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I know I am! But unfortunately, with the great outdoors, comes the not-so-glamorous reality that there are lots of creepy crawlies out there that can transmit some pretty nasty infections. And the knowledge that the blacklegged deer tick Ixodes scapularis — tiny creatures as small as a poppy seed or a sesame seed — can transmit infections such as Lyme disease Borrelia , Bartonella, Babesia, Erhlichia, Anaplasma, Tularemia, Rocky Mountain spotted fever, relapsing fever, Colorado tick fever, Powassan virus, just to name a few, make them seem somehow even more like something out of a sci-fi horror movie. The blacklegged deer tick And if you think that Lyme disease from blacklegged deer ticks is just a concern on the East Coast — think again. A Stanford study in found that nearly every park in the San Mateo, Santa Clara, Santa Cruz and Mendocino counties that was sampled these are the parks that I hike with my children! Another Stanford study in sampled additional parks from Sonoma County to Santa Cruz County and confirmed that virtually all of the parks contained ticks that were infected with Borrelia spirochetes, including a newly identified species called Borrelia miyamotoi. Why Worry About a Tick Bite? The biggest concern with getting a tick bite is the risk of transmission of a tickborne illness. Lyme disease takes the spotlight, with horror stories abounding on the internet, but Babesia and Bartonella can be just as devastating. An infection like Lyme or strep can trigger an autoimmune, inflammatory reaction in the brain that results in neuropsychiatric symptoms — their brains are literally on fire. And one of the first steps is making sure that we as parents know exactly what to do when our children get bitten by a tick. Prevention includes the following key steps: Stick to the middle of well-cleared paths. This is definitely not the time to be going off trail! Wear the right clothing, in the right way! Ticks can crawl under your shorts or down your shirt to find a nice warm place to take a bite and burrow in. Lighter-colored clothing and socks make it easier to spot a tick on your clothes before it finds a way inside, so you can brush it away before it can even take a bite. Frequently apply a safe and effective insect repellent that works against ticks. Several studies have found various essential oils to be effective in repelling and killing ticks. A study found a lemon eucalyptus extract to be effective in reducing the risk of tick bites. Other essential oils that may be effective tick repellents include rose geranium aka Pelargonium graveolans , clove, lavender, palmarosa, pennyroyal, rose, and sweet myrrh. Remember — essential oils are effective because of their scent. Do frequent tick checks. It has previously been thought that the tick must be attached for more than 24 hours to transmit Lyme, but it now seems that just a few hours may be enough — although the risk is much greater if the tick has been attached for over 24 hours. So early tick detection and removal is key to preventing Lyme disease. Check their waistline under their pants and any other possible points of entry. Until you actually find one embedded, it can be difficult to appreciate just how tiny and difficult to spot they are! Be as thorough as possible because most people with Lyme disease never notice the tick that gave it to them. Pets can carry ticks into your home after being outside. If possible, wash your backpacks and camping gear, or at the very least do as thorough an inspection as you can and shake everything out. What was I thinking?!?! Of course, the next morning, Kenzi goes to put on some socks before we head out to school, and comes back and asks me what the little bump on her leg is! What to do if your child gets a tick bite The first thing to do when you find a tick on your child: The first time I found a tick on my son after we had been swimming in a river in Mendocino County, I thought there was a speck of dirt on his chest. It took everything in me to not freak out and show the panic in my eyes as I was gently pulling it out, all the while holding my breath. Even this second time around, I thought it was a speck of dirt and tried to pick it off with my finger nail. How to remove a tick There are several things you should NOT do when your child has a tick bite, besides not panic. DO NOT use Vaseline, gasoline, fingernail polish, rubbing alcohol, or any other caustic substance on the tick. DO NOT put a lit match next to the tick or squeeze or crush it. Doing any of these can inadvertently cause the tick to regurgitate more of its saliva that carries Borrelia and other infections into your body. Have a small Ziploc bag open and ready. Use fine-tipped tweezers to grasp the tick as close to the skin as possible without crushing it. Pull with gentle steady pressure up away from the skin. Keep the pressure steady. This is where you might find yourself holding your breath trying not to scream like I did. Head to your local urgent care or your doctor to safely remove it completely. Immediately wash the area with warm water and soap, and apply tea tree oil or any other antiseptic that you have on hand. Note the site of the tick bite, and draw a circle with a ballpoint pen around the bite site so that you remember where it is. There are various tick-removing devices available. What do you do with that little baggie holding that fear-inducing poppy-sized vermin? Do you give you child antibiotics? Do you just wait and see if your child develops symptoms of Lyme disease? Lyme disease, if caught early and treated appropriately does NOT have to go on to be a devastating chronic illness. There are various labs that will identify whether the tick is a