Quick story for 10 years of friend's Doctor visits which did not diagnose a Lyme infection - insufficient CDC guidelines:
Friend has had increasingly difficult health problems - mistook for thyroid issues - neurological issues (difficulty standing), thinning, pain, very scary stuff. Lyme swelling around nerves in brain, I believe was the explanation. Could not work. Finally diagnosed and undergoing months of traumatic antibiotic treatments involving a "heart port" :P is improving now, back working.
mistook for thyroid issues -- Tick bite in New York
Unfortunately it wasn't, but this should have been a major warning sign. There's still a lot of education to do. Almost the number one thing related to ticks I was taught by people from nature organisations is: if you know you had a tick bite, and you feel anything seriously out of order (of which the chances are still fairly small btw), check with a doctor; and if that doctor does not come up with anything tick-related (which happens, 10 years ago I also thought Lyme disease was the only bad thing which was spread by ticks), then get a second opinion from a doctor who has experience with most cases occurring in your area.
I have an aunt on disability after a false negative for Lyme left her searching for answers over a decade. She has heart damage, blood pressure and cognitive issues. It was devastating.
Nasty, nasty things. They've really exploded in the past ten years or so in New England. When I was a kid, you never had to worry about checking for ticks when you went outside and roamed around - you'd get chewed to death by blackflies, mosquitos and copperheads, but that's relatively harmless.
Last summer, one incident I had to pull a couple hundred off my dog after she wandered into a particularly bad section of the willowwacks. Just awful little beasties.
I read an article in New Scientist a year or two ago about these. They were talking about counting the acorns on the ground as a predictor as to Lyme disease in two years time. Quite an interesting article overall.
Always check for ticks after spending time outdoors in the summer. Here's a tip: if you have body hair, use your hands to check in addition to your eyes. It's easier to feel them than it is to see them.
My personal experience is: After spending time outdoors, get a shower and a complete clothes change. They often don't bite right away but crawl around for some time until they find a spot they "like".
Also, the lore that was told in my family was, that ticks dropped from trees in the forest. But you can get them also from gras, hedges, bushes. So not being in the wood is no protection against ticks.
Yes, they will definitely keep climbing on you until they find a 'good spot'. The bite is also usually painless, so they can often hang on unnoticed for hours or days (iirc, they inject a numbing agent, as getting noticed kind of ends their life cycle).
I read an article that described their basic algorithm as climb to the top of whatever they are on, blade of grass, shrub branch, etc., and just hang out there waving their arms until something brushes by and they snag it, then climb again until they find a good spot.
In New England, I've had to get in the habit of immediately dropping the clothes in the wash, showering, and then diligently checking the whole body for tics after a run, mtn bike, or hike. And I still occasionally find one hours later. The good thing is that they don't really inject the disease until they've been attached and biting for 24 hours or so and are mostly engorged.
In your experience, can a tick attach to you if you just brush against it while moving fast (running or cycling)? They're rather slow-moving, so I thought they can't latch onto you that quickly.
I've had ticks attach themselves to me cycling off road in Scotland when it was very rough and I was cycling slowly through quite thick and very wet undergrowth on an old unused track.
YES, especially to any fabric such as socks, shorts, etc. seem especially good for them to snag, considering the number of times I've caught them crawling up a leg or something. I'd guess less so against a shaved leg or something, but still check diligently, since shoes, socks, etc.
Running is probably an ideal speed for them to snag you (think how they'd be snagging deer, dogs, etc), and I've never found biking fast enough to not get them. It seems like they don't grab by any reflex, but just by hanging a few hooks out in the breeze to snag whatever comes by.
Another thing I found that I didn't expect -- I'd guessed that they'd be most active in hotter weather, making motion easier, etc., but it seems that the most active times are moderate temps, maybe 10-25C (50-77F), but we still need to watch out outside of that range. I've seen them all the way down to almost freezing and up in the 30C+/90F+ range.
They're everywhere. I play golf in Massachusetts and basically refuse to go hunting for a ball that's in fescue because that tall grass is loaded with ticks. I'll take a damn penalty if I'm playing seriously or just drop a fresh ball if playing for practice. A golf ball and game isn't worth the risk of lifelong infection.
Ticks are awful. I used to be completely unconcerned by them as a kid, and have a knack for removing them without breaking, but after having a number of family members and pets affected by Lymes I am super careful.
The random tangent about deforestation and global warming seems ideological to me. Ticks aren’t being forced into contact with us, they want to be wherever they can be.
If anything my guess would there’s a problem with lack of predators, like a reduction in possums or something similar.
It's really strange... I grew up on a farm and remember running through the fallow fields barefoot with shorts on all summer, but the first time I actually saw a tick was in my mid-20s after I had moved to the city and took a walk through the local park. Since then I've found at least one tick on me every summer.
I don't know if I just got lucky in my youth or if ticks are getting worse, but it's something that's stood out to me as curious.
> and you probably haven't destroyed so many forests/wildlife as other countries.
What does this have to do with it? New Hampshire is much more forested than it was 200 years ago. The last two years there have been WAY, WAY more ticks than in the years of my childhood. It's a mini crisis here and is completely unrelated to forest destruction or lack thereof.
I had the exact same experience, sans farm. I grew up in a small town, though. Spent a ton of time in the country on friends' farms, lying in long grass in shorts no shirt—all of it. I never had a single tick bite. Horseflies, mosquitoes, spiders, all of that, but never ticks. Even in the city I've (thankfully) never seen one.
Now beaches and parks back there (rural south-western Ontario) are littered with "Tick Warning" signs.
You're not the only one who's confused and curious about it. It's like they used to be a non-issue. We were warned about them, I remember that—but that's all.
Me too. Grew up in the country (running through cornfields etc) in SWO and never had a single tick or even thought about ticks. Then this year my son picked up a small tick in McGregor Park on Lake Huron which thankfully tested negative for Lyme. The areas around the shoreline of Lake Huron seem particularly bad these days.
Also anecdotal but I grew up in California camping and hiking all the time, never once got a tick. I’ve been in the Bay Area for the last eight and a half years, also spending lots of time outside and nothing. Then, about a week ago, I got a tick while hiking in Point Reyes. Not even going through deep woods, just on one of the well maintained coastal trails. Thankfully I caught it early, I felt what I thought was a pimple near my armpit and investigated on the car ride home only to realize that it was quite a large tick
The thing is you might have had ticks on you and not even known it. You have to be very careful to check all over your body. How many people actually do that? Also, the tick might be in your hair, so you might not even see it. Finally, some baby ticks (which can carry Lyme) are smaller than the period at the end of a sentence. They are very hard to spot.
Ya, I'll definitely be searching much more thoroughly now. I was lucky that the tick was huge and hard to miss (though it didn't feel that way at the time)
Times have changed. Ticks in the old days weren't all that prevalent and/or carying Lyme. It has worsened after habitat destruction (less wolves and other big predators, more deer that act as tick breeding ground, more mice that act as Lyme reservoir, more migration).
They're insects, I don't think it has anything to do with natural predators but rather environment conditions, their food source and breeding grounds. Just like with the tiger mosquito, climate and car tyres.
It's getting worse. Due to overall warming ticks are creeping to areas that never had them (in european alps it is at least 1500m altitude these days).
I grew up in relatively cold part of my country around mountains, we never ever had ticks around as a kid. It was just some exotic scourge in the lowlands. These days, they are abundant there. Same goes for example for some exotic poisonous spiders creeping from south. One day, malaria/dengue/yellow fever/etc in central europe will be a reality, unless we eradicate it sooner.
No clue whether they increased concentration in the already-present areas though.
I had the same anecdotal experience from the North East of the US, maybe once every two or three years one tick - now I can expect to find one anytime I walk in long grass.
