It's the season for tick-borne Lyme disease
A tiny bite can have lasting health consequences
Published: Sunday, May 26, 2013 at 6:01 a.m.
Last Modified: Friday, May 24, 2013 at 12:06 p.m.
Growing up in Ottawa, Canada, Holly Donohoe was just 10 minutes away from Gatineau Conservation Park, where dealing with ferocious bugs was part of life.
Preventing and treating tick bites
■ Wear repellant that is 20 percent DEET.
■ Wear long pants and long sleeves, if possible, and light-colored clothing so ticks are detectable if they get on your clothes.
■ Tuck pants into your socks so ticks don't have a chance to get down to your ankles.
■ Pull long hair back.
■ If you do have ticks on you, remove with a tweezer; if possible, aim for just below the tick's head instead of the body.
■ Look for other ticks in body parts where they could hide: under the arms, in and around the ears, inside the belly button, between the legs and behind the knees and hair.
If you are concerned about lyme disease:
Watch for flu-like symptoms to develop within 30 days of the bite. These include headache, fatigue, nausea and joint pain. Also, a “bull's eye” red rash might develop where you've been bitten. If it does, consult a doctor.
A nature lover, Donohoe pursued a career in environmental management, spending years working outdoors. On her off days, she was a kayaking instructor.
So, in 2010, when she was diagnosed with Lyme disease, which is transmitted from a tick bite, she had no idea when she might have been bitten — the occasions were countless.
Donohoe had read a little about Lyme disease, but the diagnosis still stunned her.
“For someone who spends all her time in an environmental management setting, I would be the type of person you would expect to be knowledgeable, and I wasn't,” said Donohoe, who is an assistant professor in the Department of Tourism Recreation and Sport Management at UF.
Suddenly, a litany of health problems, including infections, joint pain and memory loss, started to make sense.
“I just thought it was aging,” Donohoe said — even though she was in her early 30s when the symptoms emerged.
The diagnosis relieved her.
“I called my family and was beside myself with happiness because I knew for years that something wasn't right,” she said.
But after a couple of months, the euphoria of having her intuition validated wore off.
“I started to feel the burden of the battle,” she said.
Lyme disease that isn't caught within six months of the tick bite can enter the bloodstream, becoming a chronic condition that causes fatigue, arthritis and cognitive difficulties.
“Some days I couldn't even put a sentence together,” said Donohoe, who suspects about five years passed between the time of her infection and the diagnosis.
Donohoe adopted a poodle named “Noble” after being bed-bound and unable to walk for several months. When she got her dog, “I could walk to the end of the driveway and back,” she said. “He's been a wonderful source of energy and reason to get up.”
Donohoe's son, Sabin, now 16, became the man of the house, doing laundry, mopping floors and cooking. “He's a wonderful chef,” she said.
Donohoe has been able to keep her job and sometimes works from home. About six months ago, she finally started to feel better — after many rounds of antibiotics and holistic therapies designed to boost her immune system.
Now off of the antibiotics entirely, Donohoe said that she feels 70 percent back to her old self. She is glad that she can finally sit out in the sun, since before she had developed photophobia, or light sensitivity, as one of the side effects of the disease.
“I moved to Florida for the sun, but I couldn't sit in the sun,” she said one day recently, wearing a bathing suit under her shirt, on her way to the pool.
“I'm an infallible optimist, so I knew that at a certain point things would get better.”
Lyme disease is the most common vector-borne disease — an illness caused by blood-sucking insects like ticks — in the U.S., according to the Centers for Disease Control. It is most prevalent in the Northeast and Midwest, in states such as Connecticut and Pennsylvania, Minnesota and Wisconsin. In Pennsylvania, there were 4,739 cases reported in 2011, compared to 78 in Florida, according to the CDC.
But the low reported numbers in Florida mask the fact that the disease does exist here, said Nadia Kovacevich, an epidemiologist with the Alachua County Health Department.