blacklegged deer tick and if it carries Borrelia burgdorferi or other tickborne microbes. I do recommend checking for co-infections, and not just for Borrelia alone. Ticks can carry and transmit more than one infection, and knowing what symptoms to watch for can be very helpful in early diagnosis. The turnaround time is unfortunately about 3 weeks for IGeneX. The turnaround time for TickReport is 3 days from receipt of the tick. To take prophylactic antibiotics or not — that is the question. Prophylactic antibiotics may prevent the development of Lyme disease if given as soon after the tick bite as possible. One study showed that a single mg dose of doxycycline given within 72 hours of tick attachment may be effective in preventing the classic erythema migrans rash within 4 weeks of a tick bite; however, the development of a rash is not necessarily a good endpoint as many people with Lyme disease never develop a rash, and this study had no long-term followup to determine if patients went on to develop symptoms of chronic Lyme disease. Most Lyme-literate practitioners do not believe that a single dose of antibiotics is adequate to prevent Lyme disease, and that at least a 3-week course of antibiotics is needed to ensure that you kill the Borrelia in all of its life forms — the free-floating spirochete form, the evasive cell wall-deficient form, and the dormant cyst form. If you stop antibiotics too early, you may not kill the Borrelia that is hiding out in its dormant cyst form and waiting for just the right moment to reactivate and convert to its free-floating spirochete form to cause trouble at a future date. Are they really necessary? The antibiotic chosen may be herbal or pharmaceutical, or a combination of both. But remember — the antibiotic s chosen should be taken for a minimum of weeks. For adults, a 3-week course of Doxycycline may be recommended. Doxycycline should not be given to children, so Amoxicillin and Azithromycin are typically used instead. Herbal antimicrobials targeted to Lyme and coinfections can also be used alone or in combination with pharmaceutical antibiotics. Just remember, though, that herbal antimicrobials can still disrupt the gut microbiome like antibiotic drugs, and the gut needs to supported just as fully as outlined below. Stephen Buhner, a highly regarded Lyme herbalist, recommends the herb Astragalus with adult dosage of mg daily for 30 days after a new tick bite. For prevention, Buhner recommends that adults take Astragalus mg daily during your time in a Lyme-endemic or tick-infested area may be helpful in boosting your immune system and preventing Lyme transmission. However, findings are unclear, so I do not recommend this as sole treatment at the moment. If you or your child does get bitten by a tick, please discuss what antimicrobial regimen is best with a Lyme-literate practitioner. Kimchi — Korean pickled cabbage The gut can and should be fully supported while taking antibiotics for Lyme prevention. The goal is to minimize disruption to the gut microbiome and prevent gut dysbiosis and leaky gut. Be sure to give your child probiotics at least hours after each antibiotic dose. Drink bone broth for all that healing glutamine and gelatin to support the small intestinal lining and prevent leaky gut. Watch the site of the tick bite for an expanding bullseye rash, and watch your child for symptoms of acute Lyme disease. The vast majority of people with chronic Lyme disease never recall having a rash, so you want to watch for the other signs and symptoms of Lyme disease to know when to go see your doctor. Go immediately to your physician if you or your child develops any symptoms of early or late Lyme disease below. If your child does develop signs of Lyme disease, please demand that your physician order more specialized Lyme testing through a lab like IGeneX or at the very least order a complete Lyme IgG and IgM Western blot and not simply a Lyme antibody screen with a reflex to Western blot. Unfortunately, the diagnosis of Lyme is highly controversial, but you do NOT want to miss a diagnosis of Lyme disease. Due to the inaccuracy of current testing methods, even the CDC recommends basing the diagnosis of Lyme on clinical symptoms and not on laboratory findings. What else can I do to prevent Lyme disease? I often wonder why it is that some children go on to develop PANS or chronic Lyme disease from a tick bite, and other kids do not? Why do some adults go on to develop chronic Lyme disease with devastating neurologic symptoms, and others develop no symptoms at all? I believe some of the answers lie in: These red flags include low energy, poor endurance, sensory issues, regressions after illness or prolonged recovery time compared with peers. If your body is trying to fight off Borrelia or other tickborne infections, its methylation and mitochondrial stress have increased. Optimizing health Optimal health begins with the gut and ends with the heart. Optimal health means supporting body, mind, and spirit with the following steps: Ensure a healthy gut microbiome with fermented foods, bone broth, and probiotics. Eat a diet rich in whole, unprocessed, organic foods with a variety of phytonutrients a rainbow of fruits and vegetables , healthy fats and wild, free-range proteins. Avoid pesticides, heavy metals, and artificial flavors, colors and preservatives. Supplement lacking or insufficient nutrients such as omega-3 essential fatty acids i. SLOW it down and teach your kids to manage stress through mindfulness and meditation for tips on how to do this, see my blog post on the Holistic Management of Anxiety. Get outside in nature as often as possible while watching for ticks! Check out my blog posts on sleep:
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