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8:30 AM Wednesday, June 15, 2005: Last summer, Charles Balducci of Merrill Lynch honeymooned in Kenya and Seychelles. By the time he got back he could barely breath, he was running a 105 temperature and his resting heart rate was 26. He was dieing (or is it spelled dying?). His doctors told him he had some hideous African disease or maybe meningitis. In fact he had been bitten by a home-grown, United States deer tick just before he left. . Once his doctors eventually figured out he had Lyme Disease, they gave him a month of strong antibiotics (Rocephin) injected. The story ends happily. He's cured.

I'm into my second tick bite. The good news: I have no symptoms. The bad news, many readers of this column are sending me gruesome stories. Hence, my imagination is running amuck and my fear factor is off the chart. And, with justification, since this one is so hard to nail down.

To wit:
+ You can get bitten and not know it, i.e. you may never find the offending tick and the circular rash may never appear
+ Most doctors are not Lyme-literate, so they'll happily misdiagnose your problems, screw up your treatment and prolong your agony.
+ Some doctors prescribe antibiotics instantly to patients complaining of tick bites. This dosage may not be enough to cure the disease, but may be enough to screw up the results on a later blood test. (See below.)
+ If you pull out a tick, the only way to know immediately if you're a risk is to test the tick -- not your blood. You have to wait six weeks before your doctor can order a Lyme-Titer test of your blood. That's the time it takes your blood to produce Lyme antibodies -- the presence of which will tell if you have Lyme Disease.
+ There's much wrong information about how to remove a tick off your body. Do not smother it in petroleum jelly, nail polish -- as my first aid kit from Johnson and Johnson recommends. The tick has enough oxygen to its nasty work.
Use fine-point tweezers to grasp the tick as close to the skin as possible. Gently pull the thing straight out. Place the tick in a small vial. Have the tick identified/tested by a lab, your local health department or veterinarian. Wash your hands, disinfect the tweezers, and the bite site. Do not prick, crush or burn the tick as it may release its nasty infected fluids.

Ask around. Everyone and their uncle seems to have Lyme Disease -- some people have had it several times. Lyme disease is the fastest growing infectious illness in the United States, growing at five times the rate of AIDS and HIV. Lyme disease has been reported in 49 states, every continent and nearly every area including Canada and the Caribbean. No one is immune to this.

I hate to bother you with this stuff. But the summer is beginning. Many of you will be heading to the country to enjoy bucolic bliss. Know that beneath the serenity lurks a tiny threat waiting to mess up your vacation and your life. Read the following. File it away in your overstuffed brain. Perfect health is the perfect investment.

This is the common rash. About 25% of people bitten by Lyme ticks don't get it.

This is what ticks look like. Only the top row -- the smallest ticks -- can give you Lyme Disease. It's hard to identify a tick you've pulled off your body. Keep the tick. Send it to a lab and get it tested. I once pulled off a tick that was alive. I'm guessing it's easier to test a live tick than a dead one.

The American Lyme Disease Foundation says "Studies have shown that an infected tick normally cannot begin transmitting the spirochete until it has been attached to its host 36-48 hours; the best line of defense against LD, therefore, is to examine yourself at least once daily and remove any ticks before they become engorged (swollen) with blood. Generally, if you discover a deer tick attached to your skin that has not yet become engorged, it has not been there long enough to transmit the LD spirochete."

That sounds comforting. But the Foundation goes on "Nevertheless, it is advisable to be alert in case any symptoms do appear; a red rash (especially surrounding the tick bite), flu-like symptoms, or joint pains in the first month following any deer tick bite could signal the onset of LD."

The operative word is "normally." In other words, you may be instantly infected with one quick bite.

Lyme disease is a multi-system disease which can affect virtually every tissue and every organ of the human body. Symptoms of Lyme disease can range widely and include migraines, paralysis, joint pain, cardiac trouble, overall malaise and even death. Many physicians misdiagnose the disease for other illnesses since the symptoms often mirror other medical problems such as Multiple Sclerosis, Arthritis, Chronic Fatigue Syndrome, Lupus or Alzheimer's disease. From infants to the elderly, no one is immune to Lyme disease.

Symptoms (courtesy the American Lyme Disease Foundation)
The early symptoms of LD can be mild and easily overlooked. People who are aware of the risk of LD in their communities and who don't ignore the sometimes subtle early symptoms are most likely to seek medical attention and treatment early enough to be assured of a full recovery. The first symptom is usually an expanding rash (called erythema migrans, or EM, in medical terms) which is thought to occur in 80% to 90% of all LD cases. An EM rash generally has the following characteristics:

o Usually (but not always) radiates from the site of the tickbite
o Appears either as a solid red expanding rash or blotch, OR a central spot surrounded by clear skin that is in turn ringed by an expanding red rash (looks like a bull's-eye)
o Appears an average of 1 to 2 weeks (range = 3 to 30 days) after disease transmission
o Has an average diameter of 5 to 6 inches (range = 2 inches to 2 feet)
o Persists for about 3 to 5 weeks
o May or may not be warm to the touch
o Is usually not painful or itchy

Around the time the rash appears, other symptoms such as joint pains, chills, fever, and fatigue are common, but they may not seem serious enough to require medical attention. These symptoms may be brief, only to recur as a broader spectrum of symptoms as the disease progresses. As the LD spirochete continues disseminating through the body, a number of other symptoms including severe fatigue, a stiff, aching neck, and peripheral nervous system (PNS) involvement such as tingling or numbness in the extremities or facial palsy (paralysis) can occur.

