Posts tagged #Maine

It's tick season again

While it's great that winter has finally ended and flu season is winding down, it's already time to take steps to prevent Maine tickborne diseases such as Lyme Diseaseanaplasmosisehrlichiosis and others.  The deer (Blacklegged), Dog and Lone Star ticks are already out there and the spring nymph form of the deer tick is quite small and easily missed.

Some simple precautions when outside in the yard or the woods can reduce your risk.  Check yourself, your children and pets for ticks daily.   Lyme Disease is not transmitted immediately so removing a deer tick within 24 hours greatly reduces that risk.  In some cases, a dose of antibiotic may be considered to prevent Lyme Disease if a deer tick has been attached for 24 hours or more.  Check with your physician promptly as this should be done within 72 hours of removing the tick to be effective.

Most people know about DEET for keeping ticks, black flies and mosquitoes from biting exposed skin but fewer are familiar with permethrin for treating clothing.  You can buy clothing pre-treated with permethrin or treat your own clothing (NOT skin) following the manufacturer's instructions.  This usually remains effective through several washings.  Here in Rockport, Maine Sport Outfitters has permethrin clothing spray in stock in the camping section but most of the other local outdoor sports stores also had it when I've checked in the past.

Patients often bring in ticks that they've removed.  While this can help us decide if it's a deer tick, testing the tick for Lyme Disease is not usually helpful.

Finally,  Lyme Disease and the other tickborne diseases in Maine can present with a wide variety of symptoms.  You should check with your physician if you or a family member have symptoms during tick season such as rash, fever, a flu like illness, new joint problems, severe headache or neurologic changes, enlarged lymph nodes or other unexplained symptoms.




Sinusitis treatment

NPR recently broadcast a story about sinusitis treatment.   Acute sinusitis or sinus infections are fairly common, but there are a lot of misconceptions about how to treat it.

The new treatment guidelines cited by NPR continue to downplay the role of antibiotics since most patients with sinusitis eventually get better without antibiotics and antibiotics don't seem to shorten the illness in many cases.  

As needed nasal saline flushes seem helpful for relieving sinus pressure due to poor drainage.  I learned this trick from a wonderful navy ENT (Ear Nose and Throat) surgeon in Japan where patients with chronic sinusitis would have to wait months for the ENT surgeon to visit our base.  There are not many studies on this for acute sinusitis treatment but it is commonly recommended and is an inexpensive, if somewhat annoying, treatment. Some very rare infections were reported from doing this with infected tap water recently so using sterile water to make the saline isn't unreasonable. 

Avoid using nasal decongestant sprays for more than three days as that can cause problems.

Some patients develop complications or have a different problem and not sinusitis.  NPR quickly added a clarification to their story that includes "Signs and symptoms such as worsening headaches, visual problems, changes in mental activity, facial swelling and progressive fever can indicate impending complications."    

Don't make medical decisions based on something you read on the internet, including this.   If you have questions about possible sinus symptoms, call your primary care physician or get examined.  If your physician won't answer your questions without an appointment or it's difficult to get a prompt appointment, consider Direct Primary Care.