I grew up in Southeast Michigan, moved to Tennessee in 1991 and married in 1993. We had our first child, Barbara, in 1997 and felt we were blessed again in 2000, when I learned I was pregnant again.
This is where my strange twisted story begins.
When I went to my Certified Nurse Midwife, she automatically does screening for sexually transmitted disease as well as AIDS/HIV screens. She told me there was something strange with my test results.
It was showing something like Syphilis...I looked at my husband and he looked at me, both of us confused and accusing. Then the midwife said "NO, YOU DO NOT HAVE SYPHILIS!" I thought "OK" and never thought about it again.

In April of 2001, I had my son and we believed we had the perfect family. I underwent a tubal ligation in June of 2001. General anesthesia (which I didn't know then) can cause dormant Lyme disease to become active. After my surgery, I went back to work as a waitress so I could spend more time with my baby and not work the 8-5 jobs that I had previously. One day at work, I noticed a large, red hot to the touch, rash on my left lower leg. Since I'd recently had surgery and had some medical background as a medical assistant, my first thought was "Blood clot" and that I'd gone back to work too soon after the surgery. When I got off work I went to the Emergency Room and was told the rash was cellulitis, an infection under the skin. That was when the SEVERE migraines started.

I had one of these migraines nearly every day for 4 years and due to the vomiting, lost 100 pounds in 3 month's time. Doctors told me I was bi-polar and bulemic. I kept calendars of everything I ate, the weather, barometric pressure. You name it, I had a calendar for it. I didn't believe the diagnosis and told doctors, "No. You just tell me what's causing these headaches and I'll go away quietly."
Then I was accused of drug-seeking. By this time, they had me trying every antidepressant known to man because something in them was supposed to help migraines. I would have literally tried anything at that point - my illness was affecting my life with my children and husband, not to mention our financial situation, as we had to pay out-of-pocket for what insurance wouldn't cover.

Then the tremors started. I would shake uncontrollably and had gotten dehydrated on several occasions. Doctors tried Neurotin, Depakote, Topomax. None of the medications worked and no one could figure out why. I had to quit working. My husband was now the sole money maker in the home and we were barely making it. I'm no stranger to the food bank in order to feed my children.
I did have insurance so was able to see doctors and get my prescriptions filled, however, thanks to our Governor, I no longer have this.

I was sent to a neurologist for the migraines and tremors after being told by my PCP that there was "nothing more we can do for you". The neurologist asked what the doctors had given me that would work for the migraines and I told him "Percocet 5-325". I later found out he sent a letter to my PCP, telling him that I had asked for Percocet, when I hadn't asked for anything. When my right side went completely numb, I phoned the neurologist again. I couldn't feel anything and his office told me to come in. He then wrote a letter telling my PCP I'd "demanded" to be seen, that there was nothing at all wrong with me and I should get a referral to a psychiatrist. He tells me that I need more potassium, writes a prescription and out I go.

I ended up back in his office - dehydrated, so weak my husband had to help me with every little step I took. I could barely walk. I fell onto the table in the examining room as I had no energy to even sit up. The doctor came in, asked what was wrong and I told him very firmly "What else? Another migraine and vomiting for several days." I couldn't even hold water down. The doctor laughed at me and said to my husband "She IS in a foul mood, isn't she?" DUH! I've endured years of this! HELP! SOMEBODY, ANYBODY!

I found out years later he did a drug test on me that day and it came back clean. Had I known this at the time, I would've stuck that drug test right up his smart aleck &$#. I finally found a doctor that took me seriously and I'm very thankful to have her. She is not an LLMD but is treating me.
She was the first doctor to order an MRI of my brain, which came back showing too much cerebral spinal fluid, a thickness in the frontal parietal area and multiple hygomas. An MRI of my neck showed all cervical vertebrae to be fused. The "experts" thought it was surgical, even though I've never had surgery on my neck. My doctor sent me to a neurosurgeon who told me "There's nothing I can do. Your brain is smaller than your head." I told him I certainly hoped it was or my brain wouldn't have fit in my head. This guy actually wanted me to make another appointment with him! For what? I'd just wasted a 100 mile drive for nothing.

