Unfortunately it’s not great. But there’s a huge spectrum that really depends on how long the spirochetes were in there actively raising hell.

I have a friend with very bad tertiary Lyme. He’s a super hairy dude and completely missed the tick bite and the rash (if he even had one—not every does). So it took a long time before he sought attention and got a blood test proving it was Lyme.

Here in Maine, and New England in general, Lyme is super common so most PCPs and ER docs are pretty attuned to looking for it. Once he actually sought help, he got treated appropriately with antibiotics but it was too late and a lot of his symptoms now are permanent.

He has peripheral neuropathy (numbness in his hands and feet) that makes it hard to walk or do any fine motor tasks with his hands, so he’s on permanent disability. Gets fatigued very easily. But for him Lyrica was super helpful.

A good Neurologist, combined with therapies (cognitive, speech, physical, occupational) can help. I hope your friend recovers well.