Health Break | Published July 19, 2010

Ticked off by ticks?

The last 5-10 years have seen a tremendous increase in the number of patients our office has seen with ticks. Why? No-one knows for sure; maybe the global warming that is argued about is a factor. We’ve seen many people of all ages with tick’s still embedded, more with only parts of the tick still embedded, and many with just a tick bite site wanting to know if they need to be treated for Lyme Disease.
My youngest daughter was about 5 years old when we found a tick on the crown of her head. A few minutes, sniffles, and tears later, the tick was out. Had I, the doctor/daddy removed it the best way?
Why is the tick there in the first place? To be blunt, it’s eating dinner. Like a vampire, it likes human blood. Not a lot of thought goes into it, as far as we know: sort of like some football players at the training table.
Also, it’s not willfully trying to give us some nasty disease. The Lyme bacteria are an innocent by-stander in the gut of the tick. If the tick is on us long enough to get filled up or engorged, some of them vomit up part of the blood that they’ve eaten. The Romans used to vomit intentionally at their feasts, so they could start all over again with the eating.
First, what not to do: Don’t touch a hot match head to the rump of the tick. It may make the tick want to dig in deeper to get away from the heat. Worse yet, you may cause it to vomit its stomach contents, which can contain the bacteria which causes Lyme Disease, into your skin. No-one wants a puking tick.
Don’t cover it with Vaseline, Vicks, Tabasco sauce, rubbing alcohol, or nail polish for the same reason. These may work, but there is a concern that the tick may throw up while backing out.
Because there is a better way, don’t try to grab it with fine-pointed tweezers. Tweezers tend to crush and kill the little buggers.What to do? Get some dental floss, strong thread, fishing line, inner fiber from your 550 paracord, even kite string, about 18” long. Tie a simple over-hand knot, loosely, in the middle of it. Google over-hand knot if you need to learn what kind of knot that is. Carefully tighten the ends of the thread or floss until the loop is about twice the diameter of the body of the tick. Place the loop around the body of the tick, as far down towards the head of the tick as possible. You may need another pair of hands to help with this. Use tweezers, or a pencil or pen point to help get the loop of floss or thread as close to the head of tick as you can. Slowly snug up the loop around the tick’s neck until you feel slight resistance. The idea is not to strangle to tick, but to provide a pulling point to persuade the tick to let go. Tie a second knot now, which will keep the loop from getting tighter.
Next, wind the ends of the thread or floss around a pencil, or pen, or knife-handle, or anything to give you a comfortable grip. Next, slowly lift up on the body of the tick with the floss/thread until the skin is “tented” up, forming something that looks like pictures of Mount Fuji. Keep a gentle, steady pull on the string; don’t jerk the body of the tick off of its head. In my experience it can take up to 3 minutes of steady traction until the tick decides that relieving the strain on its neck/body is worth giving up its seat at the dinner table. Almost always, this method will result in the complete removal of a tick, which may still be alive. What about using the tick removal “key” or “spoon” sold locally or on the web? Dental floss or thread is cheaper and more available.
There’s a cute Instructables.com video about rubbing the tick in a circular motion for about a minute. It seems to be very successful in getting the tick to let go. Why it works isn’t clear, maybe it’s the irritation. How would like someone to do the same to you? The proponents of this method say maybe it’s making the tick dizzy. The rubbing however isn’t causing the head of the tick to spin around, like some people like to do in between innings at the Spikes baseball games. Only the body of the tick is being moved around. The concern I would have with this method is does it make the tick more likely to puke? Who knows?
Future articles will deal with incomplete tick removal, and when a person with a tick bite should see their doctor.
Jonathan D. Adams, MD, is an associate professor, Family and Community Medicine, Penn State College of Medicine; a family medicine physician at Penn State Hershey Medical Group – Park Avenue; and on the medical staff at Mount Nittany Medical Center.

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