My child's been bitten by a tick: now what?

**This article was inspired after a friend of mine went through the process of discovering a tick on her child, and the subsequent steps she had to take. I then contacted Dr. Gina Neto, head of Emergency Medicine at CHEO. All information below is from my conversations with Dr. Neto, Christine, and the Public Health Agency of Canada, with sources referenced throughout. I acknowledge there is conflicting advice/evidence when it comes to tick bites and prevention/treatment of Lyme disease - at the end of this article I have included a list of guidelines and resources for parents to review. I also validate that YOU, as parent, need to make the right choice for your child.

It was after a swim in the pool when Christine Karpinski found the tick embedded in the back of her son's neck. During the long drive from Toronto earlier that day, the family had made a pit stop at the Odessa ONroute service centre. Looking for an opportunity to stretch their legs, they headed out to play a bit of geocaching in the treed area behind the highway stop. This is where Christine's five year-old son picked up the black-legged tick, which is the species that can carry the Lyme bacteria.

"It's been a stressful few days," says Christine. Once they had removed the tick (using tick tweezers from MEC,) they headed over to the Children's Hospital of Eastern Ontario (CHEO) emergency department to inquire about potential treatment and testing.

According to Dr. Manisha Kulkarni, 1 in 3 ticks in the west end of Ottawa is carrying the Lyme disease bacteria. There has been a 145% increase in the tick population in this city between 2016 and 2017 and this number is expected to rise. In the Odessa area where Christine's son got the tick bite, there is a 40-45% chance that the bug is carrying Lyme.

By now, most folks have learned about ways to protect themselves against tick bites, but it's always helpful to review the proper methods for removal (tick keys or tick tweezers are best, but in a pinch you can use flat-edged tweezers.) It's important not to stress the tick, so no dousing it in oils or other substances, and no squeezing or twisting the body. Grip firmly at the base and pull.

Once the tick was removed, Christine's journey into the murky world of ticks and Lyme disease began. Upon arrival at CHEO, Christine learned that not only would her son not be a good candidate for preventative antibiotics, but that the tick itself could not be sent away for testing.

"There is a role for preventative antibiotics (which is different from treatment,) if the tick was engorged (attached for > 36 hours) and the child is more than 8 years old," says Dr. Gina Neto, head of Emergency Medicine at CHEO. In kids under eight years of age, it’s still controversial** as to whether or not there’s a benefit in doing preventative antibiotics, mainly because it's not been well studied and carries potential risks.

Preventative antibiotics need to be administered within 72 hours to be effective. This means that many tick bites could be treated by a primary care physician, as long as the patient has access to timely care.

However, CHEO knows that sometimes seeing your family doctor is not practical. "We understand if families come to the emergency department," says Dr. Neto. "We accept that and we know that they’re worried." (Another alternative would be a visit to your local urgent care clinic as opposed to emerg.)

When antibiotics within 72 hours are not advisable (as in Christine's case) or when the window has been missed, then the next step is to watch for symptoms of Lyme disease. These typically include flu-like symptoms, such as body aches, fever and lack of energy. Symptoms generally present between 7 - 14 days, but parents should be vigilant up to 30 days after the bite. Also, the typical "bulls eye" rash that is a possible sign/symptom doesn't show up in all cases - when it does, it usually pops up several days after the bite.

The treatment for Lyme disease** is similar to the treatment a child would receive for an ear infection - a course of amoxicillin, as well as rest and recovery. "[Early stage] Lyme disease isn’t something that makes you really, really sick," says Dr. Neto.

With prompt treatment, patients can avoid more severe symptoms that may arise with second or third-stage Lyme disease. Dr. Neto is quick to point out how rare it is to struggle with long-term Lyme disease symptoms. "It gets portrayed a lot in the media and that’s where people get scared," she says.

And what about testing the tick that has bitten your child? As Christine discovered, that's not so easy. "CHEO doesn't send ticks for testing, nor does OTTAWA Public Health; but our pediatrician was able to send it through a lab requisition to ONTARIO Public Health (sent via gammacare) and then it's being sent to the National Microbiology Lab in Winnipeg," says Christine. Ottawa Public Health does test ticks, but only for surveillance on Lyme disease.