Just when I thought I was beginning to feel a little better, I drove 35 miles for my next doctor appointment and while driving home, began to drift in and out of consciousness. I drove right past my exit off I-40, then exited the wrong exit (unaware that I had done this) and had driven 40 miles to the next town before I realized what I'd done. By the time I made it home, I was shaking like a leaf on a tree in a hail storm. I couldn't remember anything that had happened during that episode.
Over the next few weeks, this would become a regular thing. My husband would be talking to me and I'd appear to fall asleep and not remember anything when I "came back". I was sent to another neurologist, even further away and he told me I was having focal sensory seizures - yet I was on anti-seizure meds for the migraines! He wanted to order an EEG but was unable to find a place that would do it and have it covered by my insurance. At that point, my insurance carrier changed and my doctor was not on the NEW plan! I was left to try to find a new doctor, which is hard in a small town as most doctors weren't taking new patients. I did manage to locate a doctor - one I'd never seen before.

My "blackouts" continued. In the summer of 2003, I lost consciousness and hit the cement floor between my washer and dryer. I woke up to my son sitting on top of me, screaming and crying "Mommy, please wake up!" My children have seen a lot of the horrendous things this illness does. They've seen the affect of Lyme rages, where you lose your mind over nothing and fly into a rage. On the really bad days, I had to have someone stay with us and actually help me take a shower because I was unable to stand for any length of time. God bless my sister-in-law, who helped with the kids and the housework I could no longer keep up with. I was a physical and emotional mess.

I went to a mental health counselor and saw a psychiatrist as by that time, I felt like the headaches were literally driving me crazy. She gave me the name of a neurologist who specialized in headaches, who gave me a shot in the back of my head - which did nothing to alleviate the headaches. We tried 2 or 3 more times and still no relief. This neurologist said "I have no idea why you're not responding to this treatment." - and gave up on me.

In September of 2003, I was home alone with my son when I completely lost my vision without any warning at all. I didn't even see shadows, all I could tell was light from dark. My son, being the wonderful child he is, sat and watched cartoons. I explained to him what was going on and that he needed to help mommy, which he did until my husband came home. I told my husband that I couldn't see anything. He asked "What do you mean?" I said "I cannot see you." My daughter came home and we took the kids to my sister-in-law's and went on to the Emergency Room. They examined me and put something in my eyes to make them glow. When they turned off the lights, I could see the direction light was coming from, but that was it. They put up an eye screen for me to read. I couldn't read it. We were there for hours, while the ER doctor tried to page every opthamalogist in town. None of them would answer his page, not even the opthamalogist on call. The ER doctor finally spoke to a doctor in Knoxville, Utah and set me up with an appointment for the next day - 120 miles away. The next morning my husband told me this Utah doctor would undoubtedly want to see me more than once and my husband was afraid our car wouldn't make the 240 mile trips back and forth, so he got out the phone book and started calling around to find another doctor (closer) that would take my insurance. I got an immediate appointment with Dr. Mike and he will always be my hero.

He determined my eyes were fully inflammed and I asked him what would cause that. He said "Have you recently had a rash?" Dumb me...with the short term memory loss I was suffering from, I'd completely forgotten about the cellulitis diagnosis and told him "No." Nevertheless, Dr. Mike sent me to the hospital for lab tests. The lab results went to Specialty Labs in Santa Monica, CA and when they came back, I finally had my answer - Lyme disease.

I was totally ignorant as to what Lyme disease was. I'd heard of it but it was one of those things you didn't think much about because I didn't live in Connecticut or anywhere near there.

I was on drops in my eyes every hour as they were so inflammed, my irises were nearly closed, causing the loss of vision. After a few weeks on the drops with very little improvement, the opthamalogist started shots in my eyes, which worked wonderfully. I stayed on the drops as well, but it was a very slow process until I could finally see again. Dr. Mike also started me on Doxycycline, as soon as he got my lab results. When I eventually got my vision back and could see him, I hugged Dr. Mike. Finally, an answer to my prayers as to what was wrong with me. The Lord sent Dr. Mike to me, as no one else knew about Lyme. He referred me to another doctor and told me to have this doctor run a titer test to see what the titers were doing. The test came back equivocal. He told me I no longer needed to take the Doxycycline, that I'd been on it 2 months longer than needed and that the Lyme was gone. I was thrilled.

