As far as I've seen, it's easier to get treated for lyme disease in Montana thatn to get diagnosed or thoroughly tested. My doctor, I'm certain, would continue further if I brought in compelling evidence. Which I think is a decent position for her to take. There were only so many tests I wanted following my Chronic Fatigue Syndrome diagnosis, once she felt we'd cleared all the remaining questions.
But I have so much in common with lyme disease patients (aside from my current recovery) that it has remained a lingering question mark. Bell's palsy, for example, can be a symptom of Lyme disease. And I did have a tick on me within a month prior to Bell's, and a red rash on my scalp within a month after. Although there was no evidence of a bite, there is often no evidence of a bite.
When Lyme disease had not yet been detected in Colorado, a Forest Service employee (as per the movie Under Our Skin) went in to a doctor with a ring shaped rash, a tick bite, and the tick in a jar. It still took hime two or three years to get diagnosed. So the idea that lyme is a possibility is not so far fetched. Montana doesn't have lyme disease because we're not testing for it, though we're not testing for it because we 'don't have it'.
My daughter's homeroom teacher (a junior high science teacher) has helped at least two or three local people get diagnosed due to her familiarity with the symptoms through her son (who almost died of lyme disease). In one of the cases, a student went home from school talking about ticks and lyme disease to her mother, who had been sick for months or years but hadn't had any luck figuring out the cause. When her daughter came home describing her symptoms right on the nose, she got tested, diagnosed, and treated.
Many people post in the Bell's palsy and CFS forums I read about their overlapping lyme symptoms, or about how lyme treatments are going. The two are reported to be indistinguishable by most methods of testing, but that is not an agreed upon fact. There is considerable politics and contention surrounding the topic. If you watch Under Our Skin and follow up with your own research, you come away with a pretty strong acknowledgement that some conspiracy theories are just not so easy to disprove. Some things sound unbelievable and far-fetched because they are attrocious, not because they are untrue.
So, while Montana does not have the right kind of tick, and therefore does not have lyme disease, it is not really disputed that we may have a Lyme-disease like agent adapted to local ticks, which an eye opening article refers to as a possible "cousin" to Lyme. A similar article citing the same source (Epidemiologist Todd Damrow) describes a patient with the 'mystery illness' having been helped by medication.
Other doctors support the possibility of lyme disease in Montana and report lyme positive patients who haven't traveled outside of Montana (also noting that insects are not the only transmission method).
Although these sources are all clearly of the same mind and possibly drawing conclusions based on the same general influences of thought, this certainly does not discredit them nor those influences, nor the validity of their doubts. In a addition to not looking for lyme disease here, reporting may also be flawed, and seems likely to be, at the very least due to the fact that CDC reporting standards are based on east coast lyme disease.
Officially, we 'don't have lyme' in Montana. Realistically, the degree of certainty with which patients with lyme disease similar symptoms are told they must have something else does not seem at all justified.