Wednesday, July 30, 2008 Vol. LVIII No. 31 85 cents 781-934-2811 www.duxburyclipper.

com
By Justin GraeBer
A
s soon as she woke up, Sue
Coombs knew something was
wrong. I couldnt put my left
leg down. There was so much pain in my
knee, I couldnt walk.
The date was June 23, 2006. Doctors
couldnt give the Standish Shore resident a
clear diagnosis she was told she might
have anything from Lupus to Fibromyalgia
to Chronic Fatigue Syndrome. When Lyme
disease was suggested, Coombs primary
care doctor was skeptical because she didnt
have the telltale signs a bulls-eye shaped
rash. An early blood test also turned up neg-
ative.
They said it was in my head, youll be
fne, just rest, she said. Even her own broth-
er, a doctor himself, didnt believe she had
Lyme Disease.
Through it all, the pain persisted.
I was kept awake at night by spasms,
she said. You wanted to shriek with pain.
Eventually, Coombs found a Cape Cod-
based doctor who put her on a course of high-
dose antibiotics, and she began to heal. After
being a slave to the disease many wouldnt
acknowledge she had, Coombs took her last
pill this year on July 4.
The entire ordeal was a long, painful,
frustrating journey. And as Coombs discov-
ered, its a journey she shares with many of
her neighbors in Standish Shore and other
parts of Duxbury.
Standish Shore resident Sue Coombs is not
alone in suffering the debilitating effects of
Lyme disease. Confirmed cases in Duxbury
have increased by 375 percent in the past
five years.
continued on page 13
Thursday July 31; Friday Aug. 1 & Sat. Aug. 2
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DUXBURY YACHT
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PRESENTS:
By Justin GraeBer
Duxbury wont have to
pay a $15,000 phone bill for
calls a hacker made through
the library after all, according
to a Verizon spokesman.
The Board of Selectmen
were informed of the calls at
their meeting on July 14, when
Finance Director John Mad-
den asked for a $13,500 line
item transfer to cover the cost
of the calls, the most expen-
sive of which was a 24-hour
call to the Philippines that cost
$7,732. Other calls included a
13-hour call to the Philippines
that cost $4,289 and a three-
hour call to Jordan for $884.
Verizon spokesman Phil
Santoro said last week that de-
spite an initial report that Ve-
rizon wouldnt reimburse the
town for the calls, Duxbury
wont have to foot the bill.
All of the calls that were
fraudulently made will be
credited, Santoro said.
Fradulent Calls
Will Be Credited
$15,000 phone bill from library
continued on page 18
By Justin GraeBer
The 40B project, Brewster
Commons, was approved by
the Zoning Board of Appeals
nearly four years ago, but the
developers say they need a
two month extension of their
construction start date.
Attorney Bob Devin and
engineer Richard Grady came
before the ZBA Thursday to
resolve some minor differenc-
es between the approved fnal
plan and the original compre-
hensive permit issued in 2004.
In the case of a 40B, or afford-
able housing project, a com-
prehensive permit is issued
by the ZBA rather than the de-
4 Years Later, 40B
Seeks Extension
continued on page 6
By autumn Gould
The Board of Selectmen
granted a one-day liquor li-
cense to Shore Gregory of Is-
land Creek Oysters for a festi-
val planned for Sept. 20.
Gregory said the event
will be for the whole family,
featuring three well known
chefs from Boston who will be
preparing oysters in a variety
of ways and live music.
The goal is to raise
money for the Island Creek
Foundation which benefts the
Duxbury Beach Reservation,
DBMS and Crossroads for
Kids, Gregory said. We will
be selling 1,000 tickets and
with volunteers there will be
about 1,100 people involved.
Board Approves
Oyster Festival
continued on page 18
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M
any residents in
more wooded ar-
eas of Duxbury
have contracted the disease
and that number is grow-
ing. In 2001, there was only
one reported case of Lyme dis-
ease in Duxbury, according to
statistics kept by the Duxbury
Board of Health. The numbers
grew at an alarming rate from
there: eight cases in 2003, 16
in 2004, and 33 in 2005. So
far in 2008, there have been
23 reported cases and July
is typically the month with the
highest incidence of Lyme, ac-
cording to the CDC.
