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561.368.0191|Richard A. Levine, MD FACP Board Certified Internal Medicine

During this period of social distancing, prospective new patients may call for a Telehealth or Phone Meet & Greet with the Doctor.
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Doctor’s Notes

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Doctor’s Notes: Staying Well – A Path Forward

“When the goin’ gets tough, the tough get goin”

                                                                                     Mr. Harris, high school football coach 1968

Hello, and I hope this Doctor’s Note finds You & Your Loved Ones Safe & Well. I want to bring you an update based on where we’ve been and where we are going.

I want to keep you informed as to how I, as your Doctor, can keep you as well as we can. This experience is a new one for everyone on the planet. It is a first for known mankind. That being said, open mindedness, resourcefulness and creativity should rule the day.

The Institute for Health Metrics and Evaluation website https://covid19.healthdata.org/united-states-of-america/florida is a daily update of the evolution of our efforts regarding the spread of COVID 19. It changes daily, based on the success of our response to this dilemma. As of today, here in Florida we are beginning our ascent to the current peak on Wednesday May 6, 2020. Two weeks later on May 20, 2020 is the time period currently stated to allow for some phasing in of services. This timeline has been changing as new data arises and is improved by our compliance with Public Health advice. As the old adage goes “when you have your health, you have just about everything”.

That being said, here is how my office can assist you in that endeavor.

THE OFFICE: The office has been closed to public entrance since March 14, however the Doctor and full time […]

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Doctor’s Note: We Can Do This

Primum non nocerum…First, Do No Harm
                                 Hippocrates

A young Resident in Medicine confronted with an emergent clinical problem learns, the first day, to think intelligently, act quickly and … First… do no harm….Then, do something helpful.

When the young Physicians arrive at an emergency they learn to “first, take our own pulse”. It is an exercise in maintaining your own calm in a difficult situation.

The Red Cross always starts out the First Aid Courses with reminding us that when arriving at a scene in need, we must first caution to assure we do not become another, in need of assistance, but remain as one of those helping remedy the situation. Good advice.

Try to not to panic in these times. Communication is King, and Queen.

Our Office is functional. We have adjusted our practices following guidelines that offer guidance to the patients, the staff and the Doctors. Some of the new approaches to maintaining our collective ongoing good health, include:

PLEASE NOTE:  Needs must FIRST be communicated with by PHONE.  NO WALK INs PLEASE. It puts you and us at risk.

Keeping our distance through “Social Distancing” (see my Doctor’s Note from 3/16/20) is the first and most important line of defense(along with stringent hand washing) for this new communicable virus that transmits by the respiratory route.

CALL FIRST. Also, if calling 911 or going to the ER with any COVID 19 condition PLEASE let 911 and the ER personnel know you are coming prior to just presenting ourselves.  It protects the care givers that will help you. As Jerry Maguire so aptly stated…”Help Me…Help You!”.

OFFICE VISITS: Phone visits associated with visual assistance TELEHEALTH […]

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Novel Corona Virus COVID 19: A Word from the Doctor

We are experiencing an epidemic, “an increase, often sudden, in the number of cases of a disease above what is normally expected in that population in that area”. This is a NEW disease.

 

The world is experiencing a pandemic, “an epidemic that has spread over several countries or continents usually affecting a large number of people.”

 

Public Health “is the science of protecting and improving the health of entire populations, big and small.” In the absence of epidemics and pandemics, the protection Public Health provides is not apparent in everyday life, but its’ purpose in keeping us healthy is. If the spread of a disease can be mitigated (made less severe) it can reduce the impact on society. It requires everyone taking part.

 

Where Do We Start?

 

The best current source of information is Anthony Fauci MD https://www.niaid.nih.gov/about/director When he speaks we should listen closely.

 

He has advised “if you feel sick, stay home and call your Doctor for direction.” I want to review basic things we all can do to make it harder for this transmissible virus to take advantage of our health.

 

I have found the Florida Department of Health http://www.floridahealth.gov  to be an excellent site for concise up to date information for the everyday individual seeking basic advice.

