- Privatpraxis Dr. med. C. Nicolaus, praktischer Arzt, & Dr. med. A. Schwarzbach, Laborarzt, ärztliche Partnerschaft für zecken-übertragene Erkrankungen im Gebäude des Borreliose Centrum Augsburg www.aerzte-borreliose-augsburg.de Patient Information about Lyme Disease Therapy: Chronic Lyme Compact Treatment (5 days per Week, Mon-Fri) The BCA-clinic Augsburg (BCA), a treatment facility for tick-borne diseases and coinfections, was established to offer chronically ill Lyme disease patients not just an antibiotic treatment, but also (or only) a wide range of accompanying therapies (holistic therapy approach). All services of the Lyme Compact Treatment are offered on a private medical basis according to the medical fee schedule for doctors (in Germany: GOÄ). Chronic progressions of Lyme Disease can be successfully treated in many cases; only in very few cases an improvement of ailments and symptoms cannot be achieved. A comprehensive treatment program and selected “accompanying therapies” can enhance the effectiveness of the medication (usually antibiotics), strengthen the immune system and effectively fight Borrelia bacteria and co-infections. The physical and mental strength can also be improved. Therapy options: To be chosen by the doctors and discussed with each patient individually! Basis: Treatment with Antibiotics (Long-term treatments, e.g. “Augsburg Treatment Scheme”, either as mono- or combination-therapy according to the ILADS guidelines and recommendations of the German Borreliosis Society) Illness/Ailments: Borrelia / Co-agents (Infection) + pain therapy (e.g. with pain killers, co-analgetics, and electro therapies) + “accompanying therapies“, such as: Acute / chronic inflammation processes + acidification (severely) weakened • Milieu corrections (to strengthen organs and metabolism - incl. deacidification + detox) • Dietary Supplements and possibly Natural Remedies • Change of Diet (alkaline and anti-inflammatory) • Oxygen + Electro Therapies immune system + autoimmune reactions All medical treatments and services in the BCA are offered and provided by the Medical Partnership Dr. Nicolaus & Dr. Schwarzbach only. The main focus of every therapy is a highly dosed treatment with antibiotics over several weeks under the surveillance of the attending doctor (usually an infusion mono- or combination therapy). 4b Privatpraxis Dr. med. C. Nicolaus, praktischer Arzt, & Dr. med. A. Schwarzbach, Laborarzt, ärztliche Partnerschaft für zecken-übertragene Erkrankungen · Partnerschaftsregister AG Augsburg PR 83 · im Borreliose Centrum Augsburg, Morellstraße 33, 86159 Augsburg · Tel. (0821) 455 471 -71 · Fax (0821) 455 471-70 · service@aerzte-borreliose-augsburg.de · www.aerzte-borreliose-augsburg.de Seite 2 Note: The choice of antibiotics can vary if co-infections exist. Another very important factor of the therapy is treating chronic inflammations. This is usually done parallel to the Lyme treatment. The following effects should be reached with an holistic therapy approach through supporting “accompanying therapies”, offered in the Lyme Compact Treatment: (1) (2) (3) (4) Better compatibility and effectiveness of antibiotics Strengthening of the immune system (holistic) Pain relief (even for chronic pain) Milieu changes to create an unfavourable conditions for further Borrelia reproduction (5) Lessening of the production of inflammation supporting cytokines and regulating the Th1/Th2 System (6) Support of organ functioning (incl. liver and kidneys) and detoxification (7) Improvement of body physics There are two options to receive accompanying therapies in the BCA-clinic: • Weekly program Lyme Compact Treatment – one or several weeks (please see below) • Individual therapies: dietary supplements, acupuncture, wide range of oxygen and electro therapies, photon therapy, infrared therapy, milieu / diet consultation, exercise programs and naturopathic therapies. Please note: • Patients, who do not wish to undertake an antibiotic treatment, have the option to choose an alternative therapy plan (e.g. photon therapy in combination with naturopathic treatment and other accompanying therapies) after a consultation with the attending doctor. This is also offered at the BCA-clinic. • If you do not have the time for a long-term treatment at the BCA-clinic, we can introduce you to the therapy and give instructions to your local doctor to continue the treatment at home. Weekly program over 5 working days (Mon.