In 2006, there were 331
cases of Lyme reported in
Plymouth County, according
to statistics from the Mass. De-
partment of Health. The coun-
ty-wide average incidence rate
per 100,000 people is 70. Dux-
burys incidence rate is 228.
The problem is concrete
enough that Duxbury town
offcials put out feelers to the
Mass Department of Health.
Will Lapsley is an intern
with the Board of Health, and
when he applied for the job
he knew Duxbury was look-
ing to try to disseminate more
information about Lyme dis-
ease. Lapsley, a public health
graduate student from UM-
ass-Amherst (originally from
Plymouth) has been work-
ing with the town to increase
awareness.
Lapsley pointed out that
since ticks cannot be controlled
with pesticides the way that
the Plymouth County sprays
for mosquitoes, prevention is
really the only way to control
the diseases they spread.
What Im trying to get
across most is the idea of per-
sonal prevention.
Lapsley has been putting
up information posters on
hiking trails and on the golf
courses in town. Duxbury
hosted a forum on Lyme Dis-
ease last fall at the Duxbury
Free Library that was attended
by local residents, and state
and county offcials. Lapsley
is planning two more forums
this summer: one at the senior
center at 10:30 a.m. on Aug. 5,
and another at the library Aug.
7 at 6 p.m.
Diagnosis: Difficult
Marie Gill of Allens Lane
and her four children all con-
tracted Lyme disease four
years ago.
Defnitely, the issue was
the diagnosis of it, she said.
Its diffcult getting a diag-
nosis for kids, and doctors are
not aware that they might not
test positive. Youll test posi-
tive six month later, but in the
meantime youre sick.
Shes not sure how the
children contracted the dis-
ease, as they were young at the
time and they never saw the
ticks (neither did Coombs.)
People need to be con-
stantly aware, she said.
Although no fatalities
have been linked to Lyme Dis-
ease, the effects of the disease
can linger after the bacteria is
gone. One of Gills children
was left partially blind by the
disease.
It took six months to get
my youngest diagnosed, she
said. By that point her eyes
were a mess, and she had to go
to the retina institute.
She said some of the symp-
toms her children displayed
were muscle aches, soreness
and sensitivity to light.
Its not going to go away,
she said. We have tons of deer
in Duxbury and the weather
isnt going to change. Year
round people can be at risk.
Gills family is heal-
ing, and they are focusing on
spreading awareness to others.
Im grateful that we made it
out of the illness and are now
on the other side, she said.
But some of her neighbors
arent so lucky.
People have called me,
saying theyre depressed, par-
alyzed, she said. They used
to run and now cant walk.
Kate Eldredge of Goose-
point Lanes two children
contracted the disease four
years ago. One, 2 years old
at the time, had the tell-tale
bulls-eye rash and was treated
immediately.
Her four-year-old, howev-
er, was a different story. Since
she didnt have the rash, doc-
tors wouldnt give her a clear
diagnosis and she became very
sick. She was eventually ad-
mitted to Childrens Hospital
in Boston.
We had a rotten experi-
ence with doctors, Eldredge
said.
Her daughter spent four
months in and out of doctors
offces, missing school.
She was an unhappy
child, Eldredge said. She
lost 10 pounds and on a 50
pound kid, thats a lot.
Eventually, they found a
doctor in Western Massachu-
setts who would treat her for
Lyme. The antibiotics worked,
Hot Spot: Lyme Disease in Duxbury
Symptoms of Lyme Disease
The black-legged deer tick carries the bacteria that causes
Lyme, usually picked up from the ticks larval forms biting
mice, which are the originally carriers. The female of the spe-
cies, shown here, is more apt to bite humans and is about the
size of a poppy seed.
L
yme Disease is transmitted
by the bacterium Borrelia
burgdorferi, which normally
lives in mice, squirrels and other
small animals. It is transmitted
among these animals and to
humans through the bite of a
deer tick. Larval and nymph forms
of the tick bite the mice, then the
adults bite deer and can drop off to
bite humans, transmitting the bac-
teria and the disease along with it.
Some patients will get a bulls-eye
shaped rash after being bitten.