My thought is the increase in ticks is due to the elimination of widespread DDT spaying, check out this typical scene from 1950's and 60's:
On the positive side, I never saw a hawk or eagle when I was growing up, and they have returned since they are no longer being pressured by insecticide concentration in their food chain. Maybe we could strike a compromise, bomb tick infested areas for a year or two with DDT to knock down the ticks.
[edit] A red tailed hawk just perched in the tree outside my window.
> The random tangent about deforestation and global warming seems ideological to me.
The relationship between insect outbreaks and climate change is not ideological and has a number of studies supporting the theory that insect populations increase and migrate due to climate change.
Here's one link [0] culled from a quick search on Google [1]
In the NE its largely because of exploding deer & mice populations, 30 years ago they were rare, now its normal to see deer in West Chester & NJ suburbs.
"The random tangent about deforestation and global warming seems ideological to me. Ticks aren’t being forced into contact with us, they want to be wherever they can be." - Living in proximity to forest fragmentation is a major risk factor associated with Lyme and other tickborne disease in the United States, and forestry workers worldwide are at staggeringly high risks.
I’m from Massachusetts and spend a lot of time on Nantucket, which is like ground zero for Lyme (lots of deer, no predators). A service like this can really give you peace of mind if you do get bit.
Also worth noting, a tick bite is not like a snake bite. It’s not really like being instantly injected with a venom or a foreign pathogen. From what I understand (after I got bit and looked it up) the tick really needs to be dug in for about 24-48 hours to cause a problem. So it’s more like the tick is giving you an infection, and in the course of that passing on these terrible diseases (sometimes).
Unfortunately we know all about this because our dog got bit, got Lyme disease (even though she was on the preventative medications), then developed a rare complication (heart condition). It's really made going out on the trails a less fun experience when worrying about ticks.
At least in my whereabouts, tick testing is no longer used. They said chance of false negative is too high. On top of that, bad tick doesn't mean you're infected. Two stages blood test is only fool proof way to test for Lyme.
Can confirm that ticks need time to give you Lyme. I've had Lyme twice. Both times I missed a tick on initial check and found it a day later. I get bitten few times a year and every time I find them on time all is good.
It's a bacterial infection, so I believe immunity just doesn't last as long as it does for e.g. chicken pox. The vaccine, when it was available, recommended rather short intervals between boosters.
>I’m from Massachusetts and spend a lot of time on Nantucket, which is like ground zero for Lyme (lots of deer, no predators).
Give a 100% discount on ferry tickets to anyone with a valid hunting license during deer season. The problem will solve itself. The people with money don't care what the locals shoot up over the winter. I don't see why they care what the locals shoot over the winter.
“
Diseases like these weed out sick or infirm individuals in the host population”
“Taken with other factors, like predation, “it might keep host populations within the carrying capacity of the land,” he said, possibly by reducing overgrazing and other forms of destruction to vegetation.”
Ticks and mosquitos are why I spray my hiking clothes with permethrin. It's a potent contact neurotoxin for both. It takes a little bit to act after exposure, but ticks will die quickly. Mosquitoes will also fly away and die after contacting my clothes.
It's derived from a chemical found in Chrysanthemums.
we make Permethrin 'tick tubes' for our yard. In a nutshell, it's bedding for mice laced with permethrin. Ticks attach to the mice during the mice breeding cycles in March and July here in New England.
I'm out in the yard a lot, I pull ticks off daily. I fortunately never have had Lymes but I noted (anecdotally) that the tick population has exploded in the last 10 years with the milder winters.
It's concerning. Probably going to get a flock of guinea hens this year.
Get your whole yard sprayed, too. It does make a difference if you do it a few times. As other commenters here, and I, can attest, it just isn't worth getting a bite. Lyme is awful.
Problem with this is Permethrin is quite a broad-spectrum insecticide and won't kill just ticks but also a lot of other insects (which take care of e.g. pollination and in turn are food for others, etc, the usual picture) and is also not exactly friendly for aquatic life. Also mammals are not completely out of the danger zone, depending on dose. And longer term effects are as far as I know simply unknown. So it needs at least some careful consideration in my opinion.
I looked into this when I was getting into hiking and found out that this is not allowed in Canada, though apparently the Canadian military uses it.
Fortunately at the moment it is too cold where I live for ticks so I don't need to worry about it, but as this article notes, that may not be that way much longer... :(
Permethrin is really fantastic. Anyone here know the best way to apply it to clothes? I've sprayed my clothes with a 0.5% spray, which I got for $5.92/266ml or $14.99/739ml, so about $4.00/ml of pure permethrin.
Amazon has an 8oz/236ml bottle at 10% for $36, so about $1.35/ml of pure permethrin, but then you've got to soak your clothes instead of just spraying them, and that takes several hours and you've got to get rid of the fluid afterwards.
Anyone notice a difference in effectiveness between spraying and soaking clothes?
Had to go through a Lyme treatment last year myself.. it was not fun. The antibiotics regime was easily one of the lowest points in my life - just felt terrible for weeks.
The thing I was taught by this experience, is to never, ever screw around with it. In my case I was attacked by a swarm of ticks during a hot period (Vienna, Austria) and I kind of ignored the bites .. thought nothing of them after discovering the ticks (2) and removing them .. but after 2 days, I had 4 red splotches over my body, and it was clear that I had the characteristic 'bullseye' symptoms.
Thought "okay, I can live through this" and didn't do anything about it for about 5 - 6 weeks; splotches went away, and I thought I was fine. No. Just, no. I was not fine.
Aches and pains like none I've experienced before (being Australian, I've had a few nasty bites in my life), and malaise and lethargy that was seriously affecting my ability to live life. Doctor told me I was an idiot for not coming in right away - that I could very well have done damage to my brain - and was put on a super strong antibiotics regimen .. which was pain itself, since it screwed with everything.
Anyway, had my blood tests, and they think I'm fine. But I have to go back in a month for another round of tests - because even if you think you're fine, after Lyme, you may not be fine for a few years. It can persist in the human body.
So, don't be a fool like me: if you get a tick, go immediately to the doctor and get it sorted. Trust me the symptoms are just awful.
I received a shot of the vaccine when it was available. Unfortunately the projected longevity of the immunity conferred was only 3-5 years. By the time that period had passed for me the vaccine was no longer available.
> There is no evidence to suggest that the Lyme disease vaccine ever caused Lyme arthritis, but it was taken off the market largely in response to lawsuits alleging exactly that.
> So, don't be a fool like me: if you get a tick, go immediately to the doctor and get it sorted. Trust me the symptoms are just awful.
I'm glad to hear you're on your way to a full recovery given the severity of Lyme.
Your advice to "go immediately to the doctor" is not only important with regard to ticks but to all manner of infection. Most infections have similar symptoms and distinguishing between something discomforting and something deadly is a matter for a health care professional.
Stoicism with regard to maladies is practically a cliché among strong-willed people (men especially). Always consult a doctor with unusual infections, and seemingly usual ones, too, if you can.
If you remove a tick within a few hours you're likely to be fine especially if you don't see the telltale red circular rash.
Running to the doctor for non-issues is part of why our medical costs have increased so much the last few years. There's so much marketing to "ask your doctor" about this and that and the other thing these days. And when you go, of course the doctor is obligated to run a battery of tests to cover his ass.
Depending on what part of the country/world you're in, there's also a wide variety of tick-borne illnesses with very scary mortality rates if untreated.
Unfortunately there is not always a rash present and even if there is one it's not always the bullseye rash. The other early symptoms are feeling like you have the flu, fever, and being tired. So it can sometimes be hard to catch early on your own.