-Fri. in the BCA) Recommendation: 1-3 weeks (+ continuing at home) or longer _________________________________________________________________________ _ Therapy concept (day medical clinic): Highly dosed antibiotic treatment + Supporting “accompanying + Pain therapy therapies” (mono- or combination therapy, infusion or oral therapy) eliminating Borrelia and possible co-infections - Improving the effect of the antibiotics - Better tolerability - Eliminates chronic inflammation - Pain killers - Acupuncture - High tone therapy This Compact Treatment increases your chance of healing and has many advantages: 4b Drs. Nicolaus & Schwarzbach „ärztliche Partnerschaft“ im Seite 3 • Reduce the stress of your everyday life and surroundings. A recovery requires plenty of time for yourself! • “Monitoring“ by the attending doctors: if necessary modification of the therapy or immediate actions in case of “Herxheimer reactions” (possible worsening of symptoms in the beginning of therapy) • Specific pain treatment (not only pharmaceuticals) • Exchange of experience with other Lyme disease patients and therapists From our experience we have seen that it can often be very helpful for patients to “switch off” and “find trust” in a quiet atmosphere and become familiar with and accept the therapy and recommended lifestyle changes and self-help measures. Range of services of the Medical Partnership (www.aerzte-borreliose-augsburg.de) 1. Specific infusion treatment (highly dosed antibiotics) 2. Pain therapy attendance 3. “Supporting therapies and supervision of treatment program by specialised Lyme doctors 4. Monitoring and review of results (before/after) Therapy Range offered by the Medical Partnership Dr. Nicolaus & Dr. Schwarzbach 1. For better tolerance and effectiveness of antibiotics: - Dietary supplement (Micro nutrients therapy, probiotics, etc.) Natural Remedies (for immune modulation, stop inflammation, detox) Electro therapies (finding and eliminating “hidden” Borrelia from cell tissue and achieve pain relief) Oxygen therapy 2. Pain therapy with medicine and other remedies/treatments 3. Milieu therapy with change of diet: strengthens organs, deacidification & detox, alkaline, healthy and balanced nutrition 4. Improvement of the body physique through individual exercise programs with experienced therapists 5. Gain confidence and lose your fears: finding your mental balance again, detect and recognise depression and causes of stress, exchange experience with other patients 4b BCA Immunpaket Drs. Nicolaus & Schwarzbach „ärztliche Partnerschaft“ im Seite 4 6. Additional therapy offers of the complementary medicine: TCM (traditional Chinese medicine, primarily acupuncture, herbology and dietetics), homoeopathy, naturopathy 7. Guidelines for “self-help“ (lifestyle) 8. Deacidification and Detox Programs (especially after an antibiotic treatment) Please note: • The aim of the holistic approach to therapy is to help our patients to become symptomand pain-free as soon as possible and to (re)integrate our patients into their private and professional life. • All therapies are supervised by doctors of the Medical Partnership. • The holistic therapy approach does not only decrease the side effects of the antibiotic treatment but also activates the defense mechanism of the body and strengthens the immune system. • The therapies are offered as individual treatments and some also as group sessions. Explanations of individual important accompanying therapies and the effectiveness of these therapies: Please note: • The general effects of these treatments are described on the first page. • Additional information on “dietary supplements“ and “self-help for patients“ is available in the patient information (leaflet) “Dietary Supplements – the ‘BCA Immune Package’ and other important ‘self-help’ measures during the Lyme disease therapy” (available at the reception). • Information about naturopathic treatments can also be found in a separate patient information leaflet available at the reception. Overview of Treatments and Therapy Approaches accompanying therapies in the BCA Dietary supplement products Naturopathy Better effects and tolerance of antibiotics Strengthening the immune system Lack of supplements Immune-regulating and block of Cytokine Pain relief Support with medical pain relief therapy Acupuncture, Hightone, TENS and electro