Four days later, I lost my vision again. I returned to Dr. Mike, who asked "What happened?" I told him the doctor had taken me off the Doxy because the Lyme was gone. Dr. Mike was furious. He phoned the doctor and had him fax a copy of my lab results. He said the Lyme was definitely NOT GONE, that I was still showing titers and would have to be on antibiotics for a very long time.
He said "You need to be on Rocephin IV but I can't order it for you. And the doctor you're seeing won't either because doesn't think Lyme disease warrants this treatment." Dr. Mike warned me not to go off the Doxy again, that he might not get my vision to return if I did.

When the swelling in my eyes began going down, Dr. Mike saw something on the retina of my eye but couldn't tell what it was. A retinal specialist was consulted but he couldn't tell what the "something" on my retina was either. He decided to treat it like a cyst and see what happened. Luckily, it worked. He told me to continue to follow Dr. Mike's advice, that he had a very good handle on everything. They both advised me to see an infectious disease specialist, who said I needed to be on Rocephin IV. I was thrilled. Finally, another doctor that knew about Lyme. (Or so I thought). At my next appointment she told me I didn't have Lyme disease, that I had Rhuematoid Arthritis. But I stayed on the Doxy as Dr. Mike had instructed. In the meantime, my old doctor's office called and said they were now part of the group covered under my insurance, so I got my old doctor back. She wrote out a prescription for a year's worth of Doxy. I was so happy. I was actually able to go back to work for almost a year.

Then toward the end of 2004, I was a mess again. The migraines returned with a vengeance. My body ached like never before. I literally thought I was dying. My chest hurt so badly I thought I was having a heart attack. I phoned my brother, crying and screaming as loud as I could for help. He phoned my husband and then took me to the hospital. They gave me nitro, shots of morphine and admitted me. The cardiologist ran all kinds of tests - stress test, 3-D Doppler, an Echo. It was determined I was suffering from bradycardia (slow heart rate) and the Lyme had attacked my heart. The hospital and cardiologist referred me to an infectious disease specialist that knew about Lyme - who referred me to a neurologist for the neurological symptoms I was having - short term memory loss, tremors, migraines, hair loss, light sensitivity, dizziness, disorientation, poor balance, muscle pains and cramping, nocturnal hypoxia (which put me on oxygen at night when I sleep), poor concentration, severe pain in my knees and legs. I'd begun having speech problems - stuttering, not being able to find the words I was looking for, writing numbers backwards, transposing every day words.

One day I was looking for the dustpan while I was sweeping the kitchen. I kept asking everyone if they knew where the thing was that I swept the dirt into. I couldn't remember what it was called. My seven year old daughter said "Mom, do you mean the dustpan?". Talk about being put in your place! My refrigerator has more magnets on it with notes on it than it has food inside it. I have calendars again, this time so I remember what I have to do. I can't remember what was bought at the grocery store. I've even forgotten how to cook things I used to cook all the time. Recently, I broke nearly every glass in the house due to tremors, including one special one that had belonged to my husband's now-deceased brother. I lost it right then - almost had a nervous breakdown. But back to the neurologist at the hospital...

I kept my appointment and when he asked why I was there, I told him Lyme disease. He said "THERE IS NO LYME DISEASE IN TENNESSEE!" That should have been my warning to run right there, but I was still naiive. I'd come to do a lot of research on the Internet and join Lyme support groups where I've met many wonderful people. The best thing was, we all knew what each other was going through. The CDC gives false information...there is no testing for Lyme that's foolproof. However, at that time, I was still naiive about Lyme disease. The neurologist drew blood, told me I did NOT have Lyme and explained to me that the CDC drags nets across the state and checks ticks for Lyme and that they've found no ticks to be infected with Borrelia Burgdorferi and Lyme. My question is, where exactly did they drag the net? Because it sure was NOT in my neck of the woods - or anywhere else in Tennessee where I've met the wonderful others with Lyme disease!  The CDC is full of bunk and hardly anyone with Lyme disease will meet their reporting criteria. Doctors are afraid to treat Lyme, insurance companies won't pay for treatment, doctors who have treated it aggressively lose their licenses to practice. It all sounds like a coverup to me! Anyway, I'm sorry...I'll get off my soapbox and get back to the neurologist...

