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Internal Medicine Doctors of
Mill Basin & Bergen Beach, Brooklyn

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


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

Respiratory Care


How I Can Help Manage COPD (Chronic Obstructive Pulmonary Disease)

Posted by on September 13th, 2013

Dr. Bella Zimilevich, MD

“COPD is a condition that requires careful maintenance to prevent exacerbations (flares) of the disease. If you have COPD, you need a physician who can help you manage medications and prevent flares. As your primary care physician, I will be committed to keeping you as healthy as you can be”.

-Dr. Zimilevich, MD

 What is COPD?

COPD, which stands for chronic obstructive pulmonary disease, is a chronic lung disease that includes emphysema and bronchitis. Some people with COPD have both conditions. Smoking is a major cause of COPD, but non-smokers can also develop COPD. COPD causes damage to your airways which carry oxygen to and from your lungs. Your airways can become swollen and blocked by increased mucous production (bronchitis). In addition, the tiny air sacs in the lungs where oxygen exchange takes place become damaged (emphysema), making it difficult to breathe.

What are the symptoms of COPD?

Symptoms of COPD  develop gradually. Symptoms may include:

  • chronic cough
  • coughing up phlegm (mucous)
  • shortness of breath on exertion (and sometimes at rest in advanced stages)
  • weight loss
  • wheezing
  • frequent chest infections that take a long time to clear up

How is COPD diagnosed?

I can make the diagnosis of COPD based on my physical examination, a chest x-ray and spirometry, a pulmonary function test which measures how well you can move air into and out of your lungs. Blood tests such as arterial blood gases may also be useful in  helping me to make the diagnosis.

What can I expect when I come to see you?

When you come to see me with breathing concerns, I will first ask you about your past medical history, including any history of lung infections such as pneumonia. I will ask you about any medications you are taking and also about any allergies you may have. I will also want to know if you have a family history of lung disease such as COPD or asthma.

Next I will ask about specific symptoms, such as coughing and shortness of breath. I will need to know if you are always short of breath, or if you are short of breath only when exerting yourself. If you are coughing frequently, are you bringing up any mucous? Do you wheeze when you exert yourself? Do you have frequent colds or chest infections that seem to take a long time before they get better? Do you suffer from chronic fatigue, or have you lost weight unintentionally?

I will ask you about your smoking history. Many patients feel the need to downplay their smoking history, or deny it outright. Remember that I am not here to judge, only to help. If you do have COPD, quitting now can make a world of difference in terms of the progression of the disease. I would be happy to discuss quitting options for you, including prescription medications or patches available.

Next, I will examine you. I will focus on your heart and lungs, listening carefully to both. People with COPD may have congested lungs or wheezing breath sounds. I will also check your vital signs, including your oxygen saturation. I may order a chest x-ray, spirometry and any other tests I feel are necessary to help me make a diagnosis.

How do you treat COPD?

First of all, if you are a smoker, I must urge you to quit. It’s never too late to quit! You can dramatically influence the course of your disease by quitting smoking. This fact cannot be emphasized enough. I understand that smoking is perhaps one of the hardest habits to break, and I will be here to support you using whatever tools you need to help you achieve your goal of becoming a non-smoker. You can do it!

Medications are used to keep you feeling your best and prevent flare ups of the disease. You may take a daily bronchodilator to keep your airways open and allow you to be at your best. Steroids may be used for exacerbations, and antibiotics may be needed at times if you have a chest infection. It is very important that you understand your medications- what they are used for and how to take them properly. We will spend time together discussing any medications I prescribe.

Exercise is important if you have COPD. If you exercise, your heart and lungs benefit, and you may be able to stave off a decline in your breathing. Any kind of exercise is helpful. Walking is very beneficial. We can talk about what types of activities you enjoy and can engage in to maintain your pulmonary health.

Some people with chronic diseases such as COPD lose weight because their bodies require more energy to perform normal activities. Eating a healthy diet is important to prevent exacerbations in COPD. You can follow the American Heart Association’s Heart Smart diet. Feel free to ask me any questions about diet and how a healthy diet can benefit you.