You are correct in that the longer a tick is attached the more likely you are to get Lyme. Mayo Clinic says it's unlikely to happen if it'as attached less than 36-48 hours. But some of the ones that can give you Lyme are about the size of a poppyseed and you don't notice them right away. You should always check for ticks after being outside and remove them ASAP.
> a) I have no primary care physician because I don't typicaly go to the doc for any reason
This is circular... you saying you don't go to the doctor because you have no PCP, and you don't have a PCP because you don't go to the doctor
> c) going to the doctor involves triggering an expensive and difficult to predict system that will possibly bankrupt me.
I'm having a hard time believing that a standard outpatient visit would bankrupt you. These are typically on the order of $100, and rarely more than a few hundred unless you're going in for specialized procedures, which you've already established you aren't.
Sure, if you go to the doctor, you might find out you have a more serious condition that would require future, longer-term care to address, and that future care may involve additional expenses and inpatient care which you may or may not be able to afford. But that's hardly a reason not to go to the doctor today and find out - at least you'd be able to make that decision on an informed basis.
Having grown up in India, even after I've spent almost my entire adult life in the US, I'm still reluctant to go the doctor here.
In India, the process is very simple: you call the doctor in the morning, you get an appointment for the afternoon, you show up, get looked at, pay the cost of the visit (usually less than $10-15), and you're done. It's basically like any other business transaction. So even if I had a minor seeming infection, going to the doctor was the right and efficient move.
Here, I call the doctor's office, and might not get an appointment for another two months, if I'm lucky. At that point there is some opaque process involving my insurance, and it just seems like a much weightier event than a simple visit should be.
Of course, I'm guessing that an infection would speed up the process, but the psychological barrier is already up in my mind, and I'd rather just power through on my own.
But there seems to be some hope. Recently, my wife was able to go to an urgent care clinic to treat an infection, and the process was much more like what happens in India. Still, there is some intervention of insurance, though a bit more transparently so.
As I'm sure you know, there are urgent care clinics everywhere in the USA for minor ailments and injuries, where you can be seen on a walk-in basis and pay cash if you want to.
When my kid dislocated his hip, I took him to an urgent care clinic, and the process was similar.
They did refer me to an orthopedist and I ended up being out about $450 dollars after they looked at an some imaging and decided it was a growing pain.
That was with insurance, but hey, not wholly unpredictable and because there was nothing treatable I wasn't bankrupted.
A standard office visit tends to be about $100 in my area, sure. That'll get me to talk to the doctor. But if I want to test for Lyme that's a blood test. Now the lab is involved, they may or may not have their own billing department and they won't tell me for anything how much or even ballpark estimate of what it will cost so that they are covered if they need to do more.
So I talk to the doctor and they say XYZ tests need to be run. Okay, now I know what I need exactly and get a price, right? Nope. I just get the run around and "It depends on the insurance" and "We will bill you later" and "No it's probably not $5000" and straight up "I don't know"
Oh, okay, so I need to call the insurance company then, huh? Nope, they won't tell me either. I've tried. They just say "It depends". Even when I know exactly what labs they are going to run. I can say "I understand it might change if they need to run more tests." Nope. No idea.
Sometimes they can give you a straight answer but very often they will not.
It's hidden on purpose. It is confusing on purpose. Insurance companies don't want you to know what's going on. The doctors offices don't want to share "cash-only" info publicly because insurance companies will demand that price. The insurance companies don't want to share the info because people will complain. Etc etc it is not that easy when you go to the doctor for more than the really simple things.
As to the circularity of my first point, without a PCP and no proximate cause, the wait time and cost is.... difficult to predict. With a PCP it is better, but because I don't go to the doctor I don't have a PCP.
I am a man that often avoids going to the doctor, but it isn't out of any level of machismo (I could be deluding myself). Rather, I've had a lifetime of experiences demonstrating that doctors could do nothing for me time and time again.
Not necessarily their fault (medical science is trying to debug a program that you don't have the code for, do not control/know all of the inputs to, and you risk killing them if it crashes) but they've failed me time and time again in diagnosis, effectiveness, and availability, and in the US they were a financial burden until I was fortunate enough to reach the point my budget could take a hit.
This has built a habit of assuming that if I'm not in intense pain, visiting a doctor would be a waste of time and money.
I got pneumonia once. When the cough seemed serious I asked for an appt, but it took several days and by the day of I was struggling to breathe. Ended up going to an urgent care clinic hours before my appt because I was genuinely worried I wouldn't make it to said appt if I waited. The clinic agreed, given that as I walked in to their crowded lobby they heard me rasping and bumped me to the head of the line. I had four people on me at once, giving me oxygen, taking vitals, and one entering the numbers into their computer. I could see the screen, and saw that a few entries triggered a "the number indicates a critical problem, is it accurate?" warnings. They told me later that at 1 percent lower oxygen (i was 92%, which apparently low) they would have sent me to the emergency room. I'm glad they didn't, as their care beat any ER visit I've had, and was only $100, which included lung xrays. An ER visit would have been worse just walking in the door. Still worth it when they can help me breathe, but it demonstrates one reason why one can avoid doctors for seemingly non-serious ailments and conditions, particularly with all the times they've shrugged.
I'm allergic to most everything that won't kill you (pollen, mold, dust mites, cats, dogs, even rats). I have a list of issues with this, mostly constant sinus production/drainage, but only learned it was allergies when I self diagnosed in my 30s and went to an allergist to confirm. Even then, the cause that was dramatic enough to clue me in (rats) was not part of the standard panel. I had to specifically request it...and then point out that they hadn't added it as they said they would. That ended up being so severe that the tiny scratch swelled to the size of a half dollar despite me being on benadryl (i had missed the instruction to skip such meds for the test) AND the calamine lotion they slapped on it almost immediately. Had I not asked for and checked for that test, the specific problem of the moment (my girlfriends pet rats) would have remained undiagnosed (I had a list of potential causes of an uptick in problems, not awareness of any specific one). Not one doctor growing up suggested an allergy test, even though I can now look back and see obvious signs. Not one doctor asked if my symptoms occurred at specific times or places, not one ever mentioned the high constant drainage or inflamed ear canals. (Though doctors offices are pretty allergen free. As a kid I joked that their ugly paint made you feel better, since by the time a doctor came to look in on me my worst symptoms weren't there...in retrospect the repeat experience should have been a clue to them and possibly my younger self) Instead they called it mild asthma (asthma test was negative, but shrug. My guess is that they called it that just to make me feel they had a clue)
Machismo is a problem, but it isn't the sole problem.
Be careful with this. There is a class of issues the medica system is more or less useless with (musculo-skeletal pain, digestive issues, fatigue, the uncommon source allergy symptoms you described)
Then there is stuff they handle extremely well: broken bones, bacteria, and a variety of easily treatable ailments.
I have a few health issues I know I basically can get no medical help on. And then, on the other hand, I had MRSA, and went to the doctor ASAP to get that cured.
Oh, absolutely. Despite my negative experiences I in no way endorse avoiding doctors. As noted in my story, doctors at the urgent care clinic saved me from a much worse time (possibly even death).
I'm just saying (with way too many words) that there are reasons other than stoicism or machismo that people avoid going to the doctor. Were I the OP, I too would have not gone to the doctor for seemingly mild symptoms, and would have suffered as he/she did.
Most of us have no good way of knowing which issues are medically treatable and which aren't.
What magic combination of words did you utter to get the antibiotics you needed? I had a terribly painful bacterial infection once, and six urgent care clinics and ERs all refused to help me unless I had a CT scan first. After a month of this humiliation, I wound up smuggling Augmentin across the border and felt better within 24 hours.
I had an obvious lesion with a head, which the doctor swabbed. Though I did have to go to a second doctor - the first thought it was a less serious infection.