therapy Electro therapies, Oxygen, Light Therapy and Heat Treatments 4b Photon and electro therapies (incl. magnet therapy, Hightone therapy) Oxygen therapy Day Light Therapy Infrared- and Heat Treatments Diverse plants and herbs to modulate the immune system and block inflammations Detoxification and support of organ functions Diet/Nutrition Consultation Milieu advice, dietary advice and change Deacidification, detox and strengthening of organs Instruction for a healthy and wellbalanced nutrition (focus on an alkaline nutrition / individual session and range of courses) Chinese dietetics + herbal therapy/natural remedies Drs. Nicolaus & Schwarzbach „ärztliche Partnerschaft“ im Seite 5 Traditional Chinese Medicine Acupuncture Ear acupuncture Tongue diagnostic Pulse diagnostic Dietetics Deficits and problems are determined based on a physical examination: pain, metabolism, blood circulation, flexibility, coordination, strength and power “Detox” (after an antibiotic treatment) Classical homeopathy Exercise programs Homeopathic anamnesis Various homeopathic remedies Photon therapy, magnetic field therapy Phyto therapy Liver packaging, foot bath Infrared Exercise therapy Oxygen Therapy Oxygen therapy combined with exercise improves the effects and tolerance of antibiotics. Good results in case of circulatory disorders, such as acute hearing loss, tinnitus or balance disorders. • Results in an increase of oxygen in the tissue. • Additionally, strengthens the immune system when combined with vitamins. • Based on experience, the tolerance of antibiotics can be significantly increased in patients (less side effects). Effectiveness: Oxygen is an essential substance of our life. It is used to produce energy in our body cells. Only a few minutes without oxygen can lead to damages in the brain cells. A lack of oxygen in cells can result from illnesses, unhealthy diet, lack of exercise, stress, smoking and alcohol, but also old age. These deficits of oxygen can lead to fatigue, lack of memory, weakening of immune system, circulatory disorders, tinnitus, Angina pectoris, or other illnesses. By taking vitamins and minerals the oxygen uptake of cells and binding of free radicals can be improved. A nitrogen-free and minimum of 92% oxygen mix with a flow of 5 – 30 l/min is inhaled. Improves the blood circulation by increasing the cardiac output per minute, while doing easy physical exercise. Infrared therapy Method: Radiant heat: this energy is adapted so exactly to the body energy that the body absorbs 93% of infrared radiant heat. With this method the body is effectively and deeply warmed without being stressed by excessive temperatures. In the infrared sauna about 80% of radiant heat is given directly to the body and only 20% to the air. Infrared rays warm up the skin and the heat spreads with blood circulation in the body. Infrared heat supports and maintains a healthy body and regular sessions can activate health-improving processes in the body. It can have a positive influence on the self-heeling powers of the body, improve the resistance to the illnesses and can help to generate deep relaxation. 4b Drs. Nicolaus & Schwarzbach „ärztliche Partnerschaft“ im Seite 6 Effectiveness of the infrared sauna: • Positive, deep effect (widens blood vessels, stimulation of blood circulation, acceleration of blood circulation) • Can relieve various forms of pain, e.g. headaches, back pain, etc. • Helps tense and cramping muscles • Toxins are released through the skin and kidneys are relieved • Strengthening of the immune system • Detoxification and purification Nutrition consultations Method: Milieu therapy: Instructions about healthy and balanced nutrition taking with a special focus on alkaline nutrition, as Lyme disease patients are generally overacidified. By changing the nutrition to more alkaline products, the body’s ph-level is ideally increased to values between 6.6 to 7.3. By this means, the organism will create an unfavorable environment (milieu) for the Borrelia bacteria. If necessary, individual appointments can be arranged with a physician. The costs are according to the GOÄ and are delivered by the medical partnership. Exercise Therapy Exercise therapy describes any program where motion of the body or its parts is done to relieve symptoms or to improve function. Exercises are individually selected for the patient and supervised by a therapist/trainer. Problems