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Lyme Disease

What is Lyme disease?

Lyme disease is a bacterial infection you get from the bite of an infected tick. At first, Lyme disease usually causes symptoms such as a rash, fever, headache, and fatigue. But if it is not treated early, the infection can spread to your joints, heart, and nervous system. Prompt treatment can help you recover quickly.

What causes Lyme disease?

Lyme disease is caused by bacteria. In the United States, this is usually a bacterium called Borrelia burgdorferi. It spreads to humans through the bite of an infected tick. The ticks that spread it are blacklegged ticks (or deer ticks). They are usually found in the:

  • Northeast
  • Mid-Atlantic
  • Upper Midwest
  • Pacific coast, especially northern California

These ticks can attach to any part your body. But they are often found in hard-to-see areas such as your groin, armpits, and scalp. Usually the tick must be attached to you for 36 to 48 hours or more to spread the bacterium to you.

Who is at risk for Lyme disease?

Anyone can get a tick bite. But people who spend lots of time outdoors in wooded, grassy areas are at a higher risk. This includes campers, hikers, and people who work in gardens and parks.

Most tick bites happen in the summer months when ticks are most active and people spend more time outdoors. But you can get bitten in the warmer months of early fall, or even late winter if temperatures are unusually high. And if there is a mild winter, ticks may come out earlier than usual.

What are the symptoms of Lyme disease?

Early symptoms of Lyme disease start between 3 to 30 days after an infected tick bites you. The symptoms can include:

  • A red rash called erythema migrans (EM). Most people with Lyme disease get this rash. It gets bigger over several days and may feel warm. It is usually not painful or itchy. As it starts to get better, parts of it may fade. Sometimes this makes the rash look like a "bull's-eye."
  • Fever
  • Chills
  • Headache
  • Fatigue
  • Muscle and joint aches
  • Swollen lymph nodes

If the infection is not treated, it can spread to your joints, heart, and nervous system. The symptoms may include:

  • Severe headaches and neck stiffness
  • Additional EM rashes on other areas of your body
  • Facial palsy, which is a weakness in your facial muscles. It can cause drooping on one or both sides of your face.
  • Arthritis with severe joint pain and swelling, especially in your knees and other large joints
  • Pain that comes and goes in your tendons, muscles, joints, and bones
  • Heart palpitations, which are feelings that your heart is skipping a beat, fluttering, pounding, or beating too hard or too fast
  • An irregular heart beat (Lyme carditis)
  • Episodes of dizziness or shortness of breath
  • Inflammation of the brain and spinal cord
  • Nerve pain
  • Shooting pains, numbness, or tingling in the hands or feet
How is Lyme disease diagnosed?

To make a diagnosis, your health care provider will consider:

  • Your symptoms
  • How likely it is that you were exposed to infected blacklegged ticks
  • The possibility that other illnesses may cause similar symptoms
  • Results of any lab tests

Most Lyme disease tests check for antibodies made by the body in response to infection. These antibodies can take several weeks to develop. If you are tested right away, it may not show that you have Lyme disease, even if you have it. So you may need to have another test later.

What are the treatments for Lyme disease?

Lyme disease is treated with antibiotics. The earlier you are treated, the better; it gives you the best chance of fully recovering quickly.

After treatment, some patients may still have pain, fatigue, or difficulty thinking that lasts more than 6 months. This is called post-treatment Lyme disease syndrome (PTLDS). Researchers don't know why some people have PTLDS. There is no proven treatment for PTLDS; long-term antibiotics have not been shown to help. However, there are ways to help with the symptoms of PTLDS. If you have been treated for Lyme disease and still feel unwell, contact your health care provider about how to manage your symptoms. Most people do get better with time. But it can take several months before you feel all better.

Can Lyme disease be prevented?

To prevent Lyme disease, you should lower your risk of getting a tick bite:

  • Avoid areas where ticks live, such as grassy, brushy, or wooded areas. If you are hiking, walk in the center of the trail to avoid brush and grass.
  • Use an insect repellent with DEET
  • Treat your clothing and gear with a repellant containing 0.5% permethrin
  • Wear light-colored protective clothing, so you can easily see any ticks that get on you
  • Wear a long-sleeve shirt and long pants. Also tuck your shirt into your pants and your pant legs into your socks.
  • Check yourself, your children, and your pets daily for ticks. Carefully remove any ticks you find.
  • Take a shower and wash and dry your clothes at high temperatures after being outdoors

Centers for Disease Control and Prevention

Meniere's Disease

Meniere's disease is a disorder of the inner ear. It can cause severe dizziness, a roaring sound in your ears called tinnitus, hearing loss that comes and goes and the feeling of ear pressure or pain. It usually affects just one ear. It is a common cause of hearing loss.

