UKC

No idea where to put this really so picked RockTalk by default.

I was in the Lakes over the weekend. Found a small tick on my inner thigh last night. I have removed them before succesfully with tweezers, however in the past they have been a reasonable size and relatively sturdy. This bugger was tiny and was squashed pretty much as soon as I tried to grip it, leaving the pincers still attached to my leg. There is plenty of info (including on this site - article from 2007) on how to remove them but no mention of what to do if you squash it and leave the pincers behind - only that you should avoid doing this at all costs!

Firstly: The pincers are still there, eveidenced by a tiny black dot which has resisted all my efforts at removal. I'm guessing these will behave much like a splinter and will work theselves out over time?

Secondly: Given that I have apparently done the unthinkable and probably injected its guts into me, should I be doing anything other than the usual of just keeping alert to potential symptoms of Lyme over the next few weeks?

Any advice appreciated

Cheers

Mark

In reply to The Mole:

http://www.ukclimbing.com/articles/page.php?id=398

Alan

In reply to Alan James - UKC: Cheers Alan, I have alluded to that article in my OP

In reply to The Mole:

I have read (so not sure how accurate it is, but it makes sense to me) that removing the body of the tick but leaving the head in isn't too bad. The Lyme Disease comes from the stomach of the tick so if you've removed that (hopefully without squeezing the contents into your body) then you're safe. Only problem is you still have a tick head stuck in you which as you suggested should act like a splinter, either being naturally forced out or becoming infected, or both.

Note I have no medical training and that's all based on what I reckon... although I was bitten by a tick a few days ago, pulled out the body, left the head in and the head seems to have disappeared!

In reply to The Mole:

You could use a variation of the old strategy for getting rid of crabs in the Army.

Shave a stripe up the middle of your nads, soak one side in petrol and set light to it.

When they run across the fire break, hit them with a hammer.

In reply to jonny2vests:


*chortle*

Asking for it really...

In reply to The Mole:

Hi Mark

I left the head of a tick in my dog before and the area became really infected. I would probably see a doctor just to be on the safe side. In the future you could try applying vaseline to the tick which suffocates the tick so it drops off.

Hope this helps.


Vicy

If I go ANYWHERE I get literally covered in them. As such I carry the O Tool device mentioned above everywhere. It works as well on small ones as well as big ones. It seems to encourage them to withdraw themselves - the twisting is what does it, and sometimes you can see it walk up the tool a bit (as there is nothing holding it like tweezers). The downside of tweezers is that they are not idiot proof and I would personally find it nerve wracking to do this! I hate ticks!

Advice includes wearing light coloured trousers and tucking socks in, but you can wear shorts (I often do) and then just inspect your leg after every bit of growth you walk through (obviously no good if that is all you are doing all day) and flick them off before the bite. Its quite scary as you can see them very slowly going up the leg, basically toward your bollox to where the heat is. As such, you should get someone to check your scalp, and for your to check your armpits and other places, perhaps using a small mirror.

As you may be able to tell, I have perhaps thought about this too much, but a) i get them all the time, lots of them and b) a friends dad got neurological damage from lymes disease and bascially went mad and didnt know who his family was for three years. No thanks!

Vicy - No. That is an old wives tale and is not recommended. Just get the OTool.

In reply to The Mole:

official advise is go see a doctor if you have pieces of tick left in you.
If you get a bullseye rush (good picture on wikipedia) get a doctor and antibiotics.

Now I won't recommend this but in my experience the best way to get ticks (or their remains) out is to take a sharp knife (scalpel is best, carpet knife does in a pinch) and make a small cut leading away from the ticks head. The tick (or remains) can than be pulled out easily through the cut.

In reply to uncontrollable:

Just to be really cheery, please note that you can still get Lyme disease without said rash!

In reply to petestack:

oh yep, but than you can apparently even get it without having been bitten by a tick ...

In reply to petestack: If it is lymes disease does he get a free gin and tonic.

In reply to The Mole: I had my first last summer in Germany - where TBE is more of a concern!! I bought a 'zeckenkarte' from the pharmacy and used that - it seemed to work well, and I was surprised to hear an audible 'pop' when the tick came out.

