My Open Letter to Doctors, Nurses and all Health Agencies about Lyme

I don't know if this letter will be given much credit, I am just an average individual who has been battling Chronic Lyme for 4 years.  But I was trained annually on prevention, I have a masters in environmental health, I know I was bitten, I know it was engorged, I had a rash, I got sick and yet four years later I have had to use up most of savings for treatment in the US, give up my management position and legally fight for insurance, while trying to regain as much health as possible.

I help people weekly, to try to get appropriate treatment for a bite or symptoms, to save them, so they can learn from what I have learned.  Yet, I fail, even when I send them with all the supporting documentation and studies and guide them as best I know how. https://www.linkedin.com/pulse/human-rights-violations-relapsing-fever-lyme-disease-luche-thayer

So, I have decided to write this letter, so those who care, can read it.  I beg of you,  as a member of the medical profession to just read and consider the following information.  I will reference sources for all of my points and within those sources you will find hundreds of studies to support it.  They say doctors don't have time to read all the latest science and that I can understand.  But you should know there are over 700 peer reviewed scientific papers that are showing more up to date information on Lyme and you are not being told.

Please, just please just consider what if all of this is true? What if a few minor factors in the details determine whether someone you care for ends up with a lifelong chronic illness or if they can walk away and never think about Lyme again?  What if you had the power to make sure those people never had to worry about Lyme or a lifelong illness?  Well, you do have that power doctors, nurses, and public health educators.  You most definitely do.

I write this letter pleading with all of those in health to seriously consider the items I share with you here - to save many from my demise. The solutions are so simple its ridiculous, yet from what I see the fear of Chronic Lyme is going to become a reality for hundreds of thousands more if we don't fix a few small things.

The 24 Hour Rule: If there is anything we do know about nature it is that rules don't apply.  We cannot control nature, it is not exact and we cannot assume it works the exact same way every time.  This "rule" is leaving people without treatment, giving them a false sense of security and are becoming infected every day. 

This rule was established because the tick typically attaches and feeds on a human until full. Once full it can regurgitate the blood with the lyme infection back into the human.  It takes 24 hours or more for this to occur so the rule was established for this reason.

Here is why this rule should not be followed:
1) It assumes that the tick was never attached to another host or partially fed somewhere else.  Studies have shown that ticks have partially fed, detached and attached to a new host. This greatly reduces the time before regurgitation.
http://danielcameronmd.com/have-you-been-bitten-by-a-partially-fed-tick/

2) Ticks transmit more than just Lyme and some infections that are even more debilitating that Lyme.  Studies have shown that some of these infections are transmitted in minutes.  Powassan Virus which can be deadly was proven in a study to be transmitted within 15 minutes.  I can't imagine there are too many ticks that are removed within that window, especially since the tick injects an anesthetic so you don't feel the bite. 
http://northcountrynow.com/news/ticked-new-info-lyme-disease-north-country-people-should-know-0183893

David H. Persing, MD, PhD, chief medical and technology officer for Cepheid, a California biotech firm and a world expert in molecular diagnostics.  "I don't think we know half of the agents that are potentially transmissible by ticks"

3) Lyme has been proven in animal studies to be transmitted within 6 hours.  So it is only safe to assume that is should function the same way in humans. 
http://www.lymedisease.org/lyme-disease-myth/

4) It also assumes the tick was never stressed.  If stressed it is known that the tick will prematurely regurgitate into the human host.  This could mean pressure on the tick which is possible especially if you don't even know its there.  They like to attach in hidden areas where pressure, scratching and stress would be likely, i.e. armpits, toes, head, etc.

5) Finally it assumes that the removal was proper and flawless.  Who can know whether the tick was stressed during removal and regurgitated before full removal.  Its common for removals not to be perfect and incredibly likely that at some point while preparing for the final pull the tick was exposed to some stress and regurgitated back.

