Ticks were a common part of everyday experience when we lived in South-Central Texas. Disgusting, but something you just deal with, both on your animals and on yourself. So I'd had hundreds of tick bites in my lifetime, before the story I'm about to tell you, with no dire consequences. Until this time.
A couple of years ago I went back home for a couple of weeks to help out after my 80yo dad's knee surgery. (By "help out" I mean, "sit on him, if necessary, to make him not do stuff before he's supposed to.")
In an attempt to keep him in the house in his recliner, I went out and figured out how to use his mower, and mowed every blade of grass and weed in a 10-acre area around the house, so he'd have no excuse to be out there. (It didn't work. He snuck out and got on his bulldozer and went and did stuff out behind the barn where we wouldn't see him.) This was in August. In Texas. It was hot, and by the time I finished I was covered from head to toe in a solid layer of sweat, dust, and clippings. And, it turns out, at least one tick.
The beastie managed to make its escape before I saw it, but I did notice the bite mark the next morning, only because for some reason the area of irritation took on an oddly square shape, which I thought was interesting. Nothing more than that. You go to Texas, stuff bites you. I'd already, in the span of a few days, been stung by a red wasp, several fire ants, and a number of mosquitoes. But it was square, which was kinda funny, so I laughed a little and Instagrammed it, and then promptly forgot all about it.
Two weeks later I was home in WA, trying to catch up on the vacation backlog in my practice. I didn't feel good. I was TIRED. My brain didn't want to work. It was hard work to keep myself upright and functioning. And I had that "I'm getting sick" icky all over feeling. But I had a whole schedule full of psychiatric patients to see, so I just kept muscling through it, telling myself I was just tired from my trip.
By the end of the week my temperature was spiking up to 105F and I felt HORRIBLE. I had chills and aches and a headache and nausea and weird random sharp pains here and there, and some little rashy-looking places on my neck, chest, and arms. Nothing spectacular. I tried to take a photo of it for my FNP (she's also a good friend, and I'm an NP too, so I get icky photo-sending privileges) , but it barely even showed up in the pictures, so I didn't bother.
But I felt HORRIBLE. I canceled my appointments for the next week and went to see my FNP and she did some labs, and found my liver enzymes were elevated, which is weird for me. Everything else looked normal. I can't remember clearly now what she did for me at that point, other than a bunch more labs - blood cultures and such, and had me take Tylenol, etc. She kept checking in with me and trying to figure out what could be going on, but nothing was making sense. I went to the ED a couple of times; my fever just wouldn't come down, and I honestly felt like I was dying. The MDs didn't have any answers. The last time I went they gave me fluids and did some more blood work, and told me (again) it was just a virus and would have to run its course, and unhooked everything to send me home, and then my BP tanked and they had to hook everything back up again. But they still sent me home as soon as they could get me upright without passing out. :P
My FNP, out of desperation, started me on a broad-spectrum antibiotic, but it didn't seem to help anything. By day 9 I was still getting worse; no improvement at all, other than the barely visible rash had long since vanished. I really thought I might be dying. That was the day my FNP texted me and said she thought I had Rocky Mountain spotted fever, and was calling in a prescription for doxycycline.
She was right. One dose and I started improving dramatically. In no more than a couple of days I was completely recovered. When I was back on my feet, I Googled RMSF and found out 1) you don't necessarily get a rash with it, and 2) it kills people. Ack! Most fatalities, from what I read, happen between days 6 and 10. It's super easy to treat (unless, I suppose, you're deathly allergic to doxycycline or something); the problem is that it takes so long to diagnose that people die before the doctors figure it out. (I was at day 9, so I feel pretty lucky my FNP was smart enough to catch it!) Also, even though ticks are common in the part of Texas I was in, RMSF is *not*. So it was not really even on the diagnostic radar.
So, I guess the moral of the story is, if you start running a fever or having other weird symptoms, don't wait to get seen, maybe opt for an FNP over an MD <g>, and raise the question of RMSF, to get it on the radar sooner than later. 'Cause even if you survive until later, it's no fun!