Back to Your Very Special Lyme Lesson. This is the third installment in my series on Lyme disease. May is Lyme Awareness Month, which seems the perfect time to go in to detail about how Lyme is transmitted and diagnosed, and how something the size of a poppy seed almost ruined my life. If you missed episode one or two, you may want to back up so that you are up to speed on the soap opera that is my Lyme disease saga.
One of the Biggest Problems with Tick-Borne Disease is that ticks don’t just bite you and cause a single reaction, like a bee sting. (And I know if you are allergic to bees those reactions are very traumatic.) But once you’ve recovered from that bee sting, you are essentially “cured,” whereas the initial “nibble” from a tick is the beginning of a nightmare. Ticks don’t just cause a single, isolated reaction. If you were bitten by a tick and developed the now-famous bulls-eye rash, you are actually very fortunate, because you will receive immediate treatment, long-term monitoring, and a much better prognosis – which can include total healing.
Only 20 % of Lyme warriors present with the rash The rest of us – the other 80 % – have no idea that we were bitten by the equivalent of a poppy seed, and because we never had the rash, we assumed the early stages of Lyme were a bout of flu, a little arthritis, or some extra soreness from our hot yoga class. Researchers are learning more about Lyme all the time, including the fact that those who tested positive, and received immediate treatment, and even experienced relief from the rash, flu, or joint pain may actually still be dealing with Lyme disease unless they underwent serologic testing to identify any Lyme co-infections. It’s not like a strep test or a nasal swab for flu…your practitioners need to understand that the Lyme bacteria could have taken up residence in different areas of your body, and they need to proceed with testing to find out if you were left with undetected infections.
If you were bitten in the past, and received a brief (2-4 week) course of antibiotiocs, but did not undergo follow up bloodwork, it is possible that those “undercover agents” remained undetected while triggering chronic disease. (I am really not trying to catastrophize this, and I know I sound like a real downer today. But I’m also not going to sugar coat the truth.)
Remember…Lyme isn’t just one disease: And once you are bitten – JUST ONCE, you. are. at. risk. for chronic disease. I suggested last week that we call it Lyme diseasES, because ticks carry hundreds of pathogens, any of which can wreak havoc if left undetected.
So how do ticks manage to contract so many diseases? They really are productive, reslient creatures. Ticks go through several life cycles: egg, six-legged larva, eight-legged nymph, and adult. After hatching from their eggs, ticks must feed from a live organism at every stage to survive and grow. And most ticks enjoy a varied diet, preferring to have a different “host “animal at each stage, kind of like a progressive dinner. They feed on mammals, birds, reptiles, and amphibians, all of which carry different diseases. Which means that after every feeding, ticks have ingested multiple pathogens.
Oh, and stop reading if you are already freaking out. A Chinese lab recently published a study where researchers collected local ticks and allowed them to feast on laboratory rats that had been bred in captivity (they were free of disease prior to the study.) After the tick “feast” they examined both ticks and rats for the bacteria suspected to cause chronic lyme disease. The ticks entered the lab with 373 types of bacteria, and they transmitted 237 DIFFERENT diseases to the rats.
Is anyone else wondering why ticks are able to survive with 373 diseases? Why don’t TICKS die of Lyme disease?? How do microscopic dots have 373 diseases and manage to go to work? I found an explanation for their adaptive resilience HERE
I’ve gone so far off the deep end that using freshly ground pepper throws me into a PTSD (post tick stress disorder) panic attack that can only be cured by buttercream frosting.
Once you’ve been bitten….what happens next? The bacteria that ticks produce is a very long spiral-shaped (think corkscrew) bacteria called a spirochete that is able to move about by twisting and turning in a corkscrew motion. Ticks find the human bodies to be the perfect environment to multiply because they are asexual and anaerobic (meaning they don’t need match.com or even oxygen in order reproduce). So there they are, multiplying and spreading, setting up camp in different areas of the body, while remaining undercover. Much less detectable than Sean Spicer hiding behind White House bushes. Different spirochetes do different things, too, depending on which area of the body they “land,” and what type of bacteria they are.
Remember that cloak of invisibility we talked about last week? Biofilms enable lyme bacteria to remain undetected for years…
After awhile the spirochetes evolve, and become to metabolically dormant cysts The cyst form allows the bacterium to survive your body’s inhospitable conditions and even elude your immune defense mechanisms. One of the co-infections I have, the mycoplasma pneumoaie, damaged my bladder wall by creating tears in the lining, which allowed bacteria to “slip through the cracks,” and remain undetectable while forming layers of biofilm. The biofilm allowed layer upon layer of bacteria to build up, while undetectable in most laboratory conditions until I found Ruth Kriz, PNP, and underwent testing at the molecular level.
Here is an more scientific description of what happens when a tick bites you.
For those of you who like bullet points, here is a basic description of how ticks transmit disease, per the CDC, through the process of feeding. (If you are squeamish you might want to look away for a minute.)
- Depending on the tick species and its stage of life, preparing to feed can take from 10 minutes to 2 hours. When the tick finds a feeding spot, it grasps the skin and cuts into the surface.
- The tick then inserts its feeding tube. Many species also secrete a cement-like substance that keeps them firmly attached during the meal. (Did you get that? They cement themselves to you!) The feeding tube can have barbs which help keep the tick in place.
- Ticks also can secrete small amounts of saliva with anesthetic properties so that the animal or person can’t feel that the tick has attached itself. If the tick is in a sheltered spot, it can go unnoticed. (Basically, they carry novocaine with them and numb you to avoid being caught.)
- A tick will suck the blood slowly for several days. If the host animal has a bloodborne infection, the tick will ingest the pathogens along with the blood.
- Small amounts of saliva from the tick may also enter the skin of the host animal during the feeding process. If the tick contains a pathogen, the organism may be transmitted to the host animal in this way.
- After feeding, most ticks will drop off and prepare for the next life stage. At its next feeding, it can then transmit an acquired disease to the new host.
So, as a Lyme
patient warrior, I was bitten, cut, numbed, cemented, drained, and spit upon. And I never noticed. I’d better stop here. I think I’ve given you enough to digest. Maybe digest is the wrong word.
My years in parish ministry have taught me that everyone processes diagnoses in their own way. Some get through by pouring themselves into work, or other projects, letting their doctors be the experts, while focusing their mental energy elsewhere. Others need to gather information in order to persist, preferring to be annoying active advocates, and questioning everything. (I’m sure you are wondering what camp I fall into.) And still others put their heads in the sand, refusing to think about or face their issues at all, binging on Netflix and Candy Crush. (And some are pretty judgy of those who cope in different ways, asserting or assuming that their own coping method is the best.)
And it is…for them. I would urge a little grace for those who process differently, unless you’ve tried on their shoes.
Because I am a zebra, and have been the “first of [his] patients to get this disease in 30 years of practice” and also “the first of [her]patients to get this [other] disease in 40 years,” I have had to choose the more “annoying” route, but I’m working really hard to put my faith in action and trust that not only will I thrive, but that we will be able to eek some goodness out of this unpredictable roller coaster, making “lymeade” even though I can’t drink margaritas.