“There are certain drug toxicities associated with mostly all medications. PrEP uses antiretroviral medication, and we like to monitor our patients every three months. The toxicities that are usually associated with this medication include kidney damage, liver dysfunction, and it can decrease a person’s bone density.So we like to monitor for osteoporosis, as well. when the patient comes in – we like to have them come in every three months – we do blood work to monitor their kidney function, their liver function. We monitor their cell counts because there can be fluctuations as well. It is a safe medication to take as long as patients comply with the follow up.”
Monaa Zafar, MD, is a board certified primary care doctor at Mount Sinai Doctors, seeing patients Monday-Friday. She has a particular interest in disease prevention, health promotion, and chronic illnesses. Dr. Zafar is fluent in Urdu and Spanish. Mount Sinai Doctors is an organization of clinical relationships and multi-specialty services that expand the Mount Sinai Health System’s footprint beyond the seven main hospital campuses into the greater New York City area.
Prolonged sun exposure and sunburns over long periods of time can cause skin cancer. Your genetic makeup is also a factor. In this Q&A, Tamara Lazic Strugar, MD, Associate Clinical Professor of Dermatology at the Icahn School of Medicine at Mount Sinai, explains what steps you can take to protect yourself and your family.
Why is sunscreen so important?
Sunscreen is the thing that we can control for us and for our children. Using sunscreen, SPF 30 or above, applying it 15 to 30 minutes before sun exposure, and reapplying it every two to three hours or every time you get out of the water, is one of the things that we can do.
What should I do for my kids?
Keep in mind that childhood sunburns are the ones that usually cause skin cancers later on in life. Skin cancers typically come out 20, 30 years later after the blistering sunburns. So it’s very important to start educating children early on sun protection. SPF 30 or above, a combination of a physical and a chemical sunblock, are the way to go.
What is melanoma?
In order to prevent a deadly form of skin cancer–melanoma–it’s very important to do annual skin cancer screenings, which are recommended for everybody. Once a year, you should see your dermatologist and get all your moles, freckles and the entire skin – it’s the largest organ of our body – it needs to be checked once a year. Catching a melanoma early can be life-saving, so that’s the main purpose of these screenings.
What about other forms of skin cancer?
There’re two more types of skin cancer: basal cell and squamous cell. Those are typically not deadly but can be quite disfiguring if they’re left alone. So, make sure that you see a dermatologist once a year for your skin cancer screening.
Mount Sinai Doctors offers primary, urgent, and specialty care to patients throughout the five boroughs, New Jersey, Long Island, Westchester County, and Florida.
Tamara Lazic Strugar, MD, is a board certified dermatologist at Mount Sinai Doctors, seeing patients Tuesday-Thursday. She has a particular interest in eczema, psoriasis, acne, warts, skin cancers, medical and surgical treatment of skin disorders, and a wide variety of cosmetic procedures, including Botox, fillers, microneedling, chemical peels.
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“Family Medicine is an essential aspect of medical care. Family Medicine doctors and providers tend to focus on the entire family. We apply a holistic, preventive approach. By that I mean we’ll look at, not just the children, but also the parents and even the grandparents, or extended family members. The health of one group within that family also can impact the health of the other members of the family. Typically, the preventive things that we look at are screening tests that people know about, like mammograms or colonoscopies. But we also try to take a preventive approach in terms of lifestyle change, like diet and exercise requirements or recommendations. We tend to look at cholesterol and blood sugar as well. Family Medicine doctors, unlike specialists, are people who care about the whole body. We care about not just one aspect of the human body, but the entire body, and we take that integrated approach to the family as well.”
Make an appointment with Berestrand Williams, MD, FAAP
Berestrand Williams, MD, FAAP is a board certified primary care doctor at Mount Sinai Doctors, seeing patients of all ages Monday – Friday. Trained in Connecticut and Massachusetts, he is certified by the American Board of Pediatrics and the American Board of Internal Medicine and a member of the American Academy of Pediatrics and the American College of Physicians.
After majoring in Biology and graduating with honors from Harvard University, he was awarded his medical degree from the University of Connecticut’s School of Medicine and completed two residencies – one in Internal Medicine at Boston University’s Boston City Hospital and another in Pediatrics at the combined Boston University School of Medicine – Harvard Pediatric Residency Program.
Prior to joining Mount Sinai Doctors, he practiced at the East Boston Neighborhood Health Center for nine years and then served as Chief of Primary Care at Concentra Urgent Care and Family Medicine Center. He has been nationally recognized, receiving the Surgical Scholars Award in 1987 and the AOL Foundation Grant: Franciscan Children’s Hospital in 2001. Dr. Williams is fluent in Spanish.
