 Dr. Alexis, it's so great to have you here today. Before we start, I'll do just a little housekeeping for our listeners. You guys know where to find me at JillKarnhand.com. Lots of great free resources there, lots of articles on Lyme and Mold. Our topic today is Lyme disease, and we were just dating before we got started here that gosh July is the prime time to talk about Lyme disease, so I know a lot of you who are watching, feel free to share with friends. You can share later. If you catch us midway, it'll be recorded, and you can always catch it on my YouTube channel just under JillKarnhand. So thanks so much for joining us. I want to introduce our guest. Now a lot of my guests are close friends, and this is one new friend that we run in the same circles. We are part of ILADS and ICI and a bunch of organizations that deal with complex chronic illness, Lyme disease, environmental toxicity in mold, and what we see all the time is how these things intertwine, and we'll talk about that today. But first I am delighted to introduce my new friend to you, and I'm just going to share a little bit about her with you. So Dr. Chesney is a naturopathic physician and acupuncturist specializing in Lyme disease and other tick-borne diseases. She's originally from New York and received her bachelor's at Holy Cross College in Warpchester, Massachusetts. She earned her master's in science and acupuncture from University of Bridgemont Acupuncture Institute and a doctorate in naturopathic medicine from the University of Bridgeport College of Naturopathic Medicine in Connecticut. She's one of the first naturopathic students to complete a hospital-based medical rotation. It's kind of cool because we can talk the same language. Although, you know, I just have to add I always say I've said this before, but I always joke I kind of have the heart of a naturopath because I think a lot more like you all than I do my allopathic friends sometimes. So I'm delighted to have you here and I have such great respect for your education and you're I'm always asking my naturopathic friends what would you do homey up for this or those kinds of questions. So she's dedicated her practice to treatment of Lyme and tick-borne diseases and she has a private practice in Massachusetts. Multiple professional associations like we mentioned. I am just delighted to have her here. She does have a new book out which we'll mention and we'll link up to. It's called Preventing Lyme and Other Tick-Borne Illnesses. And the timing couldn't be better, Alexis. So what I love to start with, first of all, welcome and thank you. Thank you. Thank you so much for having me. It's great to be here. And I'd love to start. Everybody has a story of why they got into medicine and what's kind of driven you. And I'd love to know a little bit about your journey here and what got you interested in what you're doing now. Sure, absolutely. So yeah, going way back as a kid, growing up as very close to my grandmother and she was unfortunately quite ill and so I was in the hospital a lot. Same hospital that my aunt was a nurse at. And I later went back as a medical assistant. So, you know, on that journey, I just was very interested in medicine and I always wanted to become a doctor. And so then later on as we got into college and pre-med and reading some holistic books, you know, I was thinking, hmm, and as I was working at that hospital actually, I was thinking, well, what about nutrition and how do all these people get here? So it was a hard hospital. And a lot of people actually, you know, I was thinking diet, exercise, lifestyle. So then my uncle actually told me about naturopathic medicine. I had never heard about it. That was taken to MCAT, ready to apply to allopathic medical school. And I just fell in love with the curriculum. You know, it was exactly what I wanted to do. I wanted to learn about herbs and nutrition and, you know, do all the basic sciences, of course, but also get all of those other pieces that really got me excited. And, you know, hopefully could help me make a difference and prevent illness. So then later at naturopathic college in Bridgeport, Connecticut, a friend of mine, unfortunately, became ill. And then we found out that all these bizarre symptoms she was having were actually due to Lyme disease. And so then again, I thought, wow, this is a really interesting illness, you know, medically speaking. It was just unfortunate for her to experience it. And I could see how, you know, on that end, how difficult it is to experience these symptoms, but then also medically thinking, you know, how difficult it can be to test for, to treat, that it's a great imitator, that you can have many symptoms, multiple systems in the body are affected. So then from there, I actually did a internship with Dr. Harwitz, amazing, he's my mentor and that got me started. So I moved to Vermont and did a residency. I had no idea at the time, but I was really on the front line of Lyme in New England. So it was a great time to arrive and have that foundational training with Dr. Harwitz and