Drugs on the trail

[Winds]

If you start it you must finish it.... and my doc gives me 30 day supplies. Its a minimum of 15 days should you get a deer tick bite - not a dog tic.... I take the spray and leave the Dox at home.

No, 10 days is plenty enough for my strategy to maintain ON TRAIL. If I start taking it, because I believe I am infected and not just bitten (that's really important) - then I will seek those far more intelligent on the subject than I such as my personal physician (who is beyond genius). In this particular regard, I won't take medications longer than 10 days without the guidance of medical professionals who know and understand what's best, and who I trust to help me back to better health.

This is not an argument, it's a glimpse of MY strategy.

[Wise Old Owl]

Well our doctors are on some different readings..We are both right.....

Borrelia burgdorferi resides in the gut of its host tick. In order for it to be transmitted to humans, it must first travel to the feeding tick's salivary gland. This process takes about 15 hours. Lyme disease cannot, therefore, be transmitted during the first 15 hours of tick attachment. Transmission of Lyme disease is, in fact, rare before 36 hours of attachment, and generally occurs only when ticks have been feeding for two to three days. By this time the tick is engorged (filled full with blood from its host), and easily visible. Ticks that are removed before they are engorged virtually never transmit Lyme disease.

The second approach to avoiding Lyme disease is to do a "tick check" at the end of each day spent in an endemic area.
Ticks can be anywhere on the body, but they especially like warm, hidden areas, like the underarm, groin, and the back of the knee. They can be removed with a tweezers placed as close to the skin as possible. The tick mouth parts may remain in the skin but will not transmit Lyme disease.
A deer tick from a Lyme-endemic area that is engorged will transmit Lyme disease about 10% of the time. There are two approaches to dealing with this situation. One is to observe the site of the bite for the development of the Lyme rash (erythema migrans), and monitor for "flu-like" symptoms for the next two to three weeks. Antibiotics can then be started if symptoms develop. An alternative is to take one double dose of doxycycline (200mg), which will reduce the risk of Lyme disease's developing to about 1.3%. Because the risk is not completely eliminated, however, you will still need to monitor for symptoms of Lyme disease.
A bite from an unengorged deer tick carries an extremely low risk of infection, and so does not justify the use of preventive antibiotics.
Thus, the third approach to Lyme disease prevention might include a single 200mg doxycycline dose after removal of an engorged deer tick, if you are in a region where there is known to be Lyme disease.
Symptoms of early Lyme disease can include a "bull's eye" rash (erythema migrans), fevers, headache, muscle and joint pains. Later manifestations of Lyme disease can include arthritis, heart block, Bell's palsy, radiculopathy (that is, pain and other symptoms like numbness, tingling, or weakness in your arms or legs that is caused by a problem with your nerve roots), meningitis, central nervous system disease, and chronic neuropathy (nerve damage that can cause symptoms such as weakness, numbness, abnormal sensations such as burning, tickling, pricking or tingling, and pain in the arms, hands, legs and/or feet.)
Treatment of Lyme disease depends on the stage and form of the disease. The symptoms of Lyme disease can, at times, take weeks to months to completely resolve. Symptoms are often not completely gone by the end of antibiotic treatment.
Treatment of Lyme Disease:

Early Lyme disease: No blood testing necessary.
Patients are treated with 10-21 days of one of the following oral antibiotics:

• Doxycycline 100mg twice daily
• Amoxicillin 500mg three times daily
• Cefuroxime 500mg twice daily

SOURCE http://www.hss.edu/conditions_lyme-d...-treatment.asp

[Sarcasm the elf]

Thanks WOO, great article.

Have you fund any info on whether the tiny (nymph stage?) deer ticks can transmit Lyme? These are the ones that are almost impossible to see when doing a tick check in the field and always worry me, but I have heard conflicting reports of whether they are a common carrier for Lyme.

I recently found one of these on me, though it was fortunately unattached. I'll post a photo of it later today to show just how small these suckers can be.

[Wise Old Owl]

I went down that pike a year back and didn't find much.... I just read... - I can ask someone though he won't get back to me for a few days...

[atmilkman]

My doctor gave me a script for Doxycycline that is good for a year and told me to just hang on to it and get it filled if needed. He also told me that if and when I did get it filled that it would be good for a year. Is this correct?

[Winds]

Have you fund any info on whether the tiny (nymph stage?) deer ticks can transmit Lyme? I have heard conflicting reports of whether they are a common carrier for Lyme.

Oh certainly!

"Most humans are infected through the bites of immature ticks called nymphs." - From the CDC
http://www.cdc.gov/lyme/transmission/index.html

[Wise Old Owl]

Hey that's why I love this blog if I don't have an answer someone always comes thru... Thanks Winds.

