Infected with lyme disease

[birchy]

I have a thru-hiker staying with me at High Mountain Haven. On Wednesday he was diagnosed with LYME DISEASE. Are there any past hikers out there that have Lyme disease or know someone who has it. The question is "can this hiker continue to hike north, after his initial antibiotic treatments take affect." ? All relevant information which will help him make a decision is appreciated. FYI, he contracted Lyme disease either in northern Virginia or Maryland.

[Jeff]

Last year we did a survey and found over 40 of our northbound guests had been treated for Lymes. Some never bothered with the testing...the doctors just looked them over and gave them prescriptions for the meds.

Even though you are supposed to "stay out of the sun" while on the meds, most hikers continued their thru. That's a risk they choose to take.

Not a single southbounder guest had contracted Lymes on the AT by the time they reached Manchester, VT. So the odds are pretty good that if you make it to Vermont northbound you may have beat the odds.

[birchy]

Thanks Jeff, I will tell him. CHICKENWING @ High Mtn Haven Hostel (PA)

[emerald]

Not a single southbounder guest had contracted [Lyme Disease] on the AT by the time they reached Manchester, VT.

How do you know this to be a fact?

Follow-up comment: My question was intended to be rhetorical. The quote is nothing more than hearsay evidence based upon information self-reported by hikers and not medical fact. There is a big difference.

Your guest would be better served by seeking the advice of a licensed medical professional with expertise in the treatment of Lyme Disease than by reading what's posted here.

[birchy]

EMERALD, what I believe Jeff is saying is that "OF ALL THE GUESTS AT HIS HOSTEL" he has not heard of any SOBO's contracting Lyme from Maine south to his hostel. That is all. I understood what he was saying. Please lets stay on topic. This hiker needs our properly advised input

[birchy]

There has to some body out there with some advice

[DaveSail]

http://www.whiteblaze.net/forum/show...rse-than-lymes

[HiKen2011]

There has to some body out there with some advice

Not absolutley sure but I think if it is caught early and treated the only real damage-risk is from sun exposure (sunburn) because of the meds. If it has time to really attack the body (over a relatively long period of time) it really drags the person done, no energy. The hiker should know best as to the above. Hope this helps!

[camojack]

I had it once. The cure is almost as bad as the affliction, but it's not something to mess around with, so advise them to get those antibiotics ASAP. Then they can continue their hike, but they'll be pretty wiped out at first...

[LDog]

Well, if it were me, I'd ask the Dr for an entire months run of Doxycycline. A two week run is normal, but there are those who recommend a month to assure all the nasties are cleaned out. I'd absolutely be tested. Tho the results might be a few weeks in coming, I'd want to know not just the Lyme diagnosis, but whether there are any co-infections. Once I felt up to it, I'd hit the trail. I'd take whatever reasonable precautions the Doc layed upon me. I'd follow up with the doc to be sure there are no nasty coinfections that might call for a different drug regimen.

But that's just me, and I'm no doctor ...

[DaveSail]

I was bitten years ago , in a locatin I did not notice . Thus , it went un - treated beyond the week or so where Doxycycline will
cure it . Now , I have it for life . Called " Chronic Lyme " . Most doctors don't " Believe " in Chronic Lyme . In my case , it causes
my left lower - leg to swell - up so that I can't walk . [ Great to be a member of ALDHA had not be able to walk !! ] I had a
" Flare - Up " on the Memorial Day Weekend . Temp of 104 Degrees . Went to the ER , and they admitted me . I told them it was
Lyme . They didn't believe me , and pumped gallons of Vanco mycin into me tinking it was some other disease . Finaly , after a
week , the test came back confirming what I had told them . So , I signed myself out and went to one of the two doctors in
Chester County , PA who " Believes " in Lyme , and got a large bottle ogf Doxy. But , of course , by then the Lyme had gone un -
treated for a week . Our county has the highest amount of Lyme per the population in the country . Lyme mimics about 75 or 85
other diseases . My younger brother has Chronic Lyme . In his case it caused his heart to stop twenty times . They were JUST
about to insert a Pacemaker when the test came back !

http://www.mayoclinic.com/health/lym...CTION=symptoms

http://arthritis.webmd.com/tc/lyme-disease-symptoms

http://en.wikipedia.org/wiki/Lyme_disease

DO NOT IGNORE any symptom . Get off the trail as soon as possible . No problem if it isn't Lyme .

If you are out in the sun while on Doxy , you will end - up looking like a boiled - lobster . Hiking in the woods would be OK .
But , you wouldn't want to do the Presidential Range a clear Summer day !!