He diagnosed me as having MS and sent me to yet another infectious disease specialist, at the same well-known hospital. I went in with information in hand, a list of my symptoms, statistics, everything. I thought "I'm ready!" This infectious disease doctor walks into the room and says "So, you're here for Lyme disease?" I said yes. He said "THERE IS NO LYME DISEASE IN TENNESSEE!" and asks what the neurologist thought was wrong with me. I told him MS. He said "I agree with the neurologist. You do not show any of the symptoms of Lyme." I handed him my list of numerous Lyme symptoms and he then very hatefully informed me that he was "a REAL doctor, not an Internet doctor."
He did draw blood which went to Quest Labs in Atlanta, GA. The Lyme AB screen came back 1.51 high. He did a Western Blot and did not use all the bands required - this lab used the references for Western Blot from a conference in Dearborn, MI in 1994! He wrote really big on the doctor's copy "NO LYME DISEASE". (I suppose just in case my doctor treating me for Lyme was blind or something). Still, she did not stop the Doxy. God bless her. The neurologist scheduled a spinal tap. I stopped the antibiotics because I wanted to get a TRUE test result this time and you need to be off antibiotics for six weeks prior to testing. I stopped taking the Doxy and before the end of the week, my husband stayed home from work because (fully awake) I was telling my daughter to get out of the closet. You couldn't put a broom in this closet much less a 7 year old girl! I remember none of this. So my husband brought me to the doctor again. All I remember was going into the examining room and lying down. I couldn't have cared less where I was or even KNEW where I was. I carried on conversations with people I didn't even remember. I was diagnosed with dementia and underwent another head CT. This one showed a sinus infection. Back on the Doxy I went and my brain (or what's left of it) came back.

It's hard to believe that I had one year left of school to become an RN and have a degree in medical transcription. I can recall hardly any of it. I can no longer type 80 wpm, I'm lucky if I get 5 words correct at a time.

Now I was shuffled to an ENT, who scoped my throat and found nothing but some sinus congestion. Back to the neuro for a six hour spinal tap. I had to beg my dad to drive me. We'd almost gotten home when the doctor phoned my house and says they forgot to draw blood and the spinal fluid won't be any good without blood. My dad turns around and drives me back - trips totally over 400 miles. I have to wait over an hour for them to draw blood. They can't find the orders for the blood draw. I'm lightheaded, my back is killing me and I'm trying to sit in a way that is somewhat lying down. My dad talked to the doctor and told him he'd bring me back on one condition - that they fire whoever forgot to draw the blood after being there six hours. I have yet to see the results as when I phoned the lab, they told me there was a holdup because they needed to check something out and it would take time. My results were coming up strange. Oh no...strange results...NOW WHAT? God only knows because I still haven't found out what the problem was or the results were.

The neurologist phoned my husband at work and informed him there was absolutely nothing wrong with me. He asked him "Then why does something happen every time she stops the antibiotics?" The neurologist told him "It's psychological." That I needed a psychiatrist. He even claimed my blindness was psychological, that I never did go blind, when my husband questioned him about it. When I phoned the opthamalogist and told him what this neurologist had said, he laughed and said not to worry about what the neurologist had said, that he doubted if he'd ever seen a case of Lyme.

Now I'm applying for medication through pharmaceutical companies as I no longer have insurance. But some good things have come out of this for me...I have met many new friends who understand what's going on with me. For that, I'm truly grateful. And by telling my neighbor about Lyme disease, it kept a co-worker's husband from getting chronic Lyme, as he got a rash and immediately went to a doctor and asked for antibiotics.

I hope my story can help someone. I ask the Lord daily to help me win the fight against this disease and to bless all the people who have it. It has destroyed so many people's lives. It puts financial strains on people, relationship strains on marriages and tears families apart.
Thank you for taking the time to read this.

Beverly
Tennessee

 

Testimony of Karen Forschner presented at the Hearing of the Committee on Labor and Human Resources First Session on examining the adequacy of the current diagnostic measures and research activities in the prevention and treatment of Lyme disease.

In 1985, our only child, Jamie, was born. Unfortunately, I had a bug-bite and the full range of Lyme disease symptoms while I was pregnant, and soon after my James birth, his symptoms started. During the pregnancy and after the birth, I was seriously ill with multiple problems, including serious joint swelling and pain. Shortly after giving birth, a doctor told me my crippling arthritis was a permanent condition, and I would remain on crutches until I required a wheelchair. However, there was this mystery illness called Lyme arthritis, and the doctor offered me two weeks of antibiotics just in case. If my symptoms went away, I had Lyme disease. My symptoms temporarily improved but once off treatment the symptoms came back - in full force.

