Sunday 4 December 2016

Fitness instructor Hannah: 'I was bitten by a tick in Wicklow and got Lyme disease'

When runner Hannah Nolan started underperforming, she knew something wasn't right. Here, she describes how she contracted Lyme disease from a tiny tick bite, that almost went unnoticed

Published 26/05/2015 | 02:30

Hannah Nolan was bitten by a tick while she was on a run
Hannah Nolan was bitten by a tick while she was on a run
A tick

The year 2012 had been a fantastic running year for me. I achieved new personal bests in every distance I ran, and topped it off by winning the Novice and Intermediate County Cross Country Championships.

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I felt like my training was really starting to pay off and was absolutely delighted when this appeared to be continuing in the beginning of 2013 with a fourth place in the Kildare Marathon.

Only a minute-and-a-half off third place, I was determined to continue with the training and get straight back running to further reduce my time and hopefully get a top three spot next time!

Following the marathon my body recovered quickly and I was back running after just a few days, with lots of energy. Unfortunately for me, this energy was short-lived.

Two weeks after the marathon I was bitten by a tick whilst out running.

I was bitten whilst out on my Sunday long run, which I do out on the trails in Avondale forest, Co Wicklow. I actually didn't even notice the bite until Monday and continued about my daily business.

Wednesday May 29, I had just completed an easy six-miler and my ankle was throbbing. I noticed the bite had now spread from my ankle to the bottom of my foot. I visited the doctor who confirmed it was infected and gave me an antibiotic cream and short course of antibiotics to take if it didn't settle down after a few days. From there, I thought absolutely nothing else of it.

About two weeks later, I was hit hard with fatigue and a general feeling of being unwell. When I was out running I noticed that my heart rate was quite irregular and higher than normal. I presumed I had some sort of virus so just rested up for a few days and thought it would even itself out, but the tiredness continued. Four weeks following the bite I had to pull out of a team race. I returned to the doctor for bloods but they came back normal.

By the end of July the detailed Garmin notes I use to track my runs were all starting to look the same; "bad run", "no energy", "high heart rate", "slow pace". My average pace had dropped by over a minute-and-a-half per mile and my Garmin notes from my long run, which had to be cut short, explained it all. My whole body just felt numb and like my legs didn't belong to me.

I returned to the doctor, but with my symptoms indicating a virus, it seemed there was nothing I could do.

By the time August came I was so overwhelmed with tiredness I was taking a two hour nap most afternoons. My heart rate was still high when I ran, so I slowed my pace down even further.

Despite the slow pace, my breathing would become difficult and laboured on exertion. I attempted a 10k race at the end of August - it was a very flat course - yet every single bump in the road felt like a mountain and my breathing was heavy and hard. My time was four minutes slower than my best and I felt like a wreck. I rested up for a few days ahead of a half-marathon and felt a little better.

Going to the half-marathon I felt good, but the moment I started I could not get my pace up at all. Five miles into the race, my breathing was hard and I had pain in my ribs. Bad side stitch I thought - but it was so bad I had to stop to walk to catch my breath. I had never walked in a race before.

My half-marathon time that day was 12 minutes slower than my best, again on a relatively flat course that should have been no problem for me. The winning female time that day was three minutes slower than my usual time and I limped across the time 10 minutes later, absolutely crushed.

The day after the half-marathon on September 2, I couldn't breathe. My resting heart rate, which was usually 45 beats per minute, had more than doubled, and lifting my hand above my head it shot up above 120. I knew something wasn't right and after seeing the doctor I was sent straight to hospital.

Initially it was thought I might have had a punctured lung, this was ruled out and a blood clot was suspected. Once again, this was ruled out.

Test after test performed and I spent over a week in hospital. The verdict was a respiratory reaction to a viral infection. I was released but deep down I knew that there was still something wrong.

A few weeks on, my hands were trembling, I felt dizzy and nauseous most days and I started getting pains in my shoulders and neck with severe headaches. Each day the headaches became gradually worse until they were constant and unbearable. I remember hitting myself on the side of the head just to try and bang out the pain. It felt like my head was going to explode with the pressure.