"The bad news is that improper tick removal may increase the chances of infection and disease." Dr. Jorge Parada, MD, MPH, FACP, FIDSA Medical Spokesperson for the National Pest Management Association (NPMA) and infectious disease specialist, Loyola University

6) And...This rule used to be 72 hours, then 48, then 36 and now its 24.  What happens if someone doesn't get treated because its 24 today but you finally get told to apply 6 hours next year. The science is saying so, so you will eventually be told.
https://www.lymedisease.org/hard-science-on-lyme-ticks-can-transmit-infection-the-first-day/

Just Ask: Dr. Richard Horowitz, Dr. Laurie Radovsky, Dr. Burrascano, Dr. Nevena Zubcevik, Dr. Liz Zubek, they and many others have written about this.

The Bullseye Rash: It is becoming more known that a very small minority of people with Lyme are likely to see a bullseye rash.  But what is less known is that only 9% of that minority will show the typical bullseye rash.  But people are being told their rash is not a bullseye and therefore do not have lyme - not true.  There are a minimum of 7 types of rashes that are representative of Lyme and a rash suggests infection.  
https://www.ncbi.nlm.nih.gov/pubmed/17945460

I know of far too many Chronic Lyme patients that were once told they had a spider bite.  Please don't assume so quickly.  There are some good resources for the different types of lyme rashes:
http://www.bayarealyme.org/blog/lyme-disease-bullseye-rash/
https://www.cdc.gov/lyme/signs_symptoms/rashes.html

The One-Day Prophylactic (preventive) Treatment: is based on only one study that was only successful in 4 out of 5 patients and by successful they mean the rash was prevented, not the Lyme.  
http://vermontlyme.com/2017/04/24/problem-single-dose-doxycycline-tick-bites/

"IDSA sometimes recommends a one-time 200-mg dose of Doxycycline. The only study supporting a single dose of Doxycycline demonstrated that it could prevent rashes but did not study whether it could prevent any chronic manifestations of Lyme disease." Dr. Daniel Cameron, International Lyme and Associated Diseases Society (ILADS) 
http://danielcameronmd.com/importance-second-opinion-prophylactic-treatment-tick-bite/

ILADS recommends that prophylactic treatment should be implemented for at least three weeks, with follow-up after a tick bite [as Bb Lyme spirochetes have the ability to penetrate the body and cells in less than 24 hours following an embedded tick bite]. http://www.tandfonline.com/doi/full/10.1586/14787210.2014.940900

I know of people that were prescribed the one day dose many days after the bite.  Both treatment guidelines will tell you thats pointless by then.  But, I just don't understand why a few weeks treatment of antibiotics is withheld based on one, not very successful study vs the hundreds that are showing Lyme persistence.  This is not about whether you get a rash or not, this is about whether you get a lifelong debilitating disease. Please treat the bite...properly. You have the collective ability to save thousands.
https://sites.google.com/site/getitrighttreatthebite/

And if you do decide to prescribe the one-day dose that eliminates the rash,  please consider that you have eliminated the single, most powerful symptom to diagnose a Lyme infection, the best symptom to tell you, without a doubt, that this person needs many weeks of antibiotics.

A rash and/or flu like symptoms following a tick bite: it's lyme, treatment is needed.  There is no debate here, please treat.  

And if I could ask one more favour here: please talk to your patients about the two different guidelines that presently exist for treatment.  Canada's Federal Framework on Lyme now refers to both treatment guidelines and The Federal Health Committee has formally requested that both be referred to on the Public Health Website (but things move slowly) so I ask that you know both: ILADS & IDSA.  You are not going to find many specialists in Canada that agree with me on that.  There are very few ILADS doctors in Canada which could explain why we all have to travel to the US for help.  You should know: the ILADS Guidelines are presently the ONLY ones that comply with the National Guidelines Clearinghouse and the Institute of Medicine.
http://www.ilads.org/ilads_news/2015/ilads-treatment-guidelines-are-now-summarized-on-the-national-guideline-clearinghouse-website/
https://www.guideline.gov/summaries/summary/49320/evidence-assessments-and-guideline-recommendations-in-lyme-disease-the-clinical-management-of-known-tick-bites-erythema-migrans-rashes-and-persistent-disease

The reason I ask that you share both is because one suggests 2-3 weeks treatment and the other 4-6 weeks treatment with symptoms.  It breaks my heart when someone is given 2 weeks with symptoms when 2-4 more could eliminate the fear of Lyme for good.  The only time you can 100% cure Lyme is at the very beginning.  The further away you get from initial infection, the more persistent the bacteria gets and the more irreversible damage is done.
http://www.ilads.org/lyme/treatment-guideline.php
https://canlyme.com/just-diagnosed/treatment/

I understand we want to decrease the use of antibiotics.  But at what cost?  Is this the place and time to be stingy?  I can promise you no one dealing with Chronic Lyme would tell you that saving 2 weeks of antibiotics is worth the hell they now live in.  Oh and by the way, my dog was given 6 weeks treatment with symptoms.

