Lyme disease is a bacterial infection that is spread through the bite of one of several types of ticks.
Lyme disease is caused by bacteria called Borrelia burgdorferi (B. burgdorferi).
Blacklegged ticks and other species of ticks can carry these bacteria.
The ticks pick up the bacteria when they bite mice or deer that are infected with B. burgdorferi.
You can get the disease if you are bitten by an infected tick.
Symptoms of early localized Lyme disease (stage 1) begin days or weeks after infection. They are similar to the flu and may include: Chills, Fever, General ill feeling, Headache, Joint pain, Muscle pain and Stiff neck.
Symptoms may come and go. Untreated, Lyme disease can spread to the brain, heart, and joints.
Kaye McGrath, NP is here to discuss Lyme disease, what symptoms you should look for and treatments available through Stoughton hospitals.
Lyme Disease: What You NEED To Know
Featured Speaker:
Her medical interests are Preventive health and Women's health.
Learn more about Kaye McGrath, NP
Kaye McGrath, NP
Kaye McGrath, NP joined Dean Clinic in 2013. Her specialties are Family Medicine and she is a Nurse Practitioner.Her medical interests are Preventive health and Women's health.
Learn more about Kaye McGrath, NP
Transcription:
Lyme Disease: What You NEED To Know
Melanie Cole (Host): You’ve heard about the disease Lyme disease. Well, if you’re somebody that likes to be out in the woods or grasses, you know that there are certain preventions, things that you can do to help prevent Lyme disease. My guest today is Kaye McGrath. She is a nurse practitioner at Stoughton - Dean Clinic. Welcome to the show, Kaye. Tell us a little bit about what Lyme disease is first, and what is the most common cause of it?
Kaye McGrath (Guest): Hi, thanks for having me. Lyme disease is actually an infection that is caused by a spiral-shaped bacteria. We call those “spirochetes.” It’s a bacteria that can affect multiple organ systems in our bodies and, therefore, it creates a wide range of symptoms. Transmission usually can occur via the bite of an infected vector. What we mean by that, is it usually occurs through the bite of a tick. Certain types of ticks carry the specific bacteria, Borrelia burgdorferi, which is kind of a mouthful, that actually causes Lyme disease, specifically. Lyme disease is found in 65 countries worldwide. There are different types of ticks that carry different types of strands of the bacteria, depending on the region where they come from.
Melanie: Wow! So, ticks. We use that stuff on our dogs but then we don’t think so much about ourselves and our children. What can we do? Let’s start with prevention because that’s the first thing that we want to talk about and then we can get into the actual disease itself but prevention would be the most important thing. What do you want people to know?
Kaye: I think the big thing to remember about prevention is it really comes down to common sense. When you are playing or walking in wooded or grassy areas, you want to cover as much skin with clothing as possible. Dressing in light colors is always a good idea. That way you can identify ticks, which are very dark most of the time, very easily. You want to tuck your pants into your socks. You’ve got to remember those little kiddos who are running around outside. You’ve really got to make sure everything is tucked in so that if there is going to be something to see, you can see it very easily and it’s not going to work its way up under the seams of clothing where you might not be able to see it as easily. Wearing long sleeves that are fitted and cuffed at the wrist is helpful. Spraying insect repellant with about 20-30% of Deet over clothing and sparingly to that exposed skin and not to the face can be helpful as well. Always doing that after activity body check, especially under armpits, backs of legs, in hair, the hair line, the groin area. All areas that a tick could potentially hang out where you might not be able to see it very well.
Melanie: So, you talk about doing a tick check. I always check, as you say, under the sock line. Because they like those moist areas, right? Under your armpits or even up in your pant leg. What do you do if you find one?
Kaye: If you were to find a tick, the biggest thing, of course, is to stay calm. A lot of times people get very freaked out right away and then they lose their logical train of thought. If you do see a tick, obviously, we want to get it off the skin. If it is not adhered, that is your best bet. If it is not adhered, obviously, it is pretty easy to get off. Most of the time people will say, “Stick it in the freezer,” or, “You want to light a match to it.” You don’t necessarily have to do any of those things. Sometimes people will make sure it is removed and they will put it in a vile or in a small plastic baggie, etc., to make sure that they can look at it safely so that they know it was not necessarily attached to the skin. Otherwise, if it is attached to the skin we say use the tweezers. You want to grasp the tick as close to the skin as possible where it may be attached. You pull the tick straight out. Don’t squeeze it or use a twisting motion. That is a very common misconception. You want to clean the area with an antiseptic which could just be alcohol or hydrogen peroxide. It can be found over the counter and in most of the cases if you use an antiseptic from first aid kits; that is completely acceptable.
Melanie: Do we save the tick and take it in to our local vet or somebody to find out if it is infected with Lyme?