and dysfunctions (e.g. pain, metabolism and circulation, flexibility, coordination, energy and power) are identified during a consultation in the program Lyme Compact Treatment. Exercise and motion programs are established individually for each patient. The therapy aims to help patients become independent and stay that way after an illness or injury. The physical condition plays an important role in giving quality to life. This is where exercise therapy helps. Effects: The therapy is supposed to bring back the normal physical functions step by step. It is sought to keep a good condition or even improve it. Therapeutic effects are reached by: - 4b Improvement of Joint functions Activating and strengthening weak muscles Stretches shortened soft parts (muscles, tendons, joint capsules, skin, scars) Regeneration of muscle balance Learning motion cycles Improves blood circulation Good for cardiovascular system, breathing and metabolism Strengthening of the immune system Pain Improves mental balance due to increased release of endorphins (“happiness hormones”) Drs. Nicolaus & Schwarzbach „ärztliche Partnerschaft“ im Seite 7 Method: There are various methods for the exercise therapy which are usually applied to many different illnesses. Generally, exercise therapy can be used for the following: - Limitations to movements and instabilities of spinal cord and other joints Dysfunctions in coordination and palsy Circulatory and metabolism disorders Dysfunctions of the organ system (e.g. cardiovascular diseases, respiratory diseases) The patient will also receive an introduction to exercises that can be easily done at home without a therapist. Range of Electrotherapies Range of application: - Pain relief - Displacement of Borrelia bacteria from the host cells (intracellular Borrelia) and from the tissue, in order to increase the effectiveness of antibiotics and the immune system to fight against them - Improvement of muscle power Electrotherapy or electro medicine is the synonym for therapeutic applications of electric energy in medicine. The main principle of the treatment is that constant and alternating electric energy floats through the whole body or through parts of it. Appropriate voltage will be realized by connecting electrodes to the skin surface or electrodes in a water bath. Magnet Therapy Method The therapy using electromagnetic field is gaining increasing attention in the complementary, sports and scientific medicine. Physiological as well as therapeutic effects are scientifically proven. The pulsating magnetic field therapy of with the BEMER 3000 is very effective and shows convincing clinical results. The magnetic field system developed by Prof. Dr. Wolf A. Kafka is seen as the most recognized and most developed world wide. Physiological Effects The significant improvements of the blood circulation are scientifically proven, particularly micro-circulation (ca. 40%), increase of oxygen partial pressure in the blood, and improved blood flow, which decreases the risk of thromboses. The cells can then work better. The BEMER 3000 therapy also influences the protein biosynthesis. One example of this influence is for example the four-fold increase bone cells formation. This is also very effective for the healing of bone fractures and therapy of osteoporosis. A more effective healing of wounds is also accomplished due to the activation of “repair protein” (HSP70). There is also an increased cell protection against oxidants and free radicals. Indication The effects of the magnetic field are due to different control mechanisms, which activate the metabolism and protein formation necessary for regeneration. Many illnesses can be positively influenced with this. The fastest healing success were seen when used as 4b Drs. Nicolaus & Schwarzbach „ärztliche Partnerschaft“ im Seite 8 supporting treatments for injuries (traumata), haematoma, swellings (oedema, mygelosis) and diseases of the bones and supporting apparatus. Chronic pain, neuralgia, migraine, headache, insomnia, chronic fatigue, inflammations, rheumatism, chronic back pain, osteoporosis, joint pain, arthrosis (hips, shoulders, etc….), arthritis, neck pain, skin diseases, circulatory disorders, cardiovascular disorders and other diseases and disorders can also be treated with the BEMER 3000. The system is also used for strengthening the immune system due to its scientifically proven positive effects on