In the end, given the age of Christine's son and the fact that the tick was not engorged (it had been attached for about 4-5 hours,) testing is rather pointless - even if the tick is found to have Lyme disease, the chance of Christine's son developing Lyme is extremely low. This is because of how tick biology works. In most cases, they need to have been feeding for a certain length of time (all guidelines point to 24-36 hours) before they start to pass the Lyme bacteria on to the host. 

Speculation is that individuals who find a tick and have gotten Lyme disease after it was attached for less than 24 hours probably had another nymph attached to them somewhere that they never discovered. Nymphs are the "baby" ticks, and can be as small as a poppy seed. This is a good reason why a nice warm shower and a thorough "tick check" is a great idea before bedtime!

To recap, the following are some of the things to do/watch for if you discover your child has been bitten by a tick:

• Remove the tick with a tick key or special tick tweezers

• Think back and try to figure out when your child could have gotten the tick (if you're camping, this will be easy!)

• Assess whether the tick is "engorged" (see picture below.) This means the body will be fat and round, and not flat. An engorged tick has most likely been feeding for a while, and could require more prompt treatment for your child.

• If your family doctor is accessible, make that your first point of contact. If you do not have a family doctor or think you're running out of time (72 hours) for preventative antibiotics, consider an urgent care clinic or your local emergency department.

• Children under 8 are not usually given preventative antibiotics here in Ottawa. In these cases, you will need to watch for signs or symptoms of Lyme disease, but this needs to be discussed with a physician**

• Your physician will be able to best guide you in your decision about preventative antibiotics OR a course of antibiotics for treatment if signs/symptoms of Lyme have occurred.** That said, you are the parent, and need to make an informed choice based on your research - which is exactly what Christine did!

• You CAN send your tick for testing, but it's not necessary for diagnosis or treatment

A GOOD VISUAL OF WHAT AN ENGORGED TICK LOOKS LIKE

**most prevention and treatment guidelines are conflicting, poorly conducted and often out-of-date. Many Lyme disease advocates argue that current guidance is not accurate. Furthermore, some doctors choose to delay treatment or can outright dismiss claims of Lyme, making it very difficult for patients to navigate the system. Below are some guidelines and a review by the Canadian Pediatric Society, which all state various recommendations based on low-quality evidence:

Canadian Pediatric Society Review

ILADS Guidelines

IDSA Guidelines

NICE Guidelines

In addition, I'd like to draw your attention to the Ministry of Health and Long-Term Care's Lyme Disease and Tick-borne Illnesses Task Force report. This contains some recommendations for improving prevention and care, including a call for a full review of all available guidelines. It is my sincere hope that we move forward as a province to ensure adults and children are getting timely and compassionate care.

Misty Pratt is health researcher, and co-Community Manager for Kids in the Capital. She lives in Orleans and enjoys regular walks in the ravine behind her house, and isn't planning to stop just because of ticks.

Has your child been bitten by a tick? Share your experience with us in the comments below.

A Surprise Staycation at Bookstreet Hotel

The last-minute planning for a staycation started when a pre-planned long weekend trip to Washington was cancelled and my entire family was disappointed. All of us were looking forward to getting away.

My husband and I scoured the internet for ideas on what we could do that were not too far away and that wouldn’t cost a lot of money (we’re still counting on a trip away-away sometime soon!). I then remembered the Brookstreet Hotel. Located in Kanata North, my daughter had taken swim lessons there through Aqua Life Swim Academy and absolutely adores the place (especially the outdoor musical instruments located outside the hotel’s front door). So, I went online and took a look at what they had to offer.

Without hesitation, I booked the “Summer Family Package” – the perfect family getaway package!

We didn’t tell my daughter what we were doing. Instead, my husband and I secretly packed our overnight bags (including our swimsuits!) and late Friday afternoon, I told her she and I had to run out and pick something up for her dad at the Brookstreet Hotel. As I mentioned, she adores the place and was eager to go back, even if it was just to pick up a package for her dad. When we got there, I told her we had to go to a certain floor to get the package. When we arrived at the room, my husband was already there and left the door a bit ajar, so I just walked in and said, “Hi! How are you?” My daughter was confused and initially did not want to leave the hallway, but then slowly made her way in when she heard her dad’s voice.

