Off North Road

Facing the wild

By Russell Hoxsie - March 23, 2006

March winds have brought rain and cold damp air. Three days ago Ticker, my two-year-old springer, and I walked out toward North Road. I hunched up trying to keep warm. Ticker bounded ahead unmindful of wind and rain. Without the tether she would have run off when we spotted together the lithe jet black form of an otter loping over the stick-strewn hill into a glacial gorge and small brook. We've seen him several times along the twisting and largely inaccessible course of our unnamed brook. Overtaking us off to the side in woods he is a daunting figure: all muscle, propelled by hugely long strides. I would hate to meet him head-on. My long-held sense of affection for otters and their fun-loving slides down banks of streams has vanished since that particular day when he ran close-by.

A day later, in almost the exact place, two deer sprang ahead of us from the beach. Their grace and golden brown, mother and yearling, vanished in a flash. Yesterday as we ate lunch, my wife Mary Ann and I noticed how bereft and ragged the bushes lay outside the windows. Our view stretched into the wetlands above a marsh. Then we spied a long curved stringer of bramble with its first bright green. The month had truly ushered in springtime although our weather had not yet noticed. A lone turkey vulture coasted on fringed wings above and disappeared out of sight. Today we made a visit to the veterinarian for a booster feline rabies injection for Mocha the cat. The technician tells us that rabies has arrived on Cape Cod. She heard of a Cape woman who noticed a raccoon while she drove along a country road. The animal appeared sick and frail; the woman stopped and took it home. Her story spread and a few days later an animal officer came to claim the sick beast. Three members of the family had been bitten already by their "guest." Fortunately, examination of the raccoon's head at a laboratory found no evidence of rabies. It is a cautionary tale to be sure. We give both Ticker and Mocha tick repellents monthly and they are prepared now for tick season. Living at the interface of the wild and the civilized we are accustomed to keeping both worlds in focus.

"Why would you want to live in what must be the most dangerous county in the United States?" my brother asked one day after I described to him the frequency of Lyme Disease (LD) and tularemia on our island. I omitted a description of babesiosis and Rocky Mountain Spotted Fever (RMSF), thinking I had already spoken too much of conditions a West Virginian would know little about. Brother's question is a good one and my only defense is that I knew nothing about all this until we had lived here for a few years.

March is the month I have contracted Lyme Disease twice. Climbing over the debris of winter along the stream I mentioned above, I had no concern in my excitement of getting out and about after winter. A few days later I felt a tender spot above my ankle and found a swelling, a fat black tick attached in the center of a red area and I began to understand the unusual headache and sweaty malaise I had been feeling all that day. Chagrined, I remembered the tick spray left on the shelf and lost no time in getting to the emergency room for antibiotics. I had no explanation for a lapse in control the second time around, but I seem to have been cured with similar treatment these years later.

Tucked-in long pants may not seem "cool" but they and light colored clothes which reveal the tick's presence easily are good preventives. If a tick is un-attached to skin or simply found walking about on clothing there is no danger. The tick must attach for at least 24 to 48 hours, to penetrate skin and deposit the bacteria causing LD. During this interval, illness may be prevented with a single dose of antibiotic although the earlier this remedy is administered the more likely treatment will be successful. If the patient or physician feels there is more danger of infection, a longer more intense course of treatment should be undertaken. The results of blood tests at the time of first visit to the physician are confusing, to say the least. Almost always the test within a few days of a tick bite is negative for LD even if the tick was infected. The lab test for LD turns positive only weeks or months later; the diagnosis should be made tentatively at first if necessary in order not to delay treatment. Blood tests after six weeks may or may not show evidence of recent infection and confirm a diagnosis. In other situations, blood tests may show evidence of recent or past infections. A characteristic rash a week or two after a tick bite is the best diagnostic sign of all for LD. However, in a significant number of cases this rash is never seen: it may not be looked for carefully enough in good light; it may be too faint to be noticed; or it simply may never occur.

Swollen joints, especially the large ones, are common in early weeks of LD infection. Less commonly, LD may cause inflammation of the heart within the first one to two months and cause slow heart rate, severe weakness, fainting or more serious dysfunction. Early or late, LD may affect the nervous system. Chronic LD resulting in arthritis, heart disease and neurological dysfunction can be long lasting and difficult to diagnose or treat. Specialty care in these cases should be sought with doctors experienced in treating LD.

The best preventive for LD infection is to stay out of the woods, brushy moist areas of ground, sand dunes at beaches and most rural areas where deer will be plentiful. Of course, these areas are everywhere on the Vineyard. Even remaining indoors all the time does not guarantee that pets will not bring ticks in with them. When all is said and done, the moment of undressing at bedtime in bright light is the most important prevention-time of day after exposure to tick country. Inspect the total body in good light and have someone gaze down your back where you cannot see. Removal of ticks before they embed is the watchword.

Tick repellent on outside clothing (Permanone) is effective in killing or repelling ticks before they reach skin. However, it is not recommended for use directly on skin, on the face or on small children. Ticks do not burrow through clothing. An unattached tick is not contagious unless its body is squeezed, burned with a match, popped, or otherwise damaged enough to release its body fluids. I find removing an attached tick with my fingers less destructive of the tick than struggling with a small tweezers. (This advice is controversial.) We remove attached and unattached ticks from Mocha and Ticker on a daily basis from March to October and always dispose of the tick in a small bottle of liquid soap concentrate and wash hands after handling in order to avoid contact with tick fluids altogether.

My brother's question still lingers. However, those encounters with the wild I mentioned at the top of this piece begin to answer his question. I am thrilled with the grace of deer and the otter, the signals at hand of the approach of seasons, and I have habits to hone and tools to use in common-sense protection from the hazards.