 

Try the COVID 19 Resource Toolkit tab in the middle of their home page. My favorite starter items are:

      http://ww11.doh.state.fl.us/comm/_partners/action/covid19_resp_prevent_8.5×11.pdf          

      http://ww11.doh.state.fl.us/comm/_partners/action/covid19_general_8.5x11_2.pdf

      http://ww11.doh.state.fl.us/comm/_partners/action/covid19_social_distancing.pdf

      http://ww11.doh.state.fl.us/comm/_partners/action/covid19_should_i_get_tested.pdf

 

Although these items seem very basic…they are, Very…Basic, much like blocking and tackling, for all you football fans out there. Social Distancing is extremely important and basic. It is not a joke, as this type of virus transmits through […]

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Doctor’s Notes: Spring 2019 – Genomics, A Primer

“ Your genome sequence can become a vital part of your medical record, thereby providing critical information about how to optimize your health” 
– Leroy Hood MD, PhD       

We have all heard talk of our genome. What is that? It is defined by the National Library of Medicine as

“…our complete set of DNA and all of its genes. Each genome contains all the information to build and maintain our organism. The human genome contains more than 3 billion DNA base pairs, contained in our chromosomes”  …23 pairs of chromosomes, of which we get one pair from Mom and one pair from Dad, for a total of 46 chromosomes. These are found in every cell in our body that has a nucleus.

The study of these genes is called Genomics and was made possible by the discovery of the DNA structure by James D Watson and Francis H C Crick on February 28, 1953 at Cambridge University and by the Human Genome Project which in 2003 was successful in mapping the entire genome of the human species. Genomic Medicine is an emerging medical study devoted to using this information for better diagnosis of conditions and diseases to be able to better personalize therapy.

How is this practical for us? There are various areas of development of this study that are maturing as this note is written.

The most common to the lay public is in the form of testing that is available direct to consumer, the most prevalent one being 23andMe which includes both ancestry and health information. The pertinent aspects are […]

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Doctor’s Notes: Fall 2018 – Eat Better. Feel Better.

“ An ounce of prevention is worth a pound of cure”
– Benjamin Franklin

”You don’t have to go on a diet, just change your diet.”  But, there are so many choices and we are all different in our makeup, routines, environments, genetics, habits and comfort foods. Of course, but if you could feel better from a change in your habits and comfort foods, mixed in with some education on the subject, it might just be worth it.

It is not that difficult. Health minded approaches to nutrition have made their way to your local grocery store and your favorite restaurant. It is understandably difficult to know where to begin in our busy lives. Let’s try to understand how we nourish and what to nourish with.

Everyone is talking about taking probiotics, “they are good for you”.

The World Gastroenterology Organization Global Guidelines define a probiotic as “live microorganisms that confer a health benefit on the host when taken in the adequate amounts” and “strictly speaking, are live microbes shown in controlled human studies to impart a health benefit”. The evidence based applications for adults are associated with active disease imbalanced states such as acute diarrheal states, antibiotic related diarrheal states, irritable bowel syndrome, colitis and certain liver diseases. The Human Microbiome Project began in 2007 and is active today at the Mayo Clinic and Scripps Institute among other centers worldwide.  What if you don’t have any of those conditions and you generally feel well?

What are my personal “probiotics” and how are they?

They are your own personal group on microbes localized mostly in your large intestine, the colon. They become associated with us while we are in the womb, increase in number during vaginal birth and stabilize […]

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Doctor’s Notes: Fall 2016 – Anti-Aging (to be or not to be)

“ Life flows on within you and without you” - George Harrison, Sgt. Pepper’s Lonely Hearts Club Band Anti-aging is defined as “used to prevent or lessen the effects of aging”. The American Academy of Anti-Aging Medicine was founded in 1992 to advance therapies for “prevention, treatment and reversal of age related dysfunction” [...]

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Doctor’s Notes: Fall 2015 – The Big Picture

“A stitch in time saves nine” – Francis Baily, English Astronomer, 1797 Much is heard daily, of new scientific and medical advances. All are important but oft times there is no further talk of them, they are replaced by new information or are years away from practical application. As our […]

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