then also brought in my naturopathic background and really started seeing a lot of people that I didn't necessarily expect. Yeah, really. Guys, thank you for sharing. And it's so interesting. Again, it's almost always like we, it's not like we choose, like I do a lot with mold and Lyme disease as well, but I didn't really choose it. It kind of happened upon me through my own experience. So it's almost like we're chosen, you know, to do these things. I agree with them. It's definitely kind of a calling thing because I remember years ago, years ago, like a decade or so, and I was like, I'm never going to treat Lyme disease. Not because I didn't know it. I mean, I believed, I saw it, I saw the patients, but I always thought this is so complex, people aren't getting better, which is not always true. But I remember just thinking, oh gosh, and of course, if I really want to help people, I have to treat Lyme disease because it's everywhere. And especially in these complex populations, I'd love to know what you think. I have this idea that there's functional medicine core, integrative functional approaches, which was basically how we both view the body and the illness spectrum. It's kind of a lot to do with toxic load and infectious burden. And like the weight of these two things is really at the core of most of our illness. And I'd love to know your thoughts about that because of course tick-borne infections are the great imitator, as you mentioned, and they're infections. And I feel like there's such a correlation because if the system's weakened by toxic load, the Lyme tends to be more symptomatic. But what's your thoughts in what you've seen with that kind of connection between the two things that we see a lot of? Yeah, oh, absolutely. I mean, the body is so complex and rarely do I see somebody walk in with classic Lyme, oh, I have a swollen knee and I have a bull's-eye rash. Occasionally that happens and like, this is great. We can take care of this right away. And they're like, what? But if we can get it acutely, which is why I wrote the book, prevention and acute treatment, then we don't have to worry about the complex chronic illness. But when we've gotten to that point, I mean, so many things have happened and sometimes people have multiple conditions and toxicity is huge, of course, inflammation. And I definitely work with mold illness and environmental illness and sometimes it's the mold. And it's really like, if you do not get out of this moldy house or change your work situation, you're not going to heal. And I've gotten a little better about being a little more pointed about that because it's not easy to do. I totally get that. You can't just wake up one day and leave your home. That's really hard to do. But I see people get better if that's one of the issues that they're dealing with, that getting out of that environment is huge for their healing. And so I think there's so many layers. And so of course, as a naturopath, I look at, and in functional medicine, we look at the full picture, we look at the whole person and all these different systems and how they're involved. And so of course, I'll be looking at toxicity, inflammation, adrenal support, how is your sleep? How is your stress level? All these things are really important. I love that because first of all, conventional medicine barely acknowledges anything except the acute tick bite. And maybe in just a second, we'll talk just about that because it's July, it's tick season. And gosh, if we could prevent even one person listening, they got a tick bite and got treated early from going on to chronic illness. That's huge. So we'll let you to address that question. But having said that, a lot of people don't remember a bite, they don't remember being bit or any sort of symptoms at all. And the prevalence of people who have underlying tick-borne infections is just astounding. So if you don't remember a tick bite, I've heard a statistic of 30% of patients and I'd love if you correct me if I'm wrong here, that actually have a bite that ends up, presenting with a bullseye rash and the typical malaise and fatigue and maybe low-grade temp. But many people do not. And another thing I wanna talk about later is tick-borne relapsing fever because many people are talking about that and it doesn't present like a typical Lyme disease. Let's go back to though, it's July and it is prime time tick season. What are some preventative things people can do if they're out hiking in endemic areas and what would they look for if they were to get bit? So tell us a little about the preventative types of things we could do for tick-borne illness. Or for a bite. Yeah, yeah, prevent the bite, yeah. Yeah, there are many things you can do and I think it's really a combination of all these different strategies that make for the best outcome. So in this area where I am in New England, we have mainly the deer ticks or the Xodes scapularis, the black-legged ticks that carry Lyme. So those are the ones we're really looking out for. So in my book, I go through all the ticks, the main ticks