Below, you will find questions that we are asked on a regular basis. Some of these questions may be helpful to you. If none of your questions are answered in the FAQ, please call our office at (206) 299-2676.
Videos
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Limbic System Retraining
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Limbic System Retraining Suggestions
The following are a list of suggestions for limbic system retraining which may be needed to “reset” the brain out of the fight or flight mode in order to properly heal from chronic neuroinflammation and stress.
- Read “Access the Power of the Vagus Nerve” by Stanley Rosenberg
- Read “The Brain that Changes Itself” by Norman Doidge
- Safe and Sound Protocol by Stephen Porges www.integratedlistening.com
- Brain Tap – braintap.com
- Dynamic Neural Retraining System – DVD program by Annie Hopper
- Heart Math Program – www.heartmath.com
- Primal Trust – www.primaltrust.org
- Listen to Binaural Beats on Youtube or iTunes
- The Gupta Program – www.guptaprogram.com
- Cranial Sacral Therapy
- Integrative Manual Physical Therapy
- Atlas Chiropractic Technique
- Frequency Specific Microcurrent
- Neurofeedback – google a practitioner in your area
- Buteyko Breathwork – www.buteykoclinic.com
- Medical Hypnosis – find a qualified practitioner
- Neurolingustic Reprogramming – www.nlp.com
Resources for Lyme Disease & Chronic Illness
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Resources for Lyme Disease and Chronic Illness
When dealing with chronic illness, the more information, and support that you have the better. Below, you will find some resources for Lyme disease, chronic illness, and more that may be helpful and provide a lot of additional information.
Financial Assistance
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Financial Assistance
The following are a list of websites that may be of use for those of you who need financial assistance:
Recommended Reading
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Recommended Reading
- Recipes for Repair: A Lyme Disease Cookbook. Piazza, G, Piazza, L., Peconic Publishing, LLC, 2010.
- Insights into Lyme Disease Treatment. Strasheim, C., BioMedical Publishing, 2009.
- Cure Unknown: Inside the Lyme Disease Epidemic. Weintraub, P. 2008.
- 2008 Lyme Disease Annual Report. A Yearly Update for Doctors and Patients. Rosner, B., 2008.
- Healing Lyme Disease: Natural Healing and Prevention of Lyme Borreliosis and its Coinfections. Buhner, S., 2005.
- Everything You Need to Know About Lyme Disease and Other Tick Borne Disorders, 2nd Edition. Vanderhoof-Forschner, K., 2003.
- Coping with Lyme Disease: A Practical Guide to Dealing With Diagnosis and Treatment. 2nd Edition. Lang, D., Liegner, K., 1997.,
- Why Can’t I Get Better?: Solving the Mystery of Lyme and Chronic Disease. Horowitz, R. St. Martin’s Press, 1st Edition. 2013.
- Healing Lyme: Natural Healing. Buhner, S. Raven Press. 2005.
- Healing Lyme Disease Coinfections. Buhner, S. Healing Arts Press. 2013.
- The Intelligence in Nature. Narby, J. Tarcher; Reprint edition. 2006.
- Lyme Disease. Ostfeld, R. Oxford University Press. 2012.
- Man and Microbes. Karlen, A. Simon & Schuster, 1st Edition. 2006.
- Compendium of Tick-Borne Disease. Spreen, K. Pocopson Publishing, LLC. 2013.
- Alkalize or Die. Baroody, T. Holographic Health Inc.; 1st Edition. 1991.
- The Antioxidant Miracle. Packer, L & Colman, C. Wiley; 1st Edition. 1999.
- Microbes and Evolution. Kolter, R & Maloy, S. ASM Press; 1st Edition. 2012.
- How Can I Get Better?: An Action Plan For Treating Resistant Lyme & Chronic Disease., Horowitz, R. St. Martin’s Press, 1st Edition, 2017.
- Lyme: The First Epidemic of Climate Change, Pfeiffer, M. Island Press; None edition (April 17, 2018).
- Chronic: The Hidden Cause of the Autimmune Pandemic and how to get healthy. Phillip, S., Parish, D. , 2021.
- Bitten: The Secret History of Lyme Disease and Biological Weapons. Newby, K., 2020.
Please note that these books are in no particular order of preference and there are many other books that may be of value to you. These are simply a selected few. Please also note that Dr. Marra does not receive any royalties from the book “Insights into Lyme Disease.”
