Sunday, 29 April 2018

Ticks, Lyme Disease and LARP

Ticks are found anywhere there are animals, especially grazing animals and those that live in woodland undergrowth.
This is important information if you are a LARPer as many of our games take place on land that is perfect habitat for ticks and the animals they live on. If you spend anytime outdoors in these sort of places you should be aware of what ticks look like and learn the early symptoms of Lyme Disease.
photograph of the back of a child's neck with the hair pushed aside to show a small dark lump embedded in the skin at the hairline. This is an embedded tick.

photograph close up of a person's finger tip. There are four ticks arranged from smallest to largest. The smallest is a fraction of a millimetre. The largest is ~3 millimetres long.  
Look out for ticks
Check your body over each day (before bed or when dressing) for tick bites. Tics usually latch on to feed so run your hands over areas you can’t see clearly or get somebody to help. Look out for bites with dark spots in the middle or small hard lumps - this is the attached tick.
If you find a tick still attached you need to remove it as soon as possible using a safe method. The best method is to use a pair of tweezers or special tick tool to gently grab the tick as close to the skin as possible and firmly pull up and out. 
Other methods such as smothering with vaseline or burning off are not as reliable and can leave you with part of the tick still attached or feeding for longer than you want.
three panel illustration from Kid's Health. Panel 1 shows how to grasp a tick with tweesers for removal. Panel 2 shows cleaning and checking the bite area. Panel 3 shows saving the tick in a ziplock bag for later testing.
Once removed wash the bite and then keep a very close eye on your general health.
The Bullseye Rash
Look out for a bullseye rash as pictured below. 
close up photograph of a person's thigh showing a large circular red rash with faint "bullseye" markings

Large poster from Lyme Disease Association showing a number of different Lyme rashes both typical and atypical.
If you develop a rash even if you didn’t see the tick or know you were bitten get to a GP as soon as you can. This isn’t an A&E (ER) thing but you do want medical attention sooner rather than later. It can take up to 2 weeks for the rash to appear. This rash is an early symptom of Lyme Disease which is a bacterial infection spread by ticks. 

Symptoms to be aware of

If you know you were bitten by a tick or suspect there is a chance you were (i.e. you have a bite but don’t know what insect did it) and start to develop severe flu-like symptoms then go to your GP as soon as you can and tell them you had an insect bite.
Severe flu-like symptoms include:
  • extreme fatigue
  • muscle and joint aches
  • dizziness or vertigo
  • tender glands esp at the neck
  • general feeling of unwell
  • you generally will NOT develop a runny nose or cough
While the rash is a classic symptom of Lyme Disease it only appears in around 50% of cases. Generally if you have a rash or other indicative symptoms your doctor will give you a prescription for antibiotics. This is usually a two to three week course of something like doxycycline. 
With an initial course of antibiotics taken within a few weeks of infection Lyme Disease is usually completely treated and cured, and you will make a full recovery. 
Untreated Lyme can have long term affects on your health and can be serious however by knowing what to look for you can get treated early and be fine. 

Other preventative measures:

Insect repellents - most insect repellent will have some effect against ticks but those containing Icaridin/Picaridin/Saltidin/Bayrepel/Piperidine or PMD/Citriodiol/ Lemon eucalyptus /menthoglycol are most effective. Remember you need to reapply throughout the day, especially if you wash or get rained on.
Clothing - ideally long sleeves and trousers that are tucked in to sock will keep ticks off of you. They can sometimes get inside cuffs and collars though to do be careful to check.
A note for LARPers- all players and crew who take place in games outdoors should be aware of this information. It’s not just combat characters who go crashing through hedges that are at risk. I got bitten at a game in October 2011 playing a non-com who was hiding. The first picture of a bullseye rash comes from a person who was bitten two weeks ago while running a game.

Why do I make these PSAs?

Now for my personal story and why I always link LARP and Lyme. As I mentioned I was bitten at a LARP game. The game was called Winter in the Willows and had us playing animal characters based on the book Wind in the Willows. I was playing a hedgehog. 
During the game we were approached by a pair of otters who were part of an evil cult. These otters radiated a mass fear effect causing all characters within a certain radius to react with terrible fear. Most characters chose to flee. However, me being a hedgehog did what hedgehogs do best. I curled into a ball and rolled into the underbush, quivering with fear, to hide. I didn't leave until the otters were gone and a trusted IC friend came and got me. Excellent roleplay. Very effective.
That evening I had a sore spot on my shoulder. I occasionally get acne or spots on my shoulders and though nothing of it, just rubbed it a bit and carried on with things. Once home from the game I still had the sore spot on my shoulder and could feel a little lump. Because of where it was I couldn't see it. I assumed it was the head of the spot or it had gone a little crusty or scabby. Gross I know but I think we've all experienced spots like that. I knocked the "scab" off and cleaned it and that was it. 
Within a week I started to get ill. I was exhausted, my body was aching, I was getting dizzy spells and my glands were tender. I assumed a bad cold or "post LARP lurgy" - it's not uncommon to pick up a bug at a LARP event after all. But I didn't get better. 
Instead it got worse, but never turned into flu. After two months of this I finally went to a doctor. I was told it was post viral fatigue and I had probably just caught a bug. I was tested for Epstein-barr virus just to be sure but it was inconclusive. Another month passed with no improvement and fatigue and pain that was causing me to miss work. That's when the real testing began. 
Over the next six weeks I had countless blood draws for testing and, thanks to my job at the time being veterinary science, we tested for pretty much everything usual and unusual and down right rare. 
I got a positive diagnosis of Lyme Disease in May, the day before my birthday. That was 6 months after I first got ill. 
I won't go in to the whole story of treatment and doctors because it is lengthy and a bit dull. But suffice to say, 6 months is too late to be starting with a basic course of doxycycline. I'm still ill 6 years later. That doesn't happen to everybody, but really you need to catch and treat it early. 
Don't be like me. Know about ticks and Lyme Disease and look after yourself. 
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