Our average wait time for an experienced doctor is 10 minutes. What are you waiting for?

Internal Medicine Doctors of
Mill Basin & Bergen Beach, Brooklyn

6301 Mill Lane (Corner of East 63rd) in Mill Basin (11234)

718-942-4600

Dr. Bella Zimilevich

Dr. Bella Zimilevich, MD
Primary Care Doctor

Dr. Bella Zimilevich

Dr. Anatoly Pisman, M.D
Physical Medicine & Rehabilitation

Dr. Bella Zimilevich

Dr. Alexander Shapsis, M.D
Gastroenterologist

Chronic Conditions Management

 

What is Prediabetes and How Can I Help?

Posted by on September 6th, 2013

Dr. Bella Zimilevich, MD

“Many people have prediabetes and don’t know it. If you have risk factors for diabetes or a strong family history of diabetes, you should be coming in to be screened routinely. Prediabetes does not necessarily guarantee that you will develop diabetes- instead, you can think of it as a wake up call to change those risk factors which can be changed before it is too late”.

-Dr. Zimilevich, MD

What is prediabetes?

Prediabetes is characterized by blood sugar levels that are abnormally high but are not yet high enough to be classified as full-blown type 2 diabetes. Untreated, prediabetes often progresses to type 2 diabetes within 10 years. Even if you do not yet have diabetes, changes may already be occurring in your heart and blood vessels as a result of even sporadically high blood sugar levels. The good news is that you can halt the progression of prediabetes to diabetes by making some lifestyle changes- diabetes does not have to be your future!

What are the symptoms of prediabetes?

Most people who have prediabetes are unaware that they have the condition, because their condition has not progressed to the point of experiencing symptoms. In fact, many people with diabetes type 2 are not aware they have diabetes until it is discovered during routine health screening.

One of the few visible signs that you are at risk of developing diabetes is discoloration of the skin. The skin in certain areas of your body may be darker than normal. Areas frequently affected include the neck, elbows, knees, knuckles and armpits (see picture).

Acanthosis nigricans, a discoloration of the skin associated with prediabetes.

Symptoms of type 2 diabetes include:

  • increased thirst
  • increased urination
  • blurry vision
  • fatigue

By the time you begin to experience these symptoms, you likely already have diabetes.

What are the risk factor for prediabetes and diabetes?

There are many situations that put you at increased risk of developing prediabetes. Some of these risk factors can be modified while others can’t.

Risk factors that cannot be modified include your age (increasing age is a risk factor for diabetes), your family history and your race (African Americans, Hispanics and Asian people are at increased risk for diabetes).

Risk factors that you can change include:

  • your weight (obesity is a risk factor for diabetes)
  • your activity level (a sedentary lifestyle increases your risk of becoming obese and developing diabetes)
  • hypertension (having high blood pressure is a risk factor for diabetes)
  • high cholesterol (if your “good” cholesterol is low and your triglycerides are high you are at increased risk)

If you are a woman and you had gestational diabetes during pregnancy you are at higher risk of developing type 2 diabetes. Also, if you have been diagnosed with PCOS (polycystic ovarian syndrome) you are at risk for developing diabetes.

What causes diabetes?

Researchers have identified specific genes associated with insulin resistance. Excess abdominal fat and lack of exercise are also implicated in type 2 diabetes.

People who have prediabetes and diabetes cannot process sugar in the same efficient way that others do. In healthy people, the pancreas secretes insulin in response to a meal or a snack. Insulin is a hormone which allows the body’s cells to use glucose for energy. In people with prediabetes and diabetes type 2, their bodies cannot use insulin as effectively, so that sugar builds up in the bloodstream instead of being used by the cells that require glucose to do their jobs (in type 1 diabetes, the pancreas does not secrete insulin at all, or secretes very little).

How do I know if I should be screened for prediabetes?

