In the Garden:
On the East coast, the deer or blacklegged tick carries the Lyme disease bacterium, Borrelia burgdorferi. Nymphs are the size of poppy seeds; adults the size of apple seeds.
Living With and Without Lyme
"Pay attention, look closely, act quickly" could be a motto for handling Lyme disease.
This June, I was feverish and extremely exhausted by mid-day. My legs, wrists, and hands ached more than usual. Yes, these are Lyme disease symptoms, but I had no distinctive red rash. I'd felt an itchy spot on my back, but it could have been a spider or mosquito bite, so I'd spritzed dismissively with alcohol.
Nothing like the impressive rash eight years ago that signaled my first deer tick infection. Then a red, hot-to-the-touch, distorted bull's eye spread across my back. The rash, called erythema migrans (EM), may or may not appear within a few days to a month after a tick bites.
This summer, busy with gardening work, I foolishly procrastinated for several weeks before calling the doctor. At the doctor's, I described symptoms among those for Stage 2, early disseminated Lyme. Nasty infectious spirochetes (Borrelia burgdorferi) were multiplying exponentially in my blood. They'd survived Stage 1, early localized skin reaction. They were advancing to inflame joints and muscle tissue and attack the nervous and cardiac systems.
I'm fortunate and fine, thanks to my doctor who immediately prescribed a 21-day course of the antibiotic doxcycyline. Despite an upset tummy, I started feeling better on day four of treatment. Without treatment, I would have progressed to Stage 3, late chronic Lyme, which can be devastatingly debilitating, as some people know too well.
"We have no natural resistance to the Lyme spirochete," said Dr. Katherine Margo, Department of Family Medicine and Community Health, University of Pennsylvania School of Medicine, Philadelphia, PA. Early Lyme symptoms include rash, headache, muscle pain, swollen glands in lymph nodes near the bite (behind the ears, in the groin or arm pits). See a doctor at the first signs of infection, she urged.
Why treatment before testing?
The northeastern US and northern Midwest are parts of the country with a high risk for Lyme disease, and people who spend lots of time outdoors, like gardeners, are especially likely to encounter the ticks that spread this disease. Someone with the above symptoms who lives or has visited in these areas may very likely have Lyme, and is best treated ASAP.
"We are quite aware (through training and experience) that we are in an area of endemic Lyme," explained Dr. Tom Lyon, Mt. Airy Family Practice, Philadelphia. They don't rush to treat but offer treatment when there is a reasonable chance of Lyme infection. When indications are high but indefinite, Dr. Lyon tries "to make sure patients are aware that the situation is not certain, testing is not terribly reliable, clinical suspicion of infection is felt to be a valuable guide, and follow-up care is important if symptoms do not resolve with treatment."
In the East and Midwest, the deer or blacklegged tick is a "vector" or carrier of Lyme, via white-footed mice and deer. Tick nymphs, small as poppy seeds, cause most Lyme disease infections, reports the American Lyme Disease Foundation.
"If a tick latches on, pull it off slow and steady (so it releases itself from the skin)," said Dr. Margo. The tick won't be infectious for 48 hours "so you have time to check your body and remove anything that looks suspicious." Monitor for early signs and act quickly accordingly.
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