The Home School Court Report
Vol. XXIV
No. 4
Cover
July/August
2008

In This Issue

SPECIALFEATURES
REGULARCOLUMNS
ANDTHEREST

Doc’s Digest Previous Page Next Page
by Dr. Rodger Sayre
- disclaimer -
Ticked Off

If I were president, I would outlaw ticks. I hate ticks. I can deal with most slimy creepy-crawlies, but ticks give me goose bumps.

A few days ago my wife came to me and said, “I think I have a zit on my back—or something…. Can you see anything?”

...
I CAN DEAL WITH MOST
SLIMY CREEPY-CRAWLIES,
BUT TICKS GIVE ME
GOOSE BUMPS.
...
www.istockphoto.com

I was late for work as usual, but I put down my briefcase and peeked down the back of her shirt. “What is that—oh, gross!” I exclaimed. “It’s a tick!”

With this announcement, schoolwork came to a screeching halt. Within seconds, eight kids abandoned their books and swarmed around their mother like flies on roadkill. It was time for show and tell (also known as “a teachable moment” for us homeschoolers).

I’m sure you have heard all sorts of stories about the best way to remove ticks. Vaseline, hair spray, a hot match, kerosene, soaking in a hot tub while sipping a strawberry slushie (I just made the last one up)…the list goes on.

Believe it or not, the best way to remove a tick is with a pair of good old-fashioned tweezers. It is fast and has been proven more effective than any other technique. The tick should be grasped as close to the skin as possible and gently pulled straight up from the skin surface.

Being overly zealous at this point is counterproductive. Too much tension will cause decapitation of the tick or will cause mouth parts to be left under the skin. With patience, the tick can often be removed in its entirety and with minimal damage to the surrounding tissues. I removed a tick from a 3-year-old child in my office in just this manner the day prior to penning this article.

Alas, with my wife I wasn’t very patient. As I said, I was late for work, and so, ignoring my own advice, I pulled with a little too much testosterone. “Nuts,” I said, as the tick popped off.

There, remaining under the skin, was a little black speck. Mouth parts.

By this time I was beginning to perspire, so I peeled off my jacket and went to get a trusty tool of the trade, an 18-gauge needle. (The kids have grown to hate those 18-gauge needles, because around our house they are the mainstay of treatment for deck splinters.) I put on my $5 reading glasses and relocated those children who were blocking the sunlight streaming through the kitchen windows. This type of work requires both magnification (especially for aging eyes!) and adequate lighting. Wiping down the area with an alcohol prep pad, I set about mining for mouth parts. I loosened the mouth parts with the sharp tip of the needle, and picked at them with some fine forceps. In a few minutes, I had carefully removed what remained of the tick, and covered the area with some ointment and a Band-Aid.

You may be wondering why I didn’t just postpone the tick removal activities until I returned home from work. Aside from the fact that Mary would have had to walk around all day with the knowledge that there was a blood-sucking critter on her back, it is best to remove a tick as soon as it is found, since the risk of tick-borne diseases increases with the duration of time the tick is attached. For example, the risk of Lyme disease is almost zero if a tick has been attached for less than 24 hours.

Even if it is highly unlikely that a tick has been attached for more than 24 hours, it is still prudent to observe the area of attachment for any sign of rash or infection. The typical rash of Lyme disease has a bull’s-eye appearance, developing approximately 10 days after the bite. Any rash or flu-like symptoms following a tick bite should be reported to your physician.

In the next edition of “Doc’s Digest,” we will discuss Lyme disease more fully. In the meantime, keep your tweezers handy and make use of those “teachable moments.”


About the author

Rodger Sayre, MD, FAAFP, has been an HSLDA board member since 1997. He and his wife, Mary, homeschool their 11 children. Dr. Sayre received his medical degree from Thomas Jefferson University, is a Diplomat of the American Board of Family Medicine, and is a Geisinger Medical Group associate with a busy practice in Tunkhannock, Pennsylvania.