Wednesday, June 20, 2012

Lyme Disease

I just read a great article about Lyme Disease.  This is very common in this area where live and we see deer in our backyard all the time!  I'm dreading the day I have to pull out a tick off my one of my kids.  I do it enough in the office... like I said, it is pretty common where we live.  Now unfortunately, this article is saying that 2012 will be the worse summer ever in the northeast for Lyme!

Click here for the full story.

So I found the article very interesting because the treatment of Lyme has always been a very controversial issue.  There are the "Lyme Literate" doctors who will put folks on antibiotics for months and months and even send patients home with IV antibiotics... then there is the "standard of care" where medical societies argue there is no benefit to that type of plan.  This article featured treating patients with refractory symptoms as if they have an autoimmune disease (like rheumatoid arthritis) rather than persistent infection.  It appears to be promising!


So quick 101 on Lyme...

How do you get Lyme?
  • infection is caused by bacteria (Borellia Burgdorferi) which is usually found on mice
  • Ixodes ticks (or deer ticks) feed on these animals and transmit to humans via tick bite
What are the symptoms of Lyme?
  • some folks get the typical circular "bulls eye" rash about 1-2 weeks after the bite (but many folks do not get this rash)... it resolves on its own in about 1 month

  • may also get rash in other places not where the original bite was
  • some get flu-like symptoms:  fever, joint and muscle aches, swollen lymph nodes, fatigue
  • some get irregular heart beat or chest pain
  • some folks get Bell's palsy (where one side of your face is paralyzed)
  • some get numbness and tingling
  • some get headaches and neck stiffness
What happens if Lyme is not treated right away?
  • late Lyme symptoms can occur weeks to years after the initial bite
  • in children, it often presents as arthritis in knee or some other large joint
  • slew of other symptoms affecting different organ systems especially neurologic can also occur (which I will not go into detail right now but can refer to link below in the comments or this cdc website:  http://www.cdc.gov/lyme/signs_symptoms/index.html)
How do you treat Lyme?
  • antibiotics for usually 3-4 weeks
How do you prevent Lyme?
  • know where to expect ticks
    • moist humid environments near wooded or grassy areas
    • near leaf litter or shrubs
    • low tree branches
    • edges of woods and forests
    • old stone walls
  • best to wear long sleeves that are tucked in and enclosed shoes
  • girls should have hair in ponytail or tucked inside a cap
  • use repellant that has 10% to 30% deet and apply to exposed skin areas as well as clothing (click here to read more about applying repellant)
  • light clothing helps you see tick more clearly
  • check for ticks daily especially:
    • under the arms
    • in and around the ears
    • inside the belly button
    • back of the knees
    • in and around hair and body hair
    • between legs
    • around the waist
  • check clothing and pets for ticks as well
So if you suspect Lyme or discover a tick... go to your doctor.  This is a tricky disease to diagnose because the symptoms are so wide and varied and there is not a very good blood test to detect it.  Nevertheless, the sooner treatment is started the better chance of a good outcome and full recovery. 

4 comments:

  1. Please educate your readers about the psychological and cognitive aspects of Lyme. Especially in children these may be the ONLY signs that something is amiss.

    Your current piece really glosses over the severity of this. I assure you from personal experience that it is very real and completely disabling if it becomes chronic due to lack of early intervention.

    And "arthritis" is the least of your worries.

    http://www.columbia-lyme.org/patients/ld_lyme_symptoms.html

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  2. Thanks for your comment and link. You are right, I wrote this last night mostly in response to the lyme article I read and I meant the 101 section purely as a brief overview. It was not mean to be comprehensive or exhaustive... but I did edit to let the readers know there is definitely many more symptoms that can be present. It is complicated and difficult sometimes to differentiate with other diseases especially if the patient or family members do not remember a tick bite or a rash. Plus with the limited method of diagnosis, Lyme remains a challenge to identify early and treat. If suspicion for Lyme is high enough, I will often treat even without blood test confirmation.

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  3. Thanks for the focus on preventing tick bites! As tricky as this is, and as varied as the symptoms are - I've read in other sources and as a layperson "stew" really does seem a great term! - I'm just hoping to avoid as many ticks as possible. We live in a high-risk area too, so I appreciate the tips on side-tracking ticks altogether.

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  4. I actually wrote "slew"... but yes... lots of nuances and complications from this so try to avoid if possible!

    ReplyDelete

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