By Virginia T. Sherr, MD
As a new-comer to the experience, do you recall your first glance through a kaleidoscope, when you were amazed by the uniqueness of its beauty and the pattern? And then, suddenly, a small shift caused a shattering of the design - all pieces rearranged themselves into entirely different positions, totally unlike the first picture, but leaving you in wonder that the change was still created by the same bits and pieces? Then, with another small shift and the colors change, leaving a pattern in different hues, unrecognizable from the earlier scenes, yet just as intriguing - and so on and on.
Shifting clinical pictures likewise manifest themselves as in typical case histories obtained in the course of illness in those with chronic disseminated Lyme Disease.
The problem is that doctors are trained to identify stable clusters of symptoms or signs which are established to identify and name an illness. However, the one stable thing in chronic, disseminated Lyme disease is its instability; its shifting pictures. The kaleidoscope-like variety of clinical presentations often overwhelms the practitioner who, rather than recall that inconsistency is the hallmark of this multisystem disease or diseases, finds it easier to write the patient up as a "crock" or "difficult person" or "all f---ed up", as one of my patients was told by an actually caring physician.
I suggest that as symptoms change (example: eye blurring, itching and sweating shift more to confusion, deep muscle pain and hyperacusis), that the patient present him/her self to the doctor as having the "Kaleidoscope Syndrome" right off the bat. This may alert the unsuspecting doctor that she/he rarely, if ever, can expect the patient to show exactly the same pattern on two subsequent visits.
The Kaleidoscope Syndrome has never read a textbook of tick-borne diseases. Symptoms go where the book says they can't but they do, and just as in a kaleidoscope, no picture is impossible. The patient has to know this and may define this phenomenon to his professional.