There is a map , somewhere , on the AT Conservancy Site , showing the areas of the trail where Lyme is likely to get you .
I'm sure it is MD / PA / NJ / NY / CN / MA / VT . ( Pretty sure ! )

DavidV. Webber

[xbEaNsx]

Remember reading about this 2008 thru hiker Blaze who got Lyme and went untreated for at least a few days. Wound up with a PICC line and spent 3 weeks off trail in VT. Can read about it here. He did finish his thru!

http://stinkykd.blogspot.com/2008/07...with-lyme.html

[LDog]

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4807a2.htm
http://theathiker.com/lyme-disease-know-the-signs/
http://asthecrowflies.org/2006/12/01/lyme-disease-on-the-trail/

[birchy]

Thanks people for all the great input

[Snowleopard]

ChillyWilly's first link (http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4807a2.htm) has a map of predicted Lyme risk, which roughly matches the other info I've seen. But, Lyme disease is spreading, so if a 5 year old map shows an area as low risk it may now be more common.
Chart of Lyme by state 2004-2008: http://www.aldf.com/Lyme_Disease_Rep..._2004_2008.pdf
For example, in Vermont the incidence of Lyme in 2004 was 8 cases/100,000 and in 2008 it was 53.1/100,000 or about 7 times more common. In 2008, New Hampshire had the highest incidence of Lyme disease, higher than Mass and Conn. Vermont and Maine are almost as bad as Mass now.
More maps of Lyme risk and prevalence:
http://www.aldf.com/usmap.shtml

Maine, NH and VT certainly have a risk of Lyme disease and a few years ago it was a lower risk than Mass, Conn, NY, NJ, PA, and MD. MD through Mass has a pretty high risk of Lyme disease. The south has the lowest risk on the AT, but I've heard of hikers getting Lyme in the south. It is rapidly increasing in Virginia.

My opinion is that we should take precautions against Lyme disease on the whole AT. From Maryland through southern Vermont you should be pretty serious about these precautions.

Precautions:
Know what deer ticks look like and what their size is.
Nightly checks for ticks and proper removal.
Know the symptoms of Lyme, bullseye rash etc. The bullseye rash doesn't always occur.
Permethrin on clothing, preferably with long pants tucked into socks or permethrin treated gaiters.
Light clothes make it easier to see the ticks.
DEET on exposed skin.
Avoid overgrown areas where you'll be in contact with bushes and tall grass (close to impossible on a long hike, but the AT is a pretty well maintained trail).
If you've had a deer tick attached for more than a day closely monitor for symptoms.
If you have symptoms, see a doctor. If the doctor seems clueless about Lyme, find another one (probably more of a problem in the south or west where there is little lyme.)

[wcgornto]

I second the suggestion for Permethrin on clothes and DEET on exposed skin. I never saw a single tick on my 2009 thru hike. I was SOBO, when ticks are less prevalent. However, there were cases of Lyme in the SOBO community that year.

[KenW]

My son "The Buddha" (nobo'11) picked up lyme most likely in Md or Va. He went to the Pocono med center on May 28th where they confirmed it. Before it was confirmed he complained of headaches and a sore neck for a week. He did not get off the trail but slowed way down for a week or so. He is now in Woodstock Vt. He is back to normal, (at least for a thru hiker)feeling good and looking forward to the Whites.

[gypsy electrician]

I had a friend years ago in Florida contract Lyme and from intravenious meds she was weak from that. Have her to see a DR.who knows what Lyme's is about, for awhile this womans Dr.did'nt know what it , let competant medical care make the call...

[mooseboy]

While section-hiking in PA in 2009, I spent the night in the Eckville Shelter along with a NOBO thru who was suffering all the classic symptoms of Lyme... blurred and fading vision, joint pain, extreme fatigue, partial facial paralysis... it was pretty sobering. He had taken a zero at the Eckville because he was totally spent. I lent him my phone several times to call his family, and he got off the Trail the next day. According to Trail Journals, I heard he got treated and finished his hike.

Now, 2 years later, I am worried I might have gotten it... in Germany of all places, though I was in upstate NY this year too... but I haven't gotten a day on the AT this year! The symptoms started small and have gradually increased. I had no tick bite recollection, and the unreliable ELISA test the doctor ordered turned up "negative" (though I had a small # of antibodies), so he diagnosed me with "anxiety" (which I have posted about on another topic)... but several weeks later, although I successfully lowered my stress level (which was low to begin with, so it made no sense) the physical symptoms are worse, and I now believe the anxiety I suffered was one of the many by-products of the Lyme Disease taking control.

I'm seeing a new doctor this week and hoping to get the Western Blot test. All of my symptoms are typical of Lyme and I never had any of them before in my life.

If the new MD doesn't believe in Lyme, I may have to come up with the money to see an LLMD, as I can't let this progress any farther if indeed it is Lyme or another tick-borne illness. And in fact, if I did get it in the Black Forest (where I went hiking in May, and which has one of the highest instances of borellia in Europe, AND where I ironically neglected to wear bug protection--which I ALWAYS do on the AT--because I didn't know this)-- if I did, do the American tests even recognize that strain?

I'd never worried too much about Lyme before because I was always careful on the AT, and heard that it was quickly treatable with doxycycline. But now that I've been potentially mis-diagnosed and had to wait things out more & more, I'm getting anxious. Oh right, must be "anxiety disorder"!

[Badger2011]

If you're fairly certain it's Lyme, don't let doctors convince you that you're crazy (or anxious). Watch the documentary Under Our Skin at the bottom of this post and you'll have the conviction you need to find the right doctor!

Lyme Disease on the Appalachian Trail