SIMEDHealth

Summer Safety Tips for the Whole Family

We all love summer. Kids and teens that don’t have to be in school during the summer are perhaps the happiest this time of year. It’s a chance to vacation, get in the water, and have more fun during these long, hot days.

However, more time to play and explore with the family also means more injury risks. Dr. David Lefkowitz of SIMEDHealth Primary Care sat down with us to provide tips on how to be safe this summer while having fun.

What are some of the most dangerous ailments you see during the summer?

Besides water-related injuries, the most dangerous summertime ailments are heat-related injuries. This includes a spectrum of issues from mild (heat cramps) to moderate (heat exhaustion) to severe (heat stroke).

Heat cramps occur during intense physical exertion in hot environments. Expect the person to be sweating heavily with cramps and muscle pain (which can occur in any muscles). Treatment includes resting, moving to a cool environment, drinking fluids (like Gatorade), and waiting for the symptoms to pass. Medical attention is usually not needed but should be sought if the cramps last longer than one hour.

Heat exhaustion is more severe and presents itself as profuse sweating with cold, clammy skin. People are often dizzy, weak, nauseated, and irritable. They may lack coordination and even pass out. Treatment includes moving to a cooler environment if possible, taking off or loosening clothes, applying cool wet towels, lying flat on your back, and drinking fluids (like Gatorade). Medical attention is usually not needed but should be sought if symptoms last longer than one hour or if they get worse.

Heat stroke is the most severe and can be fatal. At this point, the person’s core body temperature is over 104 degrees and they have altered thinking. This is a medical emergency and so 911 needs to be called a.s.a.p. However, if possible, it is advisable to help bring the person’s body temperature back down via whatever means are available. Immersing them (not the head) in a bath of ice water is the best method but that is not always available. At the very least, they should be moved to a cooler environment and covered with cold, wet towels. Do not give them fluids by mouth as they may choke (they need IV fluids).

 

How can we prevent heat-related injuries and exposure to harmful UV rays?

When people think of summer, they think of fun in the sun. However, the sun is our main source of exposure to ultraviolet (UV) rays. In the short-term, UV rays cause painful sunburns; in the long-term, they can cause skin cancer and premature skin aging.

The best and most obvious way of protecting oneself from harmful UV rays is simply to stay in the shade. When that’s not an option, it is best to stay covered with UV-protective clothing such as wide-brimmed hats and long-sleeved shirts (commonly called “rash guards”). Clothing that is made for UV-protection has a rating called the Ultraviolet Protection Factor (UPF) that goes from 15 to 50. For the best protection, aim for garments with a rating of 40 or higher.

OK, so going to the beach in pants and long sleeves just isn’t going to work for you? There’s always sunscreen. However, no sunscreen can block ALL ultraviolet rays. Because of this, it should not be relied upon as your only method of defense against these harmful rays. Sunscreens are rated using a scale called Sun Protection Factor (SPF) that goes from 15 to 100+. In general, aim for a sunscreen that is SPF 30 or higher, apply it to all sun-exposed areas 30 minutes before going out in the sun, and reapply every two hours or after swimming or toweling off. Also, make sure your sunscreen is broad spectrum (meaning it blocks both UVA and UVB rays).

And of course, don’t forget to protect your lips with SPF-rated lip balm and your eyes with UV-blocking sunglasses.

What are some summer safety tips for kids and families visiting pools and lakes?

  • Even capable swimmers should swim with a buddy.
  • Children need direct supervision when swimming. Things like “floaties,” “water wings” or “puddle jumpers” are NOT meant to replace direct supervision.
  • Avoid jumping into bodies of water when the depth is not clearly marked. This is especially true for diving headfirst into rivers or lakes. This could lead to spinal cord injury, paralysis, or death.
  • Most pools don’t have lifeguards. Therefore, the adults need to know basic CPR just in case.
  • To prevent swimmer’s ear (ear canal infection), make a mixture of 1 part rubbing alcohol to 1 part white vinegar. Put a few drops of this solution in the ear canal after swimming.

