Over here Lyme is RARE, so the Dr didn't think titers would be any good (he said there's too many false positives and false negatives, I had the bulls eye, let's just treat it). I went on 14 days of Doxy. No tests before or after. So far no flare ups that I can tell, but I also deal with an autonomic nervous system disorder that gives weird symptoms, so it's hard to separate the wheat from the chaff sometimes.
I almost wish I were on the East coast where Dr's seem to be more aware of it.