[Winds]

Hey that's why I love this blog if I don't have an answer someone always comes thru... Thanks Winds.

Yeah, it's REALLY in our best interest to try to understand AND stay atop this ugliness especially if we are going to live in it ever.

[Sarcasm the elf]

Yeah, it's REALLY in our best interest to try to understand AND stay atop this ugliness especially if we are going to live in it ever.

What do you mean by "live in it ever?". I'm from Connecticut, this is part of my daily life.

I've had lyme twice and each year pull dozens of ticks off myself as well as pulling liiterally hundreds of ticks off my dogs. In my experience the two most important things are periodic tick checks, lots of quick checks during they day and a thorough one at night, and knowing the symptoms so you can get treatment fast.

While you're hiking remember that if you feel a little tickle like something is crawling on you, check to see what it is, doing this I am able to remove a lot of ticks before they ever attach, also remember that the combination of fever and joint aches means it's probably time to have a doctor check you out. Don't rely on waiting to see a bullseye rash, I've never had one, despite my confirmed lyme tests.

[Wise Old Owl]

What do you mean by "live in it ever?". I'm from Connecticut, this is part of my daily life.

I've had lyme twice and each year pull dozens of ticks off myself as well as pulling liiterally hundreds of ticks off my dogs. In my experience the two most important things are periodic tick checks, lots of quick checks during they day and a thorough one at night, and knowing the symptoms so you can get treatment fast.

While you're hiking remember that if you feel a little tickle like something is crawling on you, check to see what it is, doing this I am able to remove a lot of ticks before they ever attach, also remember that the combination of fever and joint aches means it's probably time to have a doctor check you out. Don't rely on waiting to see a bullseye rash, I've never had one, despite my confirmed lyme tests.

Ha I would have to stop every mile... If you don't know I am a Bed Bug inspector for NJ,PA - I don't sleep so well either.

[hobby]

My doctor gave me a script for Doxycycline that is good for a year and told me to just hang on to it and get it filled if needed. He also told me that if and when I did get it filled that it would be good for a year. Is this correct?

In Georgia---The actual prescription is good for a year. After filling, the drug has an expiration date. Most pharmacies automaticly assign a one year expiration for the drug on each prescription filled. When you have the Doxy rx filled, ask the pharmacist for the actual expiration date. It will probably be much longer than one year. But this is in ideal storage conditions. (room temp, low humidity). On the trail, even in a zip-loc, storage is not 'ideal' (hot and humid) so the drug may not remain at full potency for the actual expiration date. How long will it last? Who knows! Either take the unfilled rx with you and have it filled in town if needed,(should not be a problem for and out of state prescription for a non-controlled substance--use an independent pharmacy-not a chain) or have it filled at the start of your hike and it should be fine for 6 months anyway.

[atmilkman]

In Georgia---The actual prescription is good for a year. After filling, the drug has an expiration date. Most pharmacies automaticly assign a one year expiration for the drug on each prescription filled. When you have the Doxy rx filled, ask the pharmacist for the actual expiration date. It will probably be much longer than one year. But this is in ideal storage conditions. (room temp, low humidity). On the trail, even in a zip-loc, storage is not 'ideal' (hot and humid) so the drug may not remain at full potency for the actual expiration date. How long will it last? Who knows! Either take the unfilled rx with you and have it filled in town if needed,(should not be a problem for and out of state prescription for a non-controlled substance--use an independent pharmacy-not a chain) or have it filled at the start of your hike and it should be fine for 6 months anyway.

Thank you hobby. I may get it filled in March and just carry it if this winter is anywhere as mild as last and it seems like there is going to be an early onslaught, and if we get a typical winter I'll just wait till around May and I'm further north hopefully.
But as you know the trail is the only drug you need. Once you get on it you will be so high on nature and the outdoor thingy and finding ones self and discovering the meaning of life that you will not need any synthetic drugs.

[HooKooDooKu]

unless you forced the person to take the RX medicine, i don't see how any of those 'charges' would ever lead to a conviction. the injured party could sue you, but again, i doubt any judge or jury would render that decision based on giving someone a pain pill.
and nothing in that scenario comes close to what 'intent to distribute' applies to.

that being said, i bring ibuprofen, immodium (aka butt putty), sudafed, benadryl, and gold bond MEDICATED!

All those arguments can't protect you from survivors filing a law-suit against you. Even if you win such a law-suit, you still come out the loser just for having to fork out the $$$ to defend yourself.

[lemon b]

BP Med, a couple benadryl, and a Vitamin I stash.

[Tom Murphy]

This might not apply to a popular trail like the AT, but on solo trips on less traveled trails, the one thing you truly need is as strong a pain reliever as you can get your hands on.