Untreated, the infection may
spread to other parts of the
body within a few days to weeks,
producing an array of discrete
symptoms. These include loss of
muscle tone on one or both sides
of the face (called facial or Bells
palsy), severe headaches and neck
stiffness, shooting pains that may
interfere with sleep, heart palpitations and dizziness due to changes in heartbeat, and pain that moves
from joint to joint. Many of these symptoms will resolve, even without treatment.
After several months, approximately 60 percent of patients with untreated infection will begin to have
intermittent bouts of arthritis, with severe joint pain and swelling. Large joints are most often affected,
particularly the knees. In addition, up to 5 percent of untreated patients may develop chronic neurologi-
cal complaints months to years after infection.These include shooting pains, numbness or tingling in
the hands or feet, and problems with concentration and short term memory.
Most cases of Lyme disease can be cured with antibiotics, especially if treatment is begun early in the
course of illness. However, a small percentage of patients with Lyme disease have symptoms that last
months to years after treatment with antibiotics. These symptoms can include muscle and joint pains,
arthritis, cognitive defects, sleep disturbance, or fatigue. The cause of these symptoms is not known.
There is some evidence that they result from an autoimmune response, in which a persons immune
system continues to respond even after the infection has been cleared.
Source: Center for Disease Control (www.cdc.gov)
A typical symptom of the disease is this bull's-eye rash that
radiates from the site of the original tick bite. The red ring
typically expands in the first few days after the initial bite.
However, not all Lyme Disease patients display the rash.
35
Percent of cases in Mass.
that did not have a bulls-eye
rash in a 2005 study.
By tHe
NumBerS
8
Lyme disease cases reported
in Duxbury in 2003.
1
Lyme disease case reported in
Duxbury in 2001.
33
Lyme disease cases reported
in Duxbury in 2005.
23
Lyme disease cases
reported in Duxbury
through July of this year.
39
Average age for confirmed
Lyme disease case in Mass.
2,342
Confirmed cases of Lyme
disease reported in Mass.
in a 2005 study.
46
Percent increase in cases of
Lyme disease in Mass. over
prior year in 2005 study.
228
Incidence rate of Lyme
disease in Duxbury in 2006.
70
Incidence rate of Lyme
disease in Plymouth County
in 2006.
22
Incidence rate of Lyme
disease statewide in 2006.
(cases per 100,000)
continued on next page
14 Wednesday, July 30, 2008 Duxbury Clipper
but theyll never know for
sure because there was never
a positive test.
Diagnosis for Lyme dis-
ease can be excruciatingly dif-
fcult. Often called the great
imitator, symptoms from the
disease can be extremely var-
ied, said Lapsley. There can
be neurological symptoms
like memory loss, mimicking
Alzheimers. There can be
joint pain like arthritis, facial
spasms like Bells Palsy and
severe fatigue as in chronic
fatigue.
Theres a blood test, but
its not perfect, he said. Also,
not every patient has the tell-
tale bulls eye rash. Lapsley
said hes heard that anywhere
from 50 percent to 90 percent
of Lyme patients display the
rash.
Nobody really knows the
numbers, he said. Doctors
need to use a combination of
the symptoms, patient history,
and the ticks themselves if
theyre caught, to make a frm
diagnosis.
Its not just a cut and dry
thing, he said.
A controversy over
treatment
The lack of consensus can
lead to diffculty when there is
doubt as to whether or not a
patient has Lyme. In Coombs
case, she was told she had Lu-
pus and Fibromyalgia. Her pri-
mary care doctor couldnt help
her. It wasnt until she found
a doctor on the Cape who had
been able to help several of her
neighbors on Standish Shore
cope with the disease.
Dr. Sam Donta, who has
offces in Falmouth and Bos-
ton, has been working with
infectious diseases his entire
career. For the last 10 years,
he has been working at Boston
University Hospital.
He opened a Lyme clinic
in the late 1980s, when the
disease was exploding in rural
Connecticut. He realized there
was a group of patients whose
Lyme symptoms lingered even
after the initial antibiotic treat-
ments.
Donta said he sees many
patients from towns like Dux-
bury on the South Shore.
Its to be expected, where
you have deer and mice thats
what happens.
Patients who have either
been misdiagnosed or who
have not gotten better after an
initial round of treatment often
wind up in Dontas offce.