“Patients often ask – can I walk on an ankle sprain? The answer is it’s really a case-by-case basis. First, you must differentiate an ankle sprain from a fracture. If you have difficulty bearing weight and have a lot of swelling and deformity, then you have to see your doctor right away and get an x-ray. For a minimal ankle sprain, we use an acronym: RICE – Rest, Ice, Compression, Elevation. That’s how we treat a grade one or minimal ankle sprain. Those ankle sprains you can put weight on, and it’s actually shown to help promote healing, as long as you protect the ligaments while you’re putting weight on it by wearing an air cast, a lace-up ankle brace, or a high-top boot. If the ankle pain continues, you should definitely follow up with your doctor.”
Make an appointment with Jonathan Gordon, MD
Jonathan Gordon, MD, is a board certified orthopedist, specializing in sports medicine and foot and ankle surgery, at Mount Sinai Doctors, seeing patients Monday, Tuesday, Thursday, and Friday. Trained in Philadelphia and New York, he is certified by the American College of Orthopedics. He was awarded his medical degree from Drexel University, where he completed his residency in Orthopedic Surgery, and completed his fellowship in Foot and Ankle Surgery at the Hospital for Special Surgery.
Dr. Gordon serves as the Medical Consultant for the NBA Milwaukee Bucks and a consulting physician for the New York Police Department and the Fire Department of New York. Prior to joining Mount Sinai Doctors, he served as an Orthopedic Consultant for the U.S. Figure Skating Association, American Ballet Theater, New York City Ballet, World Boxing Association, and the University of Connecticut Men’s basketball team. His research includes examinations of lower extremity trauma and the biomechanics of the ankle. He has a particular interest in arthroscopic and minimally invasive surgery of the knee, shoulder, foot and ankle.
“Blackheads, by medical terminology, are called open comedones. A comedone is the pore, the opening in your skin, that connects your sebaceous, or oil-producing gland, your hair follicle, and little tiny muscles that help your pores open and close. When that pore gets stuffed with debris, dead skin, oil pollution from the environment, that becomes a blackhead. Sometimes people confuse those with whiteheads. What are whiteheads? That’s when the blackhead gets closed. It has a cap of skin on top of it, literally making it look white rather than black. Dermatologists distinguish between open comedones, or blackheads, and closed comedones, or whiteheads. The optimum treatment for these are topical retinoids. These are by prescription. They are related to vitamin A, and these can be given to you by your dermatologist.”
Reena Rupani, MD, is a board certified dermatologist at Mount Sinai Doctors, seeing patients Monday-Thursday. She has written several publications, including two textbooks, on dermatology and has contributed to multiple peer-reviewed articles. She has a particular interest in both adult and pediatric medical and surgical dermatology, as well as cosmetic care, including Botox, chemical peels, injectable fillers, and laser therapies. Mount Sinai Doctors is an organization of clinical relationships and multi-specialty services that expand the Mount Sinai Health System’s footprint beyond the seven main hospital campuses into the greater New York City area.
“A bunion deformity is a prominence on the inner side of the foot that is created by an angular deformity between the first and the second metatarsals. So the first metatarsal drifts towards the inner side of the foot, where the great toe, which we call the hallux, drifts towards the lesser toes. This is what creates the bony prominence or eminence on the medial side of the foot. One of the ways to prevent it is to create an arch support. Orthotics can be very handy to maintain the longitudinal arch, which keeps the bunion or the metatarsal in a more favorable alignment. However, sometimes you can’t prevent a bunion because bunions are also genetic. When you have the genetics that predispose you to having an increase in the space between the first and second metatarsals, then often bunions would need to go on to surgery. However, there are things you can also do to stop a bunion from getting worse, and that’s not wearing shoes that are narrow. If you wear shoes that are narrow and high-heeled shoes, it pitches the foot forward, which also causes the toes to be squeezed. That increases the angle of the great toe being pushed over towards the lesser toes, and that’s what helps to precipitate a bunion.”
Make an appointment with Thomas Goldman, DPM
Thomas Goldman, DPM, is a board-certified podiatrist at Mount Sinai Doctors, seeing patients Monday-Friday Trained in New York, he is certified by the American Board of Podiatric Medicine. He was awarded his medical degree from the New York College of Podiatric Medicine and completed his residency in Podiatry at Coney Island Hospital. He has a particular interest in podiatric minimally invasive foot surgery and sports medicine.