At the same time all 5 of our beloved pets, 3 cats and 2 show dogs, became seriously ill after multiple tick bites and required repeated hospitalizations. As fate would have it, all of us contracted Lyme disease. Eventually all my pets were lost due to Lyme disease. Jamie was the light of our life; blond haired, blue eyed and smiling. By the time he was 6 weeks old, his health was in question. He had repeated vomiting and eye tremors. By 6 months old, he was showing signs of brain damage, eye problems, possible deafness, and had ceased to grow properly due to malnutrition. I questioned the doctors about whether my son could get Lyme from me during my pregnancy. I was guaranteed he couldn't. Our son was never exposed to ticks, and never had a tick bite.

To understand this disease I would like to explain what it did to our son's brain. The bacteria attacked the part of his brain that controlled Jamie's eye movements, causing his eyes to swing back and forth, turn inward and outward, and become light sensitive. This caused him to have double vision, motion sickness, inability to open his eyes outdoors, and blindness. Jamie's facial and tongue muscles caused his face to be partially or fully paralyzed and droop, resulting in drooling, loss of speech and loss of the ability to eat or swallow. It allowed food or saliva to go directly to his lungs. Children and adults started staring at him; loss of speech frightened him; feeding him by mouth became life threatening as repeated lung infections started. Eventually a partially collapsed lung resulted in multiple hospital stays. Jamie could not tell us he was scared, had a headache, or even that he needed the bathroom. Jamie became mute, malnourished, and frustrated. It affected Jamie's hearing, causing his hearing test to show he was totally deaf. Then Jamie started talking. The Lyme disease nerve involvement had affected the test. It affected Jamie's stomach, causing repeated vomiting. Since he was too weak to lift his head, we had to worry about his drowning during times he was lying down. It affected Jamie's nerve conduction, causing loss of muscle tone. Jamie was "floppy", and couldn't sit, crawl, feed himself or even hold his head up. This devastating set of involvements made Jamie 100 percent dependent - for life.

Tests, probes, biopsies, none could pinpoint the problem. When Jamie was one and a half, he had surgery to realign his stomach in an attempt to stop his life threatening vomiting. The surgery didn't work, and our son had a permanent hole cut into his stomach so that he could have a feeding tube installed to help keep him alive.

Tom's company, a CPA firm, declared Tom (my husband) didn't have that "zip" that potential partners needed, and proceeded to let Tom go. Today, family leave would have given him some time to take care of his devastating family life. As Jamie approached his second birthday, we found ourselves unable to provide the medical care Jamie needed, and were told to institutionalize him. I turned into my son's advocate, and spent several months researching medical literature. I realized Jamie had Lyme disease contracted through placental transmission. Transmission of infection during pregnancy and adverse outcome had already been documented in medical literature.

Then, a doctor saw permanent damage in our son's eyes - damage caused by a congenital spirochetal infection. Lyme disease is caused by a spirochetal bacterium. Then I found out about a test for Lyme disease resulting in Jamie and I testing positive! All of my son's symptoms were explained by the medical literature on Lyme disease. Life was good. I was told my son would get treated and the disease process would stop. Lyme was easily curable. Not true. Jamie was treated and relapsed several times. The meningitis in his brain had caused his head to enlarge to the size of a 14 year old. Clothes didn't fit unless adapted "for the multi-handicapped". How I learned to hate that word. When Jamie's relapses were in process, even his throat would collapse, and he spent time on life support. Media people were rushing out to see this child. I thought Jamie's story was of courageous struggle, but Dan Rather termed it the way the media saw the story: as "every parents worst nightmare". Those words will always haunt me. And then the nightmare started.

Over time he was on life support many times. When Jamie received treatment he would recover. His vision returned. His speech started. He started to feed by mouth. His vomiting stopped. He gained weight. His lips could kiss and his arms could hug. But, despite the dramatic and documented improvements, over the years local doctors and health officials would interfere repeatedly with our son's retreatment because Lyme was "easily curable". Despite the proved cause and effect of treatment, evaluated by many independent professionals, the label of "Lyme disease" caused paranoid behaviour and the withholding of life-saving treatment. When we asked the pediatrician for a three-month perscription of Amoxicillin to give our son to prevent a relapse, we were told that Amoxicillin was dangerous, and there was no proof the Lyme bacteria could survive the short-term intravenous medicine he had been given while on life support. Two weeks later, we were back to the pediatrician for a potential ear infection. The same pediatrician prescribed the now safe antibiotic Amoxicillin to prevent an ear infection that had not yet started. And, the prescription was issued in the same dose we had requested for a total of four months!