And finally, the Minister of Health for Ontario sent a letter last year (2016) to the College of Physicians and Surgeons stating that Lyme should be primarily a clinical diagnosis and not to rely on the blood test to be positive for treatment.  
http://ocfp.on.ca/docs/default-source/default-document-library/minister-letter-to-docs-re-lyme-2016-07-29_english.pdf?sfvrsn=582df889_0

I think the fact that the blood test is inadequate is becoming well known in the medical community. You may note that just last month (June 2017) the Centre for Disease Control (CDC) finally released this fact and suggested you should treat with antibiotics upon suspicion.  So, although it is too late for me and many others (I was not treated because my blood test was negative) I hope this information may save some.  But you should note the CDC is often who we look to for this type of direction.  They came forward with this much too late and way behind Ontario's efforts.  So what other information might we be getting a little to late.

Just know, the science is there to say the bacteria is persistent, can become chronic and infection can be quite rapid.  Please don't dismiss the patient that was once bitten and treated as they could have a chronic infection. Please don't under treat a patient who is just bitten. You have the power to cure them, then and there, for good.  What an amazing influence you can have on the management of this illness.
http://lymeconnection.org/news_publications/meet_the_lyme_disease_experts.html/title/dr-richard-horowitz

Thank you for taking the time and for your consideration.
Yours in fighting Lyme,
Kristy

A Passionate Thank You to Those Who Have Helped Me in My Battle With Lyme

On June 17, 17 friends and family came together with a most powerful event to raise funds for further treatment and advocacy of Lyme.  It is sad that in a country where medical treatment is to be covered that friends and family must come to gather to support someone who has to seek coverage outside of their country in order to survive.  But I have come to accept that is the way it is for Chronic Lyme in Canada and I couldn't be more grateful for the support I have received.  So I wanted to share excerpts of my thank you speech.  

Thank you to all of you for being here tonight, the hard work of many to put this together and the amazing entertainers who offered their Saturday night and most of all their talent. I also want to thank my friends who called in special favours to to get these amazing musicians, incredible silent auction items, volunteer help with set up, food, tickets, and the list goes on.   Some very special people in my life were adamant that this event happen. 

If I can back up a little on the thank you: I also want to thank all of those who sent private messages, text messages, emails, phone calls, Facebook comments, gifts and love over the last year - thank you.  I hope I responded, but if not just know that I read and was filled with gratitude with every single one.  I reread them on the tough days and they definitely carried me through. 

Did you know - I have the absolute best friends in the world!  All of my life my friends have been family to me.  New and old; they sure made me feel like family this last year with the things they did for me.  You wouldn’t believe what good people will give of themselves when a friend needs a hand.  The most amazing thing about them is that they are not only there for the good times…because they know how to have a good time.  But they have amazing ways of making the bad times feel like good times. 

I do need to mention a few people individually - my children and my husband.  My kids were great at never making me feel sick…especially when the dishes needed to be done or supper cooked lol.  In all seriousness they carried more weight the last year than many their age, and they did it with grace, I could not ask for more…

Although I got more, in a husband with the tolerance level of a saint.  I know what many of you are thinking, he had to have been a saint for putting up with me before…you are right, but this last year was the ultimate test.   Despite everything he managed to make me feel strong, determined and a fighter when all I felt was weak, lazy and pathetic.  With all we had to give up, he could only focus on our blessings.  How lucky am I!?

Many of you have had to put up with my Facebook warnings, quite a few of you had to listen to a very long presentation in Pakenham, many of you asked questions when you were curious. I want to thank you for all of that.  Who would have thought the one place I loved to be, the place I encouraged all of you to spend as much time as possible and many of you joined me outdoors in fitness and other activities and yet it is the one place, where a small little bug tried to ruin my life. 