> but it demonstrates one reason why one can avoid doctors for seemingly non-serious ailments and conditions, particularly with all the times they've shrugged.
You didn't have breathing problems when you asked for an appointment; you had a cough. Then when you had breathing problems, you sought out emergency care and had that taken care of. But you blame your original doctor for... not predicting your breathing problems? Or not giving you lung x-rays the moment you diagnosed yourself with pneumonia? I'm confused what you would rather they have done.
The missed allergy sounds like a legit failure, though, but I'm not a doctor.
> I'm confused what you would rather they have done
Other than having more doctors in the world (thus higher availability) and/or lower prices, I don't think this is a solvable problem. My point was not that doctors are terrible, but that people may have decent reasons to suspect going to the doctor for a mild rash (as article had) would not be worth it. Reasons other than stoicism. When I have a cough now, I still don't go to the doctor because the last 4 trips have been "You have bronchitis, just wait it out". I've resigned myself to having a constant low-level cough between Nov-Mar every year.
I do think my allergies should have been detected, but at the same time I understand the reasons they weren't. My goal was not blame, though I can certainly see how my pity-party comment could sound that way.
i have the same problem. i called my primary care to say i hurt my neck in the shower, they said the earliest they could see me was 2 months into the future.
i had step throat, they refused me antibiotics because although i had all the classic symptoms, the strep test was negative. a bottle of penicillin i had at home cured me pretty quickly.
i had pnemonia, i told them this was the sickest i have ever been in my life. my whole body was in pain and i had trouble breathing, especially at night. they told me to drink water and rest. after 2 weeks i got another appointment, i was in really bad shape. they told drink water and rest. 3rd week same, but i refused to leave. i reminded them i lost 40lbs, only then did they take a real look at me.
> "Not necessarily their fault"
I do put the fault on them. i think there is something around 'white male, send them home' mentality.
And yet, that is sometimes not enough.
A good friend showed his obviously infected foot to a doctor who dismissed the circular rash left from a tick as a localized infection. Fast forward one year and my friend was having major health issues and difficulty making it through the work day. Eventually, it was the worrisome neuropathy in his arms that motivated him to get a full blood test which revealed... it was Lyme disease after all. And bonus! with a year's worth of disease development, a much harder infection to get rid of.
> It may be worth lodging a complaint with whatever authority your country may have against that doctor that dismissed the bullseye rash.
Because Lyme's disease is regional - almost exclusively found in the Northeast and Minnesota/Wisconsin - most doctors won't have had much experience with it. Lyme's disease also presents with a lot of different symptoms that are very difficult to differentiate from other conditions (including other tick-borne diseases), which makes it difficult for doctors in those areas to diagnose.
The trademark "bullseye" rash of Lyme looks striking in pictures, but in most cases, it's less heavily pronounced, and it's harder to differentiate from many other possible sources of a rash or irritation. This is actually a problem for people who contract Lyme's disease more than once - after you've had Lyme's once, you will always test positive for the disease, even though you may no longer need treatment, so it's hard to identify patients who have been reinfected.
Just got back from a trip to Brazil and got several tick bites. I'm an epidemiologist, so of course I have the litany of things I'm now exposed to - and the incubation period for all of them sits right on my flight home.
Told my wife that I'm going to feel like crap because of 30+ hours of flying, but if I have a headache that doesn't go away, I need to go to the hospital right now. That was a fun conversation.
There is also a window of time between when a tick attaches and when it can transmit disease. The ticks don't transmit disease until they have spent some time feeding so if you catch the tick within the first 24hrs or so you should be fine.
EDIT: Fixed some incorrect information after I did some more reading on the specifics. Here's a full break down of it:
Actually they start feeding immediately, but the bacteria which causes lyme disease lives in the ticks intestinal system (not all ticks carry the bacteria). After the tick is done feeding (in general approx. 1-2 days but can be longer or shorter), or overfeeds, it can ’vomit’ back into the host and possibly spread the bacteria from its intestines. This is also why you want to be careful when removing the tick and it’s best to use special plyers, and avoid squeezing the ticks body.
I'm sorry I believe my initial understanding was wrong. The time frame is still correct but I thought it was feeding but after you asked this it made me doubt myself and upon looking it up it's a different reason.
They feed immediately but it appears that it is contingent upon when the tick starts having to get rid of excess water. Until the blood meal has started to engorge the tick, though, the organisms are not activated in the tick's gut. So until you see that the tick has actually engorged a slight amount, it's apparently not enough for you to catch disease from the tick.
probably, my wife had it, and she received doxycycline. She felt terrible for days, not fun. Fortunately we discovered the tick, and later the "bullseye" quite quick, so we hope that it exterminated everything.
FWIW I have been treated for early-stage Lyme twice, both times with amoxicillin, which is often a little gentler on the body than doxycycline (and you don't have to give up alcohol or sunlight). Fortunately it seems like Lyme isn't (yet) too picky about which antibiotics should be used to fight it.
have you tried pemf? as you already know, anti-biotics currently cant completely eradicate lyme. it seems the only effective treatment i have seen are PEMF therapy. you can buy from companies like ampcoil.com, it is fairly expensive at about $7k but worth its weight in gold considering how life crippling lyme disease can be. i know because ive had several friends whose life been turned completely upside down due to lyme and it was difficult to watch. they couldnt go outside and always felt weak. months or even years of antibiotics didnt treat them.
then after research they ordered an ampcoil. its what they call a Tesla coil that you just put on your chest one hour a day and it emits magnetic frequencies that targets worms such as Borrelis amongst vast other things. you can actually see these little worms under microscope on your blood samples, scary little bastards. however, within short months of treatment they were pretty much back to being healthy and active again. you should seriously take a look at ampcoil, it seems to be a pretty effective treatment for lyme (i hear its got a 90% success rate), as they penetrate into worms smaller than your cells that antibiotics sometimes cant get into.
Regarding watching out for the bullseye rash (ie. "EM rash"):
I didn't even notice mine (though it was 4" in diameter) until after I was diagnosed with Lyme disease (via blood tests), because the rash was on my back -- a place I don't regularly look or check. I also had no idea I was bitten by a tick, or even had any ticks on my body. My biggest mistake was probably just not wearing insect repellent while going in to the woods in an area that had a high incidence of Lyme disease.
Regarding antibiotic treatment -- my own treatment wasn't painful, but more annoying than anything because the antibiotics made my skin very light-sensitive, so I had to mostly stay indoors with the blinds drawn. It's the period before the treatment that was miserable, as I had all sorts of painful symptoms.
When you find a tick, make sure to take the necessary precautions. I know someone who could've carried it with him for as much as 72 hours before discovery, and who didn't go to the doctor. He ended up with lyme.
Whereas if he had gotten antibiotics right after he'd probably have been okay.
It is also important to note that removing ticks quickly reduces the chances of contracting Lyme Disease. This means having a good and thorough tick check routine when outdoors is important. It is annoying after a long day of hiking or what not, but very important.
Lyme disease is unpleasant, but at least North America doesn't have Russia's tick-borne encephalitis, which kills or causes permanent neurological damage.
Rocky Mountain Spotted Fever has case fatality rates well above 50%, can cause multi-organ system failure, and has a 20% hospitalization rate even when treated.
It's transmitted in many of the same places Lyme is.
Back story on why a vaccine existed years ago ...and then was shelved because of anti-vax outrage is absolutely enraging for people who live in Lyme territory.
The withdrawal was unfortunate IMO. But it's not as simple as "anti-vax outrage." Efficacy wasn't great, vaccination only protected for a few years, and there were questions about side effects especially over the long term. [1] Especially given how Lyme has become such a problem in some areas, it's too bad it was withdrawn, but it's not a black and white case.