in all of North America. So depending on the area you can look at, well, what ticks am I looking for? Because they all look different and they all carry different pathogens. So I really wanna empower people to get familiar with this idea so that you know, oh, actually it was a tick that doesn't even carry anything, which is a little rare, but can happen. Like the American dog ticks in this area actually don't carry any diseases at this point. It's amazing, I hope it stays that way. Like the Lone Star ticks are moving their way up. So at some point we're gonna have these two ticks, the deer ticks and the Lone Star ticks to look out for. And they carry completely different things. So yeah, so some familiarity with that. And if you had a tick bite to save the tick, because then you could get it identified and tested to find out what pathogens it's carrying. But in order to prevent that, which is certainly the first goal, you know, things like tick repellents, right? So thinking about personal protection. I like something called Cedar essential oil. Cedar side is the company I tend to use. There's some studies behind that. And I also just see, you know, anecdotally through patient use and my own use, I use on some animals, dogs that I'm friends with and had in the past do really well with repelling ticks. You can certainly use DEET. Then other thing that I really find very effective and there's some amazing studies on this is permethrin. So permethrin not on your skin, it is toxic, but to your clothing, your shoes. If you're going camping, please, you know, think about your equipment, your tent to repel or disable or kill ticks. So there was a study looking at just doing your socks and your shoes with permethrin and that decreased the chances of a tick bite by 76, 76%. And so that's pretty amazing. You know, you're much less likely to get a tick bite from that, from using that. Also, there's something called tick tube. So taking that permethrin use that you can use on your clothing and then applying it to the yard like thinking about, well, okay, let's also think about my environment and some place I might frequent like my yard, I might garden or hang out there and I might have kids and we wanna think about that and make it a safe environment without ticks. You can put tick tubes out there. I just love them. I've had such great feedback from patients. It actually decreases ticks by 93%. Wow, tell us about it. I don't even know what it is. Yeah, so it's actually targeting the mouse population because most ticks first get infected by feeding on someone like a mouse, a small animal, right? Because ticks have these three different life stages. So by the time they get to us, they've probably already become infected by feeding on something like a mouse. So if we target that population, that will decrease the tick population. So the tick tubes, you can make them yourselves, you can buy them. It's basically like a tube. You can save a paper towel roll or a toilet tissue roll. So it's biodegradable and then you can save your lint from your dryer or you can get cotton or some kind of material like that that a mouse would like. And then you treat that material with permethrin, safely wear gloves, go outside, spray it down, let it dry. And then when it's dried, put it into the tubes and then you put the tubes out in the mouse habitat. They bring it back, they go inside the tube, they get the cotton, they bring it back to their nests and it kills the ticks on them and their family. That's so, yeah, it's pretty incredible. It's so, so practical. And then I wonder with the permethrin, is that safe for animals or not? Once it's dried. So, yeah, yeah, it's great for dogs. They make actually some bandanas and little dog shirts. You can find all sorts of things online or you could treat your own clothing. They could treat a bandana, let it dry and your dog could wear that on a hike and that would offer some protection. That sounds great. It would. Yeah, yeah. There's a company called Insect Shield. This is what I recommend for clothing because it lasts longer when they treat it commercially. So it lasts 70 washes in the washing machine versus if you do it in only last six weeks. Okay, so that's good to keep. Yeah, so it's like, okay, shoes, we're not gonna send to Insect Shield. Let's get the shoes on the schedule every six weeks, put them out, spray them down, maybe socks too because of that other great finding. And then other clothing, maybe we want some gardening outfits or hiking outfits or whatever. Get that from a proper company that can do it a little better. Oh, this is so practical. I love it. And then another thought that I had, and I love your opinion. So I've heard seen the lemon eucalyptus and I thought there were some studies on that but I don't know how effective. What's your opinion on the natural stuff that's alternative to the, is it effective or not really? On mosquitoes, yes. The thing is they kind of confound mosquitoes and ticks. So when I was doing my research for the book, you know, I kept coming across