A Presentation by Michele Moynihan It was 8 months before I was properly diagnosed with Lyme disease and treated with antibiotics. By different doctors, I was told I had Chronic Mononucleosis, Rheumatoid Arthritis, and a possible tumor on my optic nerve. Since I went so long without treatment, I am still on strong antibiotics. It has now been a year and a half since I first started on medication. I know I am not a doctor. • Yourselves • Your Family Members • Your Pets • Your Friends and Neighbors • Your Colleagues • Your STUDENTS Why and How Lyme Disease Can Be Misdiagnosed The Symptoms of Lyme Disease How to Protect Yourself from Ticks How to Remove Ticks Over 50% of Lyme victims DO NOT remember being bitten by a tick. WHY??? A tick bite DOES NOT HURT due to the anesthetic it injects upon puncturing the skin. PLUS... Lang, 16 Ticks are TINY and hard to detect on the body. Some nymphs are the size of a small mole or a period at the end of a sentence. The time lapse between a tick bite and the emergence of symptoms can be weeks or even months! Type of symptoms and severity of symptoms can vary in everyone. 100 Strains 300 Strains The blood tests are NOT RELIABLE! “Generally accepted testing procedures have had a 30-40% reliability rate, at best” (Lang, 16). This means... There is a 60-70% chance you could have a “false negative” result. If a person is currently on or has recently taken antibiotics, it can reduce the body’s production of Lyme antibodies. The Lyme bacteria, called the “spirochete” can hide in the body by shifting and changing to avoid detection by the immune system. The Controversy ELISA Western Blot CDC says you must have 5 But I only bands!!! have 2! And I feel lousy! “Several studies have shown that sensitivity and specificity for the…Western Blot ranges from 92% to 96% when only two specific bands are positive” (National Guideline Clearinghouse: Summary of ILADS Guidelines for Lyme Disease, 3). Western Blot Panel IgG- 10 bands- older infection IgM- 3 bands- recent infection “Called the „Great Imitator,‟ Lyme disease, because of its myriad of symptoms, can mimic What are the two hundred other illnesses” (Lang, 33). Because of this, Lyme is frequently misdiagnosed as… • Chronic Fatigue • Chronic symptoms of Syndrome Mononucleosis • Fibromyalgia • Multiple Sclerosis Lyme • Rheumatoid Arthritis • Alzheimer‟s Disease • Lupus disease? • Thyroid Disease • Lou Gehrig‟s Disease • Depression • And more… One of the first symptoms of Lyme Disease can be what is called a “Bull’s Eye” rash. There are 10 documented variations of rashes associated with Lyme disease, and not all of them look like a “Bull‟s Eye.” Many rashes may resemble a spider bite, ringworm, blisters, hives, or even cellulitis or shingles. Lyme Rash Lyme Rash Lyme Rash Shingles Lyme Shingles Ringwor Lyme m Lyme Even though the rash is a tell-tale sign of Lyme disease... Over 50% of victims DO NOT exhibit any rash at all!!! (ILADS, 2) and/or Muscle Pain Joint(but over 50% don‟t get one) RASH (with or without swelling) Neck Back Feet Ankles Elbows Knees Flu-like symptoms Wrists Hands Unusual Fatigue (with or without fever) • Frequent Headaches • Dizziness or Vertigo • Lightheadedness • Frequent Nausea • Gastrointestinal Problems • Ringing or Pounding in Ears • Blurred Vision • Burning Eyes • Numbness, Tingling, or Burning • Heart Palpitations • Chest Pain • Excessive Sleeping or Insomnia • Extreme Fatigue • Poor Memory & Concentration • Brain Fog • Irritability • Anxiety • Sadness, Crying “Lyme disease is a CLINICAL diagnosis and test results should be used to support rather than supercede the physician‟s judgment” (National Guideline Clearinghouse: Summary of ILADS Guidelines for Lyme Disease, 1) . *Clinical Diagnosis = Diagnosis based on symptoms, not just blood tests that can often yield a “false negative” result. How can you Male Female protect Lonestar Tick Female Dog Tick Male yourselfFemale from ticks? Male Dog Tick Blacklegged Deer Tick Thumb Tack to Pin Head Cm Cm • On Pets • On Birds, Squirrels, Chipmunks, etc.. • In Wooded Areas • Overgrown Areas • Shrubs/Flower Beds • Grass (tall or short) Tick Ticks climb to the tips of grasses Larvae and weeds and lay in wait for their next host to brush against them. Ticks are most active between May and November, but studies have proven that ticks can be found “questing” all year round at temperatures as low as 38 degrees F. Nothing‟s a 100%! is a THOROUGH physical inspection Tick Fangs Engorged Tick •DO NOT touch the tick •Infective agents may enter through mucous membranes with bare hands. or breaks in the skin. •DO NOT twist or jerk •Mouthparts of the tick may the tick. become imbedded, increasing the risk of infection. •DO NOT squeeze, crush, or puncture •The tick‟s saliva and gut the body of the tick. contents may be released, increasing the risk of infection. •DO NOT put alcohol, nail polish, or Vaseline •This may cause the tick to regurgitate its stomach contents, on the tick, and DO NOT increasing the risk of infection. burn the tick. The most important aspect of tick removal is to make sure the mouthparts do not remain in the skin. If the tick is a nymph, it may be harder to tell if the mouthparts have been removed. • Use a tick removal device such as Ticked-Off, Tick Nipper, Pro-Tick Remedy, or De-Ticker. You can Google search these and find them on-line. • If no other tool is available, use a fine-point tweezers. • Grasp the tick as close to the skin as possible, and gently pull straight upward; do not twist or jerk. • Put the tick in a plastic bag with the date, and then put it in the freezer for later identification. • Wash the area with a disinfectant. • Seek immediate medical attention. An infected tick can transmit Lyme bacteria after being attached for only 4-24 hours (Lang, 12). School Nurse Supply 1-800-485-2737 Page 74, Item #56010 $2.59 Why and How Lyme Disease Can Be Misdiagnosed The Symptoms of Lyme Disease How to Protect Yourself from Ticks How to Remove Ticks Bock, Steven J. “The Integrative Treatment of Lyme Disease.” The International Journal of Integrative Medicine. 1/11/07 <http://www.avonhistory.org/bug/l14.htm>. Cameron, Daniel. “Evidence-Based Guidelines for the Management of Lyme Disease.” 5/19/07 <www.lymeproject.com>. Cameron, Daniel. “Lyme Disease: What You Need to Know.” New York: National Guideline Clearinghouse, 2007. “Facts About Ticks and Tick-Borne Diseases.” 5/19/07 <http://www.bada- uk.org/facts.html>. “Home of the De-ticker.” 5/19/07 <http://www.deticker.com>. International Lyme and Associated Disease Society (ILADS). “Basic Information about Lyme Disease.” 5/19/07 <http://ilads.org>. Lang, Denise. Coping with Lyme Disease: A Practical Guide to Dealing with Diagnosis and Treatment. New York: Owl Books, 2004. “National Guideline Clearinghouse: Summary of ILADS Guidelines for Lyme Disease.” 5/30/07 http://ilads.org/guidelines_ilads.html. “Ticks and Lyme Disease.” 5/19/07 <http://www.arun.gov.uk>. “Ticks and Tick-Borne Diseases in Texas.” 5/22/07 <http://ticktexas.org>.