Wump wump wump wump wump.
“...it’s tick season. Wear long sleeves and pull your socks over your pant legs.”
Blah blah blah. “...make sure you cover up if you are in the bush or close to long grass or lots of trees.”
Public health warnings about ticks are all over the place: on the radio, in the news and online. Somehow, I didn’t think they were talking to me. Campers, and hikers, for sure. We got medication for our dog. But us?
Wump wump wump wump….” …ticks are endemic in most of Ontario.”
I’m not careless. I’m not a bad mother. So why wasn’t I listening?
Long before the pandemic, we loved our vaccines. My husband would track the annual flu vaccine until it arrived at our local pharmacy, then sign us up for first day shots. We handed our baby to the pediatrician and sometimes remembered to ask “and what was that vaccine for?”
We are believers. We listen to public health. But ticks? Ticks were somebody else’s problem.
“Did you twist it on the trampoline?” we asked our 10 year old.
His knobby knee had blown up to the size of a grapefruit. It was scary looking. And it hurt.
“Maybe you fell on the ice and hurt yourself more than you realize?”
His knee had ballooned overnight. But it didn't disappear quickly. At times it was so painful he couldn't walk. Sometimes, it looked bad but it didn't bother him, Overall, the bulging knee was a punishing sentence for a kid who loves sports. It meant no games, no gym, no running club, no hockey, no nothing.
It was late November. The doctor prescribed rest, ice, and ibuprofen. Since we couldn’t pinpoint what had triggered the swelling, the doctor also ordered blood tests. The tests came back normal, the swelling went down and the worries shrank away.
Six months later, I brought my son for his annual check up with his pediatrician. She listened to his heart and lungs, checked the curve on his spine, bent his arms and legs, this way and that. All of a sudden she stopped, cupping her hand over his left knee.
“Does it hurt?” She ran her hand slowly up and down about an inch from his knee. She was frowning. “There is a lot of heat around that knee. Are you sure it doesn’t hurt?”
Nope, my son replied. But wait, since you’re asking ….
He told her about his knee puffing up so badly in November that he pulled out of a hockey tournament.
As we were talking with the doctor we remembered something else: some out-of-the-blue shoulder pain. One morning in September he woke up and his right side was really sore. He could barely raise his arm. That pain settled down, and then it happened again, except this time, it was the other shoulder.
His doctor is wonderfully attentive, and protective. She ordered another round of blood tests and referred us to a specialist in childhood arthritis.
My son felt fine leaving the doctor’s office. The next afternoon, I got an urgent call from the school: his knee was puffed up to an alarming size. It turns out his doctor had used her hands like a divining rod. I ran to pick him up and we started the icing and ibuprofen regime. Back in November, he missed hockey. This time he was worried it would ruin his soccer themed birthday party.
I am laying out all the mundane details because …well, it was mundane. Kids get fevers, and stomach bugs and scrapes and bruises. When the doctor brought up childhood arthritis, suddenly the worry meter skyrocketed.
“We’ve ruled out everything,” the doctor said. “The arthritis specialist says there is one last thing to try.”
One blood test and a few days later, we got a telephone call.
“He’s what…..?”, I thought I was hearing things.
“He’s tested positive for Lyme disease? You’re calling from where?”
It was a public health nurse. Boy did we feel like terrible parents. Looking back, we can see the signs we missed. In mid August, he was feeling off. When he fell asleep on the couch in the middle of the day, we thought it was the summer heat. When he complained that his muscles were sore, we chalked it up to growing pains.
We were dead wrong. Our son had Lyme disease and we didn’t have a clue.
We have since learned that the disease was progressing by the book.
A few days to a month after being infected, a person can begin feeling like they have a flu: chills, fever, sore and aching muscles. My son had some of these symptoms but nothing intense enough to trigger any alarms.
Left untreated, the bacteria travels into joint tissues and causes inflammation. By then, the chills and fatigue have long passed. The inflammation pops up months after a tick bite. The swelling occurs most often in the knees but other large joints like the shoulder, elbow, ankle and hip can also be affected. The swelling comes and goes, and moves around.
This is exactly what happened to my son through the fall, winter and spring.
I felt like I'd been hit on the head with a thunder stick. I could see but I was blind.
He had Lyme arthritis and the symptoms showed up right on cue. The photos I took of his knees look almost exactly the same as online photos of kids with Lyme arthritis. A textbook case.
I can see now how the pieces fit together perfectly. We’d spent most of July at a cottage, and that’s likely when he got the tick bite. A month later, he was suddenly falling asleep in the middle of the day. Lyme disease was simply not on our radar – we didn’t use bug sprays, my son ran around barefoot, and we didn’t do skin checks. If he had developed the tell-tale bullseye somewhere on his skin I would have known it was a tick bite. But, by the way, it turns out that even the bullseye is a bit of a myth. Some people will get a distinct red ring with a center circle in the middle but most people get a more generic-looking rash, easily confused with any kind of bug bite. Lyme disease wears a lot of disguises.
It took almost a year for my son to be properly diagnosed and treated. We are all so relieved that he doesn't seem to have any lingering problems.
There are several hot spots in Canada and each year, more people get infected. In 2009, there were 144 reported cases. By 2023, it was closer to three thousand.
In places like Eastern Ontario, Nova Scotia, parts of BC, public health officials now just presume that if you are bitten by a tick, you are at risk. The remedy is an immediate course of antibiotics.
Ticks present so many devilish problems, from the hard-to-distinguish symptoms to weird things like how we can vaccinate our dogs, but not ourselves. Human clinical trials are underway and a vaccine against Lyme will eventually be available. It will be a bit of back to the future since there was a made-for-humans vaccine decades ago. It wasn’t perfect, but researchers say it was good. However, back in the 1990’s tick-borne diseases were confined to a few places on the map. The anti-Lyme vaccine drew so little interest that the pharmaceutical company stopped manufacturing it in 2002.
A vaccine against Lyme disease will be a relief, but really, we should never let our guard down when it comes to ticks. They can transmit several other diseases too. A vaccine targeting Lyme won't stop ticks from spreading those other diseases.
Don’t make the same mistake I did. Cover up. Pull those socks over your pant cuffs. Use deet-based bug spray. It is the only repellent proven to work. Check your skin, check your child, closely if you’ve been in a woodsy area.
Stay vigilant even if you think you made it through the summer scot-free. When the first snow flies, when thoughts of summer and bug bites are far away – watch out for the most obvious clue -- swollen joints. If you wake up one day, your knee pulpy and bloated for no apparent reason, get thyself to a doctor. Pronto.
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