this, oh, because it's another arthropod, it would probably work with ticks. And I really wanted to look for studies that would be specific to ticks because in my experience, actually, I use the lemon eucalyptus for mosquitoes, but not for ticks, I use the cedar side for ticks. And I see that I really need to use different things. So much said. And thank you again, I'm learning a lot right alongside our listeners. And the cedar, tell me again the brand that you like for that. It's called cedar side. Okay, okay, very practical. So we talk about clothing, talk about prevention. What if someone, so if they do get a tick bite and they find the tick, you said, let's send it in. I know a few companies, what would you recommend? Are these commercially available to the patients or do they have to go through their doctor? How would they get a tick tested? It's all personally driven, yeah. So I use tickreport.com, that's out in New England. So it's in Massachusetts. They're UMass, they're excellent. Really quick turnaround time. But there are a few others. IGNX does it, technology. There's actually one in Colorado. Cannot remember the name of it. What I would look at, when we're looking at this, the expense and what are you getting for your money, right? So like how many, like what are they testing? Some of the companies only test for a few pathogens. And so I'm really interested in looking at, okay, which tick is it? And then which pathogens per tick do we need to look for? And UMass definitely does that, but tickreport.com. So I would just check into that to see if it's really worth doing or if you can really feel good about the results and oh, it's negative, great. It doesn't have any pathogens, which is nice to get. And this is so great because again, I've seen different reports on how long it has to attach to infect. And I think it may vary by the species. Is that correct? Can you tell us just a little about the two main ones, the deer tick and the lone star tick, which are coming up with high birds of infection and what they typically carry? Sure. So the deer tick, the black legged tick can carry Lyme, Borrelia myemotoi, which is tick-borne relapsing fever, but it's hard tick relapsing fever. Because a lot of the tick-borne relapsing fever is actually from the soft tick. That's more out west and south. Yo, I'm seeing a lot of that out here. Yeah, yeah, I'm wondering. I'm seeing more tick-borne relapsing fever than typical Borrelia, for good or for easy. Yeah, I wonder, like with the outdoors, like the soft ticks, like Ornithodorus that carry other Borrelia species really affect people when they're sleeping in places like cabins or really, or in caves, actually. Caves and, yeah, really interesting different sorts of environments. And from what I've read on those ticks, they can come out at night with the human being attached and detached within seconds and really infect a person, and they never know it and they often don't get a rash. So it's a little bit more mysterious as far as how it. So back to the ticks that we were talking about. I didn't expect to be picked. So they carry Borrelia, the classic, and then what about like Bartonella, Babesia? Do they typically carry those? So black legged ticks also carry, or can, right? Can carry Babesia, Lyme crotty, and then Anaplasma, Phagocytophilum, and Poison virus. So those, so, yeah, deer ticks can carry a lot of different pathogens. The lone star tick can carry something called Star-Eye, which like doing research for this book, I just thought there has got to be an unfortunate epidemic of whatever is causing Star-Eye because it's a Lyme-like illness. You can get a rash that is like Lyme, but they still haven't figured out which pathogen is causing this syndrome. That's very Lyme-like. And somebody actually identified something called Borrelia lone starry. But then in another study, it dismisses that. And there just aren't enough studies out there about this topic. So I'm really looking forward to hopefully some researchers getting to the bottom of that because I can only imagine people are going untreated. So lone star ticks. So that's, yeah, that and Ehrlichia, those are the big ones for lone star ticks. There's also a Heartland virus in certain places that a lone star tick can carry. So, yeah, it's really tick by tick, very different as to what they might carry. So, you know, in the book, I go through the profile of each disease so that you can look it up and say, okay, you know, many people are familiar with Lyme, but what if it's a tick that doesn't carry Lyme, like these soft ticks, although they're very Lyme-like symptoms in some ways, or the lone star tick, you know, what am I looking for? And when do I need to tell my doctor? So that's what I was finding in my population is patients that presented with Lyme-like illness that weren't testing for Borrelia burgdorferi, which is the classic. And again, for out here, I've seen a lot of tick-borne lapsing fever. Let's talk for people who aren't familiar, what would be a classical presentation of Lyme after? I mean, we know