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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

Question and Answers

 

I found a lump in my breast. Should I be concerned?

Posted by on October 13th, 2013

Answer: Finding a lump in a breast is enough to strike fear into any woman’s heart. You’re right to be concerned. While many lumps are discovered by women themselves, most are benign- but this doesn’t mean you should ignore them. It takes only a few minutes to check a breast lump, and it is far better to be safe than sorry.

The following are some general rules of thumb. Keep in mind that they are not meant to falsely reassure you (or cause panic):

  • Painless lumps are of greater concern than painless lumps
  • Hard lumps are of greater concern than soft lumps
  • Lumps that are “fixed” in place are of greater concern than lumps that move freely
  • Rough, irregular lumps are of greater concern than smooth lumps
  • Lumps that increase in size very quickly are not usually dangerous

As I said, the above are not hard and fast rules. All lumps should be assessed by a medical professional, especially if you have never had a lump before.

Many breasts become lumpy before menopause. This is due to changes in hormone levels. However, as women age they are at higher risk of developing breast cancer, so if you are close to menopause you should not assume that lumps in your breasts are normal. Danger signs that warrant immediate attention and concern include changes in the skin (dimpling or thickening), a change in the size or appearance of a breast or a change in the nipple position (including inversion of the nipple). Nipple discharge (clear, sticky or blood-tinged fluid) should also be checked carefully by a physician.

As I mentioned earlier, many women discover their own lumps while showering. Partners also sometimes discover breast lumps. It is important for women to check their breasts regularly (men should also examine their testicles for lumps routinely). Get in the habit of checking your breasts for lumps on a monthly basis. Breasts should be examined in the shower (soap helps the fingers glide smoothly over the skin). The pads of the fingers should be used to check the entire breast, moving from outside to the inside, checking the entire breast (don’t forget the armpit). Breasts should also be examined in the mirror with your arms at your sides and raised above your head. This helps you to see any obvious changes in shape or size (note that it is normal for one breast to be slightly larger). Lastly, examine your breasts while you are laying down, which allows the breast tissue to spread out along the chest wall. You should move the pads of your fingers in small circles, being sure to cover the entire breast. You should also be sure to squeeze the nipple to check for discharge.

Up to 40% of breast cancers are discovered by women, not their physicians, so get in the habit of checking your breasts monthly. If you find a lump or notice a change in one of your breasts, make an appointment and come in to see me. I can determine fairly quickly whether the lump is cause for concern and, if it is, refer you for further testing or a second opinion. You can combine your visit with a pap smear if you are due (or overdue) for your exam.

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I have read so many things for and against the flu shot. Do I really need one?

Posted by on October 10th, 2013

Answer: Every year, my patients ask me this question, so thank you for bringing this important topic to the forefront!
Flu season will be upon us soon. Typically, the influenza vaccine is made available to doctors by mid to late October. This allows us to immunize a large proportion of the population before flu season hits hard, which usually coincides with the holiday season when people gather together in large crowds indoors- this practice helps to spread the virus very efficiently! It takes a few weeks for the flu shot to take full effect, so immunizing in the fall makes sense.

Many people question the need for a flu shot. In order to understand why I advocate getting a flu shot, it’s important to explain the concept of herd immunity. This term refers to the fact that when a large proportion of individuals are vaccinated against a certain disease, those who cannot be immunized (such as small children or people with compromised immune systems) will still enjoy a measure of protection. In other words, the more people get vaccinated, the greater the chance that susceptible individuals who may die from the disease in question will be protected. The concept of herd immunity explains why we are seeing a resurgence of diseases such as diphtheria and measles. Many parents are choosing not to immunize their children, and as fewer people are immunized, these diseases are becoming more commonplace again.

Many healthy adults are resistant to the idea of immunization against the flu, claiming that they never get the flu and, at any rate, they are healthy and should have no problems recovering if they do get it. Many people forget that influenza can result in significant illness, even in people who are healthy with no chronic health issues. Even if you are healthy, getting the flu can mean that you are too weak and sick to get out of bed for several days, which means time off work and lost pay for some. Can you afford a week away from work or school?

If you have contact with children or older adults, getting the flu shot may protect them. The flu claims many lives every year (which many people seem to forget), and getting the flu shot may be the best way to protect those you care about from getting ill.

If you have a chronic health condition, you should definitely get a flu shot. Anyone with heart and/or lung disease, obesity, diabetes or other chronic conditions should get a yearly flu shot, as getting the flu could result in serious complications. If you are an older adult, you are at higher risk of complications such as pneumonia.

To answer your question, I believe that everyone should get a flu shot to protect not only themselves, but others who are high risk of dying from the flu, such as infants, patients fighting cancer or other serious illnesses affecting their ability to fight off infection and the very old.

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How do I know if I have a cold or the flu?

Posted by on October 10th, 2013

Answer: People get confused between the common cold or the flu all the time. The flu and a cold share common symptoms but are not the same. The flu generally makes you far sicker for a longer period of time than the common cold does.

  • Onset– the flu hits quickly. You may wake up in the morning feeling well and by afternoon you may be so sick that you have no choice but to go to bed. A cold comes on slowly. It may start with a tickle in your throat and a runny nose and progress over a couple of days until symptoms are full-fledged.

  • Fever– with a cold, you may experience a low-grade temperature. With influenza, you may get chills and a very high temperature.

  • Muscle aches– with a cold you may feel unwell and you may feel a little achy. When you get the flu, you may experience intense muscle aches all over your body.

  • Ability to work – most people who have a cold are able to continue working (this is not to say that they should, only that most can). With influenza, the affected person may be so weak and ill that they will find it impossible to work (and they should definitely not go to work and spread the virus to others!)

  • Coughing – both influenza and the common cold are respiratory illnesses. A cold will often lead to a cough that may be productive. The cough associated with influenza is dry and non-productive.

  • Sore throatsore throat may be one of primary symptoms with a cold and may be very uncomfortable. You may also experience a sore throat with influenza but it will not be the primary symptom.

  • Nausea and vomiting – nausea and vomiting is not a common symptom with either illness, but some people with influenza may experience nausea and vomiting and possibly even diarrhea, depending on the flu strain. For example, the H1N1 strain of influenza that hit so hard in 2009 caused gastrointestinal symptoms in a larger proportion of sufferers than is typically seen with the flu.

  • Nasal congestion – this is very common with a cold. It is far less common with the flu.

  • Headache  – headache is very common with influenza. It may occur in the common cold but is less common and is usually not severe.

  • Complications – complications may occur with either illness. Otitis media (middle ear infection), bronchitis and sinus infections may occur as a consequence of the common cold. With influenza, pneumonia is not uncommon and may be deadly for the elderly and those with compromised immune symptoms. People with underlying lung disease may experience a complication of either illness more often than people who have a health respiratory system and the ability to fight off infection.

Washing your hands is the most important thing you can do to stay well this winter. You cannot wash your hands too often! To avoid the flu, I strongly recommend that you get a flu shot, particularly if you are obese, you are a smoker or you have a chronic health condition such as diabetes, heart disease or lung disease. If you are taking medications (such as steroids) that can weaken your ability to fight off infection or if you are being treated for a chronic health condition, getting a flu shot may be life-saving.

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Our Location

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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

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