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Stupid Bug


Deer Tick. Watch out for this one. Photo Credit: Ragnhild Brosvik

Can I just say that if I were all-powerful, ticks would rot in hell. 

I sat here on the couch, happily tapping away at my writing project, when


the little bugger stabbed me in the back.

I have never, in all my life, felt a tick bite. And, growing up playing in the forest, I’ve had my share of ticks.

My brother had Lyme disease before it was well-known. He got pretty sick, but thankfully the doctor who saw him was familiar with the illness and treated him right away.

One of my blogging buddies, Looking for the Light, blogs about Life with Lyme.

So between the two of these, of course, my hypochondria went into hyperdrive when the stupid jerk decided I looked like prime rib.

Hubby got the thing out of me, but by the time he was done, I was stretched out on the floor. Can’t believe I didn’t pass out. That sucker (see what I did there) had REALLY dug in. Apparently he likes rib meat.

Liked. Now he’s dead. I named him Charlie, so tomorrow I can tell the kids “Charlie BIT me!”

You know you wanted to see that again.

Anyway, I went to the best diagnostic tool ever, The Internets, to find out whether I should be concerned about my own demise.

In looking for information, I came across a great website. Since this is tick season, here’s what you need to know:


There are many different types of ticks in the United States, some of which are capable of transmitting infections. The risk of developing these infections depends upon the geographic location, season of the year, type of tick, and, for Lyme disease, how long the tick was attached to the skin.

While many people are concerned after being bitten by a tick, the risk of acquiring a tick-borne infection is quite low, even if the tick has been attached, fed, and is actually carrying an infectious agent. Ticks transmit infection only after they have attached and then taken a blood meal from their new host. A tick that has not attached (and therefore has not yet become engorged from its blood meal) has not passed any infection. Since the deer tick that transmits Lyme disease must feed for >36 hours before transmission of the spirochete, the risk of acquiring Lyme disease from an observed tick bite, for example, is only 1.2 to 1.4 percent, even in an area where the disease is common.

The organism that causes Lyme disease, Borrelia burgdorferi, lies dormant in the inner aspect of the tick’s midgut. The organism becomes active only after exposure to the warm blood meal entering the tick’s gut. Once active, the organism enters the tick’s salivary glands. As the tick feeds, it must get rid of excess water through the salivary glands. Thus, the tick will literally salivate organisms into the wound, thereby passing the infection to the host.

If a person is bitten by a deer tick (the type of tick that carries Lyme disease), a healthcare provider will likely advise one of two approaches:

Observe and treat if signs or symptoms of infection develop

Treat with a preventive antibiotic immediately

There is no benefit of blood testing for Lyme disease at the time of the tick bite; even people who become infected will not have a positive blood test until approximately two to six weeks after the infection develops (post-tick bite).

The history of the tick bite will largely determine which of these options is chosen. Before seeking medical attention, the affected person or household member should carefully remove the tick and make note of its appearance (picture 1). Only the Ixodes species of tick, also known as the deer tick, causes Lyme disease.


The proper way to remove a tick is to use a set of fine tweezers and grip the tick as close to the skin as is possible. Do not use a smoldering match or cigarette, nail polish, petroleum jelly (eg, Vaseline), liquid soap, or kerosene because they may irritate the tick and cause it to behave like a syringe, injecting bodily fluids into the wound.

The proper technique for tick removal includes the following:

Use fine tweezers to grasp the tick as close to the skin surface as possible.

Pull backwards gently but firmly, using an even, steady pressure. Do not jerk or twist.

Do not squeeze, crush, or puncture the body of the tick, since its bodily fluids may contain infection-causing organisms.

After removing the tick, wash the skin and hands thoroughly with soap and water.

If any mouth parts of the tick remain in the skin, these should be left alone; they will be expelled on their own. Attempts to remove these parts may result in significant skin trauma.


Tick characteristics — It is helpful if the person can provide information about the size of the tick, whether it was actually attached to the skin, if it was engorged (that is, full of blood), and how long it was attached.

The size and color of the tick help to determine what kind of tick it was (picture 1 and figure 1);

Ticks that are brown and approximately the size of a poppy seed or pencil point are deer ticks. These can transmit Borrelia burgdorferi (the bacterium that causes Lyme disease) and a number of other tick-borne infections, including babesiosis and anaplasmosis. Borrelia burgdorferi infected deer ticks live primarily in the northeast and mid-Atlantic region (Maine to Virginia) and in the midwest (Minnesota and Wisconsin) region of the United States, and less commonly in the western US (northern California).

Ticks that are brown with a white collar and about the size of a pencil eraser are more likely to be dog ticks (Dermacentor species). These ticks do not carry Lyme disease, but can rarely carry another tick-borne infection called Rocky Mountain spotted fever that can be serious or even fatal.

