer:
most likely it's the post Lyme chronic disease syndrome..

Detailed Answer:
Hello XXXX, Welcome to HCM,

I've gone through your query in details and understand your concern..

Yes your concern is quite justified and I do believe that you've done quite a lot of researches on Lyme disease..

Let me get to the point, You've been treated with appropriate antibiotic (Doxycycline) for adequate duration by your doctor, so don't worry..

No, don't worry about the second tick bite as your doctor has rightly pointed out that you don't need additional duration of therapy simply because your body was already on maintenance therapy with Doxycycline and there was a sufficient loading of the antibiotics already..

Yes, once again your doctor was right when later on describing that your immunity seems to be intact so most likely you'll fight it away..

Now, despite completing Doxycyline therapy, experiencing these symptoms could be due to :

1. post Lyme chronic disease syndrome- the on-off prolonged problem experienced quite often by the patients and requires only supportive therapy, and no antibiotics recommended, so once again your doctor's quite right in this aspect, if this is it..

2. next possibility is any other Co-infection (since you've already suffered from sinusitis), mostly in your case their may be another organism(either tick-born or environmental), so for these you can discuss with your doctor for further investigations(2 sets of blood culture and sensitivity, gram stain, throat swab, specific tests like blood smear, IFA to rule out Babesia-it's a protozoa,if detected needed appropriate anti-protozoan therapy with Azithromycin/Atovaquone and few other organism depending on your local area antibiogram) to rule out these possibilities..

3. An additional therapy with another antibiotic like Azithromycin can be considered only if there's another infective etiology is detected, so as of now there's no immediate need for it , however further investigations can be done to rule out other possibilities as I've explained above..

Catskills, being the hilly and mountain area, must be having lot of bugs and ticks, so please refrain yourself from those mowing and gardening activities at least for the time being, as they'll make you more prone for not only this type of bugs/ticks exposure but also lot of mould/polens exposure also..

So I've tried to make it as simple as possible for you to understand in a nutshell.. Let me know if there's any further concerns, i'll be glad to clarify..

Take Care
Kind Regards

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Brief Answer:
Follow the Advises..

Detailed Answer:
Hello Dear, Welcome back ,

Thanks for the detailed follow-up..

Well all these infections and such a prolonged course of antibiotics definitely have some tolls on the health plus sinusitis itself is an extremely bothersome condition which hampers the sleep..

Good to know that you're so health conscious and already following such a healthy regime of foods..

Yes it's always appreciated to cure this kind of problems without medications..

Yes, those depression, feeling heaviness and stuffy are part of sinusitis as well as sleep deprivation though not really seems that much related to post lyme's syndrome, don't worry..

Although i'm practicing allopathy, let me enlighten you with some common natural home remedies in this regard, do let me know if you've tried any of them yet and if not try and see how you stay..

Most importantly, try not to think about sleeplessness at bedtime, as it causes unnecessary anxiety and delay the sleep, keep your mind occupied otherwise..

Take steam inhalation three to four times a day to clear off the nasal passages and sinuses..
XXXXXXX warm Chamomile tea half an hour before bed time..

Preferable dinner time should be 2-2.5 hr prior to your regular bedtime..
Try to read a favorite novel of yours prior to sleep..

Try to sleep in complete dark rooms and with maximum noise free surrounding..

Try to cut down smoking/alcohol (if at all you take) as much as possible..

Eat fruits and vegetables with 'flashy' colorful skin, i.e. spinach, lettuce, beetroots, sweet corn , sage, XXXXXXX leaves, pineapple , berries(blue, red etc.), banana , apple, nuts like almonds and pistachios etc. as they are having a very noble melatonin (the hormone aiding sleep) boosting effect in our body.. I don't want to bind you within choices, as they create more complications, so simply include these in your diets and just make sure that they're not over cooked to preserve the goodness, so just enjoy the goodness of nature.,

Try to implement them in your day to day diet and observe how you stay, effects are not immediate, but within a few days only you'll feel if they're taking effects..

Let me know how you stay in the due course..

Best Wishes..
Kind Regards

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