After attending a medical conference, I realized much information about Lyme disease was not reaching the medical community nor the public. And, with the help of many researchers, business, and lay people I established the first organization dedicated to Lyme disease - the Lyme Disease Foundation. Our mission was to provide an area where all of the scientific information could be discussed, not just the US version of "status quo". I gave up my career, and have spent 70 hours a week for the last 5 years as a volunteer. The sacrifices were great. We used up our life's saving in the process. Family provided us with food, clothing, holiday gifts for our son, and much support. We were in a race against time. Within two years, we had reached 210 million beople, and Lyme disease became a household word. Yet, there were no answers for our son. Doctors started fighting about whether or not my son should be retreated - even doctors not involved in my son's care! There was proof that Jamie's persistent infection continued to ravage his body, but electron microscope pictures of the Lyme bacterium proving current infection were not enough "proof" for the pediatricians. After all, they had talked to the state health department and an academic who recommended no retreatment.

In 1990, NIH's new test photographed the bacteria still in my son despite repeated treatment, I was dismayed. When I showed this to his pediatricians, the doctors cancelled my son as a patient because I planned to have him retreated, since he was heading into another serious relapse. Once Jamie was retreated he gained back speech, muscle tone, vision, eating, and many other little boy skills. He was finally mainstreamed, into kindergarten. You see, once you are ill there are many battles to wage. Jamie developed girlfriends, learned to operate an electric wheelchair, became potty trained and finally found the little boy inside the diseased body. We waited for over a year for the NIH test to be released in order to check our son's progress. As my son started to relapse again, I waited for the NIH test. It never came, and we waited too long.

Our son's last relapse started, and he began having seizures from the brain inflammation. Within 24 hours he was put on life support. The day he was declared "out of the woods", he died. His brain swelled up so much it killed itself. There was no tissue bank to send his remains to, so I had the unpleasant task of calling researchers around the country, and dividing up my son's body to send to different researchers. I loved this little boy, and would have died for him. Instead I was forced to arrange an autopsy. You see, the CDC has been denying congenital Lyme and death due to Lyme, despite numerous publications to the contrary, and I hoped this would provide proof that would help other children. Our insurance limits were used up. Jamie's medical bills had totalled more than 2 million dollars. The final cost to society for our son was around 2 1/2 million dollars. The majority of the cost was in disability care, and excessive non-Lyme disease testing. A minor amount was used for treatment with antibiotics.

And, yes, the autopsy proved Lyme disease bacteria was still in his brain. Our lifetime savings were gone. Our pets were gone. Our jobs were gone. Our baby was gone. If public policy was prevention oriented instead of anti-antibiotic hysteria oriented, my son would be alive today. I am not alone. Other mothers have also lost their children.

Thousands of us have worked toward finding the truth about this disease. Unfortunately, some parts of the government have an obsession with keeping the status quo. The true hero's of Lyme disease have been a mixture of public support groups, researchers and academics, front-line physicians, and some members of congress. HHS has proved to be a failure in coping with emerging epidemics, and Lyme disease patients are one more casualty from the current ineffective health care system.

We have not asked what the country can do for us, we have always tried working with the government. We are now demanding the government become responsive to the publics' needs. I think this disease may not be easy to diagnose, easy to treat, nor easy to cure. Sometimes, permanent damage may occur. There may even be deaths due to Lyme.


Reprinted with the permission of Thomas Forschner.

Karen Forschner is one of the co-founders of The Lyme Disease Foundation
Karen was named "Woman of the Year" by Family Circle Magazine in 1992, "Woman of Worth" by L'Oreal in 1993, "Woman of Merit" by the Daughters of the American Revolution in 1994 and "Woman of the Year" by the Veterans of Foreign Wars Ladies Auxilliary in 1994.
She co-produced the LDF's international award-winning children's TV special "Dr. Ticked Off Says: "Do A Tick Check".