 All I can say is this: I am so grateful it was me.  I had no idea that little tick could do so much damage and I had no idea our country was so willing to bury its head.  

But I also want to say this: that tick is not going to ruin my life and this country is not going to get away with this forever. 

Despite all the work and healing that still has to happen and despite Lyme’s efforts to take away everything I was, I still believe it has given me more than it has taken away.  Take a look at this room, how could I not think that.  

So I wanted to share with you some of the things I have learned that convince me Lyme has given me more:

• I have learned about chronic illness, that it is invisible, you can look fine and be battling the biggest battle of your life inside.  I hope to have more empathy as I go forward that we all are battling things at times that others may not see or understand.  But it could never hurt to just offer a little more empathy despite what we don't understand. 

• I have learned that sometimes motivation is not always the answer.  [I know some of my boot campers are thinking its about time - she's is finally going to lay off the motivation} I used to believe anything was possible if you just pushed yourself hard enough. What a hard lesson to realize that sometimes in life we are given something to handle that is beyond motivation, willpower and blunt determination.  And that we don't always need someone to lift us up, push us forward or keep us going.  Some days the most powerful words you can hear are “its ok” 

• I have learned that everyday there are so many little blessings happening and because life is happening so fast we don't have the time to notice them.  And that all of your abilities, all of your passions and favourite things can be taken away and all of a sudden you will have the chance to see all that you were missing.   I know I am blessed beyond belief and each of you have played a role in that.  

• Random acts of kindness are one of the most powerful tools we have to make the world a better place.  I wish i had the time to share with you tonight about all the incredible acts of kindness I have experienced in the last year.  Maybe i could sum it up by saying living and growing up in a small town is probably one of the greatest blessings anyone could experience.  The businesses, the organizations, people I barely know and the generosity leaves me lost for words…and we know that doesn’t happen often. Sometimes what means nothing to you to do means the whole world for someone else and rarely is anything to do with money.  

• yes, I did say rarely…because there is a saying in the Lyme world that goes; “money doesn't create happiness, said no lyme patient ever”.  But I am a lucky one, because many have lost houses, cars, savings, marriages, jobs, and many cant fund travel to the US - all while trying to heal.  Yet, lyme patients don't refer to themselves as victims, they call themselves lyme warriors.  They have fought an illness that slowly and quietly takes away their functioning, fought a medical system that either doesn't know how to help or refuses to and a government that moves so damn slowly to resolve anything.  I thank you tonight for joining my team and becoming a lyme warrior.  

You know - A top Lyme doctor in the world said his one message to every lyme patients is “dont ever give up”.  There is no one treatment for every patient, just keep trying and there is no clear cure, but someday there will be.  So, although there have been many points in the process I have wanted to give up…Lyme is an endurance test, its long, its slow and many time it goes backwards - its a lot like life, magnified. So if anything I think its a message to all of us.  No matter how bad it seems at the time, don't give up.  Keep striving for what you love, seeing the blessings that are all around and believe, believe that things will get better, justice will prevail and that with your contribution that world will be a better place.  

Kristy’s Kitchen Party For Lyme Advocacy 

June 17, 2017

Thank you Speech 

My Open Letter to Dog Lovers About Lyme

In the middle of my first year of recovery with Chronic Lyme, after being misdiagnosed, I decided to get a puppy.  You spend so much time alone and feeling ill that many sufferers find comfort in a furry friend.  Our previous beloved pet was a Border Collie and Labrador Retriever mix.  She loved to run with me, hike, kayak, atv, many of the things I could no longer do.  But we decided a similar dog mixed with a quieter breed would be appropriate and fell love with "Aggie" a Border Collie/Great Pyrenees cross.

Having a dog was great motivation to get up and go for a walk most days, regardless of how sick I was.  She was great company and would just hang out beside me when I was too ill to do much else.  One day following a hike, I discovered an engorged black legged tick on her.  Unfortunately, it was days before her 3 month appt where she would have started the preventative tick/Lyme treatment.  I saved the tick to show my vet and she felt it was not a concern because it was not engorged (although it did seem so when it was attached).  Regardless, it was too early to test and I was sent back home with preventative meds and the tick. 

