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"eg the tick could have been on me all day"

Well, that's a problem. If it's only been one day, they aren't going to give it to you. It's only supposed to be past 72 hours. Of course they're not going to listen and they'll argue if you're pushing something beyond the guidelines. If you frame it differently, like you don't know if it's been on there for days, then they're more likely to work with you.

I've actually had a similar tick issue for a child. There was no way of knowing for sure how long it was attached until tested in the lab. The doctor was still willing to prescribe the doxycycline when we explained the situation. There's also a state lab that will test ticks and give a report on whether the tick tests positive for about a half dozen diseases and also tell you how long it was attached. The doctor's lab could only test the tick for Lyme. He was genuinely interested in learning about this other lab from me even though I was not a medical professional.



My griping was more about the medical system in general. My one experience of going to the doctor for a tick was actually pretty good (my primary care doctor, who suffers from the standard push you out the door after 10 minutes and can't you go to the ER instead, but has otherwise been pretty agreeable). I think I told them I knew it was on me for at least 4 hours, but could have been 12, and they prescribed Doxycycline. So either the 72h guideline isn't standard, or there is room for judgement that makes sense to push for. Because personally, I'm not looking to gamble with long tail Lyme and I generally find length of time guidelines for stochastic events pretty uncompelling.


It's standard. Although in this publication they are going by engorgement. Doctors aren't that concerned with the details. It's unlikely they will get sued for prescribing doxycycline to a patient who doesn't have a known allergy to it, so why not.

https://www.cdc.gov/ticks/tickbornediseases/tick-bite-prophy...

https://www.cdc.gov/ticks/tickbornediseases/tick-bite-prophy...


Is it really supposed to take 72 hours for a tick to begin feeding? The 72 hours in that link seems to be about whether it's within the window that prophylaxis would have an effect (although you seem to be acknowledging this?).

In my case the doc asked if the tick was engorged, to which I responded that I didn't know - I'm not a biologist that studies ticks and can't give such a judgement as a nice tidy answer. Which is getting back to my point about expectations - if the treatment was amputating my leg, then I'd want some professional judgement calls. But given that the output of the medical system was going to be either (doxycycline and blood draw for lab, or nothing), I'm going to push towards the former option given the lack of expected harm and overall lack of attention outside of these scarce 10 minute visits.

FWIW I think I got a full course of doxycycline, perhaps just to avoid breeding antibiotic resistant bacteria rather than for the tick bite itself.


The post exposure prophylactic treatment is actually only a single dose.

The 72 hours in the link is from time of removal. The 72 hours I reference is how long it typically takes for a tick to regurgitate into a host (it has to feed for some time before it regurgitates). The article referenced it as being engorged. The correct answer is in the middle. It takes 72 hours for the tick to regurgitate, but it could technically crawl off a dead host and on to you. But it's harder to identify if it's engorged. These facts led us to use the doxycycline while the lab confirmed if the tick was positive and how long it was feeding.




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