The more severe, potentially debilitating symptoms of later-stage LD may occur weeks, months, or, in a few cases, years after a tick bite. These can include severe headaches, painful arthritis and swelling of joints, cardiac abnormalities, and central nervous system (CNS) involvement leading to cognitive (mental) disorders.

And death. Yes, you can die from Lyme Disease.

Early treatment of LD (within the first few weeks after initial infection) is straightforward and almost always results in a full cure. Treatment begun after the first three weeks will also likely provide a cure, but the cure rate decreases the longer treatment is delayed.

Doxycycline, amoxicillin and ceftin are the three oral antibiotics most highly recommended for treatment of all but a few symptoms of LD. A recent study of Lyme arthritis in the New England Journal of Medicine indicates that a four-week course of oral doxycycline is just as effective in treating late LD, and much less expensive, than a similar course of intravenous Ceftriaxone (Rocephin) unless neurological or severe cardiac abnormalities are present. If these symptoms are present, the study recommends immediate intravenous (IV) treatment.

The Lyme Titer blood test:
There are several blood tests for Lyme Disease and they can be very difficult to interpret. The first test is a Lyme titer which looks for antibodies in the blood. These antibodies can mean that you have a current or past infection. The results can be positive, negative or equivocal, (which means borderline). An equivocal result should be repeated in two to four weeks to see if there is any change. Since antibodies to other infections may look similar to Lyme Disease antibodies a “false positive” result may occur. “False negative results may occur under the following conditions:

* The test may have been done before the body has had a chance to make antibodies.
* Antibiotics taken in the early stage of the disease may prevent a person from ever making antibodies.
* If the test is taken after a course of antibiotics there may be a decrease in the level of antibodies present.

There can be no comparison from one test to a repeat test because the lab performs these tests against a “control” which changes from batch to batch. Therefore, you cannot see if the titers are rising or not. The only way they can be compared is if the same lab froze one of the samples and then ran both samples in the same batch. A Lyme titer may remain positive for a long time even after antibiotic therapy has been completed and this does not mean there is still active disease.

How to prevent Lyme Disease
You can minimize your chances of getting a tick bite:
* Wear a long sleeve shirt and long pants and tuck pant legs into your socks
* Wear light shaded clothing as it makes it easier to spot a tick, although they are as tiny as the size of a poppy seed when in the "nymph" or beginning stage
* Use an insect repellent containing the chemical DEET or Permethrin.
* Inspect yourself and your children once you come back inside. Remove any ticks promptly.
* Wear long sleeves and long pants tucked into socks when going into wooded or grassy areas.
* Put clothing including jackets and coats in clothes dryer for thirty minutes to kill ticks.
* Use sprays and dips containing permethrins and pyrethrins on dogs, cats and horses to kill deer ticks.
* Use prescription strength tick collars obtained from a veterinarian on your pet

Now you know more than 99% of doctors.

Where are interest rates going?
George Friedlander is the bond whiz at Citicorp's Smith Barney. I recommend him. Today at 4 PM he has a conference call. Number is 1-888-769-8517. Password is Friedlander

What happens in the dark closet:
A woman takes a lover home during the day while her husband is at work.

Her 9-year old son, Johnny, comes home unexpectedly, sees them and hides in the bedroom closet to watch.

Then the woman's husband came home a moment later.

The woman puts her lover in the closet, not realizing that Johnny is in there already.

Johnny says, "Dark in here."
The man says, "Yes, it is."
Johnny - "I have a baseball."
Man - "That's nice."
Johnny - "Want to buy it?"
Man - "No, thanks."
Johnny - "My dad's outside."
Man - "OK, how much?"
Johnny - "$150."
Man - "Sold."

A few weeks later, Johnny and the lover again find themselves in the closet together.

Johnny - "Dark in here."
Man - "Yes, it is."
Johnny - "I have a Wilson fielders glove."
The lover, remembering the last time, asks Johnny, "How much?"
Johnny "$350"
Man - "Highway robbery. Sold."

A few days later, the father says to Johnny, "Grab your glove, let's go outside and have a game of catch.

Johnny says, "I can't, I sold both my ball and my glove."

The father asks, "How much did you sell them for?"

Johnny -"$500"

The father says, "That's terrible, overcharging your friends like that. That is far more than those two things cost. I'm going to take you to church and make you confess your greed."

They go to the church. The father makes Johnny sit in the confession booth and he closes the door.

Johnny says, "Dark in here."

The priest says, "Don't start that shit again, pal, you're in my closet now."

Harry Newton

This column is about my personal search for the perfect investment. I don't give investment advice. For that you have to be registered with regulatory authorities, which I am not. I am a reporter and an investor. I make my daily column -- Monday through Friday -- freely available for three reasons: Writing is good for sorting things out in my brain. Second, the column is research for a book I'm writing called "In Search of the Perfect Investment." Third, I encourage my readers to send me their ideas, concerns and experiences. That way we can all learn together. My email address is . You can't click on my email address. You have to re-type it . This protects me from software scanning the Internet for email addresses to spam. I have no role in choosing the Google ads. Thus I cannot endorse any, though some look mighty interesting. If you click on a link, Google may send me money. That money will help pay Claire's law school tuition. Read more about Google AdSense, click here and here.
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