After a month I became concerned with her loose stool and called the vet, concerned it might be Lyme. The amazing thing about vets is they have the best understanding of Lyme.  The treatment animals receive by the veterinarian community is far superior to what any human receives by the medical community.  While I was serving as a lyme patient witness to the Federal Government, one MP asked the expert Doctor "are you trying to suggest that the data and treatments animals receive are better than what humans receive?" to which the medical Doctor responded, "I am not suggesting, I am telling you it is a fact."

So when the Vet told me loose stool wasn't necessarily an indicator or lyme, I let it go.  I was a little surprised as it can be a common symptom in humans, especially since fever and the flu are early symptoms of Lyme in humans.  But she was a young puppy, eating many new things and new to me, so it was hard to determine what was out of character for her.   I also knew I was probably hypersensitive because I didn't want anyone to struggle as I have with this disease.  

A few months later, I knew it was getting to be too much.  I called theVet and insisted she be tested for lyme.  A quick in clinic test and she reported "I guess your instincts were right - she is positive for lyme."  

And here becomes the very important part of this story:

The Vet then stated "typically we would not treat her with anything since she is not showing symptoms, just the presence of lyme in her system.  So I have to ask why were you so adamant she be tested for Lyme".  That is when I stated it was because she is symptomatic for Lyme.

She is showing many of the same symptoms of Lyme that were missed when I first started to get sick.  

1) She was panting and feverish more and more.  Some nights she would get me up to let her outside to just sit in the cold.  

2) She was happy to go for a long walk and play hard, but seemed to be very lethargic the following day or two

3) She drank more water than any dog I knew

4) Her shedding was increasing

5) Her eyes were bloodshot regularly

6) She appeared clumsy and would trip once in a while

7) Even though she wanted to jump up on a couch or something she seems hesitant and it looked like she had to coax herself to push off to get up

8) Loose stool that seemed like it was getting better, then return

The one thing I remember clearly with this my illness is that just as you think you are getting better, it all of a sudden returns and maybe worse.  It was a cycle, that makes you think you are better, then sick with something else.   So in a dog it is even harder to detect because the cycles make you think they are unrelated and our furry friends can't let us know how much they are suffering.  A dogs natural instinct for survival is to hide suffering as that would make them vulnerable in the wild.  So you can never expect to know how bad it really is and well, Lyme is called the invisible disease for a reason. 

Aggie after 6 weeks of antibiotics.
Symptoms are gone and she is doing well.  

The vet explained that the symptoms they are looking for are limping, stiff joints, loss of appetite, etc.  And that is right, but for me that was three years into my diagnosis.  It is chronic then - recovery is much tougher at that point.  We want to catch this disease early, so it is treatable and responds to antibiotics.  I was adamant she receive treatment.  I was confident the signs were early Lyme and I don't want what comes next in the progression of this illness for anyone, human or animal.  

I share this with you because Lyme is still a very misunderstood disease.  Humans are treated even less than animals in Canada and once its chronic cannot get treatment at all in this country.  It was hard for me to be sure I wasn't over reacting.  She also had Great Pyrenees in her and I was less familiar with that breed.  Some of the symptoms at first could have been attributed to her breeding.  But they progressed and seemed more extensive than they should be.  And I have been there, I too passed them off many symptoms for a while and look where that got me.  I was not going to have the same thing happen to new best friend.  

The other thing I know with Lyme is many of the symptoms seem minor on their own, but they start to build and add up. You need to keep a running list of what is happening.  Minor symptom after minor symptom will start to add up over time and you may have a valid concern.  Lyme symptoms were very hard for me to explain to my doctor for years.  It is close to impossible for a dog to let us know what is happening before its too late.  I wish Lyme was better understood and treated in humans in Canada because I believe this information could also help our furry friends when they can't describe what they are feeling.  

If your dog tests positive for Lyme, please don't assume they are not symptomatic.  It is a horrible, hidden disease.  Vets are not only better diagnosticians than doctors, they are also very willing to properly treat animals for the illness,  yet it is still complex and sometimes misunderstood illness. If anything just be aware.  You don't want your pet to suffer silently. 