the initial, we talked about that, but what if someone's had it in their system for years? What would be the type of symptoms you would see in patients with Lyme disease for those who don't already know? Oh, yeah, the list is long. So of course there's that coming and going and moving around of joint pains. It can happen, it may not, that's very typical. Neurological symptoms, you know, tingling numbness, especially tingling numbness that comes and goes and moves around, very classic. There can be joint swelling, there can be cognitive issues, fatigue, also nerve pains like burning or stinging or bite feelings that people describe that those can come and go. I mean, as you know, the list goes on. Yes, yeah, and I always think especially, like you said migratory, because there's a very, very small differential, we need other types of things that could cause it if it's either nerve types of pain or joint pain in general that goes from elbow to shoulder to knee, you know, migratory in nature. It's a very small list of things that can do that. So that's always, like you said, high on my list of possibilities if someone's experiencing that type of pain. Tell us a little bit about what someone who finds a tick attached their skin, what do we do about that? So I would recommend taking it off as soon as possible. And I don't personally like tweezers. I don't know if you've had experience with them, but in the office, I mean, in the beginning when I use, it's just, it's mutilating the tick most of the time. It's hard to get off. And then we're agitating the tick, so it might actually regurgitate pathogens back into the patient. So I love something called an OTOM, the tick twister. Oh, great. Actually from France. And I can't even remember where I came across this, but it is amazing. You just, it has this twisting system, so it's these tines, and they make different ones out there, but sometimes the tines are, you know, like if you have, if you're gonna slide this under a tick, sometimes they're too far apart. So once I had a patient come in, she said, I'm trying, I'm trying to get this and she couldn't get it off. And it wasn't the OTOM, it was a different one. So I tried with hers and then I took out mine and I got it right off, you know? So it's really easy, and you can use it on dogs and animals, you know? They're great. It's just a little slide and twist action. So, and then after that, I would save the tick and consider sending it out to be tested, and then you know, okay, if it's negative, we don't have to worry about it. If it's a trusted company, you know, if it's positive, then, you know, there are the next steps. I do a lot of prophylaxis with patients, so we can talk about that and we can actually look at, well, which pathogen is the tick carrying? It doesn't mean that we know if it's transmitted or not, but what do we want to do preventatively? Maybe your tick is carrying Babesia and the other person's tick is carrying Lyme, so that would be a different prophylaxis. So it sounds like ideally, if they can afford it, if there was a tick attached, you want to send it because then you know what you're treating, potentially prophylaxis. What would be your approach? Number one, to someone who we didn't have the tick, we have no idea about knows they got a bite, maybe has a rash and symptoms versus someone, you know, who we have the actual tick and an ID on maybe infections. Tell us about how you approach those two patients. Right, so like an asymptomatic patient versus somebody with signs and symptoms? Correct, yeah. So yeah, so if there are no symptoms, then it's really a choice of the patient, of course in my experience, I would treat it myself and my family, but you know, some people want to be proactive, some people don't, so either they could watch and wait, send the tick out or they could do a prophylactic treatment, which I use, I've created these tick bite formulas. So it's per tick, right? So there's the deer tick bite formula, which has cats claw, knotweed, cryptolepis and hutunia, because those are some of the top herbs that go after the pathogens that the deer tick carries. And then it's per tick, you know, I have different formulas. And also of course, herbs are doing so much more, right? They're helping the immune system work better. I mean, there's studies showing some of these, how specific they are working on how to combat, how Lyme takes over the immune system and to correct that, it's pretty amazing, knotweed especially. So yeah, so we might do that for 30 days if you have no symptoms, you know? And then if you have symptoms, so then we're in a totally different camp, right? So now we're dealing with symptoms, maybe you have the bullseye rash, maybe you have a fever, flu-like symptoms, maybe joint pain started. So then I look at, do we wanna use antibiotics? And I'll use antibiotics and acute disease because this is now considered an acute tick-borne disease. And then also we might do the tick bite formula along with it or some kind of other herbal formula and strategies depending on either, you