She was still confused, but then noticed the suitcase and a Brookstreet backpack on a bed and excitedly asked, “Are we staying here? REALLY?! YAY!” And then jumped up on her bed to take a look at her complimentary backpack that included a Brookstreet water bottle (which is valid for free soft drinks when dining in Options, Perspectives or Ironstone Grill) and tokens for the hotel’s Zone 525 Games Room. The games room features an interactive floor game, arcade games, video games and a movie theatre!

My daughter could hardly wait to change into her swimsuit and head to the Brookstreet’s outdoor AND indoor salt water pools. We spent a long-time swimming that evening – the water in both the indoor and outdoor pools is so warm, you won’t want to leave!

Once we were done swimming, we headed back to our room, but not before my daughter was greeted by Buzz, the hotel’s mascot. At nine, she was trying not to be excited, but she had a hard time not smiling when she saw him. Buzz can be found buzzing around between the hotel’s lobby and the Flex Fitness Studio a few times during weekends, which is a fun addition to any family’s stay!

After a quiet and comfortable night’s sleep we enjoyed a delicious breakfast buffet at Perspectives. This breakfast is not your typical hotel breakfast – think smoked salmon, waffles, fresh fruit salad, gourmet cheeses, yogurts, pastries, bagels, and so, so much more!

After breakfast we headed to Blackbird Falls Mini Putt for a fun 18-hole game. My daughter liked this course because it looks easy, but it is actually challenging (she also loves that there is so many ‘water holes’).  

We then went to the games room where my daughter used her tokens to play the “grabby thingy” and won three stuffies – much to my chagrin. Afterward, we headed back to the pools, well, I sat in the whirlpool tubs… and then in the sauna.

We also took a look at the outdoor ping pong table, outdoor chess and chequers tables near the outdoor pool area, as well as the kids play rockers. Needless to say, a family with kids of all ages could easily spend a weekend – if not more at the Brookstreet Hotel.

Families can also look into various activities that take place during the weekend. The weekend we stayed, there was a movie night being hosted on Friday night in Zone 525 (the games room) as well as an ice cream inspired “B Creative” craft Saturday morning. The hotel also offers complimentary bicycles, helmets, locks and cycling trail maps for all guests!

The Summer Family Hotel Package includes so much, it is truly unlike any other hotel I have stayed at and it really felt like we got away – even if we live just minutes down the road. The package includes:

• One night’s accommodation
• Family Pass for Blackbird Falls Mini Putt
• A ‘Brookstreet Backpack’ for each child including:
  • A Water Bottle (Free soft drinks when dining in Options, Perspectives or Ironstone Grill)
  • A Surprise Kids Activity
  • Tokens for the Zone 525 Games Room
  • 15% discount in in Perspectives Restaurant, Options Jazz Lounge or Ironstone Grill (a voucher is given at check in that can be used throughout your stay)
  • A Freezie or Popsicle for each child (a voucher is given at check in to pick up the treat from the B café)
• Access to their indoor and outdoor saltwater pools, including a kid’s wading pool
• High-speed WiFi
• Parking in their secure underground garage

We will definitely return to the Brookstreet for another staycation – my husband and I are also looking into indulging in the Couples Getaway package!

Have you stayed at the Brookstreet Hotel before? What was your favourite part?  

A family night out with the Ottawa Fury

KITC would like to welcome back, guest blogger, Stephen Johnson. Stephen Johnson is an Ottawa writer who loves to write about family travel.  During the summer, you will most likely find him and his family at a local fair or festival.  During the winter, a beach in Mexico is a likely bet.  

Certain summer nights are almost perfect.  We experienced one of those moments at a recent Ottawa Fury FC match.  

The first element was the weather.  As all Ottawans know, our spring has been less than stellar. The night we attended the Fury game, there was not a cloud in the sky and the temperature was a perfect twenty-two degrees celsius.   

The second factor was the game day experience.  Our son, David, had been picked to be part of the pre-game ceremonies. We arrived at TD Place  stadium and met up with someone from the Fury staff. We were soon down on field level. David had the opportunity to watch the players practicing. He enthusiastically gave them high-fives at the end of their practice.

David was given instructions for what would come next.  He was given a Fury flag along with a number of other children. I must admit to feeling chills as the players walked out accompanied by the booming voice of the stadium announcer. David got an up-close view as the players passed through the tunnel of Fury flags.

Soon enough, both national anthems were complete and it was time to make our way back to our seats. The Fury were playing against the Charlotte Independence. Both teams were evenly matched and the soccer was high quality. I liked the fact Fury fans represented all different ages and demographics. There were families enjoying an evening out along with more hardcore supporters who probably knew the history of each player.   