My mother came over from the UK to visit and having not seen me in a few months she saw how bad I was and took me straight to the doctor.

That day there was a French locum on call and she took a note of all of my symptoms and suggested that all of my symptoms sounded like Lyme disease. She asked me when was the last time I felt "good", and honestly, the last time I felt good was when I finished the Kildare Marathon mid-May. Everything after that really went downhill. She went back through my medical notes and saw I had been bitten at the end of May and joined the dots and started the process of testing for the disease. This was the first time I had ever heard of Lyme disease.

To think that in the course of just six months, a small bite I barely remembered has changed my life in such a dramatic way. It seems inconceivable.

At the beginning of my treatment I seemed to respond very well and by summer 2014 I felt I was better, and even started training for another marathon. I was so grateful that I could run again. But unfortunately, that was short-lived.

After just two months of feeling good I knew something wasn't quite right, and when my heart rate and breathing deteriorated again I knew the bugs were back.

Evidently, all the bacteria hadn't been killed off so it had slowly multiplied again in my system. By October 2014 I had fully relapsed.

My consultant has since changed my medication to try and keep attacking the bacteria and I am slowly getting better (I hope). I am on three different antibiotics including the one they use to treat TB.

I am told recovery can be slow, and I am definitely impatient - but I hope that through my experience I may be able to help raise awareness for a group of diseases that can be easily misdiagnosed, often going for years without detection, and are completely crippling and sometimes even fatal.

For many of us, we often put tiredness, or lack of running performance, down to a "virus" or a "bad day", but in reality, it could be a sign of something more sinister lurking underneath the surface.

* Hannah Nolan is the owner of whyweight.ie, an online weight loss business

Lyme disease: the facts

Lyme disease, or 'Borreliosis', is a bacterial infection passed to humans through a tick bite. It is currently the fastest growing tick-borne disease.

The bacteria is shaped like a corkscrew (called a spirochete) which enables it to burrow through body tissue which most other bacteria wouldn't be able to penetrate.

Infection starts with a tick bite and symptoms usually follow a few days or weeks after a bite. The first signs are an erythema migrans (EM), or "bulls eye" rash that generally radiates outwards from the source of the bite. Presence of a rash is a strong indicator of infection with Lyme disease although it might not be present in up to 50pc of patients. Chronic flu-like symptoms and fatigue are usually experienced.

Occasionally, the patient may carry Lyme disease but have no outwardly obvious symptoms. Ill health may crop up years later following an illness or period of stress. This leads to a late Lyme disease diagnosis, where symptoms are similar to Multiple Sclerosis, Chronic Fatigue Syndrome or Parkinson's disease. Lyme disease can lead to joint pain, weakness, muscle aches, pelvic pain, visual problems, tremors, headaches and heart problems, and can even result in paralysis and loss of sight. Symptoms become more varied and debilitating the longer an infection is left untreated.

Treatment is by a course of antibiotics and if caught and treated within a few weeks it is normally successful. However, infections lasting more than a few weeks become increasingly difficult to treat needing long courses of antibiotics and in some cases intravenous antibiotics.

The "high risk" areas in Ireland are Wicklow, Kerry and Cork - although many cases have been reported country-wide. It is worth remembering that there are bacterial infections other than Lyme disease too - I have tested positive for Spotted Fever Rickettsia which is just one of many infections that can be transmitted along with Lyme.

Top Tips to Protect Yourself

If you are on trails or in forests - or anywhere that is green and contains wildlife (more prevalent in areas where deer and sheep reside) - you are at an increased risk of exposure to contracting a tick-borne disease.

1) Wear long-legged/long-sleeved clothing (preferably tucked into socks)

2) Use insect repellent before you set out on your run/walk

3) Stay to the centre of the trail paths away from any leaves or vegetation

4) If you do find a tick, carefully remove it, using tweezers to ensure the head and entire body is removed

5) Be alert for any symptoms that may appear following a bite and seek medical advice with any symptoms or rash.

For full tips and information please visit www.ticktalkireland.org

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