Tag Archives: queenstown

Bicycle Riding During COVID-19

By: Jamie Harms, M.D.

With families looking for safe outdoor activities during this time of COVID-19, many people are turning to bicycle riding to get some fresh air and exercise. Your chances of being exposed to the coronavirus while riding are low, but there are still some precautions you should take. And it wouldn’t hurt to brush up on good riding practices before you hit the road.

Coronavirus bicycle tips

  • Face mask: You don’t have to wear a face mask in Maryland while bike riding, but it’s a good idea to have one handy for when you stop or are riding close to others. In hot weather, try an athletic mask made from fabric that wicks moisture. Make sure your mask fits well and covers both your mouth and nose.
  • Social distancing: Try to keep at least 6 feet from other riders and pedestrians, especially at stops. If you’re on a busy bike trail, or if you’re drafting other riders, wear a mask.  Pack drinks and snacks so you can avoid stopping at crowded stores.
  • Shared bikes: If you plan to rent a bicycle, sanitize the handlebars and seat before and after you ride ─ and wash your hands.


Other bicycle safety tips

  • Wear a helmet:  Helmets are required for riders under 16. For everyone else, they’re your best safety gear. Wear one every time you ride.
  • Obey traffic signs and signals: Bicycles must follow the rules of the road like other vehicles.
  • Watch speed limits: Bikes are not permitted on roads with a speed limit of 50 MPH or faster.
  • Keep an ear open: You may not wear headsets or earplugs in both ears.
  • Don’t ride against traffic: Always go the same direction traffic is moving.
  • Know where other vehicles are: Learn to look back over your shoulder, or use a rear-view mirror.
  • Use hand signals: Hand signals tell motorists and pedestrians what you intend to do.

Graph of bikers hand signals

  • Ride in the middle of the lane in slower traffic: Get in the middle of the lane at busy intersections and whenever you are moving at the same speed as traffic.
  • Use lights at night: The law requires a white headlight and a rear reflector or taillight.
  • Sidewalk riding: You can ride on sidewalks, but pedestrians have right of way.


Special rules for electric bikes

  • Electric bike motors must automatically disengage at 20 MPH to keep you from going too fast.
  • Any person operating an electric bike must wear a helmet.
  • Electric bikes must follow the same traffic laws as cars and bicycles.
  • You can ride them on roads and bike paths, but not on sidewalks.
  • Electric bikes must yield to pedestrians and roadway traffic.

Feeling Down? It May Be the Winter Blues

By: Jamie Harms, M.D.

It’s the coldest, darkest time of the year. It seems like spring will never come. For many people, this time of year brings feelings of sadness ‒ the “winter blues.”

Perhaps you recognize some of the symptoms in yourself: increased sleep; increased appetite, with cravings for starches and sugars; weight gain; emotional irritability; and a heavy feeling in your arms and legs. You may find yourself withdrawing from social activities or having difficulty concentrating.

What causes the winter blues?

Scientists think these symptoms result from a decrease in the activity of serotonin in the brain when days get shorter. Serotonin is a chemical that helps nerve cells in the brain communicate with each other. It is important for mood and alertness, and it helps control your appetite.

How to beat the winter blues

For most people, symptoms are mild, and they end when the days get longer. Here are things you can do to feel better:

  1. Get enough sleep. Sleep and moods are closely connected, and many of us skimp on sleep in our busy lives. Most adults need 7-9 hours of sleep a night.
  2. Get some exercise. Exercise increases serotonin in the brain, so it can make you feel better physically and emotionally. Aim for 30 minutes of exercise most days of the week. Bundle up and take some walks outdoors in the daylight if you can.
  3. Get some sun. Exposure to daylight can help boost your mood. Bundle up and go outside whenever you can, even if it’s just for a few minutes.
  4. Pay attention to what you eat. Decrease carbohydrates and caffeine, which may make you feel better for a short time but can make moods worse overall. Choose lean meats, fruits and vegetables.
  5. Pay attention to your thoughts. It’s easy to develop habits of thinking and reacting to life events that just make you sad or worried. Practice looking for a few good things every day, even if they’re small.

Some people have more severe symptoms of depression in the wintertime. This is called seasonal affective disorder (SAD). If you have more than mild symptoms, or symptoms that last more than a few weeks, contact your doctor. Treatments such as light therapy, anti-depressant medication, and psychotherapy can be effective for wintertime depression.

HPV, the First Cancer Vaccine

By: Jamie Harms, M.D.

