by Cora Rivard, N.D., owner and doctor at Seasons Natural Healthcare, LLC, a natural medicine family practice located in Derry, New Hampshire. I am currently available for telehealth consults regarding Lyme disease and other health concerns. My info is located at the bottom of this article.

More people have been enjoying the outdoors and gardening through these pandemic times, which is fantastic- except there still is an old foe lurking nearby: transmittable diseases carries by ticks.

Let’s say you start feeling fatigued, achy, or otherwise under the weather during these warm months. Don’t overlook the possibility that it could be something that warrants treatment as soon as possible, and contact your doctor with the details of your illness and your recent activities. There may not be a tell-tale rash or noticed tick bite.

After dealing with my own late stage Lyme infection years ago, and working with patients who have Lyme disease, I know firsthand how critical it is to prevent it. This includes knowing how to move quickly with the right tools and steps when you or a family member gets a tick bite. So, I am providing you with the info here that I wish I had known many years ago! (1. Prevention, 2. Procedures for Bites.)

First: Prevention:

1. Get one of these by “Ticked Off.” This is hands down the best tick remover device you can get. I have tested out many styles, but my favorite by far is the notched spoon method. It can safely remove ticks of any size, even nymphs and larval sizes, with head and mouth intact every time. I like the 3 pack because it is great to have back-ups. We keep one on a hook in our home, so anyone knows where to find it quickly when needed.
2. Wear pants (preferably light-colored so easier to visualize ticks) tucked into socks when in the woods and when doing yardwork.
3. You may apply tick repellent sprays: Herbal products are unreliable, but formulations with essential oils like lemongrass, cedar, rosemary might repel ticks (but should be re-applied often to clothing). Do not apply directly on skin, especially for children. DEET works to repel ticks about 85% of the time, but it does not kill them. Again, don’t apply to skin, just to clothing. Be particularly careful if you choose to use DEET with children. Permethrin does kill ticks pretty quickly after contact. One of my colleagues in Maine has designed a treated “tick wrap” which used permethrin, that can be worn around the legs to prevent ticks from crawling up. The treated part of the fabric does not contact the skin. You can read about it here and order them online!: https://everythingticks.com/tick-protection/repellant/
4. As soon as you come inside from outdoor work or adventures, remove your clothes (this is also entertaining for your neighbors who have been bored lately) and toss them in the dryer for 5-10 minutes. It’s not necessary to put them in the washing machine; ticks don’t drown in the wash,  but a spin through the dry heat of the dryer will kill them.
5. Nightly tick checks. Ticks are not polite- they will crawl up until they hit a crease, fold, or simply can’t climb up anymore. Always check the nether regions, back, neck, under breasts, armpits, legs, belly button, and go through the hair and scalp carefully. Another important spot to always check (especially in children) is within the curves and folds of the ears. Do this every single evening whenever snow is not covering the ground, even if you or your children have not been outside, ticks can still migrate indoors on pets….so:
6. Don’t Sleep with Rover. You might think it is OK since you treat with him/her with chemical treatments or with a collar, but think again. It may actually repel some ticks to crawl over to a more welcoming host to bite- you!

If you are really committed to prevention, consider some landscaping/gardening techniques to naturally keep out ticks- I discuss them in my previous article, “Plants Vs Ticks.”

Second: Steps to take when you get a tick bite:

1. Get your tick remover. If using the “Ticked Off” device, apply traction to either side of the tick bite, pulling skin tight, and gently scoop tick out with a smooth, non-jerking motion so that the mouth parts don’t break off in the skin. If you only have tweezers, gently grasp from tick from where it is attached to the skin, and pull gently out, also applying traction to skin.
2. Never try to burn, squeeze, or otherwise irritate the tick by putting anything on it, like essential oils or vaseline. This can cause the tick to disgorge its stomach contents into the wound, along with infectious organisms.
3. Wrap tick in a moistened piece of paper towel or moistened cotton ball, and deposit into a zip plastic baggie.
4. Apply hydrogen peroxide, or other antiseptic to the site of the tick bite.
5. Call your doctor’s office to ask about their protocol for treating tick bites, and to seek advice based upon how long the tick was attached, or how inflated it appeared. Note: ticks can start transmitting the organisms that cause Lyme well before 24 hrs of attachment.
6. In the mean time, consider sending the bagged tick off for testing. Unfortunately,  UMASS’ Laboratory of Medical Zoology ‘s TickReport program has been suspended due to the pandemic. But, you can still submit ticks to the University of CT’s veterinary program for testing, which has also been a great resource. Here’s more information: https://cvmdl.uconn.edu/service/tick.php

For further info

Call your doctor with concerns, they might suggest preventve treatment depending on the circumstances of the tick bite, even without symptoms. “Preventive” treatment should mean full treatment time-I often recommend to patients to complete 4 weeks of antibiotic treatment in early disease. This is longer than the guidelines set forth by the Infectious Disease Society of America (IDSA). Signs and symptoms of Lyme disease and other infections may include any of the following: spreading rash, fever, head aches, stomach aches, flu-like symptoms, swollen lymph nodes, and joint aches and pains. However, it is also possible to have no signs or symptoms for weeks or months during the initial infection. It is common for the skin surrounding tick bites to get a little red and even scabby- this is because your immune system becomes activated with the mechanical irritation of the bite, and also may react strongly to the proteins in the tick’s saliva. This is not the same as an erythema migrans- the typical Lyme rash. Show your doctor immediately if you have any kind of rash or reaction, they can help to distinguish the two.

Testing for Lyme disease in humans: generally, you must wait at least a month to get tested, as it takes a while for antibodies to mount diagnostic levels. Therefore if it is likely that you might have contracted a tick transmitted illness, either by symptoms, history of deer tick bite, or by an unusual rash (since many people who contract Lyme disease never discovered an attached tick)- your doctor may opt to go ahead and treat you.

If you do go through treatment, remember to talk to your doctor about taking probiotics (take at a separate time from antibiotics) throughout your treatment period and for at least 2-3 months beyond. Antibiotics will help to kill tick-borne diseases, but they will also wreak havoc on your intestinal ecology. Probiotics can help to protect you from getting a serious intestinal infection while your defenses are down during and post treatment. Again, talk to your doctor for guidance!

Cora Rivard, N.D. is a licensed naturopathic family doctor and owner of Seasons Natural Healthcare, LLC, in Derry NH. Please visit my website at www.seasonsnatural.com. Inquiries about appointments and services may be emailed to info@seasonsnatural.com