know, if we test the person and find out, you know, what they have or if it's an erythema migraines rash, then we know that's a sign of Lyme disease, you know, the Lyme rash can look a lot of different ways. Yeah, so it's kind of just the approaches. I love, you kind of glossed over, you developed these tick bite formulas, this is amazing, it makes so much sense to me, those are some of the same herbs that I like to use chronic or acutely, but I really love the idea of doing that for someone because I've always, of course, I'm allopathic medicines, I was like, do we give doxycycline or not, you know? And of course, chronically, I love the herbs, I use them all the time, but I actually have rarely thought about using herbs in the acute setting, but for an asymptomatic individual that doesn't want antibiotics, it makes so much sense. I think that is just an incredible way to do it. So how many different tick bite formulas do you have? Geez, maybe seven, I think I profiled seven different ticks, so yeah. Do you kind of put together in your office or those commercially, like available for other practitioners to use or how does that work on your people? Well, I work with an herbalist at Surgeon's where I work, but you can certainly, and in the book, I give woodland essence, herbis herbs, there are different companies that carry these, because some of them are kind of esoteric herbs, cryptolepsis sometimes are the fun. So I also, for those who are interested or people with an herbalist background, actually go through how to make the tincture yourself, and to really, it's a hard process, so it's not for somebody who doesn't want to invest the time and effort, but if you do it in this particular way that my herbalist does it, I feel like, okay, we'll have the medicinal benefit that we really want to get from these herbs. This is so helpful, and I'm gonna be sure, and so I want to talk just a little about your book, because all this stuff is in there, and I just ordered a copy, so I can't wait to get that, and I was just delighted again to have you, because you're such a wealth of knowledge. Tell us a little about, it sounds like you wrote the book to give people this kind of information, and really there's nothing like that out there right now. I mean, there's a lot of people talking about medication treatments, a lot of people denying it exists, which is crazy, and then some other things, but this sounds really helpful. Tell us a little bit about the book. Yeah, thank you. I just saw that gap in knowledge out there, like you're saying, you know, just how I mean I came to it in my clinical experience, more so dealing with people with chronic illness, but then unfortunately I would see people come back, you know, they'd get better, and then hey, we live in a beautiful place, they're getting tick bites, and I might have told them, hey, you know, try some repellents, try this, try that, they may have done it, they may have not, you know, and so every year my handout would just get longer, and I was like the tick prevention handout, I was like two pages, three pages, ridiculous, so you know, people said like you should write a book, or you know, I first actually wrote an e-book, and then story publishing, I got a call one day just after it went out on Amazon, and Carlene, you know, called me saying, we'd love to have you write a book with us, which was great, you know, I didn't expect that, and I just really wanted to get this written down, you know, in a longer, more thorough manner, you know, in an e-book, which, you know, I forget, the 50 pages or something, and people could get it, and now it's beautiful, you know, I love how I got to work with an illustrator, so you can really, there's a little tick ID in the back, so you can color guide, so you can really find out, you know, which ticks are in your area, like I mentioned, and be able to hold your tick up next to it, if you had a tick bite. So yeah, I just, I really want to empower people, because so much of this is really in our hands, you know, there's no vaccine, there's really no proven, you know, one easy treatment to cure Lyme at this point, you know, it can be a really debilitating illness. So, you know, I think prevention at this moment is really the cure, and so if people really put their effort into prevention, I hope that less people can deal with, what can be a really hard illness. Gosh, this is so, such great information, so now two questions before we go, someone asked about the tick remover is the name, and I wanted to be sure we repeated that, and I can actually type it in here, what was the name of that? Oh yeah, O-Tom, so it's an O apostrophe, Tom. Okay, and tick- Tick twister. Got it, okay, very good. I will reply, and then someone from the UK, so Europe, I know nowadays with international medicine and telemedicine, sometimes we encounter people who either travel or that, but is there any information on us for European ticks that you have, any basics on what we might see that would be different from the US? I know, I think about how I wanna look at