Kaye: Most of the time, they are not going to run any kind of testing on the tick itself as far as a health care provider. You can certainly take it in, especially if it is a dog or what not. Every vet or provider might have their own preferences but for the most part, no, we don’t actually need the tick itself. Sometimes, if you are unsure, “Is this a dog tick; a deer tick; a wood tick? What is this? Sometimes bringing it in can be helpful for the provider just to see what kind of tick it is to know what your risk factor is. But that is, as far as how helpful that tick might be, that is really as far as it goes.
Melanie: What are the symptoms of Lyme disease? Because, Kaye, that seems to be one of the biggest confusions surrounding this particular condition is that it’s so difficult to diagnose. You hear about people who go undiagnosed for years because nobody can figure out what it is.
Kaye: Correct.
Melanie: So, what are some symptoms that might send us to a doctor and the person might say, “You know what? I really want to be checked for Lyme disease?”
Ms. McGrath: Sure. I think it is a great question because Lyme disease has been known as the great imitator. It can really mimic a lot of other different kind of illnesses and diseases. The biggest one that we always hear about is that bull’s eye rash, which is erythema migrans. Again, we call it bull’s eye rash because often there are clear rings with a central darkened area. This can appear anywhere between when you get bit by the tick to 30 days after. So, obviously, that is a very wide window of time that something like that can occur. But more and more, of course, we are seeing that there are possibilities for atypical rashes and still having Lyme disease. So, just because it’s not a bull’s eye rash does not mean it is not potentially Lyme disease. Some other symptoms that you can potentially have can be: chest pain and rib soreness, shortness of breath, feeling like your heart is fluttering – we call that palpitations, nausea and vomiting, new onset constipation or diarrhea, irritable bladder or where you are going all the time or you think you have a bladder infection, also joint and muscle pain, swelling and stiffness especially in one joint, such as a knee or elbow, etc., and muscle stiffness.
Melanie: Okay. If we have some of these symptoms and we go to see the doctor, do you ask your health care practitioner, do you say, “Please check me for Lyme disease because I like to go camping,” or “I found a tick on myself a year ago.” Do we make sure to point this out? Are there tests for it?
Kaye: Yes. So, I always say it’s a good idea. Your health care provider is generally probably going to be doing a very thorough history anyway. For the most part, what we are looking for is if you’ve had a recent exposure or you know you’ve been around something much like camping or you know you’re in the North Woods, etc. Those things are relative and we do like to know about them. Especially if there is a rash that has occurred afterward, I think it is a good idea to mention that. But also, when it comes down to testing, there are no perfect tests for Lyme disease out there. We look for the antibodies of those bacteria that I was telling you about before. It’s a two-step test that we use – a screening and then what is called a Western blot.
Melanie: What are the treatments? I’ve also heard that people go through treatments for years and they still have some of these symptoms of fatigue and musculoskeletal issues. I mean, it can really devastate the quality of your life. Speak about the treatments a little bit.
Kaye: The sooner treatments begin, the better recovery generally is. Again, ideally having that conversation with your health care provider is really important to rule it out or at least to know what your risk factor is or percentage of risk for Lyme. Again, early detection is really key. Generally, a 14-21 day course of antibiotics for an early stage Lyme disease is appropriate. Depending on age, we use different antibiotics. Certainly, IV antibiotics can be utilized for cases where there is recurrent or persistent symptoms, just basically because they can be more intense and long-lasting. Often, it is when we find Lyme disease later in the stages, so you have more bacteria that need to be taken care of. Often, that will require IV antibiotics. However, some people will have chronic Lyme symptoms and for those things, sometimes retreatment is necessary as well as just supporting the system and symptom control and treating symptoms. Because, generally, once we kill the bacteria with antibiotics, the bacteria aren’t necessarily problematic anymore but it’s kind of the residual that they leave behind.
Melanie: Why do you think, Kaye, that some people who suffer from Lyme disease need these support systems and that there are support groups out there for Lyme disease?
Kaye: Generally, functional impairments from chronic Lyme disease, like you said, as far as quality of life, it really affects people’s quality of life. Fatigue and problems sleeping, lethargy and depression, those things all tend to be things that can be linked chronically to Lyme. Certainly, groups can be helpful as far as support. People that go through the same things, treatments, sharing information, disseminating new information and research can be helpful in those groups, too. So, I certainly think that getting good support mentally and physically is important when you do have chronic Lyme-type symptoms.
Melanie: In just the last minute, give us your best advice--what you would tell people that ask you about Lyme disease and what you really want them to know.