From time to time you may benefit from seeing a pulmonary specialist. If necessary, I can refer you to a specialist in lung disease, and I can work with you to follow your specialist’s recommendations. It is important that you have one doctor to act as the “gatekeeper” for your health, someone who knows all about you and who you can see regularly for all health concerns, not just those relating to COPD. I would love to be your partner in managing your health. Together, we can help you to enjoy good quality of life and prevent flares.

If you are concerned that you may have COPD, or you have COPD and are searching for a primary care physician to oversee your health, please call the clinic to make an appointment today.

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How I Diagnose and Treat Pneumonia

Posted by on August 28th, 2013

Dr. Bella Zimilevich, MD

“Pneumonia is usually caused by a virus or a bacteria and can make you feel very ill, particularly if you have underlying heart disease, diabetes or lung disease such as asthma or COPD. In people with chronic health conditions, weakened immune systems or the elderly, pneumonia can be life-threatening if left untreated. If you think you may have pneumonia, you should make an appointment to come in immediately”.

-Dr. Zimilevich, MD

 What is pneumonia?

Pneumonia is an infection of the lungs. In pneumonia, the tiny air sacs that are responsible for gas exchange fill up with fluid and/or pus. This causes congestion of the lungs and is responsible for the coughing that is prominent in pneumonia. It may also cause difficulty breathing. Anyone can get pneumonia, but people with weak immune systems, the elederly and the very young are most at risk from this always serious and sometimes deadly disease.

What are the symptoms of pneumonia?

If you have pneumonia, you will usually feel quite ill and may feel sicker than you do when you have a cold. Symptoms may include:

  • productive cough
  • fever/chills
  • chest pain
  • difficulty breathing/shortness of breath
  • decreased appetite
  • sore throat (may be due to coughing)
  • headache
  • fatigue
  • body/muscle aches
  • GI upset (nausea/vomiting, diarrhea
  • decreased level of consciousness (in the very ill)
  • lower than normal body temperature (in the elderly or people with weak immune systems)

What causes pneumonia?

Pneumonia can be caused by bacteria, viruses or fungi. If you are healthy and young, your immune system can normally prevent microorganisms from invading your lungs, but if you are older, have a chronic health condition or your immune system is not up to snuff (i.e.  you are being treated for cancer or your body is fighting another infection somewhere else) you may be at higher risk for pneumonia.

Pneumonia may occur on its own, or it may occur after you have had a cold or the flu as a secondary infection. This is why it is so important to get an annual flu shot– not only does it prevent the flu, but it can also stop you from developing a secondary pneumonia, which can be very serious when your immune system is exhausted from fighting the flu.

Pneumonia that occurs when you have been in the hospital for another reason is called hospital-acquired pneumonia. This type of pneumonia can be more difficult to treat than pneumonia that is community-acquired.

What can you expect when you come in to see me ?

When you come in to see me, I will want to know a little about your history (if you are a new patient). I will need to know if you have any health problems and whether you are taking any medications. I will also need to know if you are allergic to any medications.

I’ll ask you when your symptoms started. Have you had a cold or the flu? What symptoms are you experiencing? Does anything make them better or worse? Tell me as much as you can about your symptoms and how you have been feeling.

Once I have gathered some information, I’ll want to examine you. I will look in your ears and throat and feel your neck for swollen glands. I’ll listen carefully to your heart and lungs for abnormal breath or heart sounds. I may also examine your abdomen.

Based on my findings, I may order diagnostic tests such as a chest x-ray and blood work to look for signs of bacterial infection and perhaps dehydration.

Once I have all the information I need, we’ll discuss the results of my examination and any tests I may have ordered. If I believe you have pneumonia caused by a bacteria, I will prescribe antibiotics. If I order antibiotics it is important that you finish the entire course of antibiotics. If you are not better in a few days after starting your antibiotic, you should come back in to see me. If you have a viral pneumonia, antibiotics will not be helpful.

Other things you can do to speed your recovery include:

  • drinking plenty of fluids (this helps to thin out the secretions in your lungs)
  • get plenty of rest
  • eat as healthily as you can
  • manage your fever and muscle aches with an over-the-counter pain medication
  • avoid smoking or being around people who smoke

{Note: if you are experiencing severe chest pain or shortness of breath, you should go to your nearest emergency room}

If you think you have pneumonia, you should not wait to be seen. Pneumonia is a very serious condition and can be life-threatening for the elderly, people with chronic health conditions and people whose immune systems are compromised. If you have symptoms of pneumonia, make an appointment now to come in and see me.