Europe and other places, you know, there's so many different types of ticks. A lot of the information is similar, I didn't profile any, like, Risonous, I think it's Exodes Risonous, is a big population of ticks in Europe. I do mention, you know, Garenite, Borrelia Garenite, you know, that's one of the main causes of Lyme disease in Europe. So, you know, I think basically the prevention strategies, you know, most of what I wrote about is gonna apply, you know, but you won't have a nice little identifier for the tick. Yeah. So. Yeah, what I'm finding, again, some of these that are supposed to be Europe only, I think like Babisi Divergence maybe is supposed to be more of a European, and I've seen a lot of that in US. I think what's happening is just with our travel, a lot of it is crossed, so we'll probably see more and more of everything, everywhere. I know, I know. Bubbles, and even here I am in Colorado, it's supposed to be a non-endemic state, and I cannot tell you the number of people that I treat with tick-borne illness. And what's interesting, because there's a lot of, patients with a lot of dog history, dog exposure, horses. Right, oh yeah. And then like I said, the tick-borne relapsing fever is much more endemic out West and in Texas in these areas, so I'm seeing a little bit more. One, I just keep thinking of questions, but one other thing I think will be interesting for our patients, because a lot of them will be like, oh, I got tested, I'm fine. So what's your thought on a classical Western blot from one of our hospital labs? I still do those, because once in a while I'll find a positive, they're great to start, but the sensitivity is quite low. So do you have any comments on that kind of a test versus the more maybe hygienics profiles? Oh, absolutely, yeah. Yeah, this is a conversation. I'm all the time with my patients, so. Yeah, me too, that's what I hear. I'm sure, I'm sure. So I mean, I always talk about the different levels of testing and levels of accuracy. So we first have the ELISA, which I never do, although I can pick it up, and if it does, hey, you know, I'm great, but it doesn't rule it out. And then there's a Western blot through a regular hospital, sometimes because that's covered by insurance, people opt for that, and that one's 60 to 70% accurate. So, you know, again, it doesn't rule it out, might pick it up. And then we go to IGNX, Western blot, about 70 to 80% accurate, sensitive, you know. And then after that is their immuno blot that came out with what, maybe two years ago? Here we go, yeah, and that's great, that's 90% sensitive, and then that one is picking up on, like you mentioned, like Borrelia garini. So all these different strains, these different species and strains of Borrelia, and sometimes you can even order to get that speciation, so you find out what species it is opposed to Borrelia burgdorferi, which is the Lyme disease of North America that we typically see. So yeah, they're gaining so much data by having that speciation available. So I'm just, you know, sometimes we'll screen, like you said, because it's covered, but if I really suspect it, I almost always go to the higher level testing, because it's just so much more helpful. Of course, of course, so it's not cheap, so those of you out there, there is some insurance coverage, so sometimes you can get it covered, but it is very expensive, but usually it's very, very worth it to have the diagnosis in the clinic. Well, before we leave, first of all, thank you so much for your time and expertise. Like I said, I learned some great things and super helpful information for patients. Thank you for your labors with this, because this is just such critical information, especially because we often have books about treatment, but to have someone that goes the whole spectrum, including prevention is so critical, because that's where we can maybe make a difference. Where can people find you? And then is there a preferred source to purchase your book? I'll be sure and include a link. Sure, so you can find me at dralexachestny.com. I see patients remotely through my private office. I also work full-time at an amazing clinic in Vermont called Sojourn's Community Health Clinic. And my book is available widely. It's on Amazon, indie books, any bookstore you can order it through them, any local bookstore. Also, if you want a signed copy, I created this because I had all these events for a book tour laid out and then they were all canceled. Oh yeah, correct. So my book came out in March. So I've been doing some things online and so I can't sign books in person, but if you were interested in such a thing, you can go to my website and then there's a link to get a signed book sent to you. If I will include our feed. Alexis, thanks again. It has been a delight to get to know you. I'm sure maybe once we travel again, we'll actually meet in person. I know, I hope so. I was looking forward to the ICI-M. I know. Conference in person. Great work you do. And just for being so generous with your knowledge today, thank you again. Thank you so much.