Kaye: Sure. My big take home points are prevention is key. Knowing how to prevent a tick bite is optimal. Lyme disease can include many symptoms. It is called the great imitator. Make sure that you do talk to your health care provider if you do have a concern. Again, the more detail, the better. Diagnosis is not done by any one single test and there are many factors to consider when we diagnose Lyme disease. It is not a perfect science yet and there is still a lot to learn about Lyme. Early treatment leads to the best outcomes. And, of course, you can certainly learn more at good places like the CDC and the Lyme Disease Association which are all generally found on-line.
Melanie: Thank you so much. What great information. You're listening to the Stoughton Hospital Health Talk and for more information, you can go to StoughtonHospital.com. That's StoughtonHospital.com. This is Melanie Cole. Thanks so much for listening.
Lyme Disease: What You NEED To Know
Melanie Cole (Host): You’ve heard about the disease Lyme disease. Well, if you’re somebody that likes to be out in the woods or grasses, you know that there are certain preventions, things that you can do to help prevent Lyme disease. My guest today is Kaye McGrath. She is a nurse practitioner at Stoughton - Dean Clinic. Welcome to the show, Kaye. Tell us a little bit about what Lyme disease is first, and what is the most common cause of it?
Kaye McGrath (Guest): Hi, thanks for having me. Lyme disease is actually an infection that is caused by a spiral-shaped bacteria. We call those “spirochetes.” It’s a bacteria that can affect multiple organ systems in our bodies and, therefore, it creates a wide range of symptoms. Transmission usually can occur via the bite of an infected vector. What we mean by that, is it usually occurs through the bite of a tick. Certain types of ticks carry the specific bacteria, Borrelia burgdorferi, which is kind of a mouthful, that actually causes Lyme disease, specifically. Lyme disease is found in 65 countries worldwide. There are different types of ticks that carry different types of strands of the bacteria, depending on the region where they come from.
Melanie: Wow! So, ticks. We use that stuff on our dogs but then we don’t think so much about ourselves and our children. What can we do? Let’s start with prevention because that’s the first thing that we want to talk about and then we can get into the actual disease itself but prevention would be the most important thing. What do you want people to know?
Kaye: I think the big thing to remember about prevention is it really comes down to common sense. When you are playing or walking in wooded or grassy areas, you want to cover as much skin with clothing as possible. Dressing in light colors is always a good idea. That way you can identify ticks, which are very dark most of the time, very easily. You want to tuck your pants into your socks. You’ve got to remember those little kiddos who are running around outside. You’ve really got to make sure everything is tucked in so that if there is going to be something to see, you can see it very easily and it’s not going to work its way up under the seams of clothing where you might not be able to see it as easily. Wearing long sleeves that are fitted and cuffed at the wrist is helpful. Spraying insect repellant with about 20-30% of Deet over clothing and sparingly to that exposed skin and not to the face can be helpful as well. Always doing that after activity body check, especially under armpits, backs of legs, in hair, the hair line, the groin area. All areas that a tick could potentially hang out where you might not be able to see it very well.
Melanie: So, you talk about doing a tick check. I always check, as you say, under the sock line. Because they like those moist areas, right? Under your armpits or even up in your pant leg. What do you do if you find one?
Kaye: If you were to find a tick, the biggest thing, of course, is to stay calm. A lot of times people get very freaked out right away and then they lose their logical train of thought. If you do see a tick, obviously, we want to get it off the skin. If it is not adhered, that is your best bet. If it is not adhered, obviously, it is pretty easy to get off. Most of the time people will say, “Stick it in the freezer,” or, “You want to light a match to it.” You don’t necessarily have to do any of those things. Sometimes people will make sure it is removed and they will put it in a vile or in a small plastic baggie, etc., to make sure that they can look at it safely so that they know it was not necessarily attached to the skin. Otherwise, if it is attached to the skin we say use the tweezers. You want to grasp the tick as close to the skin as possible where it may be attached. You pull the tick straight out. Don’t squeeze it or use a twisting motion. That is a very common misconception. You want to clean the area with an antiseptic which could just be alcohol or hydrogen peroxide. It can be found over the counter and in most of the cases if you use an antiseptic from first aid kits; that is completely acceptable.
Melanie: Do we save the tick and take it in to our local vet or somebody to find out if it is infected with Lyme?
Kaye: Most of the time, they are not going to run any kind of testing on the tick itself as far as a health care provider. You can certainly take it in, especially if it is a dog or what not. Every vet or provider might have their own preferences but for the most part, no, we don’t actually need the tick itself. Sometimes, if you are unsure, “Is this a dog tick; a deer tick; a wood tick? What is this? Sometimes bringing it in can be helpful for the provider just to see what kind of tick it is to know what your risk factor is. But that is, as far as how helpful that tick might be, that is really as far as it goes.
