Frequently Asked Questions

Clinical Questions

Dr. Jemsek coined “Lyme Borreliosis Complex” years ago, and it is now a widely used term throughout the Lyme medical community. To fully understand the term, it helps to break it down word-for-word. “Lyme” is the common name for Borrelia, which is the type of bacteria that causes the infection. “Borreliosis” refers to the actual infection itself. “Complex” refers to the group of other infections or microbes that contribute to symptoms. Lyme/ Borrelia (being the causative agent) results in, for lack of a better phrase, “immune confusion” which allows these other infections to proliferate. These can be other tick-borne diseases that would not normally result in exacerbated symptoms or communicable diseases. However, these infections get picked up and become part of our normal biome due to the “immune confusion.” In the grand scheme of things, the terms “Lyme disease”, “Borreliosis”, or even “tickborne disease” do not encompass the vast variety of infectious microbes and genetic and immunologic factors that result in symptoms—hence, the need for the coined term.

Why is this important?

There is overall an inadequate degree of understanding of this disease process preventing many clinicians from recognizing or even doing an appropriate work-up regarding LBC. Essentially, a full, thorough physical exam and history is imperative in order to determine the multiple factors that can indicate LBC. In addition, it helps us rule out other etiologies and make changes to medications, supplementation, and interventions that may be more effective at improving a person’s quality of life. Many providers have become so specialized that looking at the entire patient is not seen as their job and therefore the patient becomes a “problem” or sent off to the next specialist who has his/her niche area in which the LBC patient will likely not fit. This situation occurs when a provider is looking at the patient with a limited view of the causative agent and not a broader view of the patient and their complete symptomatology that the LBC diagnosis warrants. Treatments then are implemented with a limited view of the problem.

The real dilemma is the inadequate amount of time providers have with a patient. The face-to-face time has been cut so short that it is difficult to even properly treat one problem let alone the complex and chronically ill. The concern isn’t necessarily an ignorance of LBC but the complete compartmentalization of the patient. In medicine, there is a theory that many symptoms are likely due to one cause as opposed to several different etiologies, yet in our technologically advanced world we have archaically changed this stance—ultimately seeing complex patients as a problem, not trying to find a solution. Looking at Lyme disease rightfully so as a complex will spare providers today, and into the future, a myopic view of the problem, and will facilitate quicker positive outcomes for patients.

We treat children of ages 8 years or older.

Unfortunately, many cases of Lyme go undetected by the standard test, and many patients who were treated for Lyme Disease and now test negative for Lyme Disease may be still be infected with the bacteria that cause Lyme Disease.

Jemsek™ Specialty Clinic diagnoses patients using a multifasceted approach to determining whether or not you are actually infected with Lyme Disease.

Jemsek™ Specialty Clinic has been at the forefront of Lyme Disease treatement and has contributed important discoveries and research to the field. You can read more about Jemsek™ Specialty Clinic's innovations here.

Great question. Lyme Borreliosis Complex is a complex disease that does not behave like any other. This infection has many components that work together to potentially disrupt practically every system in the body. LBC creates intense stress within the human body causing immunologic chaos, turmoil and ultimately significant dysfunction. In advanced cases, the immune system has ‘lost the battle’ and is just ‘making noise’ with only a small chance of regaining immunologic control by eliminating multiple primary and opportunistic infections.

Treatment at the Jemsek Specialty Clinic (JSC) starts with stabilizing – “centering” – our patients so that they can best benefit from antimicrobial therapy. The more centered and stable your system is, the better it will respond to antimicrobials. Some examples of system stress that we seek to stabilize include: oxidative stress, mood issues, pain, sleep disruptions, nutritional deficiencies, gastrointestinal dysfunction, cardiac issues, and hormonal imbalances among others. Our goal is to minimize the instability as much as possible. Your initial interview, exam and labs help us to identify your key stress areas so that we can create a proper plan of care.

Controlling stress is essential to treatment and recovery, given LBC’s biologic turbulence. JSC’s treatment strategy focuses on three main and interrelated components; decreasing the amount of infection in the body, organizing and strengthening the immune system to restore lasting immunologic control, and facilitating tissue healing, with healing only possible after purging the infections.

Unfortunately, when the infections die they do not go quietly. When exposed to antimicrobials, these infections cause an inflammatory reaction. This is known as the herxheimer reaction or “herxing.” Effectively killing these infections can potentially worsen any and all issues that the infection compounds. Some patients may develop new issues as layers of infection are exposed. This is another reason why it is essential to obtain optimal stability before starting antimicrobials. Treatment begins with the “centering” phase, and then depending on the body’s response, we progressively move through the treatment protocol. It is not uncommon to adjust support measures as we move through treatment to minimize stressors and maintain stability within the body.

Looking at the alternative, what would happen if we did not attempt to stabilize your system before starting antimicrobial treatment? It’s quite simple. If your system is fighting back a variety of stressors, then it will not be as efficient at maintaining a strong response to therapy. Additionally, the very symptoms that you are trying to ease may become more prominent, and new ones may surface. Ignoring stabilization before starting antimicrobials should be avoided at all costs. It’s clear that by stabilizing your system, prior to, and throughout treatment, you not only feel better, but your system will be able to respond more efficiently and effectively. To ensure success, stabilization is critical to your positive outcome.

The timeframe depends on the patient but typical treatment will require a stabilization period of 4-8 weeks followed by therapeutic core therapy that averages 12-18 months.

No, unfortunately at this time JSC does not draw blood in its office. If needed commercial labs are nearby or labs can be completed in your home.   

Administrative Questions

JSC prefers that patients use the patient portal located on the website here, otherwise call the clinic at 202-955-0003 to schedule an appointment. Unfortunately, for the time being JSC will not be accepting new patients.

Follow-up appointments can be scheduled right now! But since Dr. Jemsek is our only provider for now wait times may be longer than normal.

Yes, as long as the patient has been previously seen by JSC.

The normal cutoff for a routine follow-up visit before being converted to a prolonged visit has been extended from 12 months to 18 months due to JSC being closed for several months this spring 2024; exceptions for patients requiring more time can be arranged

JSC is committed to rebuilding! We’re off to a great start with a strong core JSC employees. Once the clinic is up and running we plan to add 1-2 new providers by the end of the year and by 2025 we anticipate having a staff of 15 or more.

No, unfortunately JSC does not accept insurance but is happy to provide patients with records and appeal letters for out of network coverage if your insurance has this provision.

The appointment fees have increased largely due to inflationary pressures; the precise fee for your upcoming visit will be discussed at the time your appointment is scheduled

Parking is located at the 20th street Colonial One parking garage. The clearance of the garage is 6 feet and 4 inches, more information about the garage can be found here. Because 20th street is a one-way street going north, patients driving to JSC should travel going one block south to H street and then turning left so you are going north on 20th St to access the garage located up the street on their left.  Street parking is also surprisingly often available.

The nearest metro stops are:

  • Foggy Bottom – Lines: Silver, Orange, Blue
  • Farragut West – Lines: Silver, Orange, Blue


The nearest airport is:

  • Ronald Reagan National Airport (DCA)

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