One other note about Lyme: don't assume that because they were treated with an antibiotic that the illness is gone.  The vet told me that day she had a dog who was treated but the illness returned.  She wasn't sure whether the dog had been bitten again or not.  I explained to her the there are many scientific studies proving the persistence of the Lyme bacteria.  Treatment can attempt to kill it all but fall short.  The longer someone has the illness the harder it is to treat.  It is possible for someone to recover with antibiotic treatment but have it still return.  It just means not all of the bacteria was killed off.  So monitor for symptoms long after treatment, just in case. 

This letter is dedicated to our previous, lost, loved dog, Keesha, who we now know suffered in silence, for years, with Lyme.  I am sorry my friend that you struggled more than we knew.  If I knew better, I would have done better.  Now I know better.  You are so missed. 

Acute Lyme Treatment - What You Must Consider

I have spent my last year of recovery desperately trying to figure out what I did wrong and how I fell through the cracks, not receiving appropriate treatment for lyme and missing diagnosis.  It took a while to fully accept that I did not fall through the cracks. This is how treatment is missed and ignored in the Lyme world, over and over again. My story is identical to thousands of others.

Author Lori Dennis, Lyme Madness explains more:
https://www.linkedin.com/pulse/doctors-listen-up-lori-dennis-ma-rp?published=t

I think the most important part of Lyme is that each patient should have all the information so that they can seek the help of a medical professional and make appropriate decisions knowing they have considered all the facts. Lyme is curable in its early stages, so it should be something that is ruled out first, not diagnosed by process of elimination.

Things to consider:

OUTDATED GUIDELINES
Canadian's are following Infectious Disease of America (ISDA) guidelines which have been noted to be outdated.  They are based on old science.  And since then there are hundreds and hundreds of studies that support a different protocol, that has yet to be considered.
https://www.lymedisease.org/idsa-guidelines-removed-ngc/

OTHER APPROVED GUIDELINES
The International Lyme and Infectious Disease Society (ILADS) have approved guidelines that include science and specialists from all over the world.
http://www.ilads.org/ilads_news/2015/ilads-treatment-guidelines-are-now-summarized-on-the-national-guideline-clearinghouse-website/
They hold regular conferences, share recent scientific findings and collaborate on treatment protocols and success.  The guidelines clearly explain where the old guidelines fall short.
https://www.lymedisease.org/lyme-basics/lyme-disease/treatment/
They typically support a slightly longer course of antibiotics to solve this illness (in its acute form).  Pretty simple solution if you ask me.  Scroll down to Executive Summary: http://www.tandfonline.com/doi/full/10.1586/14787210.2014.940900

THE ONE DAY DOSE DILEMMA
Many people do not receive treatment after a bite, but if they do it is often two doses for one day of doxycycline.  It should be known that this is based on one study that is over 10 years old and only shows treatment of the lyme rash, does not prove to kill the Lyme bacteria.  Oh and it only cured the rash in 80% of a very small test sample.  I enquired about this further with a Chief Medical Officer and was told, it is really considered a prevention (assuming Lyme has not yet entered the body), not a treatment.  Many people believe they are being treated.
https://www.lymedisease.org/single-dose-doxy-tick-bite-prevents-rash-not-lyme-disease/

Another thing you have to make note of when accepting the one-day dose is that it will likely mask or delay many of the Acute Lyme symptoms that would warrant treatment.  It is meant to alleviate the rash and that is the one symptom that will encourage doctors to treat Acute Lyme.
http://vermontlyme.com/2017/04/24/problem-single-dose-doxycycline-tick-bites/

EARLY LYME IS ALMOST IMPOSSIBLE TO DIAGNOSE
I lived it myself and I hear it all the time.  The early symptoms, typically after 30 days, are incredibly easy to pass off, make excuses for or consider part of aging.  They are so subtle they are often mistaken for a stressful period, being overtired or the feeling that you are fighting something.  It never amounts to enough for anyone to get concerned.  My best suggestion is if you know you had a tick bite, you should demand treatment with the tiniest, most subtle change in your health.  It is likely related and with a course of antibiotics early on, it is very easily cured.  Don't waste time and wonder, because it can become too late.  Note: More than half of Lyme patients, don't even know they were bitten (that's a whole separate conversation).
https://www.canada.ca/en/public-health/services/diseases/lyme-disease/health-professionals-lyme-disease.html
See guidelines for appropriate treatment:
http://www.tandfonline.com/doi/full/10.1586/14787210.2014.940900


