Tick Mania Part II

     How do I handle tick bites?  Thankfully, I haven’t had any recent bites but I can't seem to keep them away from my three-year-old daughter.  Perhaps they are on me as well and her pristine skin gives them away while mine just go unnoticed, but I have plucked four ticks off her in the past two years.  However, I can’t force her to stay inside and stare out the window like an indoor cat anxious to bust outdoors.  She needs a daily dose of nature.  At first that meant she would safely watch the trees from a Baby Bjorn and I didn’t have to worry.  However, even as she began to explore on her feet I never really thought about potentially dangerous insects, I was more concerned she would fall in a lake or tumble off a stone wall.  Basically I figured that if we steered clear from obvious tick habitats like unkempt grasses and deep woods then we would be relatively safe.

       

     No such luck.   At age two she got her first tick at my parent's house just playing in the yard.  Tick number two was acquired there as well just one month later.  At that point in my neurotic mind the peaceful woodland yard was forever rendered into a shadowy danger zone.  I got both of the ticks tested for Lyme and various coinfections.  Mercifully the ticks were negative for Lyme but the second tick was positive for Anaplasma, a bacterium that actually caused Dave Letterman to get sick after a day in his Connecticut backyard.  I took my daughter and the tick report from the lab to the doctor’s office.  The pediatrician scolded me for getting the tick tested and then gave us a prescription for doxycycline just in case she became symptomatic.  I told her that while I respected her opinion I personally prefer to know what to expect, and at least if I am aware Anaplasmosis is a possibility than I can get her treated in time if symptoms should arise.  No symptoms manifested so we were good, and to the best of my knowledge tick free, until the following May. This time the tick crawled onto her hip at my friend’s house.  We were in the garden trying to enjoy the beautiful spring flowers. The tick was sent to the lab and now gardens are suspect too, not that we are giving them up.  This time we rejoiced in a completely negative tick and I sent a silent prayer of thanks to St. Jude.   

     The latest tick finding was the one that really threw me. She seems to have caught it simply by being outside.  I never even noticed it, but thankfully my husband spotted it attached to her neck.  Once again we sent the tick off to be evaluated; once again the little beast was negative for Lyme and positive for Anaplasma.  So while I feel relieved that we caught it, we had to go get another supply of doxycycline and are currently watching for strange symptoms. 

I don’t mean to overreact with constant tick testing, but I figure if I find the tick then it makes sense to be diligent.  I guess I have heard too many tick horror stories, and even if some of the lore is legend I prefer to play it safe.  In the meantime, after every tick bite I give her an immune boosting protocol which includes echinacea, astragalus, and elderberry syrup three times a day for a month.  I also give her a bit of chopped garlic soaked in raw honey with each substantial meal (as long as she doesn’t exhibit stomach upset).  The tick bite itself is doused daily in an anti microbial solution of thyme, myrrh, comfrey, and calendula until it disappears.  Luckily her tick bites have not looked angry; inflammation around the bite, even if it isn’t in a bull’s eye pattern, can be an indicator of infection.
     And of course while we are probably more aware of ticks we are not going to let them limit our outside excursions. Daily tick checks, as tedious as they are, are an imperative. In addition, light colored clothing and white socks pulled up high over her pant legs are a part of her new eccentric outdoor look.  I also force a hat on her because hair tick checks always end up feeling futile.  And finally a healthy application of tick repelling essential oil formula is a must have for us.  We reserve the Deet for long hikes in the woods, which honestly we may avoid for awhile.

So I have a new healthy attitude about ticks in Maryland. I respect them but I am not going to fear them.  After four tick bites, I hope I am learning something. 

Tick Protocol:

1)    Don’t panic and carefully remove the tick with tweezers by grasping the tick as close to the skin as possible.  Do not apply anything to the bite before the tick is removed (including alcohol).  There are tick removing devices available but the one I tried was useless for the nymph deer tick I was trying to remove, I think it was geared toward the removal of larger ticks.

2)    Disinfect the bite with alcohol and disinfect your hands and the tweezers as well.

3)    Keep the tick!  Place the tick in a plastic baggie with a tiny bit of wet paper towel.

4)    Try to estimate how long the tick was attached and consider testing. Two labs I have used with quick turnaround times are Clongen in Germantown, MD and UMASS tick testing at University of Massachusetts Zoology Department.

5)    Watch the tick bite for inflammation and monitor symptoms for one month.

6)    Consider adjunct treatment with herbs to support your immune response. This could be similar to the elderberry-astragalus-echinacea blend I give to my daughter or you could try other herbs like andrographis, cat’s claw, or medicinal mushrooms.

Tick Mania Part I

I live in Maryland which is considered an area endemic for the ticks that carry Lyme disease.  Stories of Lyme are ubiquitous in Maryland and most people have some awareness of the disease, even if they haven’t personally experienced infection.