In reply to The Mole:

I had a similar experience a few years ago, I ended up digging away at what I thought were bit of head/ mouthparts for weeks. That's probably not very helpful is it? Well I'm alright now anyway...

In reply to The Mole:
Took interest in your thread because I might have Lymes at the moment and am on antibiotics to get it eradicated, if that's what's causing my symptoms. But to put things in perspective, during my time I've hill walked and climbed pretty extensively in the Scottish Highlands over the last 25 yrs or so, and have had probably literally hundreds of bloody ticks having a go at me(ranging in size from grains of sand to the obviously visible)during this time.I guess they prefer sweet meat.
My real point is though, it's taken all that time and all those ticks before I picked anything up, so the probability is you DO NOT have Lymes.
The doctor I saw mentioned that negative blood tests for Lymes are notoriously false, when in fact they can be positive (so,unhelpful here then!)and symptoms can vary enormously (mine being sensory loss and numbness down the RH side of the face).

In reply to The Mole:

Yes, but it is really useful for readers to actually have the link to click as well.

Cheers

Alan

In reply to The Mole:

I've had well over 100 ticks on me over the years, 30 or more of which I had on me about 2 weeks ago after walking into a nest up at Seana Bhraigh. I don't normally worry too much about them other than to make sure they are removed and keeping and eye out for a bulls eye rash. With over 30 of them I thought I had best do some research. I worked out that they were larve ticks. Ticks go through 4 stages from larvae through to nymph etc. The chances of a larval (seed) tick contaminating your blood is very, very low. These ticks have never been on another host so have no chance to contract disease.

What you had sounds like a larval tick.

Keep an eye out for a rash and try and not itch it too much.

I have read that you need to see a doctor if you leave the head in and I have also read that it is best to let the head work its own way out.

That is your call.

Best of luck with it,

Andy

In reply to The Mole: ..i don't know..but i'm goin' to the doctor tomorrow
'couse i found one on me ..
i was out on the lake and camped out for the night..
doh.

In reply to Mario Sciacca:

If I went to the doctor's every time I took a tick off myself, I'd be classed as a hypochondriac.

Sod the doctor. I have been getting ticks at the rate of about 1 a week recently. If the head remains in when you pull the tick off you can dig it out quite easily with a pin. My gf left the head in on one that got in her eyelid. We couldn't dig that out so soaked it as often as possible with a cotten bud in salty water. After a week it just dropped out. If you get a rash around the area then start to worry, especially if it is doughnut shaped. Go to the doctor then.
the best way to avoid them is stick to paths and tuck your trousers into your socks. Also don't go bouldering where all the landings are heather.

In reply to jonny2vests: Yeah I thought about that pic after I had posted!!

In reply to All: Thanks for all of your replies. The bulk of my concern stemmed from the fact that the head was left behind - I have removed plenty of them before without squashing them.

Thankfully I managed to get the offending bit out of my leg last night, it was so tiny I almost wondered why I bothered! Like I said this fella was vey small.

Anyway I shall do all the normal things such as look out for the rash and be alert to feeling unwell

Thanks again

Mark

In reply to The Mole:

That's an awesome profile picture...you look like the future version on Baldrick in Blackadder's Christmas Carol!

Put some trousers on and perhaps you'll find the ticks attack you a little less in the leg department

I have also pulled ticks out before and have left the head in. Although, I excavate the head out at great pains. From my past experiences I have suffered no ill effects from suppurating wounds or Lyme's disease. Contracting Lyme's or something horrid from the head-end of the tick left behind is pretty slim it would seem !

In reply to The Mole:

I find it odd that some people seem more prone to them. Anyone know why?

In reply to The Mole:
A few of the guys I used to work with got them on the bollocks and gave a demo to everyone else on how to remove them Twisting always seems to help removing them although I'm still never sure which direction.

In reply to boonie: In my defence the photo was taken in a relatively remote Scottish Glen. I am not in the habit of wandering around the fells looking like that! Having said that one advantage of hardly wearing anything is that ticks are very easy to spot! I don't recall having any problems on that day, possibly because we were swimming a lot.