Do you have any additional tips on how to prevent summer injuries?

On land, make sure you and your children are wearing proper safety gear such as helmets and pads when using bikes, scooters, and skateboards. Children should not drive ATVs unsupervised and anyone on an ATV should have full protective gear on (including a DOT-approved helmet).

On the water, the name of the game is prevention: preventing boating accidents and preventing drowning. Skippers should not be under the influence of alcohol and everyone on the boat should be wearing a life jacket.

All children should be supervised at all times to prevent drowning, even if they are capable swimmers (for example, rip currents can lead to drowning even in strong swimmers).

Need specialized tips for your family? Click here to request an appointment

AIDS: Learn Symptoms, Prevention, More

Image of woman with red shawl against a brick wall and statistics about HIV infection.

On December 1st, we celebrated World AIDS Day by bringing awareness to AIDS, a virus that impacts people all over the world and from all walks of life. We asked SIMED Primary Care Dr. David Lefkowitz to give us the details on AIDS so we can gain a better understanding of the disease and how to prevent and avoid it.

What is AIDS?

AIDS stands for Acquired Immunodeficiency Syndrome. It is the disease that results from untreated infection with HIV, or Human Immunodeficiency Virus. To understand AIDS, you have to understand HIV.

HIV is a type of virus that attacks our immune system. Because of this, we can’t fight infection or cancer like we normally do. If untreated, it leads to the disease we call AIDS. This can be thought of as advanced-stage HIV infection. At this stage, the immune system becomes so weak it cannot fight off certain germs called opportunistic infections. The actual diagnosis of AIDS is made either when a person with HIV develops opportunistic infections, or when their blood counts drop so low that their immune system can’t fight these infections.

How Do People Get HIV or AIDS?

HIV is spread through body fluids such as semen and blood.  Because of this, the most common methods of spreading the virus are through sexual contact and through needle sharing (of IV drug users). It can also be spread via breast milk and other body fluids. The infected bodily fluid has to come into contact with a mucous membrane (such as inside the vagina) or directly into the bloodstream (such as with a needle). You can’t get it if the fluid contacts unbroken, healthy skin. It is also not transmitted in saliva, sweat, or urine

How Can We Treat HIV?

There is no cure for HIV, but fortunately there has been great progress in treatment. We call HIV treatment Antiretrorviral Therapy, or ART. Current ART is effective at preventing HIV from turning into AIDS.  It also helps to prevent transmission of the virus to non-infected individuals. The medicines that we use for ART are many, and they are used in combinations aimed at attacking the virus from different angles.

How Can People Prevent HIV?Graphic on how to prevent aids with stop sign

Like I said, sex and dirty needles are the most common ways of spreading HIV. Therefore, condom use (in sexually active people) and clean needle use (in those who are IV drug users) are the best methods of preventing the spread of HIV.  Certainly, abstinence and avoiding needles altogether would be even safer. Condoms are usually available for free at local health departments and some cities now have needle exchange programs.

Transmission from infected mothers to their unborn babies (either through the placenta or after delivery through breastfeeding) is possible, but with ART the transmission rate is now extremely low.

Some populations are considered very high risk for getting HIV. Examples would include those who are IV drug users as well as those who have an HIV positive sexual partner. For these folks, Pre-Exposure Prophylaxis (known an PrEP) can help reduce their risk of acquiring the virus. PrEP involves taking a daily ART medicine as well as regular visits to the doctor.

What Is Life Like For People with HIV?

I think you would have to ask someone who has lived through the diagnosis and treatment first-hand to get the real answer to that question. From a medical standpoint, I am happy to say that prognosis and quality of life have drastically improved with our advances in ART. Whereas HIV used to be 100% fatal, life expectancy for someone with treated HIV is now almost the same as for someone without HIV. 

How should people use this information?