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Considering A Doctor’s Appointment For Help Managing A Cough?

Posted by on August 7th, 2013

Dr. Bella Zimilevich, MD

“Cough is one of the most common reasons why people come to see me. Most coughs are not serious and are caused by a virus, but some coughs may be be caused by a bacteria and may require an antibiotic. It can be difficult for people to determine whether a cough is serious or not- this is where I come in. If your cough lingers for a long time after a cold, is accompanied by a fever or shortness of breath, you need to make an appointment to come in and see me in the clinic”.

-Dr. Zimilevich, MD

What is a cough?

A cough is a reflex, the purpose of which is to keep your lungs and airways clear. Coughs can be annoying if they are frequent or they keep you awake at night, but they are important to your body’s defense. In fact, people with weak coughs due to certain musculoskeletal problems often suffer from frequent pneumonia infections because they lack this simple ability to keep their airways clear of germs.

Acute versus chronic cough

Coughs may be acute, caused by a viral or bacterial illness such as the common cold or pneumonia and lasting a week or two, or chronic as in asthma and COPD. Chronic coughs lasting more than a couple of weeks may be caused by:

  • allergies
  • smoking
  • COPD (chronic obstructive pulmonary disease)
  • asthma
  • medications (i.e., certain blood pressure medications)
  • throat problems
  • GERD (gastroesophageal reflux disease, or acid reflux)
  • CHF (congestive heart failure)
  • malignancy of the respiratory tract (i.e., lung cancer)

When should I be concerned about my cough?

Coughs associated with colds will most often go away on their own in a week or two. Sometimes the cough will linger for a short time after the cold symptoms have disappeared. Although the cough may be bothersome, it usually does not require any treatment. Using a cool mist humidifier, drinking plenty of water and/or sucking on cough drops or lozenges may soothe a lingering cough. Sometimes coughs are caused by post-nasal drip (nasal secretions traveling down the back of the throat).

There are certain instances when your cough should prompt you to come see me in the clinic. You should make an appointment if:

  • your cough changes in character (becomes deeper, more frequent or produces more sputum than previously)
  • you have fever asociated with your cough for more than a day or two
  • you have chest pain when you cough
  • you have blood in your sputum
  • your cough interferes with sleep or other activities
  • you have shortness of breath associated with your cough
  • your cough lingers long after other symptoms have gone away, or lasts longer than a couple of weeks
  • your cough is associated with weight loss, loss of appetite, night sweats or other unusual symptoms

What can I expect when I come to see you about my cough?

When you come in to the clinic to see me regarding your cough, I will first want to know a bit about your past medical history and any medications you are taking if I have not seen you before. I will need to know when the cough started, what other symptoms are associated with it (i.e., sore throat, cold symptoms, fever), whether your cough is productive (you are coughing up phlegm) and what makes your cough better or worse. I will also need to know if you are a smoker.

Once I have gathered some history about your cough I will examine you, which may include:

  • looking in your ears, nose and throat
  • listening to your chest with a stethoscope for abnormal breath/breathing sounds
  • obtaining your vital signs (temperature, blood pressure, pulse, respirations and oxygen saturation)
  • feeling your head and neck for enlarged lymph glands
  • palpating your abdomen
  • listening to your heart

Based on what I find when I examine you, I may order diagnostic tests, which might include a chest x-ray to rule out pneumonia, blood tests to check for hydration status or signs of infection or inflammation, a sputum sample or pulmonary function testing. I may order other tests if warranted.

Once I have all of the information I need, I will base my treatment on what I believe is causing your cough. I will discuss any test results with you and explain any treatments I prescribe. You should feel free to ask me any questions- I will be happy to answer any questions you have.

If you are suffering from a cough that concerns you, make an appointment to come and see me in the clinic. I promise to take your symptoms seriously- that’s the Mill Basin difference.

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Considering An Appointment For Respiratory Care?