Ticks are widespread in Central Europe, but if you are cautious things are usually safe: wear long pants if you are in the woods, especially in summertime. No Flip flops. After you come home, check your entire body for ticks, it takes up to 24h to get Lyme. Have a tick card on you all the time, one like this: https://www.amazon.de/Zeckenkarte-mit-Lupe-Kurzbeschreibung-...
Interestingly enough it seems to be poorly recognised in France. (according to my personal experience, would love to hear more feedback)
I have two members of my family fighting to get diagnostic even though they both got bitten where here in the UK it doesn't seem to be a problem at all.
After reading this comment thread, i can attest that it's clearly not known enough in france indeed. From what i've read before (because i knew about Lyme), the only region affected by Lyme is nord-east of the country. We get tick bites whenever we go to south of France with my family, but so far nobody every got anything looking like Lyme.
One of the side effects of the fire ant problem in Texas is that they have significantly reduced the tick population. I have heard more than one person mention how they no longer find ticks after having been out in the woods, fields, etc.
Here is a page that talks about fire ants and some quotes:
"Fire ants voraciously consume populations of fleas, ticks, termites, cockroaches, chinch bugs, mosquito eggs and larva, scorpions, etc.—after learning this, I realize that it really has been years since I last set off a flea bomb. A non-overstated culinary creed for fire ants could be the following: If it will stay still for a bit . . . then it's dinner!"
"Although fire ants are a big challenge to keep under control, one of the benefits of having the fire ants around (at least in East Texas) is that they kill ticks. If you have ever spent any time in the Piney Woods of East Texas, you understand how valuable that can be to you, your dogs and your livestock."
I have gone through the article, suprisingly, there was no data to backup claim that "the ticks are comming". Is that a real threat or just a mere speculation?
I couldn't find the name of the author of the article, just to make sure it is someone who knows something about health problems.
Lack of data plus IStock photos suggest that the research behind the article might not have been very thorough. For instance it would be interesting to learn what persentage of ticks carries bacteria dangerous for people, how the number of people infected was changing over the past years, etc.
One summer, during an outing, I remember trying to remove a tick with tweezers, leaving the head in and having to use a pen knife to remove it. At the time I did not (or ignored) about Lyme disease, so in my mind it do not warranted a trip to the doctor.
Reading all the comments on this thread make me glad I don't spend as much time as before in place where ticks are present.
Happy to not have Lymes but I'm on year 3 of being allergic to meat that comes from hoofed animals (alpha-gal) because of a tick bite. I go out a lot less now but when I do I also use Permethrin.
Wow, I've heard about meat allergies from ticks but I didn't realize they were common enough for 2 people on HN to have them. Permethrin really is amazing, isn't it?
I spent a couple of years in Chile in some poorer parts of Santiago and I saw lots of ticks on lots of street dogs. I was outside much of the day and yet I never got a tick. I kind of wonder if the dogs being a plentiful and easy target resulted in the ticks just not trying with humans.
The article is somewhat alarmist, behavior modification can greatly limit the risk of ticks. This might be something that is more alarming in the UK for some reason if they haven't had to worry about it so far?
I live in Massachusetts, pretty close to ground central for Lyme's disease.
I've been mountain biking, hiking, doing outdoor photography, etc.. most of my life and have never managed to get bit by a tick and contract it. I've found 5 ticks or so in that time have always found them before they could bite me just because I was aware of the risk. And that's talking hundreds of days per year of outdoor activities.
Tall grass is high risk. Taking your sweet time golfing is risky. Riding your mountain bike through grass at 20mph is much less risky. You'd tend to be riding on a trail too, even if it's not more than 6" wide, it still somewhat reduces the surface for the ticks to cling to. Having a job like being a surveyor is very high risk since they're out in the grass working and not moving quickly.
Once you get under major tree cover (we have lots of it) the undergrowth tends to thin out and you'll contact less grass/leaves and have less exposure to ticks grabbing onto you. This is perhaps one of the reasons you hear a lot about people getting Ticks down on Cape Code if they're exploring tall grass environments, there is less dense tree cover on the Cape compared to the mainland.
By far the riskiest thing anecdotally seems to be owning a dog. Dogs love to go walk through the high grass, ticks love to grab onto their fur. Then they bring the ticks into your car, into your house, sit on your lap. When you walk your dog you tend to go where the dog wants to go within reason. And you're walking, so you're moving at speeds ticks are happy with. So you're perhaps walking areas you wouldn't walk alone if you're wary of ticks. It seems like practically every dog owner I know regularly deals with ticks brought in by dogs, and a lot of the dog owners have actually gotten Lyme's disease, some more than once! You'll hear stories of 10 ticks on a dog coming back from a walk.
If I guess I've found 5 on me in 25 years of outdoor activities 1 was biking in/around tall grass on Cape Cod (found it on my leg), 1 was walking in North Carolina (found it on my sock), 1 was brought into the house by a dog (the only deer tick of the 5). Not sure of the others, maybe 5 is generous.
The article also doesn't mention how certain activities can be done in different months to limit risk. Particularly deer tick are much harder to spot if you are out in risky areas in the early spring. They're super small at that point. But later in the summer they're grown and easy to spot.
For me that super high risk deer tick season where they are immature coincides with mud season. We are already discouraged from hiking & biking through the mud, so the double whammy of peak tick season + mud season makes it easy to select outdoor activities that are lower risk at that time of year.
It's just really hard to take the article seriously, this just is not going to be a risk for people who live in big cities and spend little time in natural environments, particularly if they also don't have pets. That covers a lot of the population.
why not just tuck your pants into your socks, and no more ticks. or you could use Eucalyptus in the shower and no more ticks. WTF are you talking about the next global health threat. Like wearing a condom protect your self and buy some eucalyptus ticks hate that and lemon oil works better than deet and all natural non toxic.
161 comments
[ 4.3 ms ] story [ 224 ms ] threadFriend has had increasingly difficult health problems - mistook for thyroid issues - neurological issues (difficulty standing), thinning, pain, very scary stuff. Lyme swelling around nerves in brain, I believe was the explanation. Could not work. Finally diagnosed and undergoing months of traumatic antibiotic treatments involving a "heart port" :P is improving now, back working.
Tick bite in New York.
Unfortunately it wasn't, but this should have been a major warning sign. There's still a lot of education to do. Almost the number one thing related to ticks I was taught by people from nature organisations is: if you know you had a tick bite, and you feel anything seriously out of order (of which the chances are still fairly small btw), check with a doctor; and if that doctor does not come up with anything tick-related (which happens, 10 years ago I also thought Lyme disease was the only bad thing which was spread by ticks), then get a second opinion from a doctor who has experience with most cases occurring in your area.
Last summer, one incident I had to pull a couple hundred off my dog after she wandered into a particularly bad section of the willowwacks. Just awful little beasties.
I read the physical magazine but think that https://www.newscientist.com/article/mg23431195-800-lyme-dis... is the same article.
Also, the lore that was told in my family was, that ticks dropped from trees in the forest. But you can get them also from gras, hedges, bushes. So not being in the wood is no protection against ticks.
I read an article that described their basic algorithm as climb to the top of whatever they are on, blade of grass, shrub branch, etc., and just hang out there waving their arms until something brushes by and they snag it, then climb again until they find a good spot.
In New England, I've had to get in the habit of immediately dropping the clothes in the wash, showering, and then diligently checking the whole body for tics after a run, mtn bike, or hike. And I still occasionally find one hours later. The good thing is that they don't really inject the disease until they've been attached and biting for 24 hours or so and are mostly engorged.
Definitely a hazard to be diligent about!