DO NOT WAIT FOR TESTING
Not only has the testing proven to be too inaccurate to provide a diagnosis, it is not recommended for 4 weeks after the bite (it tests for antibodies that take time to develop). At that point early treatment would have already resolved he issue.  The Ontario Minister of Health sent a letter to Doctors last year starting that testing is to only support a clinical diagnosis.  You must rely on symptoms and risk to determine treatment.
http://ocfp.on.ca/docs/default-source/default-document-library/minister-letter-to-docs-re-lyme-2016-07-29_english.pdf?sfvrsn=0

24-36 HOUR RULE
See my previous blog on Prevention to learn why you do not want to rely on the 24-36 hour rule to wait for treatment. This is a protocol many doctors and hospitals insist on that; the tick was attached for that time before treating.  Science is showing that is not reliable and you should not assume you have not been infected in less time.  http://outofthewoodz.blogspot.ca/2017/04/lyme-prevention-what-you-want-to-know.html

RULE OUT LYME FIRST
Lyme is an illness that should be considered first.  It is very easily treated early on with a very common dose of antibiotics.  Patients often seek treatment after they have gone years ruling to everything else.  That is when it is too late and at that point doctors cannot legally prescribe in Canada, the dosages that are required for remission.  This is one disease you must be your best advocate for. If you do then you will not have the same regret I do, when I let doctors belittle me and convince me I was crazy when I questioned Lyme.
http://www.prnewswire.com/news-releases/delayed-diagnosis-of-lyme-disease-has-devastating-effect-on-patients-300091001.html

I hear it time and time again...patients are told they are self diagnosing, reading into their symptoms or don't understand Lyme.  Learn from me and millions more who ignored their gut instincts and let the professionals convince them differently.  They were wrong. Unfortunately, with this illness, when it gets bad enough to prove you were right and they were wrong, its too late.  Just remember, if the professionals are wrong, there are no long term consequences to them.  The only one who suffers for the rest of their life, is you.  If I could do it all over again, I would never give them that much power.  Trust you, trust that you deserve better for you and your health, trust that you deserve respect. That's my basic desire for those suffering with this illness (now and in the future) - the respect they deserve.

Lyme Prevention - What you want to know

There is so much wrong and misunderstood about Lyme, especially when it comes to chronic lyme. And while many are lobbying for things to change, as they have for decades, the professionals insist that prevention is the key.  I always agree prevention should be a mighty tool and yet there is no comfort in this because the prevention information we are receiving is not only wrong, many pieces are missing.  So I am writing this blog to share beyond the traditional prevention tips that are out there.

Removal is key

Regardless of time attached, proper removal can be mean infection or no infection.  So I strongly encourage people to learn proper removal.  Many tools have been developed to eliminate the human factor.  They are supposed to protect us from making human error when removing a tick, but they dont always work in every situation too.  Many suggest that tweezers allow for human error, but I disagree.  I believe regardless of what you use you must understand the key principles to removal:

1) You must not stress, push, pull, twist, drop oil on the tick.  That will only cause it to get upset and possibly regurgitate the bacteria in to you.
2) it is more important to take you time to remove it properly that to rapidly rip it off however you can. 
3) You must get as low as you can to the attachment site to make sure to remove the whole tick, including the head.
4) If using tweezers apply consistently pressure and pull directly up. 
5) Clean the area with an antiseptic such as alcohol https://youtu.be/AmM5NmQMHVo

Aside from removal there are a few things we can do to prevent ever having to remove a tick.  I share these with you as they come from one of the most renowned Lyme literate doctors in the world.  And these are his recommendation for prevention that are not shared in Canada.

