Be Lyme safe while enjoying the outdoors

[untonuggan]

I've just spent the past six to seven years coping with untreated and undiagnosed Lyme disease, a disease which is quite easy to get if you spend a lot of time out in the woods. So as it is a royal pain in the arse, I thought I'd do a quick Lyme disease FAQ/linkspam to hopefully help people avoid having the same problem.

What is Lyme disease?
Lyme disease is a bacterial infection transmitted through the bite of an infected tick (usually a deer tick, which often resembles a poppy seed).

What are the symptoms of Lyme disease?
That depends on who you talk to. Initial symptoms can include a "bull's eye" rash, Fatigue, chills, fever, headache, muscle and joint aches, and swollen lymph nodes (source: CDC). 

However, later on in my illness, I was getting really weird symptoms such as dizziness; one knee that buckled randomly while I was walking; extreme light sensitivity; headaches misdiagnosed as migraines; nerve tingling; etc. I'd been diagnosed with fibromyalgia and so we kept attributing weird new symptoms to that rather than looking for a "global problem" such as Lyme. Lyme has been called the new "Great Imitator" (after syphilis) and so a lot of the symptoms are very similar to other illnesses such as MS, ALS, Fibromyalgia, Chron's, etc. If you're interested in what case studies of these might look like, I highly recommend reading Treatment of Chronic Lyme Disease: 51 Case Studies in their regard. The author has been in practice for decades and discusses his experiences treating chronic lyme and look-alike illnesses.

What is Chronic Lyme and does it or does it not exist?

This is an excellent question and one that I am still wrestling with. Basically, some people in the medical community feel that a 3-week course of antibiotics should treat any Lyme exposure. Any remaining symptoms after that are "post-Lyme disease syndrome", which is evidence of long-term damage done by the bacteria. Others feel that the course of antibiotics for TB, HIV, and many other infectious diseases takes a lot longer...why shouldn't it for Lyme? It's actually really a contentious medical battle at the moment.

To understand it from the patient's perspective, I recommend checking out this article from the Washington Post.
How can I prevent Lyme disease?

I love being outside, and I do not plan, as one author has suggested, to build a 10 foot high electric deer fence around my yard to keep out tick hosts. Nor do I intend to stop feeding the birds, as I am an avid birder and feel that they're losing a lot of food due to habitat loss in my neighborhood.

However, there are some concrete steps you can take if you plan to be outside:

1. Use an insect repellent containing permethrin on your clothing. Permethrin kills ticks (and other things) so it's important not to get it on you. Rather, you treat your clothing. So, for example: have a pair of hiking pants that you spray with permethrin (outside in a well-ventilated area when you're not wearing them). Let them dry, and bingo! instant tick risk reduction. The permethrin will last through several washes.
2. Wear long pants. I know it gets hot in summer, but consider: being a little hot, or getting Lyme disease? Similarly, it's best if you can tuck your pants into your socks to prevent ticks crawling up your pants or if you have those pants with the drawstrings at the bottom that let you pull them closed. Also, if it's that hot, maybe you should just go swimming at the pool instead of hiking.
3. Wear light-colored clothing so that you can see if there is a tick crawling on it.
4. If you can, avoid long grasses where ticks like to hang out.
5. When you come home, do a tick check to see if you've missed any on your body. This includes those hard-to-spot crevices. Often times it's hard to feel a tick bite and they can be the size of a poppy seed. The longer they're attached, the more likely they are to transmit infection. Check you (and your pets) after a walk to make sure you didn't bring anyone home.
6. If you get a tick bite, know how to remove it (tweezers, not a match!) and save the tick so that it can be tested. Also, if you are bitten, be alert for any of the symptoms of Lyme listed above. You don't want to miss it.

Hopefully I haven't scared anyone off a walk in the woods and instead have made it a safer place for everyone except for ticks.

Comments

[spiralsheep]

Thank you for this! It's always useful to have a reminder.

I also recommend checking any available local information before hiking. In Britain this might include Tourist Information or local nature centres.

[moizissimo]

This is really interesting to read. We don't have ticks where I hike (No, really! I'd have to rent a car and drive somewhere to go hiking where there are ticks!) so I've never bothered with any of this.

As someone who only wears skirts out hiking, due to pant fit difficulties, what would you recommend? Would knee gaiters be OK? Or are pants really the best option. Because that could be a problem.

[holyschist]

If I were going to wear skirts hiking--and I would really, really not want to in tick country, and I don't live in Lyme territory (it's very rare out here--Rocky Mountain Spotted Fever is more common), I would go for a shortish skirt, so as not to be dragging it around in the grass picking up hitchhikers, and either tights (which sounds kind of miserable) or over-the-knee socks. And I'd be checking my legs really really frequently.

In Lyme territory...I am not sure I'd be willing to take that risk; I'd probably restrict hiking to winter if I had to wear skirts, personally. I'm pretty paranoid about ticks--not only do I tuck pants into my socks and spray, but I visually check my pants legs periodically while hiking. But if there are no ticks where you hike, yay!

