Ticks

I never thought I’d be typing about ticks this Saturday, but it feels suddenly and strangely important. A student called a few days ago after a hike to tell me he had a tick stuck in his back. His girlfriend tried to remove it, but she left some bits behind. I paid them a visit, excised the remnants, and got on with the night.

Not 30 minutes later, another call from another hiker with another tick embedded in the same part of his back after a hike! His girlfriend was a little more timid, however, so the complete tick was still embedded. Same procedure, but this time I rescued the tick as well (no charge), though missing part of a leg. They kept him as a momento of their SLO visit.

Red Flags:

• Fevers
• Neck stiffness
• Engorged tick embedded for a long time
• Bulls eye expanding rash, aka “erythema migrans”
• Joint pains
• Rash/spots on hands/feet or elsewhere
• Paralysis
• Deer tick (amazingly tiny)
• Hiking in New England

Happy Words

• “Definitely wasn’t there a few hours ago”
• “Tick isn’t engorged yet and still seems to be settling in”
• “Otherwise healthy and no symptoms at all”

The debate continues about best ways to remove ticks, but one common thread is that it’s better to lift from the neck than from the body to avoid injecting tick contents back into the patient. From my vantage point, because I own lots of lidocaine, my preference is a touch of lidocaine followed by small excision. For you at home with tweezers, credit cards, olive oil, battery acid, cigarettes, and lighters, just aim for the tweezers and go slow.

Lyme disease is the illness most talked about. Back east, frequently you won’t even need red flags to receive prophylactic doxycycline. The deer ticks are everywhere and fear of the illness is immense. Ticks cause plenty of other illnesses as well. If you want to dig deeper look up Rocky Mountain Spotted Fever (not only in the Rockies), ehrlichiosis and, amazingly “tick paralysis.” Apparently the treatment for tick paralysis is to remove the tick, though I’ve never made that kind of save. (If you’re paralyzed at home, don’t call Pre-R hoping it’s a tick.)

More important than anything is the daily/nightly “tick checks” especially following hikes or rolling around with animals. Even more effective is to have a baby, never leave home, and sit typing on a Saturday!
Lots more to read here.

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