[edt: spelling]
Edit: I had no idea Lyme Disease was a risk here:
http://www.ticscotland.org.uk/incidence
Running is probably an ideal speed for them to snag you (think how they'd be snagging deer, dogs, etc), and I've never found biking fast enough to not get them. It seems like they don't grab by any reflex, but just by hanging a few hooks out in the breeze to snag whatever comes by.
Another thing I found that I didn't expect -- I'd guessed that they'd be most active in hotter weather, making motion easier, etc., but it seems that the most active times are moderate temps, maybe 10-25C (50-77F), but we still need to watch out outside of that range. I've seen them all the way down to almost freezing and up in the 30C+/90F+ range.
On yourself even after taking a shower, or in your clothes that you threw into the wash?
Doesn't help if you wear shorts or go barefoot of course
The random tangent about deforestation and global warming seems ideological to me. Ticks aren’t being forced into contact with us, they want to be wherever they can be.
If anything my guess would there’s a problem with lack of predators, like a reduction in possums or something similar.
I don't know if I just got lucky in my youth or if ticks are getting worse, but it's something that's stood out to me as curious.
Might be they only go after certain people.
What does this have to do with it? New Hampshire is much more forested than it was 200 years ago. The last two years there have been WAY, WAY more ticks than in the years of my childhood. It's a mini crisis here and is completely unrelated to forest destruction or lack thereof.
Now beaches and parks back there (rural south-western Ontario) are littered with "Tick Warning" signs.
You're not the only one who's confused and curious about it. It's like they used to be a non-issue. We were warned about them, I remember that—but that's all.
I grew up in relatively cold part of my country around mountains, we never ever had ticks around as a kid. It was just some exotic scourge in the lowlands. These days, they are abundant there. Same goes for example for some exotic poisonous spiders creeping from south. One day, malaria/dengue/yellow fever/etc in central europe will be a reality, unless we eradicate it sooner.
No clue whether they increased concentration in the already-present areas though.
My thought is the increase in ticks is due to the elimination of widespread DDT spaying, check out this typical scene from 1950's and 60's:
http://slideplayer.com/slide/5357033/17/images/22/to+Humans+...
On the positive side, I never saw a hawk or eagle when I was growing up, and they have returned since they are no longer being pressured by insecticide concentration in their food chain. Maybe we could strike a compromise, bomb tick infested areas for a year or two with DDT to knock down the ticks.
[edit] A red tailed hawk just perched in the tree outside my window.
The relationship between insect outbreaks and climate change is not ideological and has a number of studies supporting the theory that insect populations increase and migrate due to climate change.
Here's one link [0] culled from a quick search on Google [1]
[0] http://www.bioone.org/doi/abs/10.1641/0006-3568(2001)051[072...
[1] https://www.google.com/search?num=100&source=hp&ei=CNtxWsyxB...
Indeed the abundance of predators, notably martens and foxes, in some areas has been linked with a decrease in infected ticks. http://rspb.royalsocietypublishing.org/content/284/1859/2017...
Bring back coyotes.
I’m from Massachusetts and spend a lot of time on Nantucket, which is like ground zero for Lyme (lots of deer, no predators). A service like this can really give you peace of mind if you do get bit.
Also worth noting, a tick bite is not like a snake bite. It’s not really like being instantly injected with a venom or a foreign pathogen. From what I understand (after I got bit and looked it up) the tick really needs to be dug in for about 24-48 hours to cause a problem. So it’s more like the tick is giving you an infection, and in the course of that passing on these terrible diseases (sometimes).
This is the case here in Ottawa:
http://www.ottawapublichealth.ca/en/public-health-topics/lym...
Unfortunately we know all about this because our dog got bit, got Lyme disease (even though she was on the preventative medications), then developed a rare complication (heart condition). It's really made going out on the trails a less fun experience when worrying about ticks.
Can confirm that ticks need time to give you Lyme. I've had Lyme twice. Both times I missed a tick on initial check and found it a day later. I get bitten few times a year and every time I find them on time all is good.
It's pretty close. Only ~150km from Plum Island.
Give a 100% discount on ferry tickets to anyone with a valid hunting license during deer season. The problem will solve itself. The people with money don't care what the locals shoot up over the winter. I don't see why they care what the locals shoot over the winter.
“ Diseases like these weed out sick or infirm individuals in the host population”
“Taken with other factors, like predation, “it might keep host populations within the carrying capacity of the land,” he said, possibly by reducing overgrazing and other forms of destruction to vegetation.”
It's derived from a chemical found in Chrysanthemums.
https://en.m.wikipedia.org/wiki/Permethrin
https://organicdailypost.com/make-tick-tubes/
I'm out in the yard a lot, I pull ticks off daily. I fortunately never have had Lymes but I noted (anecdotally) that the tick population has exploded in the last 10 years with the milder winters.
It's concerning. Probably going to get a flock of guinea hens this year.
Problem with this is Permethrin is quite a broad-spectrum insecticide and won't kill just ticks but also a lot of other insects (which take care of e.g. pollination and in turn are food for others, etc, the usual picture) and is also not exactly friendly for aquatic life. Also mammals are not completely out of the danger zone, depending on dose. And longer term effects are as far as I know simply unknown. So it needs at least some careful consideration in my opinion.
https://en.m.wikipedia.org/wiki/Permethrin#Safety
https://www.citylab.com/environment/2015/02/suburban-birds-a...
It saves having to spray the clothing before each trip. Treatment is supposed to last for 70 washings.
Fortunately at the moment it is too cold where I live for ticks so I don't need to worry about it, but as this article notes, that may not be that way much longer... :(
Amazon has an 8oz/236ml bottle at 10% for $36, so about $1.35/ml of pure permethrin, but then you've got to soak your clothes instead of just spraying them, and that takes several hours and you've got to get rid of the fluid afterwards.
Anyone notice a difference in effectiveness between spraying and soaking clothes?
In NY, VT, ME, and NJ I find ticks on my socks almost every single time I run in the woods. The white socks make them easier to spot.
The socks are not exactly stylish, but I've embraced the look.
The thing I was taught by this experience, is to never, ever screw around with it. In my case I was attacked by a swarm of ticks during a hot period (Vienna, Austria) and I kind of ignored the bites .. thought nothing of them after discovering the ticks (2) and removing them .. but after 2 days, I had 4 red splotches over my body, and it was clear that I had the characteristic 'bullseye' symptoms.
Thought "okay, I can live through this" and didn't do anything about it for about 5 - 6 weeks; splotches went away, and I thought I was fine. No. Just, no. I was not fine.
Aches and pains like none I've experienced before (being Australian, I've had a few nasty bites in my life), and malaise and lethargy that was seriously affecting my ability to live life. Doctor told me I was an idiot for not coming in right away - that I could very well have done damage to my brain - and was put on a super strong antibiotics regimen .. which was pain itself, since it screwed with everything.
Anyway, had my blood tests, and they think I'm fine. But I have to go back in a month for another round of tests - because even if you think you're fine, after Lyme, you may not be fine for a few years. It can persist in the human body.
So, don't be a fool like me: if you get a tick, go immediately to the doctor and get it sorted. Trust me the symptoms are just awful.
https://www.historyofvaccines.org/content/articles/history-l...
https://www.pbs.org/newshour/show/dogs-can-get-lyme-disease-...
I'm glad to hear you're on your way to a full recovery given the severity of Lyme.
Your advice to "go immediately to the doctor" is not only important with regard to ticks but to all manner of infection. Most infections have similar symptoms and distinguishing between something discomforting and something deadly is a matter for a health care professional.
Stoicism with regard to maladies is practically a cliché among strong-willed people (men especially). Always consult a doctor with unusual infections, and seemingly usual ones, too, if you can.
Running to the doctor for non-issues is part of why our medical costs have increased so much the last few years. There's so much marketing to "ask your doctor" about this and that and the other thing these days. And when you go, of course the doctor is obligated to run a battery of tests to cover his ass.