Permethrin
There is actually a product that is not only a deterrent, it will kill the tick on contact. It is not meant for use on your skin, but is highly recommended for spraying on your clothes.  It is an insecticide and as such, should not be inhaled.  But if you take your clothes to a well ventilated area (like outside) and spray with permethrin, it will dry within 2 hours and will bind to the outside of your clothing leaving no residual vapours that can be inhaled.

Health Canada does not approve this product for human use, so it is not as easy to obtain.  Yet the Canadian Paediatric Society recommends it (with the above qualifier from Health Canada).  It has been used in the military for years.  Ironically, it the same ingredient you will find in horse spray (and applied by humans) at a percentage of 50%. 

Since this is not promoted by Canada it is not always as easy to get, but not impossible.  So a few suggestions to acquire it: 
1) I have ordered it through Amazon, a few came to me no problem, but one product was held up at the border.  However, I have the same issue with many of my vitamins.
http://www.tickencounter.org/prevention/protect_yourself
2) There is a company in the U.S. that you can mail certain articles of clothing to and for a reasonable fee they will spray them for you and return them.  They are considered sprayed for up to 70 washing (which I am told is past the life of most clothing).  They will ship to Canada, however you must be aware that you will be responsible for ship both ways and duty. 
www.insectshield.com
3) You can buy pre-sprayed clothing at some outdoor stores (but mostly in the US). 
http://sectionhiker.com/treating-your-clothes-with-permethrin/
4) I am also told you can buy the clothing spray at some outdoor stores such as Bass Pro.


I understand the spray is very harmful to cats, as a word of caution.  There is no pretending, it is a chemical, so it must be something you consider all of the options, before using.  For me, I will be spraying all my families hunting clothes.  The alternative for me has been a lifelong, once debilitating disease that is not treated in my country (using most of my retirement saving).  Not really a question in my mind.  Here's more info for you to decide for yourself.

Repellant sprays
At the moment DEET is recommended as a direct on skin repellant spray for humans.  The good news is there are newer products on the market that are performing just as well as DEET at a lower percentage (20%) and are considered safer. 

Picaridin (sometimes listed as Icaridin): This can be obtained in Canada, just not everywhere.  You will only find it at 20% and can find at large box stores where insect spray is usually found and I know it is at MEC.  I have also ordered this from Amazon.

Avon Skin So Soft has it as an ingredient at 10% (which just means it many need to be reapplied more frequently).  However, I haven't found it in stores yet, but did receive it by mail quite easily. 

There are other newer ingredients that seem to be performing well.  I have not been able to investigate their acquisition in Canada, but I encourage you to visit the US Environmental Protection Agencies tool on their site.  It will not only help you find the right repellant for you, it will give you all the info you need re: application and longevity.  Great site.
https://www.epa.gov/insect-repellents/find-insect-repellent-right-you


There are natural alternatives but it is hard to say which ones work.  I cannot find tests or studies that compare them. However a natural solution has to be better than none.  I am sharing one for Dr. Josh Axe, a published doctor on the treatment of chronic illness and Lyme disease.  

The 24-36 Hour Rule
One last quick and important piece of advice is -  not to assume you are okay by the rule that says you cannot be infected until after 24 hours. The rule comes from the fact that it usually takes 24 -36 hours for a tick to feed and fill up on you.  It is generally understood that is the point where it "overfills" and the lyme bacteria can be regurgitated into you.  But that assumes so many factors, such as: 


1) It was not feeding on something else and fell off

2) It was not pushed, pressed on or moved in any way

3) It was not stressed at any point, when they're known to regurgitate 

4) The removal was perfect 

There are many studies revealing infection from a tick can happen well within the 24 hour period, such as one that infection was as early as 6 hours. ( I will site these studies shortly) Myself, I believe the tick was attached for around 8 hours and I was infected likely for many of the reasons I mention above.  Another study has shown that some of the co-infections that accompany lyme, infected within 10-15 minutes.  Seek treatment, it is your next best prevention after a bite (another blog to follow on treatment info). 

Among other handy tips that are available on-line, you can always use a sticky roller (white) to see if you have any ticks on you upon return. You can put your clothes in a dryer and do a really good tick check before showering. 

Happy and Safe Outdoors My Friends!