How Can You Reduce Tick Habitats Near Your Home
Here are some ways to limit exposure to ticks near your home:
- Mow the lawn regularly to keep the grass short
- Remove leaf litter, brush and weeds at the edge of the lawn and around stonewalls and woodpiles
- Stack firewood neatly and in a dry area
- Put barriers to exclude deer around your home and seal stonewalls and small openings to discourage rodent activity
- Place childrens recreational playground sets, patios and decks away from the yard edges and trees. Place them on a woodchip or mulch foundation and in a sunny location, if possible.
- Treat pets that are commonly exposed to ticks with oral or topic acaricides as they could carry ticks into the home
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Living With Late Stage Lyme Disease:
Its hard to imagine that one can live with a disease like late stage Lyme disease. Its much easier to think of it as a short term issue that can be treated with antibiotics. What you may not realize though is that many people live with symptoms of late stage Lyme for years on end. Lets talk about what you need to know about living with late stage Lyme disease.
The symptoms of late stage Lyme disease can be debilitating. If you are living with these symptoms then its important to seek help right away. Its important that you know what signs to look for so that you can catch an infection early on when antibiotics are most effective. If you have been bitten by a tick, see your doctor as soon as possible so they can do a test to find out if your health is at risk from late stage Lyme disease.
If youre having issues breathing, if you are weak or feel like you have no energy to get up in the morning, it could be a sign of late stage Lyme disease. If these symptoms persist or worsen after receiving antibiotic treatments then its best to consult with your doctor so they can help you identify what is going on. It could be that antibiotics arent enough to treat whats going on so additional testing may be necessary.
Where Is The Most Common Place To Get Lyme Disease
Cases of Lyme disease have been reported in nearly all states in the U.S. and in large areas in Europe and Asia, but the most common areas are the Northeast, upper Midwest and northwestern states.
Can you get Lyme disease twice?
Reinfection: You can get Lyme disease again if you are bitten by another infected tick, so protect yourself from tick bites. People treated with antibiotics for early Lyme disease usually recover rapidly and completely.
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What Is Lyme Arthritis
Lyme arthritis occurs when Lyme disease bacteria enter joint tissue and cause inflammation. If left untreated, permanent damage to the joint can occur. Lyme arthritis accounts for approximately one out of every four Lyme disease cases reported to CDC. Because of reporting practices, this statistic may overstate the frequency of arthritis among patients seen in routine clinical practice.
Seek Medical Care Early To Prevent Lyme Disease From Progressing
Its easy to get bit by a tick and not know it. Most people dont feel a tick on their skin or the bite. Checking your skin for ticks after spending time outdoors can help you find a tick and remove it.
Removing a tick can prevent Lyme disease. A tick must be attached to your skin for at least 36 hours to infect you with the bacteria that cause Lyme disease.
Its not always possible to find a tick, so its important to pay close attention to your skin. If you notice any signs of Lyme disease or develop a rash, get medical care right away. Ticks can cause other serious diseases, such as Rocky Mountain spotted fever.
Related AAD resources
ImagesImage 1: Centers for Disease Control and Prevention, Public Health Image Library, Last accessed May 11, 2017.
Images 2, 3, and 7: Used with permission of the Journal of the American Academy of Dermatology. J Am Acad Dermatol. 2011 64:619-36.
Image 6: Used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.
ReferencesBhate C and Schwartz RA.
Lyme disease: Part I. Advances and perspectives. J Am Acad Dermatol. 2011 64:619-36.
Lyme disease: Part II. Management and prevention. J Am Acad Dermatol 2011 64:639-53.
Centers for Disease Control and Prevention:
Signs and symptoms of untreated Lyme disease. Page last updated October 26, 2016. Last accessed May 2, 2018.
Lyme disease: transmission. Page lasted updated March 4, 2015. Last accessed May 2, 2018.
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Lyme Disease Warrants Additional Research
Included below are some aspects of Lyme disease that I think warrant further research.
Lyme disease vaccines: There are no approved vaccines for the prevention of Lyme disease in the United States. Many believe that vaccines warrant development due to the significant healthcare costs and productivity losses resulting from Lyme disease.
: New compounds for the treatment of Lyme disease are warranted. Perhaps newer antimicrobials that are better able to target Borrelia bacteria will eliminate Borrelia and all persister material during treatment.
- Hygromycin A
Biomarkers of chronic Lyme: Are there any commonalities in terms of biomarkers among individuals with Post-Lyme Disease Treatment Syndrome ? These may warrant additional investigation.
Persister material: Research indicates that B. burgdorferi can form persister organisms due to both antibiotic pressure and stationary phase growth.
- Does the amount or type of persister material correlate with severity of chronic Lyme symptoms?
- Are there any potential methods to eliminate the persister material?
- Does eliminating persister material result in symptomatic improvement or curative effect?
