The scourge among us.

I’m not sure why I think of boxing as an urban activity.  Perhaps it is because I’m from a city and the references I think of have to do with city life.  Consider boxing genre films which have been replete with images of the city, from Rocky’s Philadelphia landscapes on through the seedy backstreets of John Huston’s Fat City or the tawdriness of Girlfight’s Red Hook.

So why bring up the tiny deer tick in an erstwhile boxing column?  Because there are those of us who live and revel in outdoor spaces – whether training in a storied place such as Catskill, New York, merely spending a day walking through the woods or actually living and working in small cities and towns that afford an urban feel on an otherwise quiet country lane.

What happens in those places – and increasingly even in those vest-pocket parks both large and small interlaced as so many canyons between New York’s highest skyscraper peaks – is a tiny insect gloms on to your arm or you leg or in a fold of your neck to grab its afternoon lunch leaving behind a little tiny gift, albeit unbidden and unwanted.

That “gift” is now a scourge among us in the form of Lyme Disease, Babesiosis and Ehrlichiosis to name the most prevalent of the tick-borne diseases in the North East of the United States (though also moving south and west with comparable strains in Europe).

With new variants developing all the time chronic illnesses have become increasingly prevalent in and amongst the acute phases of the bulls-eye rash, fever and chills, and accompanying joint aches and pains. Even if you only ever call the city your own, it is good to get educated about the possible diseases, their symptoms and treatment, if not for yourself, than for your country-side loving friends and family.

It should also be noted that in New York City alone, there were in excess of 650 cases of Lyme Disease reported in 2009, and that number is expected to climb – and while the main vector for the host is considered to be the white-tailed deer (hence the name deer tick), the disease is also carried by the more prevalent white-tailed mice and may well be moving on to other species.

As spring and summer are the most likely time of year to get these awful diseases – and having seen the effects in family members and friends laid low by such things as Lyme Arthritis, central nervous system disorders and chronic fatigue – I thought it might be a good idea to remind Girlboxing readers that these sorts of illnesses are painful, debilitating and at their worst deadly.

Symptoms and signs to be on the look out for include the following:

–Ticks on your body (see pictures). These are generally small.  If removed promptly say within a few hours of a bite, the rule of thumb is that you’re okay – though a trip to the doctor for a course of AB’s might well be in order if you are unsure when you were bitten. You should also watch out for the bulls-eye rash on the site where the tick was removed.

If you’ve been in the country-side for the day – also please, please, please perform tick checks on yourself, your companions and most especially any children who accompanied you.  Important places to check include the hairline, scalp, and folds and creases of body (behind the knees is a favorite) in addition to the more obvious places.

– Bulls-eye rash (usually several days after a tick bite).  This rash is unique for its shape (round), size (large) and for its general actual appearance as a bulls-eye.  That’s not to say that if you don’t see a rash you don’t have Lyme, quite to the contrary, there are cases where the rash never shows up, is so small as to be missed or may be in a place (such as the scalp) that you just don’t see.

It is also important to note that there is *no* bulls-eye rash present with the other prevalent tick-borne illnesses: Babesiosis and Ehrlichiosis.  Some patients do, however, get a rash with Ehrlichiosis that tends to be a bright red with tiny spots and will be found on the extremities and accompanied by flu-like symptoms.

– Unexplained fever, chills, malaise, swollen glands, neck pain, headache, muscle/joint aches and pains, dark urine, and loss of appetite.  These symptoms in differing combinations are part of the general differential.  Note that it may be tough to diagnose, but if you know you’ve been in areas where there are ticks and/or if you been in the park lately it really is a consideration.

Some tips for prevention include:

– Covering up:  Yep, that means if you’re planning on a nice hike through the woods, very little of your skin should be exposed.  So instead of those cutie-pie shorts you’ll need to wear long pants, socks, boots, and long sleeves.  Socks should be folded over pants legs, shirts tucked into your pants and a liberal does of insect repellent applied early and often – especially in those places where you clothing has openings (ankles, waist, wrists, neck and so on).  Even then, the ticks, often very tiny “nymphs” (immature ticks) this time of year have a horrible habit of burrowing into small nooks and crannies (think your feet).

– Tick check:  This is *crucial*.  As soon as you’re back at home, think of yourself as a Gibbon and start picking away at yourself and your companions. To have some fun with it, put on some music, grab a beer and have a tick-picking party. The point is, it needs to become part of your routine, and the more you do it, the better you’ll be at finding and removing them.

– Keep informed:  There are parts of New York State and Massachusetts were it seems as if the norm is to actually have Lyme or have had it at least once.  I’m serious about this – it is getting out of hand and no one’s really talking about it.  In my family alone – every family member who lives in upstate New York has had some form of tick-borne illness at least once if not three and four times.

Since the ticks aren’t going away any time soon, that means it’s up to you to stay informed about the signs and symptoms, the particular permutations for your area of the country and the general trend in the number of cases near you. This also means identifying the right kind of medical care with the knowledge base necessary to treat the disease if for some reason, you or a family member does not respond to initial treatment or gets diagnosed later in the cycle of the illness.  Each of these things has consequences to your health and well-being so with another round of please, please, please, keep informed and make sure you are talking about this with your neighbors and your friends.

Again, just because you might live in Dumbo doesn’t mean you are not susceptible – and for those of you living the good life in a rural or suburban paradise, please take heed.  The ticks out there are multiplying.

For further information there are several great websites I can recommend.  If you are sick – or face the potential of getting sick because of where you live or play, keep in mind the more informed you are, the better you will be able to cope with the consequences.

For more information on tick-borne illness please click here and here.

Other information/Organizations

International Lyme and Associated Diseases Society (ILADS)

American Lyme Disease Foundation

Center for Disease Control – Ehrlichiosis

Center for Disease Control – Babesiosis