This section is devoted to those questions that I most commonly see -- usually by email. It's a good place to start to get your questions answered.

For those who have come to this page by clicking on an email link, I have referred those links here because the answer to most every question that's asked can be found here. There is good information here, and this is just my way of encouraging writers to see this page first. For those who desire to write me, my true email address is listed on this page. 

Table of Contents

1. I've found a tick on me. What do I do?
2. How do I best remove an attached tick?
3. How is Lyme diagnosed.. by the tests?
4. Where can I find a good Lyme-literate medical doctor?
5. What is a good proper treatment?
6. What is the best long-term prevention?
7. I have a sed rate by modified Westergren 39H, with a high hematocrit. I'm on I.M. Biaxin and Zithromax, but my neighbor has a supra-clavicular IV picc.
8. What is your real email address?

I've found a tick on me. What do I do?

First of all, don't panic. This doesn't automatically mean lyme transmission. Reading just a bit further here will empower you with some pretty strong information to make some good decisions. To the point, not every tick carries the infection. The prime type of transmitting tick is the smaller, deer tick. (Hopefully, I'll get some pictures here soon.) While it is true that the larger, common, dog tick can also carry the lyme organism, it's much less common. Depending on what area of the country (or world) you live in, you may also want to check regionally. For instance, in the US Midwest, the Rocky Mountain Spotted Tick can carry not only lyme, but the more problematic Babesia infection.

To give some estimates, maybe one tick in three is a common lyme carrying type. And not all of these carry the infection -- maybe again one in three. From here, if the tick has not been on for longer than a few hours (see the tick removal question below), then even a lyme-carrying tick will probably not have had time to transmit the infection.

So.. the best defense is good vigilance -- check yourself frequently when you're in a tick-type environment. And (properly) remove anything you see quickly.

OK, so it's been on longer. Now what? Again, from the numbers above you can see that lyme transmission is more likely not to happen from a single tick than it is likely. However, lyme transmission can be miserable down the road, so this truly is the time to consider action. Although some will recommend preventative antibiotics under the situation of any bite, taking antibiotics is not without it's own considerations. My own opinion is to now monitor closely for symptoms. Read the Diagnosis question and familiarize yourself with which symptoms are common to lyme. Then if no symptoms appear for an extended period of time, you are probably in the clear. (If this seems too risky to you, then consider seeking a doc who will prescribe precautionary antibiotics in such a case.)

If you choose to wait, take the next action in the meantime. Do some research and mentally line up a good lyme-specialized doctor. If you do suddenly begin to find symptoms, do not delay in the least. This is the time for action. -- Having waited this far, you do not want to even delay even another day if at all possible. Go and see that doc immediately, and get a proper treatment. If a lyme infection is given proper treatment within the first week or two, it will be completely eradicated, with no permanent effects. But it must be treated quickly! I can't emphasize this strongly enough.

How do I best remove an attached tick ?

This is a very important question. There is a right way and a wrong way to remove a tick. The wrong way has the potential of actually creating an infection where there had not yet been one. The proper way is to grasp, with a tweezers, the mouth of the tick as close to the skin as possible. (Do not grasp the tick on it's body, which would tend to squeeze tick contents -- which may be infected -- into the wound. For this reason also, do not apply vaseline or gasoline to the tick, as this may cause it to regurgitate it's contents into the wound.) 

Having grasped the tick close to the skin, gently work it's mouth parts back and forth until the tick lets go -- hopefully with it's own contents un-injected. Of all the removal devices that I've seen, the most ingenious (and highly recommended on my part) is this device at www.tickremover.com. With this remover, it's Swedish inventor has embodied all the principles in good tick removal. A real recommendation to at least check out!

How is lyme diagnosed..  by the tests ?

No!!  Do not depend on the tests. Under some circumstances, it could even be dangerous to wait for the test results. Even the CDC states that Lyme is diagnosed by it's symptoms (which is called "clinically"), and not by the blood tests. The reason for this is that the tests results are simply well known to be inaccurate -- in both directions, positive and negative. Furthermore, what's worse -- the worst cases of lyme will commonly tend to always test negative. (I never did get a positive test result. See falsenegative.htm) An uninformed doctor, relying on these false-negative results can do real damage in the face of a true lyme infection. Lyme is ultimately diagnosed by the presence (or absence) of characteristic lyme symptoms. 

