Friday, May 7, 2010

Spring Fever Can Hurt (Marin IJ)

Each spring, something stirs. Spring fever it’s called; sunshine, birds singing, an itch for exploration, and a sense of romance in the air. But in your local emergency room, spring’s stirring mean something quite different. In the ER, spring fever is hay fever and instead of bird songs we hear sniffling and wheezing. The itch is poison oak and that “sense” is an embedded tick being pulled from your skin.
With the brilliance of spring comes a myriad of outdoor opportunities, but also some hazards. If you spend a lot of time outdoors, you’re aware of these annoyances, but nonetheless the season calls for a review. So here are ways to avoid the three Ps of springtime – poison, parasites and pollen.

Thanks to El Niño’s rain, poison oak is growing like crazy and causing agony for careless outdoorsmen. With poison oak, prevention is key. So, please heed these four tips. 1) Know what poison oak looks like (shiny with leaves of three) and do not treat it like a decorative shrub – as a family friend did when she transplanted a bush from her backyard to the planter box. 2) Remember that poison oak’s oil (urushiol) is what causes the rash and that the oil stubbornly sticks to clothing – so do not follow the example of one ER patient who thanked her husband for clearing poison oak by greeting him with a naked embrace. 3) Be careful about slipping into the woods to relieve yourself in the bushes – several days later this convenience may cause prickly discomfort in the danger zone. 4) Finally, do not fall for the myth that drinking poison oak tea makes you immune – it doesn’t, in fact quite the opposite – a poison oak tea party leaves guests with painful swelling of the mouth and throat.
If, despite your best efforts, you fall victim to poison oak exposure, act quickly and you still may be okay. Wash off, as thoroughly and as soon as possible. Scrub with Technu or Fels-Naptha soap and get all your clothes into the laundry. If a rash occurs, (usually two to three days after exposure due to a delayed immune reaction) focus on alleviation. Don’t worry, you can’t “spread” the rash by touching it at this point, although you should definitely avoid scratching at it. Aveeno and oatmeal baths may help calm the symptoms, but severe cases will need steroids (such as prednisone) – sometimes for a two week course of treatment.

Ticks are disgusting creatures. These pests are both parasitic and sneaky; they slowly crawl under clothing and discover tucked-away folds of flesh. To top it off, ticks can transmit infectious disease (such as Rocky Mountain spotted fever and Lyme disease) and in some instances inject a toxin that produces full-body paralysis. Luckily, these complications are rare, and although Lyme disease does occur on the West coast (transmitted by the nymph form of the deer tick, the Ixodes pacificus) it is much less common than on the East coast. It’s thought that we have our backyard friend and tick host, the blue-belly lizard, to thank for this –the lizard’s cold blood kills the bacterium that causes Lyme. Most of the time, ticks are merely esthetic hazards – and stubborn ones at that. There are a lot of myths about how to remove a tick: flame its bottom, smother it with Vaseline, or douse it with gasoline. These tactics might have worked for someone at some time but, really, the safest and most effective way to remove a tick is to patiently exert brute force. Using forceps or tweezers, grab the tick’s head as close to the skin as possible and gently pull until the tick releases. Once successful, do a celebration dance and flush the littler sucker down the toilet. Don’t be concerned if there is redness around the area of assaulted skin – this is a normal inflammatory reaction. If there’s a bull’s-eye appearance to the rash, however, that is more sinister and it’s time to think about Lyme disease treatment and prevention. The Centers for Disease Control and Prevention (CDC) recommend preventive treatment for Lyme disease if, and only if, all of the following criteria are met: the tick is likely to be of the Ixodes (deer tick) species, has been attached to the skin for at least 36 hours and treatment can be started within three days of removal. The treatment itself is simple: 200 milligrams of Doxycyline (this shouldn’t be given to children under the age of 8), but somewhat controversial in this area of the country (given the low rates of Lyme disease). The best way to avoid unnecessary medication is to give you and your family a thorough post-hike preening for ticks – and don’t’ forget to look in the tucked-away places – pulling an attached tick out of your belly button is not a pleasant proposition.

Has your spring been a sniffly, wheezy, watery-eyed one? If so, you’re not alone – so far it’s been a banner year for seasonal allergies. Fortunately, you can manage the discomfort of seasonal allergies by monitoring pollen counts in your neighborhood (check out and talking to your doctor about seasonal treatments (which include inhalers and over-the-counter drugs such as loratadine). Truly miserable sufferers may need immunotherapy (allergy shots). Allergy sufferers, be advised that now is not a good time to stop and smell the flowers.
“Spring,” former Marin resident Robin Williams once remarked “is nature's way of saying, ‘Let's party!’” Particularly in this county, spring is a party not to be missed. And with a watchful eye and prudent prevention, you won’t be left with a three P hangover.