[moizissimo]

Interesting. I usually wear tights or running shorts and a knee-length (or shorter) skirt. I see what you mean about not wanting to risk health, though. "Hiking trousers" should probably go at the top of my sewing list... I don't know where I'll be hiking this summer, and I want to be prepared!

[untonuggan]

Yeah, speaking from experience, Lyme sucks, and there's other insects to worry about (see chiggers, below). Not to mention things like poison ivy/stinging nettles/etc.

I'm in a similar boat with hiking trousers - it's a pain to find ones that fit because I have short legs and a rather large size. I'm probably going to have to get some and alter them or something.

If you do sew some yourself, you could probably put in lots of cool pockets for storage if you wanted...and don't forget to make them light-colored so you can check for ticks.

[moizissimo]

I... need to google chiggers (Those are creepy!). We don't have poison ivy either. Or venomous snakes. Or pretty much anything that will hurt, if it's not a cliff or a bear or a cougar. So yeah, I'm seriously clueless!

I was thinking of some awesome zipped cargo pockets so I can access them even when my hip belt is on. There's a local store that sells a really nice DWR trouser weight fabric in a light grey and a light tan, so I'm covered there! I'm pretty sure they have a summer weight fabric, as well.

[holyschist]

I think tights and a shortish skirt would probably be okay, except I'm not sure tights material is as good for a) protecting your skin from the permethrin or b) keeping teeny-weeny ticks off your skin. Personally, I would probably keel over from heat exhaustion if I wore tights in the kind of weather I often hike in, but if they're comfortable for you and you feel like they're sufficient protection, they sound like a good solution.

Re: cuffed pants...I personally would still be a bit concerned about ticks crawling under the cuffs, which they can't really do if they're tucked into your socks. (As I said, I'm really paranoid about ticks!) Cuffed pants would be way more comfortable tucked into socks, though.

[niqaeli]

Wear long pants. I know it gets hot in summer, but consider: being a little hot, or getting Lyme disease? Similarly, it's best if you can tuck your pants into your socks to prevent ticks crawling up your pants or if you have those pants with the drawstrings at the bottom that let you pull them closed. Also, if it's that hot, maybe you should just go swimming at the pool instead of hiking.

Additionally, this is pretty much the same advice for avoiding picking up chiggers, which are annoying as fuck if you live anywhere where those are an issue. (And, in some parts of the world, also often carry unpleasant bacteria.)

[holyschist]

Yes! I spent two months tromping around Oklahoma during a hideously humid (and hot, because birders are a strange breed) summer and never got any chiggers or ticks. I'm not sure I'd trust the drawstring pants as well as tucking into socks, though....

[moizissimo]

How about trousers gathered into a tight jersey hem thing, a la harem pants? (I'm considering my options!)

[untonuggan]

The best defense is probably still the incredibly attractive trousers-tucked-into-socks look. It basically "seals the crack" that the ticks could use to crawl up your trouser leg.

I suppose you could try harem pants, but then you also have to consider what's going to be covering your ankle. (So, long socks under the pants leg? Or something.) I mean, if you're already going to all this trouble to protect against ticks (sewing your own pants, etc) then you may want to just bite the bullet and look like a geek.

[moizissimo]

I know this is ridiculous, but I can't actually wear socks that are high enough to tuck anything into. My calves are too big! I find the elastic digs in and cuts off circulation even if I fold them over, so I get the ones that stop just above the ankle bones for hiking.

That's why I was thinking of a harem pant idea. If I gather the pants to a tight band of jersey, then the jersey can be tucked into the shorter socks, thus covering my skin. Or even gaiters, because they can be snug around the ankle of a hiking boot, and they cover all the way to the knee. And I can make them to fit MY calves (I can't actually purchase gaiters either. Even Men's XXL is too small.). I just don't know if that's as effective as tucking pants in, which is why I was seeking more information.

[holyschist]

Hmmm. I think if there's significant overlap between cuff and socks or gaiters and socks, it might be fairly effective. Ticks are, in my experience (at least in my area), kind of lazy and baffled by human clothing and skin--they spend a while crawling around looking for a nice sheltered preferably hairy area to feed (they don't like being exposed, and we have way less fur than most mammals), so if in order to get to your skin and a nice meal they have to burrow a long way between two layers of fabric, they probably won't.

[untonuggan]

This is a complete crap-shoot...but do you by any chance knit as well as sew? Because one of the great things about knitting is you can custom-fit socks for non-traditional body shapes. For serious, I have hobbit feet: wide and short, and I always find socks dig in too much as well because my ankles were apparently swollen from lyme disease. But I digress. Anyway, I am now in the process of fine-tuning the hand-knit sock process. It is addictive and delightful.

If not maybe you have an awesome friend who could hand-knit you hiking socks? Or perhaps you could commission a pair?