Lyme Disease
Hits Duxbury
This special report was written by Justin Graeber with additional
reporting by Autumn Gould. Editing and layout by Josh Cutler. Spe-
cial thanks to Janet Whittmore, Will Lapsley and the Duxbury Board
of Health for assistance. Sources referenced include the Center for
Disease Control, Mass. Department of Public Health and the Lyme
Disease Association Inc.
continued from previous page
Confirmed Cases by Street
Alden Street 1
Allens Lane 2
Bayridge Lane 1
Beaverbrook Lane 1
Blueberry Lane 1
Bolas Road 1
Buckboard Road 1
Candlewick Close 1
Captains Hill 1
Carr Road 1
Chapel Street 1
Christina Court 1
Congress Street 3
Cove Street 1
Crescent Street 1
Crooked Lane 2
Duxburough Trail 1
East Street 2
Elderberry Lane 1
Elm Street 1
Evergreen Street 1
Fort Hill Lane 2
Franklin Street 3
Goose Point Lane 1
Heritage Lane 1
Homestead Place 1
Hounds Ditch Lane 1
Hummock Lane 1
Keene Street 1
Kingstown Way 1
Marshall Street 4
Mayflower Street 1
Mill Pond Lane 1
Millbrook Way 1
Myrtle Street 1
North Street 3
Oceanwoods Drive 1
Parks Street 2
Pine Ridge Lane 1
Pine Street 1
Salt Meadow Lane 1
Samoset Avenue 3
South River Lane West 1
Standish Street 2
Stonegate Lane 1
Summer Street 1
Surplus Street 2
Temple Street 3
Tremont Street 2
Union Bridge Road 1
Union Hall Road 1
Wadsworth Road 1
Walker Road 1
West Ford Farm Road 1
West Street 3
Windward Way 1
Windy Hill Lane 1
Wirt Way 1
Data from 2005-2007
Source: Duxbury Board of Health
continued on page 16
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He said the test for Lyme
isnt a detection of the disease
itself, its a test for antibodies,
which can be slow to build up
in a persons body. Thats why,
he said, many people like
Sue Coombs appear nega-
tive for the disease if the test is
taken too early.
The test doesnt tell you
if you still have it, just that
youve been exposed, said
Donta. If its negative it
doesnt prove you dont have
Lyme its circular reason-
ing.
We dont want people to
stay on antibiotics for longer
than they need to, he said,
but weve learned certain
antibiotics do help and others
dont.
He said the only research
thats been done was one trial
with a month of IV antibiotics
and a two months of oral anti-
biotics and it didnt work.
Its like doing one can-
cer trial and saying it doesnt
work, so stop there, he said.
National Institute of Health
never wanted to fund addition-
al treatment trials.
The issue of antibiotics is
at the heart of a controversy
over the treatment of Lyme
Disease.
Donta is one of a group of
doctors Lapsley called Lyme
literate. Many of these doc-
tors believe that people whose
original Lyme diagnosis goes
untreated can develop a more
persistent, more severe form
of chronic Lyme disease.
The problem with aggres-
sive antibiotic treatment for
Lyme disease, said Lapsley, is
that high-dose antibiotics can
sometimes make patients sick-
er, or even contribute to some
bacteria becoming resistant.
The controversy is even
the subject of a documentary
flm, Under Our Skin, which
depicts doctors having their li-
censes revoked for aggressive
Lyme treatments.
Dr. Bela Matyas, medical
director of the epidemiology
program for the state health
department, acknowledged the
controversy, but said the states
position is not to get involved.
This is a disease where
there are differences of opin-
ion, he said. Its not our
place to tell doctors how to
treat patients.
He did acknowledge that
the state is trying to get the
information out to physicians
that Lyme patients dont al-
ways present the classic bulls-
eye rash or other symptoms.
It still comes down to the
doctors own feelings about
something, he said. Some of
this is philosophical, some of
it is based on peoples own
experience. If someone sees a
lot of cases they can get a bet-
ter idea of the range.
Where there are deer,
the ticks will follow
Why does Duxbury seem
to have such a high incidence
of Lyme? Its no mystery, ac-
cording to Dr. Matyas.
Standish Forest has lots
and lots of deer ticks, he
said.
For Lyme disease to be a
problem in the community,
Matyas said, three things
need to be present. Deer, deer
ticks, and the mice that carry
the bacteria that causes Lyme.