In 2006, the first vaccine to help prevent a cancer was released in the United States: the HPV vaccine.

Cervical cancer was one of the most common cancers among women in the U.S. until Pap smears became routine and helped identify pre-cancerous and early cancerous cervical cells. Cervical cancer is almost always caused by a virus, the human papilloma virus.

HPV is common

The human papilloma virus (HPV) is also the cause of anal and genital warts, as well as vaginal, anal, penile and oral cancers. It is spread by skin-to-skin contact, including sexual contact as well as oral sex and hand-to-genital contact.

HPV is common. It is estimated that 75-80% of sexually active adults will become infected with at least one strain of HPV by the age of 50. There are over 100 strains of HPV, and while most of them are not harmful, about 15 are known to cause cervical cancer. Most times, HPV infection goes away on its own, but in 10-20% of women, the HPV infection does not go away. These women are at risk of developing cervical cancer.

The HPV vaccine

In 2006, a vaccine against HPV was released in the U.S. The vaccine is recommended for both girls and boys at 11-12 years of age. It is given in a series of two vaccines, 6 months apart. Teens and young adults can get this vaccine later but will need three vaccines if it is given after age 15 because the vaccine is much more effective in younger teens.

Proven safe and effective

Here’s the best news… this vaccine is making a difference in our health. In girls 13-19 years of age, HPV infections have dropped by 83%. The number of women 20-24 years of age infected by HPV has dropped by 66%. That’s HUGE! The frequency of genital warts in girls and boys has dropped, too — girls by 67% and boys by 48%. The number of precancerous findings in girls has dropped by 51%.

So, this vaccine is working, and working well. Since the vaccine was released, there have been no reports of major side effects. The most common side effects are soreness and redness at the injection site, headaches and nausea. Some parents have worried that giving their child this vaccine will result in decreased fertility or will encourage them to have sex earlier or more often, but studies show that this is not true.

MPCP recommends that your child receive the HPV vaccine with their other required vaccines at 11-12 years of age. Talk with your doctor or look at these good sources for more information:

Tick Bite FAQs

By Jamie Harms, M.D.

Warmer weather is here, and with it, ticks are back.  Here are some frequently asked questions about ticks and tick bites.

What should I do if I am bitten by a tick?

Use tweezers to grasp the tick as close to your skin as possible, then pull the tick off with steady pressure. Then wash your hands and the area of the bite with soap and water. Sometimes, the mouthparts of the tick will break off and stay in the skin. If you can remove them easily, use the tweezers to pull them out. If you can’t remove them easily, just let the skin heal. Your body will break down the remaining mouthparts over time.

What kind of tick bit me?

Lyme disease is carried by the deer tick, also known as the blacklegged tick. It is not carried by dog ticks, so you should try to identify the type of tick that bit you. The CDC has excellent illustrations of the ticks found in Maryland. The ticks that are out in the spring are nymphs. They are very small, about the size of a poppy seed.

What is my risk of getting Lyme disease from a tick bite?

Ticks need to be attached at least 36 hours to transmit Lyme disease. If you pull off a tick which is crawling on your skin or which is not engorged with blood, you will not get Lyme disease.

Should I take an antibiotic after a tick bite to prevent Lyme disease?

Researchers still don’t have a clear answer about this. There have been some small studies suggesting that a single dose of  doxycycline may  reduce your risk of getting Lyme disease after a tick bite, but only under these conditions:

  • You are not allergic to doxycycline. No other antibiotics have been studied for preventing Lyme disease. Children must be at least 8 years old to take doxycycline. Pregnant women should not take doxycycline.
  • The tick can be identified as a deer tick.
  • The tick has been attached for more than 36 hours based on the time of exposure or the observation that the tick is engorged with blood.
  • You can take the dose of doxycycline within 72 hours of removing the tick.

Experts do not recommend that people take antibiotics to try to prevent other tick-borne diseases, such as anaplasmosis, babesiosis, ehrlichosis or Rocky Mountain Spotted fever.

Do I have Lyme disease?

Most people with Lyme disease will get a rash around the site of the tick bite one to four weeks after the bite. The rash is often described as  “bullseye” rash, because it is often red on the outside and clear on the inside. Lyme disease rashes can also come in other patterns, though. A Lyme disease rash gets bigger each day, and it usually over two inches wide. Check out these photos from the researchers at Johns Hopkins Hospital.

When should I see my doctor?

If you were bitten by a tick and have an expanding red rash around the bite or have “summer flu” symptoms, you should see your primary care provider.