Resources For Maine Residents
Public Law, Chapter 340, LD 597, 126th Maine State Legislature: An Act to Inform Persons of the Options for the Treatment of Lyme Disease
- Acknowledges difficulty in diagnosing and treating Lyme disease
- Information on risks of long term antibiotic therapy
Public Law, Chapter 235, LD 422, 127th Maine State Legislature: An Act to Improve Access to Treatments for Lyme Disease
- Allows licensed physicians to prescribe long-term antibiotic therapy to eliminate infection or to control a patients symptoms
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Ongoing Symptoms Of Lyme Disease
A few people who are diagnosed and treated for Lyme disease continue to have symptoms, like tiredness, aches and loss of energy, that can last for years.
It’s not clear why this happens to some people and not others. This means there’s also no agreed treatment.
Speak to a doctor if your symptoms come back, or do not improve, after treatment with antibiotics.
The doctor may be able to offer you further support if needed, such as:
- referral for a care needs assessment
- telling your employer, school or higher education institution that you require a gradual return to activities
- communicating with children and families’ social care
Page last reviewed: 05 July 2021 Next review due: 05 July 2024
Clinical Approach To Patients With A Chronic Lyme Disease Diagnosis
Even if CLD lacks biological legitimacy, its importance as a phenomenon can be monumental to the individual patient. This is because many if not most patients who believe they have this condition are suffering, in many cases for years. Many have undergone frustrating, expensive, and ultimately fruitless medical evaluations, and many have become quite disaffected with a medical system that has failed to provide answers, let alone relief.
Beyond this generalization, patients referred for CLD have heterogeneous medical, social, and educational backgrounds. Furthermore, there is great variation in their commitment to a CLD diagnosis. Some patients are entirely convinced they have CLD, they request specific types of therapy, and they are not interested in adjudicating the CLD diagnosis. By contrast, others are not particularly interested in CLD per se, and are content to move on to a broader evaluation. In the authors experience most patients fall somewhere in betweena certain amount of time must be spent reviewing past experiences and past laboratory tests, then explaining why Lyme disease may not account for their illnesses.
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Questions To Ask Your Doctor
- I found a tick embedded in my skin, but I cant get it out. What should I do?
- Ive been bitten by a tick. Do I need to be seen?
- Do I need a blood test to confirm Lyme disease?
- Which antibiotic is best for me?
- How long will I have to take the antibiotic?
- What tick or insect repellent should I use for me or my child?
- How long will the symptoms last?
- What should I do if I still dont feel well a long time after I was bitten?
The Constant Tiredness That Comes With Lyme Disease
Im just so tired.
Youve heard us say it, if youre still listening, maybe hundreds of times. We say it with furrowed brow, slumped shoulders and shaking head as if, after all these years, were still bewildered by this level of fatigue.
It is confounding, after all this weariness. It doesnt feel like a part of us not a true part. Its an interloper posing as a piece of our original self an implant, installed into our being, not by an alien race, but by a tiny tick, or a flea, a mosquito where we get it is actually a matter of debate, even though you may have heard differently. But all we know, is that we are succumbing to the invader.
We cant help it.
This is not a fatigue that can be soothed by sleep or erased by caffeine. It cannot be swayed by a brisk walk in fresh air. This lassitude is as thick as tar, coating our limbs, drip, drip, dripping into our brains, sucking at our feet, pulling them toward the ground like weve been given a super dose of gravity.
We have lost seconds, minutes, hours, days, weeks of our lives to sleep, to heads full of fog. And still, we are tired and sleepy. We have fallen asleep on the job, in our kitchens with our heads on the hard, cold countertop, in the middle of conversations, in parking lots, or at the side of the road between errands. But oddly, not in our beds at night. We have only quantity, not quality.
We want you to know that when we say, I am so tired, you would be wise to translate that as, I am so sick.
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Will You Have Permanent Or Reversible Damage
Every case is unique and depends on the specific individual, severity of disease, and response to antibiotic therapy.
Some individuals may sustain significant permanent damage, whereas others may experience reversible damage such that problems eventually resolve within weeks, months, or even years following treatment.
Most people that get treated early in Lyme infection will end up with reversible damage.
What Treatment Does Ilads Recommend For Lyme Disease
Many patients with early Lyme have been treated with short courses of antibiotics and recovered. However, both in practice and in the scientific literature, it has been observed that a significant number of patients do not return to their pre-lyme health status.
The ILADS guidelines working group reviewed the available research and developed recommendations, based upon the best-available evidence, clinical expertise, and patient-centered values.
ILADS recommends a 4-6 week course of antibiotics as initial therapy for patients with early Lyme disease presenting with EM. Further treatment is guided by the clinical course and response to treatment. Although the guidelines do not discuss the treatment of non-EM early Lyme disease or disseminated disease, these topics are reviewed in the Fundamentals Course. For non-EM early disease, initial treatment is similar to that for EM. Patients with disseminated disease may need longer courses of antibiotics and antibiotic combinations.
ILADS emphasizes patient-centered, person specific care, and the importance of careful assessment and re-assessment of the full clinical picture to guide treatment decisions, initially and if symptoms persist or return.
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What You Need To Know About Lyme Disease
Lyme disease is an infection caused by the spiral-shaped bacteria Borrelia burgdorferi, which is most commonly transmitted by a tick bite.
There are over 300,000 estimated new cases of Lyme disease in the United States each year.