As a kid I grew up exploring the woods and fields around my house. It was blissful because I was unaware of any actual dangers in the wilderness beyond my imagination; nature was just a part of my life.  We didn't worry about ticks much except for the exciting and relatively rare encounter with a bloated gray dog tick. The big concern with tick bites back in the 70s / 80s was Rocky Mountain Spotted Fever (RMSF).  A disease which sounded vaguely intriguing to me even though I knew from my Mom's anxiety level when she found a tick on us, that it must be bad news.  But the corkscrew shaped bacterium which causes Lyme is not actually carried by the dog tick, it is carried by the Ixodes scapularis tick, also known as the deer tick after one of its favorite hosts. The deer tick is a minuscule spider-like speck of a tick that is chilling just for the irony of its inconsequential presence.  And while this type of tick may not carry RMSF, it does carry Lyme and plenty of other co- infectious pathogens bearing Biblical sounding names like Babesia and Anaplasma.

I can clearly recall my first encounter with deer ticks---I was about ten, enjoying a run through tall grasses behind our house when I glanced down to discover miniature ticks all over my legs. I never again ran innocently through tall grasses after that. 
My next tick experience was in middle school, at my friend's house which was nestled in the woods. She pointed out that one of her cat's had creatures attached to its eyes. Indeed, horrifyingly tiny ticks were feeding off her oblivious cat's eyelids. I held my disgust and went home trying not to think about it. 

And I really didn't think about ticks much for the next 20 years or so until Lyme disease began to gain more publicity.  At first Lyme didn't seem too alarming.  An emerging but treatable malady marked by fever, joint pain, and a distinctive “bull's eye” rash.  I could handle that because it was readily identifiable by the trademark rash, and thankfully treatable.  However, over time a firestorm of controversy began to surround Lyme disease.  A controversy marked by conflicting viewpoints from two disparate organizations---Infectious Disease Society of America (IDSA) and International Lyme and Associated Diseases Society (ILADS).  While the IDSA still holds the party line that Lyme is a relatively simple and highly treatable bacterial infection, ILADS paints a more harrowing portrait of the disease.  ILADS asserts that Lyme left untreated can become a chronic affliction with a myriad of debilitating, and sometimes deadly symptoms. Think of late stage syphilis in the 16^th century (syphilis, like Lyme is also caused by the corkscrew shaped bacteria known as spirochetes).  Furthermore, ILADS and other “Lyme literate” health care practitioners claim that the standard testing is inaccurate and that the rash only occurs in about 30% of those with Lyme.  Therefore, many with Lyme are misdiagnosed and left vulnerable to chronic infection.

Whether you subscribe to the IDSA or ILADS guidelines it is still prudent to educate yourself and remember the ticks are out there ---whether you are working in a springtime garden, sunbathing in the front yard, walking through fall leaves, or hiking through thick woods.  Early antibiotic treatment is considered to be the most effective way to eradicate the disease completely and if you know you had a tick bite then you can be prepared for action if any bizarre symptoms should manifest.

Living in a tick infested area does have possible health ramifications and I believe awareness, not excessive worry is the best policy.  However, I do admit that while I strive to remain composed in the presence of a tick, I have also fallen into a blind panic.  

***Stay tuned for my next post to find out how I calmly handle tick bites (my three year old has had four bites so far) and what sort of natural remedies can come in handy in case you also find yourself with a tick.

EGGS

 I have had a complicated relationship with eggs since childhood.

I remember having texture issues with scrambled eggs as a youngster but I think I could usually tolerate other styles like soft-boiled and fried eggs.  In general, I did not eat them that much.  But I was a fussy eater with a lot of stomachaches so my food choices were all over the place.

Later in life ----around the time I committed to eating a good, hearty breakfast every morning----- I began to eat eggs on a regular basis.  So eggs became part of a repertoire that provided a nice source of protein.  Which worked out great for stabilizing blood sugar levels.

Until the eggs didn’t work out great.  About seven years or so of eating eggs on a regular basis, I developed stomach issues in the spring.  I thought maybe it was related to spring pollen allergies. It ramped up and got worse (never as bad as pepto bismol stomach: reference first post).  But then it would stop by August or September.

A couple of years into this kind of stomach pain, the lightbulb went off and I realized it was eggs.  I finally made the direct correlation between eating eggs and the pain happening.  It started up every spring, lasted through summer and then the rest of the year I could eat my eggs.

So around March when the pain kicked in I would stop eating eggs. My suspect is that there is some cross reactivity for me between seasonal pollen allergies and eggs.  In other words, when I have the pollen allergies, an egg allergy kicks in whereas the rest of the year the egg allergy is not present.

A year and a half ago, we got backyard chickens.  We bought them as pullets in March.  By June, they decided to lay eggs. While I was in a non-egg eating mode, I threw caution to the wind and decided the stomachache would be worth it.  I wanted to try our hens’ eggs.

