BS”D
Re: Lyme Disease – if you are under the care of a rheumatologist he should have tested you for it regardless of your living in a city – someone could have gone to the country and brought a deer tick back with them and it then got to you somehow. Ask him if he did and if he did not insist that he does. If it turns out you have indeed had Lyme for 4 years then it is best treated by an infectious disease specialist. Refuah sheleima – ksiva vachasima toiva!