The symptoms of Lyme disease depend on the how long the infection has been present in the body. The first sign of Lyme disease is often an expanding round or oval red “bullseye” rash.
If left untreated, people may develop neurological symptoms and heart problems, and have an approximately 60 percent chance of developing Lyme arthritis.
Stage : Early Localized Disease
Symptoms of Lyme disease usually start 1 to 2 weeks after the tick bite. One of the earliest signs of the disease is a bulls-eye rash.
The rash occurs at the site of the tick bite, usually, but not always, as a central red spot surrounded by a clear spot with an area of redness at the edge. It may be warm to the touch, but it isnt painful and doesnt itch. This rash will gradually fade in most people.
The formal name for this rash is erythema migrans. Erythema migrans is said to be characteristic of Lyme disease. However, many people dont have this symptom.
Some people have a rash thats solid red, while people with dark complexions may have a rash that resembles a bruise.
The rash can occur with or without systemic viral or flu-like symptoms.
Other symptoms commonly seen in this stage of Lyme disease include:
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What Is Lyme Disease
Lyme disease is a bacterial infection you get from the bite of an infected tick. At first, Lyme disease usually causes symptoms such as a rash, fever, headache, and fatigue. But if it is not treated early, the infection can spread to your joints, heart, and nervous system. Prompt treatment can help you recover quickly.
What Should You Do If You Get Bitten By A Blacklegged Tick
Ticks attach themselves to the skin. Most humans are infected through the bite of immature ticks called nymphs. Adult ticks can also transmit Lyme disease bacteria. Their bite is usually painless, so you may not know you’ve been bitten.
If you notice a tick has attached itself, remove it as soon as possible. Removing ticks within 24 to 36 hours usually prevents infection. Follow these steps to learn how to properly remove a tick.
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Other Variables That Should Be Considered
Somatization & functional disorders
A subset of individuals may experience something akin to a somatic reaction after Lyme disease.
This is due to the sheer stress of having Lyme disease and then undergoing treatment for an extended duration with potent antibiotics .
Symptoms may result specifically from a stress response and anxiety may exacerbate other legitimate chronic Lyme symptoms.
Others may experience functional disorders as a result of CNS/brain wiring changes in response to stress and/or the infection.
Note: Functional disorders are distinct from somatic disorders in that symptoms dont necessarily improve via stress reduction.
As Ive mentioned, if the Lyme disease wasnt properly treated the chronic Lyme is due to a suboptimally treated infection.
Odds of this are very low if you were diagnosed and treated by an actual medical doctor and followed the treatment recommendations perfectly.
The reason I suspect suboptimal treatment can increase risk of chronic Lyme has to do with data.
In the 1980s, treatment protocols werent as established as present day and rates of chronic symptoms after treatment were significantly higher .
Stage : Late Disseminated Lyme Disease
Late disseminated Lyme disease occurs when the infection hasnt been treated in stages 1 and 2. Stage 3 can occur months or years after the tick bite.
This stage is characterized by:
- arthritis of one or more large joints
- brain disorders, such as encephalopathy, which can cause short-term memory loss, difficulty concentrating, mental fogginess, problems with following conversations and sleep disturbance
- numbness in the arms, legs, hands, or feet
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Can Lyme Disease Change Your Personality
Neuropsychiatric symptoms are prominent. Lyme patients tend to have trouble with mood regulation, cognition, energy, sensory processing, and/or sleep. This can manifest into paranoia, hallucinations, mania, and/or obsessive-compulsive behaviors. Memory loss and concentration issues mirror other psychological disorders.
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Where Is It Possible To Get Lyme Disease
It is possible to contract Lyme disease in many areas across the United States, and throughout the world. Ticks carrying Lyme disease are found in tall grass, leaf litter, brushy and wooded areas, especially the woodland edge, in rural areas and in cities.
Even in areas that arent known to be endemic for Lyme disease, remember that people travel, pets travel, and ticks travel, creating opportunities for exposure.
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Complications Of Untreated Lyme Disease
If unchecked, the Lyme disease infection can spread to other bodily systems, causing significant damage. Untreated, complications of this condition can be very severe:
- Arthritis:Prolonged infection with Lyme disease leads to chronic joint inflammation and swelling, usually in the knees . These symptoms tend to arise within two years of infection, with periods of flare-ups and remissions. This arthritis is relatively difficult to manage, though antibiotics and steroids may be attempted.
- Lyme carditis:If the bacteria reach the heart tissues, they can cause inflammation and lead to heart block. The electrical signals being sent between the upper and lower chambers of the heart are interrupted, impairing the coordination of the heartbeat. Though disruptive, this is rarely fatal.
- Lyme neuroborreliosis:Inflammation of multiple nerves, including those in the spine and brain, is the chief characteristic of this condition. This can also affect the meningesthe layer of tissue surrounding the brain and spineleading to meningitis, among other conditions. Antibiotic therapy, if applied promptly, tends to be effective as a treatment.
Even in cases where Lyme disease has progressed, antibiotic regimensespecially drugs like doxycyclineare generally successful in resolving problems.