After forty-five minutes of action, the score was 0-0. It was the perfect time to stretch our legs so we made a beeline to the family fun zone. This area features a variety of activities including inflatables, face-painting and Jenga blocks. Basically, it is the ideal place to take your younger Fury fan if they want a break from the game. David took a few shots on net and scored a goal. David was craving a hotdog so we headed to the concessions area where he ate almost all the dog leaving me a small bite-sized portion to enjoy!

It was time for the second half to begin. The major excitement for us was when the Fury promo team threw  t-shirts into the crowd. A shirt landed close to our seats but was just out of reach.  An older fan grabbed the child-sized t-shirt and did the kind thing giving it to David.

Unfortunately for the Fury, even though they carried much of the play, Charlotte scored a late goal marking a 1-0 victory. To be honest, the score did not really matter to us. We had a great night out and plan to attend at least another game this summer.  

There is something of a Canadian invasion going on with the Fury lately as many of the starting players are from Canada. There are even several home-grown players from Ottawa that you can cheer. For more information about the Fury schedule and tickets, visit, www.ottawafuryfc.com

Special thanks to the Ottawa Fury for providing David with tickets for the purpose of this article; all views are his own.

Canada Day 2018 in Canada’s Capital Region

Looking for information on the official Canada Day 2018 festivities? Canada Day celebrations start June 30th at Major’s Hill Park and on July 1st at three official sites: Parliament Hill and Major’s Hill Park in Ottawa, and the Canadian Museum of History in Gatineau.

Parliament Hill

Known as the place to see on Canada Day, this year won’t disappoint with Canadian musical performances, a musical workshop, fun-filled activities, and more! Guests can enjoy Canada day on the Hill starting at 8 a.m.

Hosted by Lisa Charleyboy and Marième, the Canada Day Noon Show will include remarks from dignitaries, a fly past by the Canadian Forces Snowbirds and performances by Canadian artists: Arkells, Lights, Brigitte Boisjoli, Iskwé, Jean-Marc Couture, Rose Cousins, Martina Ortiz Luis and Queen Ka.

At 5:30 p.m., there will be an aerial show by the Canadian Forces Snowbirds.

The Canada Day Evening Show will feature artists: Arkells, Lights, Brigitte Boisjoli, Iskwé, Jean-Marc Couture, Ruth B, Klô Pelgag, The Dead South, Rose Cousins, Elijah Woods x Jamie Fine, DJ Shub and Boogát.

The evening will end with a dazzling 15-minute President’s Choice pyro-musical show at 10 p.m.

New this year on the Hill: the main entrance to the Hill is at the Supreme Court of Canada (corner of Wellington and Kent). To ensure a quick security screening process, only pack light and bring your Canada Day essentials, such as a hat, sunscreen and a reusable water bottle.

Major’s Hill Park

Canada Day celebrations start Saturday, June 30th on Major's Hill Park with all day activities for the whole family, including circus performances, games and a community culinary experience.

Kids can enjoy a ride around the park aboard a VIA Rail Miniature Train or get a unique musical ride aboard a bicycle made out of recycled material. 

You can also cheer on top Canadian artists at the Art Battle Canada live painting tournament (11 to 11:30 am) that celebrates creativity, courage and community in the visual arts. Their masterpiece is created before your eyes in only 20 minutes as you vote to help decide the winner!

Then enjoy local musical talent, including: Elijah Woods x Jamie Fine; MEGAPHONO Showcase featuring LeFLOFRANCO, SeiiizMikk and Jah’kota; and in the evening, Andréanne A. Malette and River Town Saints.

Then, on Canada Day itself, the activities and performances continue!

Jump up to 30 feet in the air on the Jumpaï (“jump high”). It's made up of four separate trampolines. Adults and kids over 36 inches tall can do an unlimited number of jumps—a mix of trapeze, bungee and acrobatics with a guaranteed wow factor!

There will also be performances by Charlotte Cardin, the Noubi Trio, The Beaches, Logan Staats, Jacobus and La Bronze, and so much more!

Canadian Museum of History

Head to the Canadian Museum of History on July 1st and enjoy free family-friendly programming and activities and then stay well into the evening to watch the pyro-musical show as it lights up the night sky over Ottawa–Gatineau.