 

So I did.  But I did not get a stomachache.  I continued to eat our hens’ eggs.  Somehow I rid myself of the egg problem---even when the pollen allergies have been their most extreme, I can eat eggs.  Not only our hens’ eggs but store-bought also.  (Although once you’ve had your own farm fresh eggs it’s so hard to go back….)

(Quick Public Service Announcement:  you can’t go wrong with getting backyard hens.  They are tons of fun, educational and give presents (the eggs).  Our hens are free range part of the time, eat bugs and get fresh air.  We control what their food kibble is.  So we have a food source that we can verify being pretty close to all natural.  Their egg yolks are almost neon yellow in color---which is the way it’s supposed to be.   Plus, they teach me new things every week.  For example, this week I learned that they cackle so loudly because they are bragging to the other ladies about laying an egg.  Sometimes a little bragging is a good thing…...)

 

 

My Big Toe and the 7 year mystery

So this is a story of international intrigue stretching from the beaches of Miami to the beaches of Barbados.  And the centerpiece of the tale is my big toe.

On 17 February 1998, I was honeymooning in Miami Beach with my new husband.  We decided to take a drive to Key Biscayne and explore the lovely park there on a surrey style bike (available for rent at the park).  Like the bikes on boardwalks, there was one place to steer and two places to pedal.  We reached a point at the end of the path where Husband had to get out and manually push the bike to turn it around. He told me to get in the steering area and, as I was doing so, but before my sandaled feet were in position, he began pushing.  In a freaky turn of events, a bike blade caught my left big toe and sliced through it.  After feeling the impact, I looked down and saw blood streaming from my toe, and my toenail was not there.  It got pulverized.  He jumped in the steering seat.  I moved over with my toe dangling off to the side still streaming blood.   The puddle of blood left behind looked like a crime scene.  Husband had to pedal back himself to the main area. Which took some time.

Back in the main parking lot, a ranger gave us first aid----inadvertently getting my blood on her ungloved hands.  She then directed us to the closest emergency room.  Once there, they had us wait for a plastic surgeon so that the toe nail bed could be stitched together in the hopes of saving it.  The moral of the story thus far was that my pulverized toenail had actually saved my big toe bone enabling me to retain balance etc and demonstrating the purpose of a toenail.  It was a long wait.  And then a big needle right in that bloody pulp of a toe.  Fun.

I left the ER with a club style bandage on the foot and crutches that were too big.  And some pain pills that didn't cut it.  We were staying in an art deco hotel in Miami Beach which had been delightful.  Part of the charm was no elevator; just a staircase.  After finally getting back that night around midnight, I acted out the part in "The Other Side of the Mountain" where the protagonist throws down her crutches and sobs.  Because I just couldn't get up those stairs.

The next day passed in a blur of pain and sleep from pain pills that didn't really touch the pain whilst Husband watched the Westminster Dog Kennel Show.  Honeymoon officially over.

And then followed the aftermath of wound care.  The toenail slowly grew in but it was ingrown.  By June 1998, it hadn't healed yet so it was necessary to go in to a podiatrist and have the ingrown stuff killed forever.  Then a couple of years later in September 2000, another procedure to do the same. 

The status then became one nail in place that never grew so it never needed to be trimmed.  It really became kind of a hoof.  Then, it started to loosen and was pretty sensitive if bumped or hit. 

Seven years after the accident (right around our wedding anniversary), it had loosened to the point that it was painful when snagging or rubbing.  I did my own surgery and lifted it off.  It was barely hanging on.  Underneath, a new nail had started its slow journey north.  Thus, explaining the looseness of the nail. 

Same thing ensued:  one nail grew in and stayed in place.  Then, six years later, on the exact anniversary of the accident (17 February 2011), the nail tore halfway off when I hit something on a beach in Barbados.  Sitting on a beach chair, I sat down and did what I had to do:  tore the rest of it off.  This time, the nail was not as ready to come off and there was nothing much underneath.  More pain involved this time too.



BEACH ON BARBADOS
 

We were not even halfway through our cruise vacation and had more beaches (i.e. more sand) to go to.  Of course, it got infected despite the salt water baths. 

Once back home, the doctor's verdict was that the nail would no longer grow in and might form a callus thus eliminating the need to do anything else. 

But the nail did grow back into hoof status.  I don't relish the idea of being in my 80s tearing my hoofs off and dealing with infections on beaches in the Carrbbean. (Being in my 80s and in the Caribbean sounds good though.)  But I guess that is the way it will continue to be....

TOES

The most interesting part of this story is the symbolism of seven years.  The body is said to regenerate cells every seven years.  This toenail has exemplified this concept and also shown how the body can decide to do its own thing.  It's an interesting journey....