Melanie: What are the symptoms of Lyme disease? Because, Kaye, that seems to be one of the biggest confusions surrounding this particular condition is that it’s so difficult to diagnose. You hear about people who go undiagnosed for years because nobody can figure out what it is.
Kaye: Correct.
Melanie: So, what are some symptoms that might send us to a doctor and the person might say, “You know what? I really want to be checked for Lyme disease?”
Ms. McGrath: Sure. I think it is a great question because Lyme disease has been known as the great imitator. It can really mimic a lot of other different kind of illnesses and diseases. The biggest one that we always hear about is that bull’s eye rash, which is erythema migrans. Again, we call it bull’s eye rash because often there are clear rings with a central darkened area. This can appear anywhere between when you get bit by the tick to 30 days after. So, obviously, that is a very wide window of time that something like that can occur. But more and more, of course, we are seeing that there are possibilities for atypical rashes and still having Lyme disease. So, just because it’s not a bull’s eye rash does not mean it is not potentially Lyme disease. Some other symptoms that you can potentially have can be: chest pain and rib soreness, shortness of breath, feeling like your heart is fluttering – we call that palpitations, nausea and vomiting, new onset constipation or diarrhea, irritable bladder or where you are going all the time or you think you have a bladder infection, also joint and muscle pain, swelling and stiffness especially in one joint, such as a knee or elbow, etc., and muscle stiffness.
Melanie: Okay. If we have some of these symptoms and we go to see the doctor, do you ask your health care practitioner, do you say, “Please check me for Lyme disease because I like to go camping,” or “I found a tick on myself a year ago.” Do we make sure to point this out? Are there tests for it?
Kaye: Yes. So, I always say it’s a good idea. Your health care provider is generally probably going to be doing a very thorough history anyway. For the most part, what we are looking for is if you’ve had a recent exposure or you know you’ve been around something much like camping or you know you’re in the North Woods, etc. Those things are relative and we do like to know about them. Especially if there is a rash that has occurred afterward, I think it is a good idea to mention that. But also, when it comes down to testing, there are no perfect tests for Lyme disease out there. We look for the antibodies of those bacteria that I was telling you about before. It’s a two-step test that we use – a screening and then what is called a Western blot.
Melanie: What are the treatments? I’ve also heard that people go through treatments for years and they still have some of these symptoms of fatigue and musculoskeletal issues. I mean, it can really devastate the quality of your life. Speak about the treatments a little bit.
Kaye: The sooner treatments begin, the better recovery generally is. Again, ideally having that conversation with your health care provider is really important to rule it out or at least to know what your risk factor is or percentage of risk for Lyme. Again, early detection is really key. Generally, a 14-21 day course of antibiotics for an early stage Lyme disease is appropriate. Depending on age, we use different antibiotics. Certainly, IV antibiotics can be utilized for cases where there is recurrent or persistent symptoms, just basically because they can be more intense and long-lasting. Often, it is when we find Lyme disease later in the stages, so you have more bacteria that need to be taken care of. Often, that will require IV antibiotics. However, some people will have chronic Lyme symptoms and for those things, sometimes retreatment is necessary as well as just supporting the system and symptom control and treating symptoms. Because, generally, once we kill the bacteria with antibiotics, the bacteria aren’t necessarily problematic anymore but it’s kind of the residual that they leave behind.
Melanie: Why do you think, Kaye, that some people who suffer from Lyme disease need these support systems and that there are support groups out there for Lyme disease?
Kaye: Generally, functional impairments from chronic Lyme disease, like you said, as far as quality of life, it really affects people’s quality of life. Fatigue and problems sleeping, lethargy and depression, those things all tend to be things that can be linked chronically to Lyme. Certainly, groups can be helpful as far as support. People that go through the same things, treatments, sharing information, disseminating new information and research can be helpful in those groups, too. So, I certainly think that getting good support mentally and physically is important when you do have chronic Lyme-type symptoms.
Melanie: In just the last minute, give us your best advice--what you would tell people that ask you about Lyme disease and what you really want them to know.
Kaye: Sure. My big take home points are prevention is key. Knowing how to prevent a tick bite is optimal. Lyme disease can include many symptoms. It is called the great imitator. Make sure that you do talk to your health care provider if you do have a concern. Again, the more detail, the better. Diagnosis is not done by any one single test and there are many factors to consider when we diagnose Lyme disease. It is not a perfect science yet and there is still a lot to learn about Lyme. Early treatment leads to the best outcomes. And, of course, you can certainly learn more at good places like the CDC and the Lyme Disease Association which are all generally found on-line.
Melanie: Thank you so much. What great information. You're listening to the Stoughton Hospital Health Talk and for more information, you can go to StoughtonHospital.com. That's StoughtonHospital.com. This is Melanie Cole. Thanks so much for listening.