I put the photo in my profile in an act of self deprecation, may be its working rather too well!

In reply to jonny2vests: I have heard that people's natural scent can have an effect on how prone you are to being bitten by midges and mosquitoes. It is certainly true that some people are more prone to being bitten by insects than others. Maybe there is a similar mechanism in action (whatever it may be) when it comes to ticks?

m

In reply to Mac Ghille Aindrais:

While it might seem logical that a larval tick is less likely to give you the disease, as far as I know there is no proof that ticks do not inherit the disease from infected "mother" ticks. In fact very little reseach has been done on the whole issue, which makes any efforts at erradication very complicated.
So don't be too complacent ...

In reply to The Mole:
You may be reassured that you will probably live and think with sympathy of the climber who returned from the West Highlands on a Sunday night to discover approximately 50 ticks distributed around the area of his underpants , all ticks enjoying his body fluids. A marathon session in the local A & E allowed him home tick free at 02.30. No long term consequences other than serious pub banter

In my youth I spent many many happy weeks striding about the highlands, pennines and lakes, usually not on paths, and never knowingly got a tick or even knew they existed. Midges (in scotland) were quite enough to be getting on with.
Now I go less often but still haven't had one. I think you're all making them up to scare off the southern softies.

In reply to JBI: Haha, awesome!

In reply to thomm:

Just to scare people off Fontainebleau too, there are quite a few ticks there in the summer, I've had a few but no nasty diseases yet.

In reply to Bruce Hooker: It's where I got my Lyme disease

In reply to grumpybearpantsclimbinggoat:

I spoke to a local chemist once about it following a question on another tick thread and he said that some people are more sensitive to it than others. Apparently if you've had it once you are more sensitive too. My daughter had one once that lead to the rings forming as mentioned already so we went to the doctor's and he prescribed an anti-biotic treatment. He didn't seem very well informed about the question though, I had the impression that he gave the treatment to humour me!

In reply to The Mole:

A few years ago I knocked a tick's body off and left the head. I got a massive rash around the area and went to the doctors. They didn't really know what to do because it wasn't all so well publicised then. Anyway, they gave me cream but the rash got worse so in the end they had to give me some tablets which got rid of the rash. Don't know if it had anything to do with Lymes desease etc but personally I wouldn't risk it if I were you. Keeping you eye out for any symptoms or even a trip to the docs may not be the worst idea....

I have heard that most GP's dont know how to deal with it. You need an extreme course of exceptionally strong antibiotics I believe, taken straight away. There are a few specialists around. If I got a rash as mentioned I would go straight to them.

I think they can be found on google, or some UK society on Lymes.

In reply to Paul Doran:


http://www.lymediseaseaction.org.uk/

In reply to Paul Doran:

Interesting. When I was a student there was a patient with neurological manifestations of Lymes on a medical ward. He was used as a test case for the MRCP examinations (the exam required to become a medical registrar and eventually a consultant physician). Not one candidate got the diagnosis correct.

In reply to MelH:


As it was the final of the French Open Tennis Championships last weekend, it should be noted that Samantha Stosur, the losing finalist, had to take a considerable amount of time out of the sport after contracting Lymes Disease at around the time of the 2007 French Open...

After the French Open, Stosur started showing symptoms of what would only after months be diagnosed as Lyme disease, an infection transmitted by the bite of ticks. By then her form had slumped. She lost in the second round at Wimbledon, withdrew from many tournaments on the US hardcourt circuit and lost in the first round of the U.S. Open, where she was seeded 29th, to the then ranked #96 Alizé Cornet of France. Stosur did not play any more tournaments in 2007.

Of course, most of us are not in the top 20 or so in the world at what we do for a living, nor so reliant on physical performance in order to maintain that position. Took months for her to be diagnosed, and I'd expect someone who is in the top echelons of a professional sport to have good medical diagnosis readily available...

||-)

In reply to grumpybearpantsclimbinggoat:

[Fontainebleau] Me too, in 2005, which prompted me to write the article on Lyme disease that Alan linked to, above.