Attacks of dizziness may come on suddenly or after a short period of tinnitus or muffled hearing. Some people have single attacks of dizziness once in a while. Others may have many attacks close together over several days. Some people with Meniere's disease have "drop attacks" during which the dizziness is so bad they lose their balance and fall.

Scientists don't yet know the cause. They think that it has to do with the fluid levels or the mixing of fluids in the canals of your inner ear. Doctors diagnose it based on a physical exam and your symptoms. A hearing test can check to see how it has affected your hearing.

There is no cure. Treatments include medicines to control dizziness, limiting salt in your diet, and taking water pills. A device that fits into the outer ear and delivers air pulses to the middle ear can help. Severe cases may require surgery.

NIH: National Institute on Deafness and Other Communication Disorders

Neck Injuries and Disorders

Any part of your neck - muscles, bones, joints, tendons, ligaments, or nerves - can cause neck problems. Neck pain is very common. Pain may also come from your shoulder, jaw, head, or upper arms.

Muscle strain or tension often causes neck pain. The problem is usually overuse, such as from sitting at a computer for too long. Sometimes you can strain your neck muscles from sleeping in an awkward position or overdoing it during exercise. Falls or accidents, including car accidents, are another common cause of neck pain. Whiplash, a soft tissue injury to the neck, is also called neck sprain or strain.

Treatment depends on the cause, but may include applying ice, taking pain relievers, getting physical therapy or wearing a cervical collar. You rarely need surgery.

Occupational Health for Health Care Providers

Health care workers are exposed to many job hazards. These can include :

  • Infections
  • Needle injuries
  • Back injuries
  • Allergy-causing substances
  • Violence
  • Stress

Follow good job safety and injury prevention practices. They can reduce your risk of health problems. Use protective equipment, follow infection control guidelines, learn the right way to lift heavy objects, and find ways to manage stress.

National Institute for Occupational Safety and Health

Oxygen Therapy

What is oxygen?

Oxygen is a gas that your body needs to work properly. Your cells need oxygen to make energy. Your lungs absorb oxygen from the air you breathe. The oxygen enters your blood from your lungs and travels to your organs and body tissues.

Certain medical conditions can cause your blood oxygen levels to be too low. Low blood oxygen may make you feel short of breath, tired, or confused. It can also damage your body. Oxygen therapy can help you get more oxygen.

What is oxygen therapy?

Oxygen therapy is a treatment that provides you with extra oxygen to breathe in. It is also called supplemental oxygen. It is only available through a prescription from your health care provider. You may get it in the hospital, another medical setting, or at home. Some people only need it for a short period of time. Others will need long-term oxygen therapy.

There are different types of devices that can give you oxygen. Some use tanks of liquid or gas oxygen. Others use an oxygen concentrator, which pulls oxygen out of the air. You will get the oxygen through a nose tube (cannula), a mask, or a tent. The extra oxygen is breathed in along with normal air.

There are portable versions of the tanks and oxygen concentrators. They can make it easier for you to move around while using your therapy.

Who needs oxygen therapy?

You may need oxygen therapy if you have a condition that causes low blood oxygen, such as:

  • COPD (chronic obstructive pulmonary disease)
  • Pneumonia
  • COVID-19
  • A severe asthma attack
  • Late-stage heart failure
  • Cystic fibrosis
  • Sleep apnea
What are the risks of using oxygen therapy?

Oxygen therapy is generally safe, but it can cause side effects. They include a dry or bloody nose, tiredness, and morning headaches.

Oxygen poses a fire risk, so you should never smoke or use flammable materials when using oxygen. If you use oxygen tanks, make sure your tank is secured and stays upright. If it falls and cracks or the top breaks off, the tank can fly like a missile.

What is hyperbaric oxygen therapy?

Hyperbaric oxygen therapy (HBOT) is a different type of oxygen therapy. It involves breathing oxygen in a pressurized chamber or tube. This allows your lungs to gather up to three times more oxygen than you would get by breathing oxygen at normal air pressure. The extra oxygen moves through your blood and to your organs and body tissues. HBOT is used to treat certain serious wounds, burns, injuries, and infections. It also treats air or gas embolisms (bubbles of air in your bloodstream), decompression sickness suffered by divers, and carbon monoxide poisoning.

But some treatment centers claim that HBOT can treat almost anything, including HIV/AIDS, Alzheimer's disease, autism, and cancer. The U.S. Food and Drug Administration (FDA) has not cleared or approved the use of HBOT for these conditions. There are risks to using HBOT, so always check with your primary health care provider before you try it.

NIH: National Heart, Lung, and Blood Institute