If you have any of the risk factors listed above, you are at risk of developing prediabetes. You should make an appointment to come in and see me so that we can assess your level of risk and determine how often you should be screened. We can also discuss what you can do to decrease your risk, including weight loss, exercise and management of high blood cholesterol and high blood pressure. By successfully managing your risk factors, you can significantly reduce your risk of developing diabetes.

What should I expect when I come in to see you?

When you come in to see me, I will first need to gather some information. I will need to know about your past medical history if you are a new patient. I will also need to know if you are taking any medications and if you have any allergies.

Next, we’ll explore your personal risk factors. I may weigh and measure you and so that I can determine your BMI (body mass index- a standardized scale combining height and weight that helps to determine amount of body fat). I will take your blood pressure. I will ask you about other risk factors you may have (i.e. gestational diabetes, family history of diabetes). I will ask you about your diet and exercise patterns. I will also want to know whether you have symptoms of diabetes (increased thirst and urination, fatigue, vision changes).

Screening will involve some diagnostic testing, including a fasting blood glucose level and cholesterol testing. I may order other tests depending on your results and whether you have any other health conditions.

Once I have gathered all the information I need, I will have you return to see me so that we can discuss your results. If your blood glucose is normal but you have risk factors for prediabetes, we can talk about ways to reduce your risk. If your blood glucose is found to be high and you have prediabetes or diabetes type 2, we will discuss how to manage this.

If you are at high risk for developing diabetes, it is important to be screened regularly and to find a physician that you can work with to decrease your risk and modify those risk factors which can be modified. I would love to partner with you to help you avoid developing diabetes, or to manage your condition if you have it. Please call to make your prediabetes screening appointment today.

Read the full article...

Chronic Conditions Management- Living with Chronic Disease

Posted by on May 31st, 2013

Dr. Bella Zimilevich, MD

If you are living with a chronic disease, you require ongoing care from a physician experienced in chronic conditions management. Suffering from arthritis, depression, diabetes or another condition that has changed the way you live your life? I want to help you  achieve the highest level of health so that you can live your life as fully as possible.– Dr. Bella Zimilevich, MD

What is a chronic disease?

Chronic disease is an illness or condition that an individual lives with for a long period of time. Almost one out of every two adults (or approximately 133 million Americans) has at least one chronic condition. Almost one-quarter of those individuals living with a chronic condition have difficulty performing one or more activities of daily living, such as bathing, dressing or toileting (CDC, 2012).

Chronic conditions include a wide variety of illnesses that can affect virtually any system of the body. Common chronic conditions include diabetes, heart disease and asthma. You may have developed your condition relatively early in life; if so, this means that you have to learn how to manage and live with your condition for many years. 

What is the impact of chronic disease?

If you live with a chronic condition, you are probably well aware that chronic conditions can affect every aspect of your life. Although the physical impact is important, your emotional, financial and social well-being can also be affected. Let’s use arthritis as an example: If you have arthritis, you may have pain in your joints on a daily basis. Medications and other non-pharmacological methods of pain relief may help with your pain substantially. Along with pain, however, you may find it difficult to manage household activities, such as housekeeping chores. In fact, getting dressed may be a chore some days! Living with chronic pain will also impact your social life (if you are too tired and in too much pain to go out), your financial well-being (if you miss days of work or are unable to work due to severe pain) and your emotional/psychological health if you become depressed because you are virtually housebound and your pain prevents you from enjoying yourself with family and friends.

How I can help

My goal is to work with you to manage your condition and to minimize the impact of your condition on all aspects of your life, not just the physical aspect. I care about all of you, not just the part of you that may not work as it should! I believe in being honest and providing you with all the information you need to make informed decisions about your health. If you choose to see me, we will work closely together as equals in making decisions about your health care. And because Mill Basin Medical is a full service clinic, I can order many tests that you might need right here.