“Doctors are diagnosing it, but the only way it is reported to me or the CDC is with a lot of follow-up testing by the doctors,” Kovacevich said. “They are choosing to treat the patients, and if [the patients] feel better, we never hear about them.”
Kovacevich said that because of Florida's year-round warm climate, people should realize that tick-borne diseases occur year-round, but the one that carries Lyme, the deer tick, is primarily only a concern in the summer months.
The lone-star tick is Florida's most prevalent tick, and causes a condition called ehrlichiosis, whose flu-like symptoms resemble those of Lyme disease.
“When I hear about a tick bite, my first thought is ehrlichiosis; in New York City, it was Lyme disease,” said Dr. Nicole Iovine, an infectious disease physician at the University of Florida and Shands who moved here four years ago from New York.
Iovine explained that the deer tick has a complicated life cycle, and lives on mammalian hosts. “Primary is the white-footed deer mouse, and we don't have it here,” she said.
The hallmark sign of Lyme is a “bull's-eye rash” at the site of the bite — although only about 70 percent of people actually develop the rash. Otherwise, they just have to watch and wait for symptoms to develop within 30 days of the bite — and then get a blood test followed by a Western blot confirmatory test to detect antibodies specific to Lyme disease antigens.
People are typically treated with antibiotics, anti-inflammatory medications and herbal remedies.
According to Dr. Kimberly Kaye, a physician with the Haile Medical Group specializing in tick-borne diseases, patients with Lyme disease are commonly misdiagnosed with other things, since the prevalence is so low here.
“That's the most common thing I hear — that whatever they have must not be related … [doctors] have done a very brief gloss-over [of symptoms],” Kaye said. “They've missed that opportunity to treat it early.”
Fatigue the most common symptom
That's what happened to Paula Pifer, an executive assistant at a local metrology consulting agency. Pifer was bitten by a tick in March 2007 while taking a walk in a friend's neighborhood in Gainesville.
The next day, Pifer woke up with two bites on her right leg that she thought were spider bites. She got violently ill, but thought it was food poisoning. She also developed a rash.
“I'm the daughter of a cop. You just suck it up,” Pifer said. “I never thought a couple of bites would do this to me.”
Other symptoms came and went over the next few years, from extreme fatigue and nausea to joint pain. The first doctor Pifer, then about to turn 40, saw suggested that she was just getting older. Another one asked if she was pregnant.
A third doctor thought the culprit was a brain tumor.
By the time Pifer was diagnosed with Lyme disease in 2011, like Donohoe, she was relieved to know what was wrong with her after so many years of struggling with an overlooked combination of symptoms. But she also was frustrated that no one had caught it earlier.
“If he would have said, ‘Have you been bitten?' ” she said, of her first doctor.
Pifer has changed her lifestyle dramatically as a result of her illness. Always fit, she now considers throwing the newspaper from the curb to neighbors' doors exercise. Some days she doesn't have enough energy to get up to get a drink of water.
“It's like I'm 80 years old. I feel like I'm sleeping my life away,” said the 46-year-old.
She also is a single mother raising her 13-year-old son, Hunter, and she fears her illness has been hard on him. Like Donohoe's son, Hunter has had to assume a lot of domestic responsibilities.
They have to plan extra carefully for outings to conserve Pifer's energy, and friends have to accompany them on long road trips because driving too much wears Pifer out.
Pifer tells Hunter, “If you have algebra, come to me at 4 or 5. Don't come at 9.”
Pifer remains optimistic that she can feel better, though. She found out about a clinic in Palm Harbor, the Sponaugle Wellness Institute, where people with chronic Lyme disease have reportedly been cured. She's now raising money and getting the word out about her condition with her website, www.PaulasFund.com.
“I just want my life back,” Pifer said, adding about Hunter: “He's got to have his childhood.”
Contact Kristine Crane at 338-3119, or firstname.lastname@example.org.