That old article was written in 2006, published on here in 2007, and I'm sure things have changed in the intervening years. Could it maybe do with a review and update on current guidelines - what do you think? I'm not volunteering for the job, though: a newborn and 2 toddler minxes take up all my time just now.

In reply to thomm:

Sadly it is not just a Northern phenomenon.

I live on the edge of Dartmoor and I finding plenty of sheep and deer ticks on the dog after a run in the woods. As the paths are getting overgrown and more foliage overhangs the paths it is getting to unavoidable when wearing shorts and running.

I've probably removed about 10 from me this year. Most of them were found before they had latched on but one got attached behind the knee.

I am removing them from the dog (who is no repecter of paths) at the rate of about 1 a day.

Not pleasant. I am tempted to shave my legs so the buggers have less to cling on to when running!

In reply to JayH: I'll be honest - I still find it as up to date as anything on the net and was the first thing I looked at when the bulls eye rashes came up on my legs.

In reply to grumpybearpantsclimbinggoat:

Ah, OK then. Cheers for the feedback. Glad you're better now, btw.

In reply to JayH: Your article was the first thing I read after the tick busrt and left its head in my leg last Sunday! It is certainly as good as anything else out there.

I noticed on Monday this week (8 days later) that the site of the bite, which had previously healed to almost nothing, has become inflamed but is still only about 0.5 cm across. It's very difficult to be objective but there does appear to be a halo around the red bit confirmed by my GP.
I've had a mildly stiff neck for about five days and yesterday and today felt pretty ropey (headache, fatigue), but not enough to keep me off work.

Been to the GP and have 50 x 100 mg of doxycycline. Dose is 200 mg per day for 3 weeks.
I had to convince my GP of the merits of this higher dose as the original suggestion was 100 mg for 2 weeks. This is still a lot lower than alluded to in your article but I frankly I think they were unlikely to prescribe any more.

Thanks for taking the time to write the article.

In reply to The Mole: Got my first tick last week. I did a short 3 day cycle tour across exmoor and North Devon. I would have thought the most likely place to have picked it up would have been exmoor as I did camp on the edge of the moor one night and was wearing shorts the whole time. However, that would have meant it was on me for 2 days before I noticed and I would have thought I would have noticed it if it had ever been engorged. Other than camping the only time I could have picked it up would have been while sitting on a bench where sheep were grazing near the coast.

The bite site has dissappeared now and no ill effects yet. I did have a look at the UKC article linked above and was surprised at the advice to remove them saying not to twist them. I used an o'tom remover which I have seen recomended often and the technique with that is to twist them off?

http://www.otom.com/

It seems to me that they are becoming more widespread. I used to do a lot of walking on Dartmoor about 20+ years ago and never got one or heard of anyone else getting one.

In reply to BigBrother:


Sadly I can recall finding ticks on me from wandering about the moor in the 1980's.

In reply to The Mole: A friend of mine had what turned out to be Lyme's Disease and was told by the doctor that it was "man flu"...

The twisting things are really cool - definitely worth having!

In reply to Victoria:

i have been told not to apply vaseline. the theory is that it suffocates them but apparently this makes then puke up, directly into the wound that they have made with their mouths, bad times!

i think it has already been mentioned but you can get little plastic tick hooks in different sizes that you use to twist and pull the little buggers off.

it seems that a lot of doctors aren't really clued up about Lyme disease and ticks but if you want some advice you could always try a vet as they seem to know more about it

In reply to ROFFER:
The current advice is NOT to twist, but to pull straight out.
http://www.lymediseaseaction.org.uk/ticks.htm

I use fine-ended tweezers - the ones in my swiss army knife.

In reply to Toreador:
That website isn't very consistent:
http://www.lymediseaseaction.org.uk/information/tick_removal.htm

On this page it tells you to twist using a specialist tool.

In reply to The Mole:

Bummer - I'm glad you caught it early and hope you're completely well very soon.