So, learn to spot the symptoms, and go get it sorted with a doctor. Like you would with any parasite.
You are correct in that the longer a tick is attached the more likely you are to get Lyme. Mayo Clinic says it's unlikely to happen if it'as attached less than 36-48 hours. But some of the ones that can give you Lyme are about the size of a poppyseed and you don't notice them right away. You should always check for ticks after being outside and remove them ASAP.
More info on what to do: https://www.uptodate.com/contents/what-to-do-after-a-tick-bi...
a) I have no primary care physician because I don't typicaly go to the doc for any reason
b) although I can afford insurance, it has an insanely high deductible and is very difficult to predict what I will be charged for
c) going to the doctor involves triggering an expensive and difficult to predict system that will possibly bankrupt me.
So I (like a lot of folks) don't go unless there is either an obvious emergency or a horrible, hard to live with long term problem.
So yeah, the advice is probably good, but the reason that I don't tend to take it has little to do with my willpower.
This is circular... you saying you don't go to the doctor because you have no PCP, and you don't have a PCP because you don't go to the doctor
> c) going to the doctor involves triggering an expensive and difficult to predict system that will possibly bankrupt me.
I'm having a hard time believing that a standard outpatient visit would bankrupt you. These are typically on the order of $100, and rarely more than a few hundred unless you're going in for specialized procedures, which you've already established you aren't.
Sure, if you go to the doctor, you might find out you have a more serious condition that would require future, longer-term care to address, and that future care may involve additional expenses and inpatient care which you may or may not be able to afford. But that's hardly a reason not to go to the doctor today and find out - at least you'd be able to make that decision on an informed basis.
In India, the process is very simple: you call the doctor in the morning, you get an appointment for the afternoon, you show up, get looked at, pay the cost of the visit (usually less than $10-15), and you're done. It's basically like any other business transaction. So even if I had a minor seeming infection, going to the doctor was the right and efficient move.
Here, I call the doctor's office, and might not get an appointment for another two months, if I'm lucky. At that point there is some opaque process involving my insurance, and it just seems like a much weightier event than a simple visit should be.
Of course, I'm guessing that an infection would speed up the process, but the psychological barrier is already up in my mind, and I'd rather just power through on my own.
But there seems to be some hope. Recently, my wife was able to go to an urgent care clinic to treat an infection, and the process was much more like what happens in India. Still, there is some intervention of insurance, though a bit more transparently so.
They did refer me to an orthopedist and I ended up being out about $450 dollars after they looked at an some imaging and decided it was a growing pain.
That was with insurance, but hey, not wholly unpredictable and because there was nothing treatable I wasn't bankrupted.
So I talk to the doctor and they say XYZ tests need to be run. Okay, now I know what I need exactly and get a price, right? Nope. I just get the run around and "It depends on the insurance" and "We will bill you later" and "No it's probably not $5000" and straight up "I don't know"
Oh, okay, so I need to call the insurance company then, huh? Nope, they won't tell me either. I've tried. They just say "It depends". Even when I know exactly what labs they are going to run. I can say "I understand it might change if they need to run more tests." Nope. No idea.
Sometimes they can give you a straight answer but very often they will not.
It's hidden on purpose. It is confusing on purpose. Insurance companies don't want you to know what's going on. The doctors offices don't want to share "cash-only" info publicly because insurance companies will demand that price. The insurance companies don't want to share the info because people will complain. Etc etc it is not that easy when you go to the doctor for more than the really simple things.
Not necessarily their fault (medical science is trying to debug a program that you don't have the code for, do not control/know all of the inputs to, and you risk killing them if it crashes) but they've failed me time and time again in diagnosis, effectiveness, and availability, and in the US they were a financial burden until I was fortunate enough to reach the point my budget could take a hit.
This has built a habit of assuming that if I'm not in intense pain, visiting a doctor would be a waste of time and money.
I got pneumonia once. When the cough seemed serious I asked for an appt, but it took several days and by the day of I was struggling to breathe. Ended up going to an urgent care clinic hours before my appt because I was genuinely worried I wouldn't make it to said appt if I waited. The clinic agreed, given that as I walked in to their crowded lobby they heard me rasping and bumped me to the head of the line. I had four people on me at once, giving me oxygen, taking vitals, and one entering the numbers into their computer. I could see the screen, and saw that a few entries triggered a "the number indicates a critical problem, is it accurate?" warnings. They told me later that at 1 percent lower oxygen (i was 92%, which apparently low) they would have sent me to the emergency room. I'm glad they didn't, as their care beat any ER visit I've had, and was only $100, which included lung xrays. An ER visit would have been worse just walking in the door. Still worth it when they can help me breathe, but it demonstrates one reason why one can avoid doctors for seemingly non-serious ailments and conditions, particularly with all the times they've shrugged.
I'm allergic to most everything that won't kill you (pollen, mold, dust mites, cats, dogs, even rats). I have a list of issues with this, mostly constant sinus production/drainage, but only learned it was allergies when I self diagnosed in my 30s and went to an allergist to confirm. Even then, the cause that was dramatic enough to clue me in (rats) was not part of the standard panel. I had to specifically request it...and then point out that they hadn't added it as they said they would. That ended up being so severe that the tiny scratch swelled to the size of a half dollar despite me being on benadryl (i had missed the instruction to skip such meds for the test) AND the calamine lotion they slapped on it almost immediately. Had I not asked for and checked for that test, the specific problem of the moment (my girlfriends pet rats) would have remained undiagnosed (I had a list of potential causes of an uptick in problems, not awareness of any specific one). Not one doctor growing up suggested an allergy test, even though I can now look back and see obvious signs. Not one doctor asked if my symptoms occurred at specific times or places, not one ever mentioned the high constant drainage or inflamed ear canals. (Though doctors offices are pretty allergen free. As a kid I joked that their ugly paint made you feel better, since by the time a doctor came to look in on me my worst symptoms weren't there...in retrospect the repeat experience should have been a clue to them and possibly my younger self) Instead they called it mild asthma (asthma test was negative, but shrug. My guess is that they called it that just to make me feel they had a clue)
Machismo is a problem, but it isn't the sole problem.
Then there is stuff they handle extremely well: broken bones, bacteria, and a variety of easily treatable ailments.
I have a few health issues I know I basically can get no medical help on. And then, on the other hand, I had MRSA, and went to the doctor ASAP to get that cured.
I'm just saying (with way too many words) that there are reasons other than stoicism or machismo that people avoid going to the doctor. Were I the OP, I too would have not gone to the doctor for seemingly mild symptoms, and would have suffered as he/she did.
Most of us have no good way of knowing which issues are medically treatable and which aren't.
But you got a point: they suck at preventing CVD, which is a shame.
You didn't have breathing problems when you asked for an appointment; you had a cough. Then when you had breathing problems, you sought out emergency care and had that taken care of. But you blame your original doctor for... not predicting your breathing problems? Or not giving you lung x-rays the moment you diagnosed yourself with pneumonia? I'm confused what you would rather they have done.
The missed allergy sounds like a legit failure, though, but I'm not a doctor.
Other than having more doctors in the world (thus higher availability) and/or lower prices, I don't think this is a solvable problem. My point was not that doctors are terrible, but that people may have decent reasons to suspect going to the doctor for a mild rash (as article had) would not be worth it. Reasons other than stoicism. When I have a cough now, I still don't go to the doctor because the last 4 trips have been "You have bronchitis, just wait it out". I've resigned myself to having a constant low-level cough between Nov-Mar every year.