the immune response. Difference to Electro Magnetic Pollution Electromagnetic pollution is usually caused by electromagnetic fields, which develop from alternating currents and high frequencies. This includes mobile phones and broadcasting equipment, which work in high frequency microwave ranges. In contrast to this, the BEMER system works with a direct current in the audio-frequency range and very small energy densities. Often problems due to perturbation and other impacts occur within the cells if are energetically weak. The BEMER treatment does the contrary by increasing the energetic status of cells and therefore the power of resistance. The BEMER 3000 changes alternating currents to direct currents and reduces it to 12 volts. Usually even people who are electro-sensible can tolerate the system very well. Are there any Contraindications? The only relative contraindication can be donor’s organs. The body tends to reject organs from a donor and this is the reason why medicine is used to suppress the immune system. The BEMER 3000 strengthens the immune system which is not aimed in these cases. Cardia valves or cornea do not count into this and are no contraindications. Other so called contraindications in terms of regular magnetic field therapy equipment, such as electronic implants (cardiac pacemaker), metal implants or pregnancy are no problem with the BEMER 3000 due to its very low flux density. Photon therapy Method In 1975, Professor Popp proved that there is light in our cells. He named them “bio-photons” and explained that photons are light quanta, which physically are the smallest elements of the light. Bio – because they are produced by living cells; the communication between our cells is performed by the help of these bio-photons. If our body or the cells are sick, the photon reproduction fails as well as the process of our regulation system – the immune system. The photon therapy transmits artificial light quanta into the body, so that the regulation systems of the organism – such as the nervous, hormone and immune system are positively stimulated. The photon therapy is based on the equipment „Bionec 880“ and has four different frequency ranges in the infrared field. It has a positive influence on the energy balance, metabolism and cell regeneration. Effectiveness for the Lyme Disease Therapy Cells keep their metabolism balanced due to bio-photons. In case of Lyme disease, the Borrelia bacteria penetrate into the cells and as a consequence the photon balance decreases significantly. During the photon therapy the cell seems to be able to transport the Borrelia bacteria out of the cell and regulate the metabolism. After removing the Borrelia bacteria from the cells they are accessible for the immune system and the antibiotics, and so can be eliminated. 4b Drs. Nicolaus & Schwarzbach „ärztliche Partnerschaft“ im Seite 9 Application The treatment with Bionic 880 is recommended twice a week. To avoid an overreaction a 2 days break should be between treatments. In total 7 to 12 photon therapy treatments are recommended. Hightone therapy Method This is a therapy measure with electric muscle stimulation and it is also a further development of the classical electro therapy. It is used as a soft alternative to the classic pain relief therapy (medicines). The high frequency therapy works in frequency ranges of 4,000 to 32,000 Hertz, whereas the electrotherapy low frequencies range from 0 to 200 Hertz and is often used in the middle frequency range of 4,000 Hertz. However, the higher the frequency, the more energy can reach the patients body. While the traditional electro therapy stimulates nerves and muscles, the high tone therapy affects the cell metabolism directly. The defined aim of the treatment is to transfer as much energy as possible to the body to support the healing process, reduce pain and release energy blockades. The treatments results in an enlargement of the mitochondria, which increase in quantity and volume. The energy potential and metabolism in the cells due to the improved cooperation and communication between cells. Application Electrodes are attached to the patient, which transfer soft electronic impulses into the body. The duration of the treatment depends on the individual disease pattern and symptoms. On average ca. 10 treatments are required for a long-term therapy success – to begin with two to three treatments per week