Don't worry too much about the doxycycline dose; it's probaly enough and if it's not then your GP will probably be more amenable to upping it if you still have symptoms at the end of the course. Quite sensibly really, they need to juggle the anti-b side-effects (can be nasty!) with the good they'll do, so will give the minimum to achieve maximal effect.

Good luck! (and don't forget the sunblock if you're on doxycycline!)

In reply to The Mole: make sure you check all over for these things...after last nights climbing I found one cheeky bugger feasting on meat and 2 veg this morning.....

In reply to JayH: Thanks Jay,

I'm not feeling desperately unwell, I have many of the tell-tale symptoms but thankfully they have all been mild - it could be something else and the inflammation of the bite site unrelated. Although it is worrisome that the bite had almost disappeared then reappeared a few days later in a different form.

I've done quite a lot of reading and the theory behind the high dose and prolonged course seem to be directed at ensuring the pathogen is COMPLETELY eliminated to prevent relapse (potentially chronic) at a later time, although as you have alluded to in your article getting objective information is difficult. One side deny the existence of the chronic condition whilst hysteria flows from chronically ill patients on the other!

I had pretty much come to the conclusion that since I got the meds in early a 'lower' dose (200 mg for 3 weeks is still pretty high) would probably be OK and since my GP was extremely receptive and open to my concerns it could be upped at a later date if needs be.

Thanks again

Mark

In reply to The Mole: I'm a GP in rural Perthshire and i was at an update meeting yesterday afternoon. We see loads and loads of tick bites and get plenty myself too. I think i've seen erythema migrans (the rash) maybe 2 or 3 times in 7yrs of general practice and i can think of 2 patients(out of 8000) who have suffered longer term problems as a result of Lyme disease.


My take home messages from yesterday were;

1. any EM or suspicion of Lyme disease then treat- Doxycycline 200mg daily for 2 weeks.(amoxil for under 12s) Don't delay waiting for blood tests which often unreliable in any case. Severe cases or those not responding will go to infectious diseases for iv antibiotics.

2.tick bite- no rash, not unwell- depends on size of actual tick, engorgement, duration of contact- if more than 48hrs then probably best treat prophylactically- this is based on a mixture of UK and American guidelines. If tiny, little engorgement, very brief contact- ie- matter of hrs- then perfectly reasonable to do nothing

3. always remember to think about Lyme disease as a differential-about 50% cases will have no history of tick bite or rash.(to paient's knowledge that is...)

4. removal- just pull the wee buggers out, everything else is mythical. Don't worry too much about digging around for teeth- they are like barbs so very difficult to get them all out- might get localised infection but most will just behave like minor foreign bodies

Graeme

In reply to graeme gatherer:

Thanks for the update, Graeme!

In reply to graeme gatherer:

With all due respect Graeme. The NHS has a poor history with dealing with this issue. While I understand your a GP, that does not make the information you receive or use infallible. Can you provide any viable sources for the information? Again. No disrespect intended, but I will always gather my information from a variety of sources and then make an educated decision. The USA has shown to have much better research and understanding of ticks and Lymes.

In reply to Milesy: I may be wrong but I believe that the guidelines used by the NHS are based on those used in the US! However there has been, and continues to be, a lot of controversy in the US as to best course of treatment particularly in the last year

http://www.ilads.org/news/lyme_press_releases/72.html

The guidelines described by the International Lyme and Associated Diseases Society recommend a more aggressive antibiotic treatment both for early stage Lyme and chronic Lyme, whereas the Infectious Diseases Society of America (which is the official line) recommend dosages similar to those described by Graeme/NHS for early stage Lyme and question/deny the existence of chronic Lyme

In reply to Milesy:

What a ridiculous thing to say when he's never even suggested it's infallible!


On which note, Graeme's quoting from 'a mixture of UK and American guidelines'. And knows (unlike you?) that it's Lyme disease and not Lymes/Lyme's...

