Four weeks ago I started a new course of treatment for my Lyme/Bartonella/Babesia/whatever the heck I’m battling. These new drugs are kicking my tuchus. It’s the strongest reaction I’ve had since the very first round of treatment, last … February.

I know, I know. February is a tough month for everybody. That’s why some kids at Yale started Feb Club way back when, throwing a party every night of the month. But I’ve never been much of a carouser, and anyway I’m sick. I can’t party like it’s 1983.

So I thought of something just as fun: I can celebrate February by learning some science — and then imparting it to you, dear readers.

Our topics today are Herxheimers and blebs.

Yes, these are actual words. I would love to claim I made them up, but that would be a lie. And science is serious stuff — no lying allowed.

I chose these topics because Herxheimers and blebs are not only fun to say, but also interesting and important. To me, anyhow: they are making me miserable.

A Herxheimer, known formally as a Jarisch-Herxheimer reaction and informally as a Herx, occurs when antibiotics attack certain kinds of bacteria — including Borrelia burgdorferi, which causes Lyme disease. This is the part of the story where you feel worse before you feel better. As the bacteria are stressed and dying, they spill toxins, which can overwhelm the body. This is not a side effect of the antibiotics. It’s an intensification of the underlying symptoms, which in my case include fatigue, muscle pain, and depression. Oh, and did I mention the recent night sweats?

Most people think of Herxheimers as a die-off reaction. (Okay, most people don’t think of Herxheimers at all. But you know what I mean.) My Lyme doctor, however, says Herxes result only partly from dying bugs, and mostly from blebbing.

Wikipedia will tell you that a bleb is a bulge in a cell membrane. What it doesn’t say is that, at least in the case of Borrelia burgdorferi, blebs can detach from the main body of the germ and go rogue. As my doctor explains it, they act as decoys for the immune system. And they make you feel sick.

Blebs are only one of the tricks that B. burgdorferi has up its nonexistent sleeve. Lyme and the other tick-borne illnesses that commonly accompany it are intracellular infections, meaning they hide inside blood cells, brain cells, and elsewhere.

What’s more, the bacteria are shape-shifters. Normally B. burgdorferi are spirochetes, with a corkscrew shape that helps them invade human cells. But under stressful conditions — like antibiotic treatment — they turn into round cysts, which are harder for antibiotics to penetrate, and harder for the immune system to recognize. That’s one reason the infection is so hard to kill off, and it’s one reason my Lyme specialist keeps changing my treatment regimen: to attack the bugs in their different forms. In addition, the cysts are semi-dormant — one reason why Lyme symptoms typically come and go, making the disease hard to diagnose in the first place.

It’s a diabolical little critter, that B. burgdorferi. But a Herxheimer reaction is a sure sign that the treatment is working. One of my new meds is a proven cyst-buster.  And so I say, bring on the blebs. After all, it’s Blebruary.

What is the Mary Oliver Challenge? Glad you asked. You can read about it here.