San Antonio Express-News (Sunday)

Take tick bites seriously by treating them promptly

- JOE AND TERESA GRAEDON Contact the Graedons at peoplespha­rmacy.com.

Q: We moved from North Texas to a lake in East Texas. Within the first week of living here, my husband discovered a tick on his stomach. He pulled it out, and a week later we saw a bull’s-eye rash as clear as can be.

I sent him off to urgent care, and he asked for a round of antibiotic­s. The clinic had not seen a tick bite or rash ever! That sounds unbelievab­le, since the Sam Houston Forest is all around us.

He took two rounds of antibiotic­s and the rash went away. Luckily, he has not had any residual effects. Don’t mess around with Lyme disease!

A: According to the Centers for Disease Control and Prevention, Lyme disease is relatively rare in Texas. There are, however, cases reported every year. Your husband was smart to get treated promptly.

Prevention is absolutely the best strategy against tick bites. Readers of this column have praised the

benefits of wearing permethrin-treated gaiters that fit over shoes, socks and lower pants legs.

One person commented: “The leading tick expert at the University of Wisconsin recommends wearing rubber boots (wellies) and says that ticks don’t like them at all. I spray my boots and pants with permethrin, and so far, so good. We have tons of ticks in our Wisconsin woods.”

Q: Two months ago, I suffered a pelvic fracture

when a big dog knocked me over. I am making progress but sleeping is a problem. The pain wakes me up, and then I can’t get back to sleep.

I am afraid to take PM pain relievers because I have read in your column that they might increase the risk for dementia. What else do you have to offer?

A: The PM pain relievers that you mention contain the sedating antihistam­ine diphenhydr­amine (DPH). This is the same ingredient

found in Benadryl that is used to treat allergy symptoms.

We discourage the regular use of DPH for insomnia because the longterm benefits have not been establishe­d. A review of sleep medicines in older adults concludes that “Diphenhydr­amine should be avoided in the elderly” (Clinical Therapeuti­cs, Nov. 1, 2016).

That said, taking a PM pain med temporaril­y to both ease your discomfort and assist with sleep

should not increase your risk for dementia. You can find many other options such as valerian, passionflo­wer, ashwagandh­a or hops in our eGuide to Getting a Good Night’s Sleep. You will find it in the Health eGuides tab at PeoplesPha­rmacy.com.

Q: About 15 years ago, I was experienci­ng significan­t pins and needles sensations in my hands and feet and was diagnosed with MS. I began taking gabapentin for the discomfort. I kept taking the gabapentin and over the years I became progressiv­ely weaker and more fatigued. Then I began seeing specialist­s for bladder issues, among other things. I fully expected to end up in a nursing home within 10 years.

Then I weaned myself from the gabapentin and noticed I was regaining strength and energy. I have now returned to living a totally normal, active life with my only symptoms being pins and needles. Careful use of supplement­s has helped reduce this, too.

It scares me to think I might never have discovered the true cause of my disability. How many people are also living with a disease induced by medication?

A: Thank you for your insightful story. Gabapentin (Neurontin) has Food and Drug Administra­tion approval to treat epilepsy and nerve pain after a shingles attack (postherpet­ic neuralgia). Doctors do prescribe it off-label for many other conditions, though. Side effects include weakness, fatigue, sleepiness, dizziness and depression.

 ?? Getty Images ?? Although Lyme disease is rare in Texas, take the threat seriously. Prevention is the best strategy.
Getty Images Although Lyme disease is rare in Texas, take the threat seriously. Prevention is the best strategy.
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