Posted by on August 7th, 2013

Dr. Bella Zimilevich, MD

“Respiratory care is a frequent need- after all, millions of people are stricken by respiratory illnesses such as colds and flu every year. Luckily, many of these illnesses are self-limited. Still others suffer from chronic lung conditions such as asthma, emphysema, and other chronic lung conditions. Whether your symptoms are short-lived or require long-term care, I can help. Just make an appointment and come in to see me. Together we can plan how best to treat you”.

-Dr. Bella Zimilevich, MD

 What is the respiratory system?

The respiratory system consists of the nasal passages, the larynx (the voice box), the pharynx (the back of the throat below the nasal cavity), the trachea (the windpipe), the bronchi and the lungs. The main job of the respiratory system is to oxygenate our blood, so that blood rich in oxygen can be delivered throughout the body. The respiratory system is also responsible for helping the body to get rid of waste products (CO2), which we breathe out. The diaphragm is a muscle that lies just below our lungs and helps the lungs expand and contract as we inhale and exhale. The actual exchange of oxygen and carbon dioxide takes place in the alveoli, tiny sacs that are located in the lungs.

What are common symptoms associated with respiratory conditions?

Conditions affecting the respiratory system may be obvious, or may be confused for a problem in another body system. The most common symptoms associated with respiratory disease are:

  • cough- a common symptom of respiratory illness; may be acute or chronic, depending on the illness
  • chest pain– many respiratory illnesses can cause chest pain or discomfort. Chest pain may result from coughing a lot (muscle or rib pain) or from irritation of the pleura, the membranes that cover the lung.
  • fever– fever may be caused by inflammation or infection anywhere in the respiratory tract; ir may also occur with mailgnancy (cancer)
  • fatigue– fatigue may be due to not having enough oxygen circulating in the blood stream
  • hemoptysis– coughing up blood may occur in tuberculosis and in malignancy (lung cancer), but it occasionally occurs from coughing too much, especially in patients taking blood thinners
  • wheezing– individuals with asthma may wheeze, this is due to inflammation and swelling in the airways that restrict air movement
  • shortness of breath– individuals may feel short of breath if their oxygen levels are low
  • malaise– malaise is feeling generally unwell
  • sputum production– pneumonia and other infections of the respiratory tract may cause increased sputum production; asthma may also cause this
  • headache– headache may be induced by coughing, or it may be related to infection or inflammation
  • hoarseness– excessive coughing or infection of the pharynx (pharyngitis) may cause your voice to become hoarse

What respiratory conditions can you treat?

I am an internal medicine physician. I am also a geriatrician. I treat a variety of adult respiratory illnesses, including:

  • asthma
  • emphysema
  • COPD (chronic obstructive pulmonary disease)
  • pneumonia
  • colds
  • influenza
  • bronchitis

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

When you come in to see me in the clinic requiring respiratory care, I will need to gather the following information from you:

  • past medical history
  • allergies (environmental, food and medications)
  • family history

I will ask you about when your symptoms started and if they are associated with other signs/symptoms of infection, such as throat pain, rhinitis (runny nose) or fever. I will ask how long you have had your symptoms and what you’ve tried at home to relieve them- what worked and what didn’t help.

Once I have gathered some history, it’s time for me to examine you. I may look in your nose, ears and throat for signs of infection. I will use a stethoscope to listen carefully to your heart and lungs. I may also examine your abdomen for any signs of tenderness. I may also look for any swelling in your legs, as this is sometimes a sign of cardiac disease, symptoms of which can often mimic respiratory disease.

After I have gathered your history and examined you, I will decide if any diagnostic testing is required. This may include a chest x-ray, a sputum sample or blood tests. I may decide to treat you before lab or x-ray results have come back, or I may ask you to return for another visit- this all depends on my findings and what I suspect is causing your symptoms.

If you are experiencing respiratory symptoms (unless you are certain you are suffering from the common cold, which should improve in 7 to 10 days) make an appointment to come in and see me. While some respiratory symptoms are undoubtedly due to a virus or a bacterial infection that may get better on their own without treatment, other symptoms may be due to a more serious respiratory illness requiring care. Call for your appointment today.

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6301 Mill Lane, Brooklyn, NY 11234.


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