Mice are actually the original
carriers: they are bitten by the
ticks larval and nymph forms,
which then grow to adults that
bite deer and sometimes hu-
mans, Matyas said.
Mice and deer are found
everywhere, he said. The
problem is that more and more
of those three things are com-
ing together in areas where
humans live.
As we develop more,
were encroaching on their
area, said Lapsley of the deer
population.
In addition to forested ar-
eas, deer ticks can live in the
dune grasses on places like
Duxbury Beach. Matyas said
the ticks are more prevalent in
areas with new-growth forest.
Its driven by the ecology
of it, he said.
Tracking the disease from
a statistical standpoint can be
tricky, said Matyas.
Because the
symptoms of
Lyme disease
can be eas-
ily mistaken
for other
diseases, or
ignored for
long periods
of time, its
diffcult to say
when the infec-
tion was frst
contract-
ed.
One of the problems is
that the incubation period is so
variable, he said, noting that
it can be anywhere from a few
days to a few years. Although
it might seem that certain areas
of Duxbury are hotspots for
the disease, Matyas said the
state doesnt track incidents
that way.
Theres no guarantee that
they got it in that community.
We havent done
enough
Both Matyas at the state
level and Lapsley in Duxbury
are working to raise awareness
of Lyme disease in general.
Duxbury state Rep. Dan-
iel Webster has been involved
in several initiatives to make
it easier for doctors to get in-
formation on Lyme disease.
He sponsored a bill, currently
working its way through the
House of Representatives,
aimed at increasing
education about the
disease. Eldredge
called him a great
advocate.
These pro-
grams would be
aimed at tick borne
diseases overall,
and would require
DPH to establish pro-
grams with doctor
and nursing
p r o -
Hot Spot: Lyme Disease in Duxbury
prevention
and tick Removal
As ticks cannot be controlled with sprayed pesticide the way mosqui-
toes can, individual preventative measures are the most effective.
When outside:
People who have been walking in woody areas should perform a
tick check. Ticks can hide in places on the body such as between
toes, in armpits, at the back of the knee and along the hairline or
behind the ears.
Use insect repellents that contain DEET on exposed skin, and other
repellents on clothes.
Stick to marked, clear pathways
while hiking.
Wear long-sleeved, light colored
shirts and long pants tucked into
socks. This will help keep ticks
from skin and make them easier
to spot.
in the yard:
Keep grass cut short.
Keep woodpiles and bird feed-
ers off the ground and away from
your home.
Prune low-lying bushes to let in
more sunlight.
Use a three-foot wood chip, mulch or gravel barrier where your
lawn meets the woods. Ticks are less likely to cross the barrier
because they are prone to drying out.
Ask your local nursery about plants that are less likely to attract
deer.
tick removal:
If you find a tick on your body, it
should be carefully removed as
soon as possible. The longer a tick
remains attached, the more higher
likelihood of disease transmission.
Do not apply kerosene, petroleum
jelly, nail polish or a hot match to
remove the tick; these measures are not effective and may result
in injury.
Use fine point tweezers to grip the mouth parts of the tick as close
to the skin as possible. The tick should not be squeezed or twisted,
but pulled straight outward with steady, gentle pressure. You may
want to save the tick for identification and testing.
Source: Mass. Department of Public Health, Div. of Epidemiology and Immunization.
Will lapsley, a public health graduate student from umass amherst, is working with the
duxbury Board of health this summer to increase awareness of lyme disease. lapsley points
out that since ticks cannot be controlled with pesticides the way that the Plymouth county
sprays for mosquitoes, prevention is really the only way to control the diseases they spread.
sue coombs took her final antibiotic pill earlier this month. now
that her own long ordeal is over coombs is hoping to spread aware-
ness of the disease.
lyme disease Forum
What: Educational forum
When: Thursday, Aug. 7
time: 6 p.m.
Where: Duxbury Free
Library
Who: All Duxbury residents
invited
The Duxbury Board of Health
is sponsoring an educational
seminar on Lyme Disease,
Eastern Equine Encephalitis
(EEE) and West Nile Virus.
continued from page 14
17 Wednesday, July 30, 2008 Duxbury Clipper
grams to include Lyme diag-
nosing information, he said.
He pointed out that pa-
tients who suffer from Lyme
long term can run into trouble
with their insurance compa-
nies.