I do think my allergies should have been detected, but at the same time I understand the reasons they weren't. My goal was not blame, though I can certainly see how my pity-party comment could sound that way.
i had step throat, they refused me antibiotics because although i had all the classic symptoms, the strep test was negative. a bottle of penicillin i had at home cured me pretty quickly.
i had pnemonia, i told them this was the sickest i have ever been in my life. my whole body was in pain and i had trouble breathing, especially at night. they told me to drink water and rest. after 2 weeks i got another appointment, i was in really bad shape. they told drink water and rest. 3rd week same, but i refused to leave. i reminded them i lost 40lbs, only then did they take a real look at me.
> "Not necessarily their fault" I do put the fault on them. i think there is something around 'white male, send them home' mentality.
Because Lyme's disease is regional - almost exclusively found in the Northeast and Minnesota/Wisconsin - most doctors won't have had much experience with it. Lyme's disease also presents with a lot of different symptoms that are very difficult to differentiate from other conditions (including other tick-borne diseases), which makes it difficult for doctors in those areas to diagnose.
The trademark "bullseye" rash of Lyme looks striking in pictures, but in most cases, it's less heavily pronounced, and it's harder to differentiate from many other possible sources of a rash or irritation. This is actually a problem for people who contract Lyme's disease more than once - after you've had Lyme's once, you will always test positive for the disease, even though you may no longer need treatment, so it's hard to identify patients who have been reinfected.
Told my wife that I'm going to feel like crap because of 30+ hours of flying, but if I have a headache that doesn't go away, I need to go to the hospital right now. That was a fun conversation.
EDIT: Fixed some incorrect information after I did some more reading on the specifics. Here's a full break down of it:
https://www.uptodate.com/contents/what-to-do-after-a-tick-bi...
And here's the process of a tick attaching: http://phenomena.nationalgeographic.com/2013/10/30/heres-wha...
They feed immediately but it appears that it is contingent upon when the tick starts having to get rid of excess water. Until the blood meal has started to engorge the tick, though, the organisms are not activated in the tick's gut. So until you see that the tick has actually engorged a slight amount, it's apparently not enough for you to catch disease from the tick.
https://www.uptodate.com/contents/what-to-do-after-a-tick-bi...
Again, sorry for the incorrect info initially!
http://www.treatlyme.net/treat-lyme-book/lyme-disease-antibi...
Just don't take antibiotics by yourself, go to a doctor.
then after research they ordered an ampcoil. its what they call a Tesla coil that you just put on your chest one hour a day and it emits magnetic frequencies that targets worms such as Borrelis amongst vast other things. you can actually see these little worms under microscope on your blood samples, scary little bastards. however, within short months of treatment they were pretty much back to being healthy and active again. you should seriously take a look at ampcoil, it seems to be a pretty effective treatment for lyme (i hear its got a 90% success rate), as they penetrate into worms smaller than your cells that antibiotics sometimes cant get into.
I didn't even notice mine (though it was 4" in diameter) until after I was diagnosed with Lyme disease (via blood tests), because the rash was on my back -- a place I don't regularly look or check. I also had no idea I was bitten by a tick, or even had any ticks on my body. My biggest mistake was probably just not wearing insect repellent while going in to the woods in an area that had a high incidence of Lyme disease.
Regarding antibiotic treatment -- my own treatment wasn't painful, but more annoying than anything because the antibiotics made my skin very light-sensitive, so I had to mostly stay indoors with the blinds drawn. It's the period before the treatment that was miserable, as I had all sorts of painful symptoms.
I agree with your post, I just wanted to clarify that people shouldn’t think they’re in the clear just because they didn’t get the rash.
Whereas if he had gotten antibiotics right after he'd probably have been okay.
[1] https://en.wikipedia.org/wiki/Tick-borne_encephalitis
It's transmitted in many of the same places Lyme is.
http://www.newsweek.com/lyme-disease-vaccine-valneva-fda-app...
Back story on why a vaccine existed years ago ...and then was shelved because of anti-vax outrage is absolutely enraging for people who live in Lyme territory.
http://legacy.wbur.org/2012/06/27/lyme-vaccine
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2870557/
[1] https://www.mec.ca/en/product/5050-423/Tick-Remover-Card
I have two members of my family fighting to get diagnostic even though they both got bitten where here in the UK it doesn't seem to be a problem at all.
http://www.caryinstitute.org/newsroom/opossums-killers-ticks
Here is a page that talks about fire ants and some quotes:
https://aggie-horticulture.tamu.edu/galveston/beneficials/be...
"Fire ants voraciously consume populations of fleas, ticks, termites, cockroaches, chinch bugs, mosquito eggs and larva, scorpions, etc.—after learning this, I realize that it really has been years since I last set off a flea bomb. A non-overstated culinary creed for fire ants could be the following: If it will stay still for a bit . . . then it's dinner!"
"Although fire ants are a big challenge to keep under control, one of the benefits of having the fire ants around (at least in East Texas) is that they kill ticks. If you have ever spent any time in the Piney Woods of East Texas, you understand how valuable that can be to you, your dogs and your livestock."
I couldn't find the name of the author of the article, just to make sure it is someone who knows something about health problems.
Lack of data plus IStock photos suggest that the research behind the article might not have been very thorough. For instance it would be interesting to learn what persentage of ticks carries bacteria dangerous for people, how the number of people infected was changing over the past years, etc.
Reading all the comments on this thread make me glad I don't spend as much time as before in place where ticks are present.
I live in Massachusetts, pretty close to ground central for Lyme's disease.
I've been mountain biking, hiking, doing outdoor photography, etc.. most of my life and have never managed to get bit by a tick and contract it. I've found 5 ticks or so in that time have always found them before they could bite me just because I was aware of the risk. And that's talking hundreds of days per year of outdoor activities.
Tall grass is high risk. Taking your sweet time golfing is risky. Riding your mountain bike through grass at 20mph is much less risky. You'd tend to be riding on a trail too, even if it's not more than 6" wide, it still somewhat reduces the surface for the ticks to cling to. Having a job like being a surveyor is very high risk since they're out in the grass working and not moving quickly.
Once you get under major tree cover (we have lots of it) the undergrowth tends to thin out and you'll contact less grass/leaves and have less exposure to ticks grabbing onto you. This is perhaps one of the reasons you hear a lot about people getting Ticks down on Cape Code if they're exploring tall grass environments, there is less dense tree cover on the Cape compared to the mainland.
By far the riskiest thing anecdotally seems to be owning a dog. Dogs love to go walk through the high grass, ticks love to grab onto their fur. Then they bring the ticks into your car, into your house, sit on your lap. When you walk your dog you tend to go where the dog wants to go within reason. And you're walking, so you're moving at speeds ticks are happy with. So you're perhaps walking areas you wouldn't walk alone if you're wary of ticks. It seems like practically every dog owner I know regularly deals with ticks brought in by dogs, and a lot of the dog owners have actually gotten Lyme's disease, some more than once! You'll hear stories of 10 ticks on a dog coming back from a walk.
If I guess I've found 5 on me in 25 years of outdoor activities 1 was biking in/around tall grass on Cape Cod (found it on my leg), 1 was walking in North Carolina (found it on my sock), 1 was brought into the house by a dog (the only deer tick of the 5). Not sure of the others, maybe 5 is generous.
The article also doesn't mention how certain activities can be done in different months to limit risk. Particularly deer tick are much harder to spot if you are out in risky areas in the early spring. They're super small at that point. But later in the summer they're grown and easy to spot.
For me that super high risk deer tick season where they are immature coincides with mud season. We are already discouraged from hiking & biking through the mud, so the double whammy of peak tick season + mud season makes it easy to select outdoor activities that are lower risk at that time of year.
It's just really hard to take the article seriously, this just is not going to be a risk for people who live in big cities and spend little time in natural environments, particularly if they also don't have pets. That covers a lot of the population.