For Patients Infected with Tick Borne Illness
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Patient Resources
Recommendations for Patients Infected with Tick Borne Illness
- DO NOT donate blood. You have been infected with a bacteria that can live in the blood, and therefore can be passed onto someone else.
- Carry a card in your wallet indicating that you have Lyme Disease (and co-infections if applicable) and the drugs that you are taking. This is important to alert health professionals in the case of an accident.
- If you have having elective surgery, let your surgeon(s) know so that they can be aware. If you need blood, I would suggest autotransfusion (you receive your own blood for a transfusion, instead of a separate donor) if necessary.
- DO NOT have unprotected sex with your partner. These infections are thought to be sexually transmitted. Although there is little data to support this, we do know that syphilis is sexually transmitted, and therefore by deduction, Borrelia and the other tick-borne infections are likely as well.
- If you are pregnant with Lyme Disease, you SHOULD be on safe antibiotics throughout the pregnancy in order to protect the developing fetus from contracting the disease.
- At birth, have the newborn tested for Lyme Disease through cord blood, placenta, and foreskin if the baby is a boy. Three samples of cord blood are suggested. Ask for a test kit to be sent to you prior through Igenex (800) 832-3200.
- If your infant tests PCR positive for Lyme Disease, you should consider antibiotics in order to prevent the development of full blown disease.
- Nursing mothers SHOULD use caution. Lyme Disease is known to be transmitted through breast milk, and therefore, antibiotics during the nursing period is highly recommended.
- If you are an outdoors person, it is highly recommended that you use some form of tick and insect repellant. Deet is recommended.
Ticks & Vector Borne Disease
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About Ticks
Ticks are considered arthropods and belong to the same family as spiders and mites, Ixodes. They have two body segments, 8 legs in the adult form and do not have wings or antennae. They have 4 life stages including: egg, 6 legged larvae, 8 legged nymph, and 8 legged adult. The larvae, nymph and adult stages can all carry and transmit infection. The life cycle of a tick is about two years barring the effects of global warming which may elongate their life cycle. Different ticks are maximally active at different times of the year, a convenient natural way of minimizing competition for host attachment. In general, May through August black-legged ticks and Lone Star ticks are active, and April through May, dog ticks are active. All of these species are potential carriers of the Borrelia bacteria.
The various ticks known to cause disease include Ixodes scapularis (deer tick) generally found in the northeast and upper Midwest and can carry Borrelia, Babesia, Anaplasma, Ehrlichia, Powassan Encephalitis, tick paralysis, Tularemia, Bartonella and Mycoplasma infections.
Ixodes pacificus is generally found on the West Coast and is known to carry all of the above mentioned tick-borne diseases.
Amblyomma americanum (lone star) is found throughout the United States and is generally known to transmit Ehrlichia, STARI (southern tick associated rash illness), Tularemia, tick paralysis, Rocky Mountain Spotted Fever and Q fever. Dermacentor variabilis (American dog tick) is found throughout the United States and is known to transmit tick paralysis, Rocky Mountain Spotted Fever, Tularemia, and Ehrlichia.
Dermacentor andersoni (wood tick) is found in the rocky mountain states and southwest Canada. This tick looks very similar to the American dog tick, and is known to transmit Rocky Mountain Spotted Fever, Tularemia, Colorado Tick Fever, Tick paralysis, and Q fever.
However, it should be noted that at this time (2011), migratory birds have been documented to carry these ticks and therefore geographic specificity of ticks is becoming less and less accurate.
There are about 850 known species of ticks worldwide and roughly 100 species are known to transmit disease. Parasitologists estimate that ticks evolved originally as feeding on amphibians and over evolutionary time, adapted to mammalian biology. Spirochetes (the bacteria that causes Lyme Disease) reside in the gut of the tick, and upon attachment to a host for a blood meal, the tick regurgitates the bacteria and deposits them into the hosts blood. This is the initial infection site, and may be the site of a “Bullseye Rash”.
Ticks rarely move more than three feet above the ground and cannot jump or fly. However, they can attach to birds, mice, deer, chipmunks, skunks, rabbits, humans and many other animals and this is precisely the way that infection spreads across states, countries and continents. Believe it or not, they have also been detected in the sea.
Ticks thrive in humidity and live in areas close to their potential hosts (i.e., leaf litter, ends of grass, attached to animals) and respond to exhaled carbon dioxide and body heat. They use chemosensors to actually locate a host. They attach to a host by a “stinger” and release an anesthetic compound to prevent the host from feeling the bite. As the tick feeds, a cement-like substance is secreted from the saliva to enhance its capacity to adhere to the skin and extract a blood meal. Ticks also secrete a substance at the site of attachment which functions as an “anesthetic” and allows their presence to go rather unnoticed by the host.