In addition to the bill,
Webster worked to secure
money to fund a state Lyme
disease commission and to
study, among other things,
the possibility of setting up a
Lyme disease research center
in Massachusetts. He feels
other states, such as Connecti-
cut and New York, are further
along in their efforts to fght
the disease.
Theres no one answer
to this, he said. This is kind
of a two-prong problem: pre-
vention, and if somebody has
Lyme disease, weve got to
learn how to diagnose and
treat it early.
Dr. Donta believes there
is little push from the medi-
cal community to do more for
those who suffer from Lyme.
There is no leadership,
he said. There is a bill be-
fore Congress and its been
there for years. Lyme doesnt
command attention as much
as AIDS, war, heart disease,
cancer. Everything else gets a
higher priority because Lyme
is not killing anyone, but peo-
ple are still suffering.
We need a better test, he
added.
Back on Standish Shore,
the residents who have battled
Lyme disease are working
to ensure it wont happen to
anyone else. Gill said School
Superintendent Susan Skeiber
has been good about dissemi-
nating information during out-
door sports seasons, and send-
ing home information with
younger students.
We dealt with it four years
ago and it has only gotten
worse, Gill said, Hopefully
people are more educated.
People dont recognize
the problem in this area and
its all over Plymouth Coun-
ty, said Eldredge.
With more awareness,
even if a tick bite occurs, if the
disease is caught early enough,
the treatment is easier. Gills
disease was mild compared to
her childrens case.
Its like a chronic fu,
she said. I was on vacation
and started to get sick, my
body felt like fu and as soon
as I had antibiotics, within 24
to 48 hours I felt different.
Gills advice for those who
think they have the disease is
to keep pushing back against
the doctors until a clear diag-
nosis is given.
Be as persistent and ada-
mant as you can ... if you think
you have Lyme, she said.
You have to be your biggest
advocate.
In the meantime, Coombs,
Gill and Eldredge hope that
those in the community will
continue to get educated about
the disease.
We havent done enough,
said Eldredge.
LYME DISEASE IN YOUR NEIGHBORHOOD? Our interac-
tive map shows all Lyme Disease reports in Duxbury by
street since 2005.
A LONG ORDEAL: Standish Shore resident Sue Coombs
talks about the debilitating effects of Lyme disease and
her attempts to get treatment.
STAYING SAFE: Will Lapsley is a public health graduate
student who is studying Lyme Disease in Duxbury. He
explains how the disease is contracted and what resi-
dents should do if they think they might have it.
For more information on Lyme disease dont
miss the special section of our web site.
Visit www.duxburyclipper.com and follow the link.
THE GREAT IMITATOR: Clipper editor Justin Graeber
explains the alarming rate of Lyme disease in Duxbury
and how its symptoms often mimic other diseases.
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781-545-3000
Upscale waterfront living
on the banks of the
Herring River in historic
Scituate, MA. Located
within walking distance to
the new Greenbush
Commuter Rail Station.
Prices from $675.
LiveAtRiverWay.com
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On site at
60 New Driftway, Scituate
Saturday/Sunday 11AM - 5PM
Monday/Thursday
Friday 12 -4 PM
Closed Tuesdays/Wednesday
MODEL UNIT
NOW OPEN
TAKE OUT PUB MENU ACCOMMODATIONS LIGHT FARE
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Great Food... Great Entertainment... Perfect Anytime!
781-934-0991
390 Washington Street
Duxbury by the Sea
Dinners nightly at 5:00 pm. Closed Sundays
Sean McLaughlin - Every Friday at 9 pm - Guitar & Vocals
We have the PERFECT SETTING for your
Rehearsal Dinner, Small Wedding or Business Function
Full menu available to take out!
Were more than Fine Dining
Patio for Drinks & Dinner
Casual Pub w/ Bistro Fare
Take-out menu
Gift certificates available
45 DEPOT STREET DUXBURY MARKETPLACE
HOURS:
Monday - Thursday 11:30am - 9pm
Friday & Saturday 11:30 am - 10 pm
Sunday 2-9 pm

781-934-8222
Recommended in Karen Browns Guide, 2007 New England
Reservations
Recommended
182 Powder Point Av. Duxbury
781.934.7727
www.ppbab.com