HIV is still an extremely important and devastating disease worldwide. It is important to remember it is often preventable. It is also important to get tested. Some patients have an “I’d rather not know” mentality, but if they don’t find out if they’re positive, they will not be able to get early treatment and could potentially risk passing the virus on to others. Talk with your doctor if you have questions about prevention, testing, treatment, or PrEP.

To schedule an appointment with Dr. Lefkowitz, call (352) 375-6279 or request an appointment online. If you would like to see another primary care doctor or have concerns about contracting HIV, call (352) 224-2225 or request an appointment online.

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Be prepared this year with Immunization & Vaccines

Be prepared this year with Immunization & Vaccines

August is National Immunization Awareness Month (NIAM) The goal of NIAM is to increase awareness about immunizations across the lifespan, from infants to the elderly. August is an ideal time to make sure everyone is up-to-date on vaccines before heading back to school and to plan ahead to receive flu vaccine. Getting vaccinated is an easy way to stay healthy all year round. During the month of August, take the time to make sure that you and your loved ones have received all of the vaccinations you need.

- "National Immunization Awareness Month." Vaccines.gov

Dr. David Lefkowitz, a Family Medicine physician at SIMED Primary Care answers some questions and brings some light on the importance of immunizations and how they prevent you and your family from getting sick.

1. Will you give a brief explanation of what immunizations are?

Immunizations are the “shots” we have all come to expect when we go to the pediatrician; they are also called vaccines. Of course, these vaccines are not just for kids but are recommended for adults as well. Vaccines stimulate your own immune system to create antibodies against diseases.

2. Why is it important to get vaccinated?

There are two reasons:

  • One, it helps protect you from getting severely sick from the bacteria or virus you are getting vaccinated against. Having antibodies ready-to-go is like having an army of soldier’s ready-to-fight the disease as soon as possible.
  • Second, it helps protect folks who can’t get vaccinated (for example patients who are on chemotherapy) by decreasing the potential spread of disease to them.

3. What are some of the most common immunizations?

The most common immunizations depends on whether the vaccines are for children or adults.

  • For children, some common vaccines include Hepatitis A and B, MMR (Measles, Mumps, and Rubella), Polio, Varicella-Zoster (Chicken Pox), Diphtheria, Tetanus and the Flu vaccines.
  • As for adults, the most common vaccines include Flu shots, Pneumonia shots, the Shingles shot, Hepatitis A & B and Tetanus boosters. Of course there are many other vaccines but these are the most common.

4. How can someone get a vaccination?

A visit to their primary care doctor is usually all that is needed. Some of the less commonly used vaccines, for example those associated with traveling to third world countries may not be carried at your primary care office. However these can commonly be ordered in to receive at a later time, or the local health department can be a good source of the travel vaccines.

5. Can a shot make you sick?

It is possible, but thankfully rare. The overall benefits of vaccinations clearly outweigh the possible short term risks. However, local reactions (arm soreness, redness, and swelling) can be seen but are not dangerous and usually resolve on their own after a short period of time. Low grade fevers can be seen for the first 24-48 hours following immunization.

6. What are some other preventative ways of not getting sick?

Wash hands, wash hands, wash hands! Avoid close contact with people who are sick. Be sure to cover your mouth and nose when you cough, try not to touch your eyes, nose or mouth. To avoid spreading the sickness, stay home from work if you are sick.

7. Why do some vaccines require boosters?

When you get a vaccine, your immune system makes antibodies. Over time, these antibodies can decrease in number. A booster shot does what it sounds like: it “boosts” the number of antibodies so that you have plenty of soldiers to fight the disease.

8. Why is there a new flu vaccine every year?

The influenza virus is a tricky one. It has the ability to mutate into many different strains. Each year, the CDC (Center for Disease Control) decides which strains will be prevalent for the upcoming flu season and puts those strains into the flu vaccine. It’s somewhat of a guessing game (more a prediction based on data) but there’s no other way to manufacture millions of vaccines in time for flu season.