are recommended. In many cases patients become free of pain within the first couple of weeks after beginning of the treatment. After completion of the therapy most patients are more agile and mobile in their movements. Main indication are Lyme disease like ailments such as moving joint and muscle pain, back pain, degenerative joint illnesses (particularly knee arthrosis), diabetic poly-neuropathy, migraine, heachache, wound healing and oedema treatment. To reduce the ailments permanently, the therapy should be applied three times per week, 30 minutes for each treatment. Otherwise ailments can return. Price List (non-commital) Chronic Lyme Compact Treatment in the Borreliose Center Augsburg Below you can find an example of an optimal therapy, including all treatments that we offer. It is also possible to select individual therapies. Differences in costs will only appear in the final invoice, if there are any unexpected changes during the therapy, which could influence the therapy further. 4b Drs. Nicolaus & Schwarzbach „ärztliche Partnerschaft“ im Seite 10 Example of Costs in the 1st Week Example of Costs in the 2nd Week Example of Laboratory Costs in the 2nd Week 4b Drs. Nicolaus & Schwarzbach „ärztliche Partnerschaft“ im Seite 11 Please find explanation of invoice codes (“Ziffern) on the next page. Price List according to the German Medical Fee Schedule (GOÄ) Number Code (as Service Description 1 2 5 7 8 K1 Consultation, also on the telephone < 10 min. Repeating prescription, also transmission of results additional via phone by BCA-Team Consultation, also on the phone > 10 min. Prominence of medical results from other physicians (not BCA) Examination according symptoms Complete examination Whole body status Surcharge for children up to 4 years A30 A31 34 60 70 80 76 A78 80 96 250 First consultation > 60 min. Second consultation Consecutive consultation Consultation (name of physician shown) Short medical note Medical letter by the physician Dietary Plan written Therapy plan Written, expert opinion Copy Fee for written reports, etc. Taking blood 252 253 269a 272 298 375 377 410 417 420 604 605 Injection s.c./ i.c./ i.m. Injection i.v. Acupuncture > 20 min. Infusion > 30 Min. Smear test Immunisation / Vaccination Additional Immunisation / Vaccination Ultrasound of an organ Ultrasound of the thyroid Ultrasound, up to 3 other organs Measurements Lung Function 605a Flow plethysmograph curve Amount in Euros € (factor 3,5 unless otherwise stated seen on invoice) 3 4 16,32 4,02 (factor 2,3) 30,60 44,88 16,32 32,64 53,04 16,09 (factor 2,3) 183,60 91,80 61,20 24,48 8,16 61,20 14,28 36,72 61,20 0,17 5,36 (factor 2,3) 8,16 14,28 71,40 36,72 8,16 16,32 10,18 40,80 42,84 16,32 32,64 32,44 (factor 2,3) 18,77 (factor 2,3) 650 Electrocardiogram (ECG) / Emergency ECG 20,38 (factor 2,3) 651 Electrocardiogram 33,92 (factor 2,3) 652 4b Stress-electrocardiogram 90,78 Drs. Nicolaus & Schwarzbach „ärztliche Partnerschaft“ im Seite 12 Number Code (as Service Description Amount in Euros € 800 849 2009 606A Neurological examination Verbal Intervention Removal of foreign particles Oxygen Therapy Maske 838A Mask for Oxygen Therapy (one-off fee) High Tone Therapy (WaDit-Horizontal Therapy) 838B Magnetic Field Therapy (Bemer) or Magnetic Ring Coil seen on invoice) (factor 3,5 unless otherwise stated 39,78 46,92 20,41 28,72 (factor 1,3) 5,50 73,73 (factor 2,3) 32,06 (factor 1,0) 566A Whole-Body-Infrared-Treatment 13,00 (factor 0,476) 530 268B Foot-Bath (Body-Detox-Foot-Bath-Therapy) (factor 1,8) + 531 (factor 1,8) + 551 (factor 1,8) + 748 (factor 2,3) Photon Therapy (Bionic 880) 23,73 46,92 (factor 2,3) Nosode 842A 846A 20 Nosodes for Photon Therapy (one-off fee) Exercise Therapy: Admission and Therapy Plan Development Exercise Therapy in individual sessions (factor 2,3) + 558A (factor 1,8) Dietary Consultation (Group) 20,00 102,00 (factor 3,5) 20,11 (factor 3,5) 24,48 (factor 3,5) BCAVital Infusion 500 ml NaCl + Vitamins + Material Costs 30,67 Material Costs Explanation of which invoicing figures are usually used in the consultations: First Consultation: A30, Examination (5, 6, 7, 8, 800), 250, material costs Second Consultation: A31 or 34, A78, 80 th 7 Week Consultation: A31, 80 (A78) Final Consultation: 34, 80 Other Consultations: depending on complexity A31 or 34 4b Drs. Nicolaus & Schwarzbach „ärztliche Partnerschaft“ im
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