In reply to all:

Finished my course of dox 10 days ago. About 9 days ago my symptoms reappeared and have been getting steadily worse. My GP referred me to Infectious Diseases today. Apparently they said that the treatment I received was perfectly adequate and it is extremely unlikely I still have Lyme. My syptoms are telling me otherwise. A request for an outpatients appointment has been made. I guess I just have to wait and see what they have to say in person.

Has anybody out there been in a similar situation who can offer me some advice?

This post also to try and raise awareness as there seems to be a significant variance in medical opinion. Most of the literature I have read suggests a significantly more aggressive course of antibiotics is required than the NHS typically prescribes.

Mark

i know these details secondhand but for what it's worth, a guy i know of became seriously ill, had various tests including Lyme's which came up negative, nothing really diagnosed and had years of misery. then someone suggested he should retake the Lyme's test, on the basis of it not being particularly accurate. hey presto!

In reply to BigBrother:

I heard that the increase may be due to sheep not being dipped like they used to be (or is it a Rural Myth) so there are more ticks in the countryside.

Can anyone enlighten?

I recently got a tick in the Lake District - nothing unusual there; like most on here I've had plenty in the past.

Shortly after I developed all the symptoms of Lyme Disease, and had what could pass for the bullseye rash.

The point of me telling this story is to highlight what happened next.

When I went to my local NHS walk-in centre, the nurse was no help whatsoever, refusing to believe that I'd had a tick or would know what one looked like. Luckily a doctor friend subsequently gave me some antibiotics as a precaution.

Hope you get sorted out soon Mark,

Ross.

In reply to The Mole:

Hope you get answers soon and feel better too.
My mum had a very large tick in her inside leg just a couple of weeks ago, she and my dad tried and tried to get it out with that tool thing with no joy, it wouldn't budge so they ended up digging it out. she was certain a tiny bit was left in, went to the nurse (as on hols) who said it'd be fine just keep putting savlon on it to prevent infection! However that day it got worse and swelled up a lot, she went back to see the doc and he gave her the same course of anti biotics you had. she finishes them on sat, has had no ill effects apart from what she think is a side effect of the anti-biotics. they say to avoid sun, but she didn't as on holdiay, and it seemed to make her skin very red, sore and sensitive. she's being very careful now and watching for any symptoms, are there any major ones you've come across that should be a big warning sign?

They're horrid little buggers, mum and dad had others that were smaller and easily removed, me an y hubby had none, although I found a half dead one on him and we were the ones in the mountains climbing, mum and dad just golfing! They are everywhere, so check all the time everyone!

Have definitely noticed a significant rise in people getting ticks over the past few years, was always dogs but never people when I was young.

We holiday in a small village on the west coast of Scotland, where said tick was found, every year, all locals say there has never been a case of Lymes disease but still worrying, do hope you're ok.

In reply to ross: Whereas my experience was completely different....also got a tick in the Lakes, definitely had the bullseye rash, so went to see my local nurse practioner. He took one look at the rash, said "nasty, characteristic of Lymes", and put me on a course of antibiotics straight away.

So it totally depends on the individual health nurse/doctor that you see.

In reply to JFort: The ill effects are from the dox - I had exactly the same. The sun sensistivity is a know side effect and has nothing to do with Lyme.

The swelling on her leg could be symptomatic of the 'splinter' left behind rather then the 'bullseye rash' assciated with Lyme. If your mother has had no other symptoms it is unlikley that she has got Lyme - it is afterall very rare.

As I have mentioned above my symptoms returned as I finished the course. I believe they are a reoccurance i.e the course was not strong/lenghthy enough, however my GP disagrees (as do infectious diseases, although I haven't spoken to them directly yet).

They must think that:

a) The timings are pure coincidence and I have something else with exactly the same symptoms.

b) They are just blinding following HPA guidelines and not looking at things objectivley.

Furthermore there is no real consensus on what is an effective treatment. There is a significant body of medical opinion that 200 mg dox daily for three weeks is inadequate to eliminate the bacteria. The NHS disagrees.

See here for an excellent article which should answer most questions

http://www.ukclimbing.com/articles/page.php?id=398

Your mother should be alert to becoming unwell for the next few weeks, but in all likelyhood will be absolutely fine

Mark