9. How do vaccines fight viruses and bacteria?

The Vaccines do not actually fight any viruses or bacteria off, they stimulate your own body’s immune system to fight off the disease. Your immune system recognizes the vaccine as “foreign” and it makes antibodies against the vaccine thus strengthening your own body’s immune system. These antibodies are then ready to fight the real disease if it gets into the body. SIMED Primary Care offers a variety of vaccinations to patients in our North Central Florida community. Here is a list of the most common vaccinations offered:

  • Influenza (Flu)
  • Hepatitis A
  • Hepatitis B
  • Pneumovax - 23 (Pneumococcal bacteria)
  • Prevnar - 13 (Pneumococcal bacteria)
  • Gardasil (HPV)
  • Varicella (Chicken Pox)
  • Zostavax (Shingles)
  • Tetanus, Diphtheria, Pertussis (Tdap)
  • Menomune/ Meningitis
  • Typhoid

Schedule an appointment with Dr. David Lefkowitz or any of our SIMED Primary Care physicians at one of our locations in Gainesville, Ocala, Chiefland, McIntosh, and Lady Lake (The Villages) to review what immunizations are appropriate for you or your family. Click here to request an appointment online.

Melanoma/Skin Cancer Detection and Prevention Month

Melanoma/Skin Cancer Detection and Prevention Month

SIMED Primary Care's Dr. David Lefkowitz touches base with us on how we can use this month to raise awareness about skin cancer and help people take action to prevent or detect it, both at home and in our North Central Florida community. While melanoma is the least common form of skin cancer, it is still the sixth most common cancer in North America. The National Cancer Institute estimates that over 10,000 people will die from melanoma this year.

There are 3 major types of skin cancer: melanoma, squamous cell carcinoma and basal cell carcinoma. Of the three, melanoma is the most concerning and most dangerous. It is the one most likely to spread (metastasize) and once it has spread, the chances of a cure go down significantly. As with most cancers, melanoma is best to catch early.

Melanoma, like all cancers, occurs when cells begin multiplying out of control. In melanoma, the out of control cells are the melanocytes that normally live in the epidermis (outer layer of skin). Melanocytes are what give your skin its color. We aren’t 100% sure what causes the cells to go haywire but it is likely a mix of genetic and environmental factors.

If you are fair-skinned, have excessive ultraviolet (UV) light exposure, have many moles, or have a family history of melanoma you could be at an increased risk. The biggest environmental risk factor is UV exposure, which is completely preventable with proper precautions.

Avoid tanning beds and prolonged sun exposure. If you are going to be in the sun, wear sunblock (SPF 15 or higher), UV-blocking clothes, wide-brimmed hats, and sunglasses.

Many people are born with moles and the vast majority of them are harmless. The best way to be sure is to have a skin exam by your physician.

Your primary care physician is able to examine skin for possible cancers. If there is ever any question, he or she will do a biopsy of the area or refer you to a dermatologist for their opinion.

To prepare for your physician visit, be equipped with your family history (remember genetics play a role in melanoma risk) as well as other history (e.g. do you tan, do you or family notice any moles changing?)

During the exam the skin will be examined and any skin lesions will be evaluated using the “ABCs of melanoma”:

  • A - Asymmetry: one side of the lesion does not mirror the other
  • B - Borders: borders are irregular, jagged, or shaggy
  • C - Color: the lesion has multiple colors, varying shades, and/or the pigment is not uniform
  • D - Diameter: the lesion is bigger than 6mm (about the size of a pencil eraser)
  • E - Evolving: the lesion is changing or growing

Treatment depends on the stage of the cancer. Cancers detected early may require only surgical removal. Later stages may require other treatments including surgeries, radiation, and/or chemotherapy.

Patients with melanoma that have been treated are at increased risk for developing a recurrence of that melanoma or developing another, separate melanoma. Therefore, close surveillance is needed (via visits for skin exams with your primary care doctor or dermatologist).

If you have any questions or concerns about possible skin cancer, or if you just want a good skin exam, schedule an appointment with your SIMED Primary Care physician. For more information on skin cancer I recommend cancer.gov or the American Association of Dermatology website aad.org.