A brown to black tick with a white splotch on its back is likely a female Amblyomma americanum (Lone Star tick; named after the white splotch) (picture 2). This species of tick has been reported to spread an illness called STARI (southern tick-associated rash illness). STARI causes a rash that is similar to the erythema migrans rash, but without the other features of Lyme disease. Although this rash is thought to be caused by an infection, a cause for the infection has not yet been identified. This type of tick can also carry and transmit another infection called human monocytic ehrlichiosis.

A tick that was not attached, was easy to remove or just walking on the skin, and was still flat and tiny and not full of blood when it was removed could not have transmitted Lyme disease or any other infection since it had not yet taken a blood meal.

Only ticks that are attached and have finished feeding or are near the end of their meal can transmit Lyme disease. After arriving on the skin, the tick that spreads Lyme disease usually takes 24 hours before feeding begins.

Even if a tick is attached, it must have taken a blood meal to transmit Lyme disease. At least 36 to 48 hours of feeding is required for a tick to have fed and then transmit the bacterium that causes Lyme disease. After this amount of time, the tick will be engorged (full of blood). An engorged tick has a globular shape and is larger than an unengorged one.

It is not clear how long a tick needs to be attached to transmit bacteria other than Borrelia burgdorferi.

Need for treatment — The clinician will review the description of the tick, along with any physical symptoms, to decide upon a course of action. The Infectious Diseases Society of America (IDSA) recommends preventive treatment with antibiotics only in people who meet ALL of the following criteria:

Attached tick identified as an adult or nymphal I. scapularis (deer) tick

Tick is estimated to have been attached for ≥36 hours (based upon how engorged the tick appears or the amount of time since outdoor exposure)

The antibiotic can be given within 72 hours of tick removal

The local rate of tick infection with B. burgdorferi is ≥20 percent (known to occur in parts of New England, parts of the mid-Atlantic states, and parts of Minnesota and Wisconsin)

The person can take doxycycline (eg, the person is not pregnant or breastfeeding or a child <8 years of age)

If the person meets ALL of the above criteria, the recommended dose of doxycycline is a single dose of 200 mg for adults and 4 mg/kg, up to a maximum dose of 200 mg, in children ≥ 8 years.

If the person cannot take doxycycline, the IDSA does not recommend preventive treatment with an alternate antibiotic for several reasons: there are no data to support a short course of another antibiotic, a longer course of antibiotics may have side effects, antibiotic treatment is highly effective if Lyme disease were to develop, and the risk of developing a serious complication of Lyme disease after a recognized bite is extremely low.


Many people have incorrect information about Lyme disease. For example, some people are concerned that Lyme disease is untreatable if antibiotics are not given early (this is untrue; even later features of Lyme disease can be effectively treated with appropriate antibiotics). Many local Lyme disease networks and national organizations disseminate unproven information and should not be the sole source of education about Lyme disease. Reputable sources are listed below (see ‘Where to get more information’ below).

Signs of Lyme disease — Whether or not a clinician is consulted after a tick bite, the person who was bitten (or the parents, if a child was bitten) should observe the area of the bite for expanding redness, which would suggest erythema migrans (EM), the characteristic rash of Lyme disease (picture 3). (See “Patient information: Lyme disease symptoms and diagnosis (Beyond the Basics)”.)

The EM rash is usually a salmon color although, rarely, it can be an intense red, sometimes resembling a skin infection. The color may be almost uniform. The lesion typically expands over a few days or weeks and can reach over 20 cm (8 inches) in diameter. As the rash expands, it can become clear (skin-colored) in the center. The center of the rash can then appear a lighter color than its edges or the rash can develop into a series of concentric rings giving it a “bull’s eye” appearance. The rash usually causes no symptoms, although burning or itching has been reported.

In people with early localized Lyme disease, EM occurs within one month of the tick bite, typically within a week of the tick bite, although only one-third of people recall the tick bite that gave them Lyme disease. Components of tick saliva can cause a short-lived (24 to 48 hours) rash that should not be confused with EM. This reaction usually does not expand to a size larger than a dime.

Approximately 80 percent of people with Lyme disease develop EM; 10 to 20 percent of people have multiple lesions. If EM or other signs or symptoms suggestive of Lyme disease develop (table 1), the person should see a healthcare provider for proper diagnosis and treatment. (See “Patient information: Lyme disease treatment (Beyond the Basics)”.)

-Linden Hu, MD

So, based on the information above, it appears I will live.

Lucky me.

Also, lucky Hubby. He won’t have to raise two kids by himself.

Now, if you’ll excuse me, I need to get him to check me for ticks.






About Those Migraines: FreeWriteDon’tStop

In response to “Today, take twenty minutes to free write. And don’t think about what you’ll write. Just write.” prompt in Writing 101. 

There’s a lot on my mind. Not most important, but foremost at the moment, is the fact that I have an impending migraine. I’ve learned a lot about migraines lately. Did you know that you can track the pre-symptoms to give you a better idea of when you’re experiencing onset? You might not think it would help, considering the ads for migraine medicine.

