Tag Archives: queenstown

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.

5 Myths About Childhood Vaccines

By: Daniel Lamphier, M.D.

Vaccinations have been used safely for decades to protect children from diseases such as smallpox, measles, mumps, diphtheria, tetanus and polio. Even so, misinformation about childhood vaccines is widespread, causing some parents to delay or avoid vaccines out of fear they may harm their children.

Here are five common myths about vaccines for kids and the real story about their safety.

 

Myth 1: The MMR vaccine causes autism.

Autism is a genetic disorder, and this myth arose from a now infamous study published in 1998. The poorly designed study found that 8 of 12 children studied who had received the MMR vaccine displayed autistic behaviors. As no subsequent studies showed similar results, the study was retracted and the author had his medical license revoked for professional misconduct.

Myth 2: Vaccines can make you sick.

You may hear someone say, “I got the flu shot and I got sick.” No vaccine is perfect, and simply getting the vaccine does not mean you cannot become infected, but simply that your likelihood is reduced. A common analogy is the seat belt in your car; you may still get in an accident, but the best protection is still advisable. Additionally, it is always easier to remember the year that you got the flu after getting the flu shot than the many years you may not have become ill.

Some people think that because vaccinations contain traces of viruses or bacteria they can cause the diseases they’re supposed to prevent. Fortunately, vaccines contain dead or inactivated viruses or bacteria, designed to prompt an immune response without causing illness.  Vaccines can’t make you ill, but some people may have mild reactions to them, such as soreness at the injection site or flu-like symptoms after getting a flu shot.

Myth 3: Vaccines contain harmful chemicals.

Many ingredients in vaccines have been pointed to as “toxic,” including mercury, formaldehyde, and aluminum. Mercury is indeed a dangerous substance but is only contained in some multidose influenza vaccines presently. Thimerosal, the source of mercury, is in a miniscule amount and in a form that does not build up in the body. Formaldehyde and aluminum are also contained in very low levels, far less than the body sees through other environmental sources. As an example, there is many times more formaldehyde exposure when eating a single pear than in receiving any vaccine.

Myth 4: You should space out childhood vaccines.

The CDC recommends a vaccination schedule for children (see the end of this article), but some parents worry that having so many vaccines may overwhelm their children’s immune systems. Of course, children and adults are exposed to many more foreign substances through the environment around us, and the immune system does not struggle with these.

The challenge with spacing or delaying vaccines is multifold. First, it prolongs the delay until immunity develops to infections that can affect children of any age. Second, it can cause difficulty with daycare, preschool, or kindergarten entry if vaccines are not given on time. Thirdly, if children must come to the office for vaccine catch-up or spaced-out vaccine schedules, they will receive a painful experience many more times than if they are kept on the recommended schedule.

The schedule recommended by the CDC, the American Academy of Pediatrics and the American Academy of Family Practice is continually tested and adjusted to best protect children.

Myth 5: Other people have vaccinated their kids, so I don’t have to.

Many people are current on their vaccinations, providing some protection to the people around them, but not everyone is up to date. If there is a disease outbreak, such as the flu, those who aren’t vaccinated are more likely to get sick. So, you can’t count on other people’s immunity to protect your children.

The bottom line is childhood vaccinations have proven to be safe and effective over many years. Don’t listen to misinformed talk; if you have concerns, ask your doctor.

Click here for CDC’s Schedule of Recommended Vaccines for Children Ages 0-6.

Dr. Daniel Lamphier attended George Washington University, School of Medicine & Health Sciences, and is certified by the American Board of Family Medicine. He sees patients in MPCP’s Queenstown office.

Birth Control Methods – Pros and Cons

By Julie Henne-Reese, Certified Registered Nurse Practitioner

There are many birth control methods to choose from, but they differ in ease of use, cost and effectiveness. Some are available over the counter while others require a prescription or a medical procedure. MPCP offers several products, including birth control pills, implants (Implanon and Nexaplanon) and IUDs (Mirena and Skyla).

The chart below lists some of the most effective birth control methods, with pros and cons for their use. The descriptions are only an overview and do not contain complete information. Talk to your medical provider about these and other methods to determine what works best for you.

Keep in mind, most birth control products don’t prevent the spread of sexually transmitted diseases (STDs). Your medical provider can advise you on how to stay safe.

Which Method is Right for You?

MethodEffectivenessFeaturesProsCons
Birth Control Implant99%Matchstick-sized rod that doctor places under the skin of woman's upper arm. Releases hormone to prevent pregnancyLasts 3-5 years. You don’t have to think about itMore expensive than other methods
IUD (Intrauterine Device)99%Placed inside the uterus to prevent conceptionLasts 5-10 years. Low maintenanceMore expensive, may cause irregular/heavy periods
Vasectomy99%For men. Doctor surgically closes the tubes that carry sperm from the testesDoes not affect ejaculationMay not be reversible, more expensive
Tubal Ligation99%Surgeon closes off the fallopian tubes, preventing eggs from leaving the ovariesVery effectiveMay not be reversible, more expensive
Tubal Implants99%Doctor puts a small metal or silicone implant inside each fallopian tube, blocking them and preventing ovulation testVery effective, doesn’t require surgeryNot reversible, more expensive
Birth Control Shot97%Hormonal shot protects against pregnancy for three months. It is injected four times a yearSince you don’t have to think about it, is usually better than birth control pillsMore expensive. May cause spotting and other side effects
Birth Control Pill92%-95%Uses female hormones estrogen or progestin to prevent ovulationVery effective if used right. May cause more regular, lighter periods, or no periodsMay cause breast tenderness, spotting, blood clots and raised blood pressure
Vaginal Ring92%-95%Soft plastic ring goes inside the vagina. It releases the same hormones as the pill. A woman replaces it herself once a monthWorks as well as the pill. May cause lighter, more regular periodsMay cause vaginal irritation or other side effects similar to the pill
Male Condom84-89%Latex condom blocks sperm from entering the woman's bodyInexpensive. One of the few birth control methods to prevent sexually transmitted diseasesNot reusable. Effective only if used correctly every time
Diaphragm84-89%Rubber dome that a woman places over her cervix before sex. It is used with spermicideInexpensiveDoctor must initially fit it to ensure proper function
Cervical Cap84-89%Similar to a diaphragm but smaller. Slips into place over the cervix. Used with spermicideInexpensive, can stay in place for 48 hoursDoctor must initially fit it to ensure proper function
Birth Control Sponge84-89%Made of foam and contains spermicide. A woman can place it against her cervix up to 24 hours before sexEffective immediately. Works about as well as the cervical capCan be hard to put in

Julie Henne-Reese, CRNP

Julie Henne-Reese, Certified Registered Nurse Practitioner, is board certified by the American Nurses Credentialing Center in Family Practice. She sees patients in MPCP’s Queenstown office.