It is for this reason that I've put the diagnostic tools that I have at this site. (These are accessed here.) By the time you get done reading through the short checklist, and the longer Dr. Bleiweiss essay, you yourself will have a pretty good idea as to whether or not you need to find a good doc, trained in recognizing lyme.

Where can I find a good lyme-literate doctor ?

If you've decided that you want to pursue further medical expertise, finding a proper doctor who is  experienced in recognizing and treating lyme is one of the most important things that you can do. An inexperienced lyme doc can either entirely miss the diagnosis, or dangerously delay it (by incorrectly..) waiting for test results. Or even if he is treating it as lyme, he can under-treat the condition, which could  also be dangerous.

This question is, in fact, one of the most common (and in my opinion, important) of all the questions that I get at this site. Read through this page: llmd.htm which will give you a very detailed answer to this question. Of all of the options that are mentioned on that page, far and away, the one that I feel the most strongly about is to write a post to the Internet newsgroup, sci.med.diseases.lyme. This group is monitored by a great many, well experienced lyme sufferers from all over the world, and who know a great many good doctors. At a moment where time is of the essence, this "newsgroup posting" is the absolute fastest way to get a recommendation for your geographic area. Make sure, though, to put an email address in the post, as the recommendations of the best doctors will tend to come only by return email, and not by a public response post.

What is a good proper treatment?

This is a very good question, as a proper treatment can mean the difference between a cure and a permanent infection. However, I'm not a doctor (see this answer) and don't know anything beyond my own experience. This, however, I do know -- and it's important to be aware of as you consult your doc: The lyme organism has a well known cycle (of active and dormant) of 28 days. Any treatment that is shorter than this is doomed to failure, because the organisms are untouchable by antibiotics during their dormant phase. Normal treatments are anything from 4-6 weeks to longer, depending on the infection and it's severity. But nothing less. You will feel better with a three week course, but such a delay as one goes happily off under the impression of "cure", has caused more than one permanent infection. Find a good doc.

Also, a couple of hundred milligrams of one antibiotic, once or twice per day, is also likely insufficient treatment. Again, I'm not a doc, but if you'd like a comparison, read the page that gives my own history. 

Find a good doc.

What is the best long term prevention ?

In my opinion, education. Familiarize yourself with the symptoms of lyme, and with the other issues as discussed on this page. Armed with this information, believe it or not, you have everything that you need to keep from ever getting permanent lyme. Even if you ever do get an infection, you will know what to do, and where to do it quickly enough that you can treat the infection quickly -- with no long term effects. 

Concerning the lyme vaccine, my own opinion is that they're promoting it with dangerous confidence (as advertisements tend to be). I personally believe it dangerous to rely on this vaccine for a number of reasons. As an example, the vaccine currently protects against two known strains of lyme. Except that there are 60 of them! What do you do for the other 58? Naively thinking that you're totally protected can be dangerous to your health.

 Again, education is the best medicine.

I have a sed rate by modified Westergren 39H, with a high hematocrit. I'm on I.M. Biaxin and Zithromax, but my neighbor has a supra-clavicular IV picc. What is your answer?

I'm not a doctor.   

What is your real email address? 

You may note that I've not put my email address anywhere at this site. This is not because I'm antisocial. I would enjoy hearing from you, and sharing what thoughts I might have that might be of help to you. But I've made this change because I've made a major geographic move, and am now working almost 60 hours per week. And my computer is also now at work -- minimizing my ability to do personal email. Simply, I do not have the ability to be as current with email as I once did. Furthermore, for the vast majority of all writers, I end up referring back to this page anyway, which addresses the questions it seems that most people ask.

So, please glance over the information on this page. I think, in fact, that you will probably find some good answers to questions that you didn't even know to ask. A real bonus! But, if you'd like to write me, either for questions or for support, feel free. But please be patient for a response as I can't check my email that often these days. I'm at this address: Don Chinnici

Oh, and please also note the response to the question above: I'm not a doctor. The essay on "When to Suspect Lyme" was written by John Bleiweiss, my former doctor -- and  a truly gifted lyme practitioner.