“Are you missing out on ninety percent of your life? Are you like this poor girl here on the couch in her backyard while everyone parties around her but she just sleeps?” First, WHY IN THE WORLD would anyone put a couch in the back yard. That’s almost as bad as the Cialis commercials with the two people in separate tubs OUTSIDE watching the sun set. Sure, it’s a cool photo op, but let’s think this through. How warm could that water possibly be?

I mean, unless you have outdoor plumbing to an old enameled tub. Two tubs, actually. Do you even know how much outdoor plumbing costs? Speaking of plumbing, another really good reason NOT to take a bath outdoors is that NO ONE wants to see YOUR plumbing. Seriously. It’s not the way to get into someone’s pants, which is the whole reason for the commercial in the first place. Especially since no one wears pants in the tub.

Bathing outdoors aside, putting a couch in the backyard is really just…dumb. What happens when it rains? And then, when everything is soggy and doesn’t dry out for three days, you have a serious mold issue. I don’t know how things are for you, but mold intensifies my headaches. Unless it’s Sunbrella fabric with special foam treated specifically for outdoor use, you’re going to run into trouble. From the looks of it, the couch in the commercial is NOT outdoor-approved. It’s probably infested with moisture-loving bugs and microorganisms as well. Gross.

But I digress. My original point: you CAN head off (ha, pun, get it?) a bit of the ache. There are some really WEIRD pre-symptoms of migraines.

First, you may lose your words. There’s probably a super-scientific name for it, but this is what I call it. When you can’t think of the word you were just about to say, “it’s on the tip of my tongue,” etc. It’s doggone frustrating and is almost bad enough to make me cuss. Almost.

I have a problem with cussing. I think it’s effing unimaginative. Get a thesaurus, people. NO, that’s not a kind of dinosaur.

But, yeah, a few days before the migraine and especially the day before, I am reduced to pre-school communication:

“Honey, can you please, um, hand me that, um, thing over there? The one that’s on top of that…(vague gesture)…ugh. That other thing. The square, uh–no, rectangular–tall box. Yes. The shiny one. The, the…fridge. Hand me the thing on top of the fridge. It’s in the brown thing up there.” By this time, Hubby is looking at me halfway between amused and annoyed.

“Oh good grief. The…AHHHH. The mug. There’s a mug on top of the fridge and I need a…writing utensil…PENCIL. Please give me a pencil from the mug on top of the fridge.”

Not kidding. It’s ridiculous.

When I start losing my words, I know we’ve got a doozy coming. A second pre-migraine symptom is weird vision. I’ve never seen “the lights” that some people get, and I’m a little bit jealous. I imagine they’re sort of like little fairies dancing in your field of vision. Once, I did see something that looked like bright fishies twirling through the air in my dorm room, but…that was due to something else entirely.

Oh, stop it! I’ve never done drugs (unless they were in those brownies…). The doctor said the phenomenon was due to a drop in my blood pressure.

Anyway, I don’t get lights, but I do get double vision and my eyes feel really weird. A third and HOW IS THIS POSSIBLY RELATED pre-symptom is constipation. What? Yes. You heard (or rather, read) correctly. Now, I don’t usually share my personal potty stories in blog form, but I was so floored by this that I felt I should pass it on. It’s absolutely true. The last few…incidents…I had were definitely precursors to the worst migraines I’ve had in a while.

I actually wasn’t looking for that little nugget (ha, nugget) of information. I was just generally looking for any information about trying to predict migraine patterns. So…if you’re having a little difficulty and things just aren’t moving the way they should, note this, especially if you’re migraine-prone.

The fourth and coolest pre-migraine symptom? CREATIVITY. Some of my most amazing pieces (well, as far as I’m concerned—you don’t have to think they’re amazing; no pressure) are ones I wrote within the 24-hour period prior to a migraine. It’s almost worth the pain. In fact, I’m likely getting one tomorrow, which is probably why this particular piece is going to go viral and sweep the nation. Or at least WordPress.

I don’t know whether it’s truly helping, but since becoming aware of these pre-symptoms, I’ve been a bit more proactive about treating my migraines. I don’t get them often enough to warrant the couch-medication, which has multiple varied side effects which range from tinnitus to mild or moderate death.

At this point, I take a monster dose (800mg) of ibuprofen and go sleep it off in a dark room with eye blinders and a pillow over my eyes for good measure.

The main after-effect of my migraines is actually pretty nice; I wake up feeling refreshed and as though someone has poured clean, cool water through all the nooks and crannies of my brain. I do also deal with the not-so-nice-after-affects (dizziness, less-severe-but-still-annoying word loss, fatigue) but otherwise…it’s sort of like the feeling of sliding between crisp, cool cotton sheets that were dried outside in the sun. Of course, if the nausea during the migraine is too overpowering…then there’s  no silver lining. No washed-out-brain feeling is worth losing my lunch.

Perhaps none of this will help you, but the information has helped me curb (I think, since there’s really no way of knowing how bad it COULD have been) my recent migraines. Do you get migraines? How do you fight them?

Next time you get really creative right before a migraine (but before the double vision and word loss sets in), let me know.


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