Why  it is important to see a physician regularly

Most patients with a chronic condition should see a physician every six months if they are relatively stable, and more often if your condition is not stable. Seeing me regularly means that we can monitor you closely for any complications of your disease. Using diabetes  as an example, I will want to see you to determine if your blood sugars are normal most of the time or if they are consistently high. If your blood sugars are high a lot of the time, this may cause a wide variety of problems down the road, including kidney failure and vision loss. High blood sugars may warrant a change in your diabetic medication regimen. Chronic conditions management is key to avoiding complications in chronic disease.

Types of chronic conditions I see 

At Mill Basin Medical, I see adult patients with a wide variety of chronic conditions, including:

  • diabetes
  • asthma
  • hypertension
  • heart failure
  • joint disease (osteoarthritis, back pain)
  • COPD (chronic obstructive pulmonary disease)
  • autoimmune disease (rheumatoid arthritis,  Chrohn’s disease, Celiac disease)
  • kidney disease
  • osteoporosis
  • cerebrovascular disease
  • cancer (not amenable to cure)
  • neurological disorders (Alzheimer’s, dementia, Parkinson’s)
  • mental disorders (depression)

If you are living with a chronic condition, it is important that you develop a relationship of trust and mutual respect with a physician. I want to be that physician for you. I want to work closely together with you to manage your health and prevent complications of your condition, while also striving for the best quality of life possible.

Tired of not having anyone in your corner medically speaking? Do you want to have one physician who can coordinate your care, someone who knows everything there is to know about you and your health? If this describes you and how you feel about your health care management, make an appointment today. I want to help you live your life to the fullest.

Read the full article...

Asthma Control At Mill Basin Medical

Posted by on May 20th, 2013

Dr. Bella Zimilevich, MD “Living with asthma involves more than simply treating acute attacks- it’s about asthma control. If you have asthma, I can help you learn to manage your condition and minimize the impact asthma has on your life”.

– Dr. Bella Zimilevich, MD

Asthma is a chronic disease affecting the airway. It may be mild, moderate or severe and affects each person who has it differently. You may have daily or weekly symptoms, or you may go months or years between “attacks”.

What causes asthma?

The cause of asthma is not known. What is known is that asthma attacks result from exposure to specific triggers. Triggers are different for everyone. Common triggers include pet dander, cigarette smoke, pollen, dust mites, molds and viral infections.

What are the symptoms of asthma?

If you have asthma, your bronchioles (airways) become inflamed and swollen and may spasm or tighten; in addition, mucous production is increased.

Symptoms of asthma include:

  • shortness of breath
  • coughing which is often worse at night
  • wheezing
  • chest discomfort or tightness

Who gets asthma?

No one knows for certain why some people develop asthma and others do not (including people who live in the same home), but what we do know is that heredity does play a role. You are more likely to develop asthma if one or both of your parents have asthma. Things in the environment are triggers for some individuals. Obesity has recently been identified as a condition which increases the risk of developing asthma.

How is asthma diagnosed?

If you suspect that you might have asthma but have not yet been diagnosed, it’s important that you come in to see me so that we can begin to work together to determine the best way to achieve asthma control. There is no reason to suffer from asthma symptoms when effective treatment is available. In addition, symptoms vary from episode to episode- just because your attacks have been mild does not mean that you are not at risk for having a serious attack.

When you come in to the clinic, the first order of business is to take a detailed history. I’ll ask you about your symptoms, including when they started, what makes them better or worse, how long you have had the symptoms and whether anyone else in your family has a history of allergies or asthma.

I will also need to examine you by listening carefully to your heart and lungs. Asthma often causes a characteristic wheezing sound that can be heard with a stethoscope. This is caused by narrowing of the airways. Sometimes the wheezing is so prominent that it can be heard without a stethoscope. I may also look at your nose, throat and your skin to look for signs of allergies, such as rhinitis (nasal congestion) and eczema, which causes reddened and irritated patches of skin. People with hay fever, allergies and/or eczema are more prone to developing asthma.