There are various opinions regarding the length of time that a tick can be attached in order for disease to be transmitted. However, Dr. Charles Ray Jones, a world leading authority on tick-borne illness in children with 50 years of clinical experience, feels that as few as 15 minutes of tick attachment is long enough for spirochetes to enter the hosts’ bloodstream. However, continued research in this area is necessary for proper documentation. Nonetheless, common sense suggests that other blood vectors need only to attach for a matter of minutes (i.e., mosquitoes, stinging flies, fleas, mites) to deposit their “venom” so the same should apply to ticks.
The map above illustrates the many counties where cases of tick-borne diseases were documented between 2018 and 2019 by IgeneX.
Instructions for Tick Removal
Any tick that is attached to the skin should be removed carefully and quickly using the following guidelines:
- Using small tweezers, grasp the head of the tick at the skin and hold firmly without squishing it, and pull STRAIGHT OUT without twisting or turning it. There may be some resistance as ticks secrete a cement-like substance that allows them a tight hold on the skin site of attachment.
- Place the tick in a small jar and save it to send to Igenex, Inc. for PCR/DNA testing of the tick for Lyme Disease.
- NEVER squeeze or burn a tick.
- NEVER use any ointments at the site of the tick bite.
- Clean the tick bite site thoroughly with alcohol.
- Phone your physician and make an appointment immediately.
- Monitor the site of the tick bite and note any strange rashes.
- Take a magic marker and draw an outline around the edge of the rash so the Lyme Literate physician can see the extent of the rash. The marker won’t wear off in a shower if you have to wait to see the physician.
- Take a picture of the rash, and bring the picture with you to the doctor’s office so that if the rash fades, the physician can still assess it.
- Rashes can also occur on the body other than at the site of the tick bite so make note of these as well.
- Fleas, mosquitoes, sand flies, and probably any biting insect may also transmit Lyme Disease, so if you have suspicious swelling after an insect bite, take a picture of it and bring that picture to a Lyme Literate doctor’s office.
FAQ
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Patient Resources
Frequently Asked Questions
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Do you accept Insurance?
We do not accept insurance directly. However, our office provides insurance-compliant superbills at every appointment, which you can submit to your insurance company for potential reimbursement. Typically, most insurance companies will reimburse you for a portion of your office visit expenses, depending on your insurance carrier and policy. For specific details, please reach out to your insurance carrier directly.
Medical Bill Gurus and American Medical Health Alliance are resources that offer assistance to patients looking to receive insurance reimbursement. We have heard that some patients have had positive experiences using their services.
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Is Dr. Marra accepting new patients?
Yes, currently Dr. Marra is accepting new patients. Please call our office at (206) 299-2676 to schedule your new patient consult.
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Do you draw blood in your office?
We do not provide phlebotomy services in the office. All labs must be done at various labs outside of the office. Labs are not included in your consult fee with Dr. Marra. Certain labs will take your insurance. Please call your insurance company for more information about coverage.
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Does Dr. Marra treat children?
Yes, she does. Dr. Marra treats children of all ages.
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Am I able to have a Phone Consult or a Telemedicine appointment with Dr. Marra?
We offer both in-person and Telehealth appointments. Phone consults will be assessed on a case-by-case basis. Dr. Marra will call you at the scheduled time for all phone consults. For all Doxy.me (Telehealth) appointments, we encourage you to enter the virtual waiting room five minutes before your scheduled appointment time to ensure that there are no technological issues before your video call. All appointments will receive a reminder from the office at least one day in advance. Fees for telemedicine are the same as in-office visits.
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Am I able to receive my test results before seeing Dr. Marra?
No, you are not able to receive test results before they are reviewed with Dr. Marra. Please do not call the office requesting test results. Test results will not be given to you over the phone, or mailed to you before they are reviewed with Dr. Marra. Please make an appointment with the office to review your test results. Thank you for your understanding.
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How do I refill my prescriptions?
Please call your pharmacy directly for all prescription refills. Your pharmacy will fax us and refills will be authorized within 24 – 48 hours. We are closed on Wednesdays, weekends and all major holidays.
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What if I have an emergency?
Please call 911 or go directly to the Emergency Room if you have an emergency. Dr. Marra’s personal line is for medical emergencies only during non-office hours. Please be respectful when contacting Dr. Marra’s personal line, as a fee will incur for all emergency phone consults. All other non-emergent medical and administrative contact can be made by calling the office at (206) 299-2676. We ask patients/parents/guardians to please have their voicemail inbox set up and not full when Dr. Marra returns a call. We appreciate your cooperation.
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How do you handle payments?
We accept payment by Cash, Check, Visa, Mastercard and Debit. The patient is responsible to pay any billed amount by Dr. Susan L. Marra during their visit. Failure to pay any outstanding amount upon receipt of a third and final statement will subject the account to be forwarded to a collection agency, with any additional fees charged by the collection agency added to the original amount owed. It is understood, and agreed that in the event that an overdue balance is referred to a collections agency or attorney for recovery of fees, the patient is fully responsible for any and all costs incurred, including, but not limited to attorney fees. At this time, we do not offer a sliding fee scale.
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Where do I get supplements?
You are welcome to purchase supplements online, at other dispensaries, or health food stores. EcoMedica is the dispensary conveniently located inside of Dr. Marra’s practice. EcoMedica can mail items purchased and paid in full, along with postage, to all patients in need of supplements. During their appointments, patients are responsible for discussing their treatment plans and supplement needs with Dr. Marra. Please note that we cannot be held responsible for the reception of items shipped to you. Unfortunately, we do not offer refunds or replacements for damaged or missing items.
Refunds are available within 30 days of the purchase date with the original sales receipt. However, there will be a 25% restocking fee, and item(s) must be undamaged, unopened, and unaltered. We do not offer refunds or exchanges for item(s) that we no longer carry.
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Can I call or email the office with questions for Dr. Marra?
Established patients may contact our office to ask Dr. Marra one to two clear and concise questions related to their treatment plan. However, inquiries that necessitate further consideration or are unrelated to the current treatment plan will require an appointment for resolution. To schedule an appointment, patients may call 206-299-2676.
Kindly note that email communications are not a secure method for sharing private health information unless conducted through our secure, encrypted email portal.
Personalized Integrated Medicine
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Progressive Personalized Integrated Medicine
In the last two decades, the United States, Canada, Australia, as well as Europe and other areas of the world, have experienced a rapid emergence of zoonotic diseases at an alarming rate. Multiple factors including: global climate change, escalating deer and grey squirrel populations, human urban development encroachment on feral animal habitats, pollution, excessive EMF exposure, and the human misuse of energy and waste management, has given rise to the 21st century global epidemic of Lyme Disease, a perfect “storm.” Even the Center for Disease Control suspects that there may be as much as 6-12 times the number of reported Borreliosis/Lyme disease cases in the United States that have not been recognized and/or diagnosed. This is a national (and global) tragedy given that scientific evidence repeatedly demonstrates that early antibiotic intervention for tick-borne illness halts disease progression and perhaps even eradicates it.
Dr. Marra’s personal belief about the treatment for multiple chronic zoonotic infections comes from a nearly 30 year career in medicine and science which emphasizes the need for: 1) integrating science and intuition, 2) utilizing a combination of eastern and western medicine philosophy’s, as well as alternative and conventional treatment modalities, 3) interfacing with other disciplines that shed new insights on old problems, and 4) exhibiting compassion and mindfulness for the needs of others.
The following are principles of healing, treatment and conduct that Dr. Marra and her staff strive for in delivering healthcare to patients:
- To deliver safe and effective healthcare
- To use a combination of wisdom and experience
- To participate in continuing education to remain at the forefront of information about the role tick-borne diseases play in chronic illness
- To use an integrated medicine approach to healthcare for tick-borne illness
- To maintain appropriate standards and boundaries for personal and patient health
- To never lose sight of individual differences
- To utilize insight and instinct whenever possible
With respect specifically to tick-borne illness, Dr. Marra’s core treatment philosophy includes:
- Decrease the pathogen load
- Decrease inflammation
- Degrade the biofilm
- Support the immune system
- Support general organ function where necessary (i.e., thyroid, adrenals, female and male hormones)
- Thin the blood
- Detoxify the body
- Rejuvenate and repair diseased tissues
Dr. Marra’s hope is that in the next decade (known as the “Decade of the Microbe”), we find therapeutic agents with new mechanisms of action that complement existing natural and pharmacologic treatments, which eliminate the unnecessary suffering that Borreliosis/Lyme Disease patients experience. New and ongoing national and international research efforts offer promising insights into future therapeutics for tick-borne illness.