During the day, activities include Hinterland's Who's Who where guests can find out about Canadian wildlife and meet a few wild critters in person; a nature-art workshop with Mélodie Coutou, La Ressourcière, where guests are invited to co-create a forest made from the interbreeding of different tree species; free airbrush tattoos, games and much more!

Canada Day celebrations in Canada’s Capital Region are made possible thanks to official sponsors President’s Choice, Manulife and Tim Hortons, as well as the valuable support of more than 500 dedicated volunteers.

To stay up to date regarding any changes or cancellations to the Canada Day schedule, click here.

This Canada Day post was sponsored by Canadian Heritage/Patrimoine canadien. 

Travelling Light with Kids

"If you can’t carry it, don’t bring it." 

That has always been and always will be my motto for airplane travel. (By car is a totally different approach: If it fits, it comes! - that can be another blog!) Whenever we have gone away by plane, the rule has been if you can’t carry it, it doesn’t come. Because really, I can’t carry it either. And, really, I don’t want to!

My name is Antonia Cetin. I am an educator and the author of You’ve Got This, Mom! A Mother’s Guide to Surviving and Thriving in Today’s Modern World. With my currently 12 year old son, I am a world traveller. Together Matthieu and I have travelled to 17 countries across North and Central America and Europe. We love to explore and to visit new places, meet new people, discover hidden treasures. This summer we are looking forward to going to Hawaii for my 5-0!

My son and I have always travelled with carry-ons because it’s easier and it’s more hassle-free. If you have large luggage, and your children have large luggage, who gets stuck carrying it all? How would you even manage carrying it into the airport, never mind some distant and unfamiliar destination? No thank you. I am a wuss, and I will stay that way.

I also never wanted the hassle of arriving at our destination with a young child and having to wait for my luggage to come. We just walk right through arrivals and keep heading out the exit. I have never wanted the hassle of wondering if all of our stuff would arrive and if it didn’t, how would I handle that with my young traveller in tow. On occasion, it has happened that our connecting flights have been very close, but no problem because we didn’t have to worry about our luggage making the connecting flight!

Further, with carry-ons, I always know where all of our stuff is, and it is always handy. Having things on hand has been especially helpful on those frequent occasions when Matthieu decided he wanted a certain toy or book or pair of socks while we were in transit. Wait, I think the socks was me!

What about souvenirs? You know there will be souvenirs. You know, those amazing and unique trinkets that your children will not be able to live without and that you will be stuck carrying for the remainder of your trip? Leave room for these in your luggage and only buy the lightest ones because you will be cursing when your luggage gets any heavier!

During our three month trip across Europe in 2016, for example, Matthieu, and I had one carry-on and one additional bag each. He had his awesome Star Wars carry-on suitcase with wheels that he could trail behind him, and his very cool satchel made out of recycled firefighter pants given to him for our trip by a dear friend. In his case, he had his clothes, sandals, toiletries, and stuffies; and in his satchel, he carried his notebooks, his reading material, his pencil case, and some precious souvenirs. I, on the other hand, had a nap-sack (because there is no way I could carry two suitcases, carry-on or otherwise, up and down stairs where there are no escalators!), and my large purse. In my knapsack, I had my own clothes, sandals, and toiletries, and in my purse, along with our documents, were our studying materials, our sketchbooks, our Chromebook, and our essential oils.

Everything else, I figured we could find along the way if we needed it.

If you think about it, the more stuff you bring with you, the more stuff you have to keep track of. This way, I only ever had to count as high as 4 and really, when you’re travelling with a bunch of stuff for an extended period of time, 4 is high enough! Occasionally, you end up with an extra bag or two anyway: that snack that doesn’t fit into your luggage, the special souvenir you bring to share at your next stop, the fragile confectionary you got for the road, and next thing you know your hands are full. Besides, you still need to keep an eye and a hand free for your most precious cargo: your child!

As you plan your own vacation this summer, please consider liberating yourself of stuff. Who needs more responsibility on vacation anyway? So, if you’re hitting the road with your kids, my best advice is to only take what you can carry because you know who’s going to be carrying most of the stuff anyway. #mamashirpaisme

For more blogs on travel, parenting, health, or life-balance visit my website: antoniacetin.com and check out my Facebook Page: @youvegotthismom