I may perform spirometry testing, which involves you blowing as hard and as long as you can into a tube, which registers the volume of air you can exhale, as well as the speed at which you can empty your lungs of air. This test allows me to compare your results to typical results that would be expected for your age and size. I may also order a chest x-ray to rule out other conditions which could be causing your symptoms and/or blood work to ensure you do not have a lung infection.

What is the treatment for asthma?

If we determine that your symptoms are consistent with asthma, I will prescribe medications that should quickly improve them. Inhaled steroids that reduce airway inflammation and bronchodilators (medications that open the airway) are two types of medications that can be very helpful in asthma and can help you attain asthma control.

Asthma management

If you have asthma, you will need careful and ongoing medical management. I have experience working with asthma patients to control their symptoms and improve the quality of their lives. Together, we will come up with an asthma management plan to minimize your symptoms, help you to identify your personal triggers and avoid severe asthma attacks which can be life-threatening.

Whether you already know you have asthma and are looking for a physician to partner with to manage your condition, or you have symptoms that you suspect might be due to asthma, I can help. Make an appointment today to take control of your asthma.

Read the full article...

Diabetes Management (high blood sugar)

Posted by on May 1st, 2013

Dr. Bella Zimilevich, MD

“Diabetes is a chronic condition that can result in a multitude of complications if improperly managed. I want to help you learn how to live well with diabetes and avoid any complications of the disease”.

-Dr. Bella Zimilevich, MD

What is diabetes?

Diabetes mellitus, or simply, diabetes, is actually a group of diseases characterized by high blood sugar levels.

What causes diabetes?

Defects in the body’s ability to produce and/or use insulin results in diabetes. Sometimes these defects are genetic. Sometimes they are acquired later in life.

Type 1 diabetes occurs when the pancreatic cells are unable to produce insulin. Sometimes this kind of condition is referred to as “insulin-dependent” diabetes. In this type of diabetes, patients need to monitor the amount of glucose in their blood, and take insulin shots in order to maintain normal levels.

Type 2 diabetes is when patients are unable to use insulin properly. This is often called “insulin resistance” or ”relative” insulin deficiency. These patients may be treated with other medications to control blood sugar.

Gestational diabetes is a common, but serious, health condition in which pregnancy contributes to the onset of diabetes.

Read the full article...

High Blood Pressure /Hypertension

Posted by on May 1st, 2013

Dr. Bella Zimilevich, MD

“Often called the “silent killer” because it causes no or few attention-getting symptoms, untreated high blood pressure causes damage to your arteries that can’t be undone. If you have hypertension, we’ll work closely together to control your blood pressure to avoid serious complications”.

-Dr. Bella Zimilevich, MD

What exactly is blood pressure?

In simplest terms, blood pressure is the force of circulating blood against the walls of arteries. (Arteries are the vessels that carry blood away from your heart to supply the rest of your body with oxygenated blood.) During each heartbeat, blood pressure varies between a maximum
(systolic) and a minimum (diastolic) amount of force.

Read the full article...

About Cholesterol

Posted by on April 30th, 2013

“High cholesterol is a risk factor for atherosclerosis, or hardening of the arteries. Can’t tell the difference between “good” cholesterol and “bad” cholesterol? This is where I come in- I can explain cholesterol clearly and help you to manage your cholesterol levels”.

-Dr. Bella Zimilevich, MD

What is cholesterol?

Cholesterol is a fatty substance that occurs naturally in the blood. We often hear about how bad cholesterol is, but cholesterol is not all bad. In fact, we wouldn’t be able to live without it! Cholesterol performs important functions in the body, including playing an important role in tissue and hormone formation. It also protects nerves, and it aids digestion. Cholesterol helps form the structure of every cell in the body.

Read the full article...

 

 

Our Location

clinic map

6301 Mill Lane, Brooklyn, NY 11234.

718-942-4600

We are not a hospital/urgent care facility. Our urgent care services are offered during normal business hours only.
Mill Basin Clinic Location

Our Services Include:

Insurances We Accept: