Caffeine: Should We Quit?

Ah, caffeine. The substance we all love to love. March is Caffeine Awareness Month and with 54% of Americans over the age of 18 consuming caffeine on a daily basis, awareness is important. We talked to Dr. David Lefkowitz about the good and bad effects of caffeine. 


How Does Caffeine Work?


Caffeine is a compound in the stimulant class. It works on certain receptors in your nervous system to cause the effects we discuss in the questions below.  It is the most widely consumed stimulant in the world, the reasons for which are a multitude.  It is relatively cheap, its effects help us perform and feel less tired, and it is found in drinks that billions of people enjoy every day: coffee, tea, and soda.


What Are Some Of The Good Effects Of Caffeine?


Caffeine is most beloved for its ability to enhance mental performance including alertness, arousal, and focus. It is also known to lessen the drowsiness that comes from lack of sleep.  This is why so many people enjoy a morning cup of coffee (or tea).  It can also be useful for treating headaches (in fact it is an ingredient in some headache medicines).  There are other possible benefits of caffeine (such as protecting the liver or reducing the risk of Parkinson’s Disease), but the studies are not clear on this and so more research would need to be done for us to know if this were factual or not. 


What Are Some Of The Bad Effects Of Caffeine?


Consuming high levels of caffeine can be associated with negative short-term effects, including anxiety, tremors, elevated blood pressure, and insomnia.  A high level would be more than 400mg of caffeine a day. For reference, an average cup of coffee has ~100mg of caffeine, a 12oz Coke has ~35mg caffeine, and an 8.3oz Red Bull has ~80mg caffeine.  Also, taking in too much caffeine can cause arrhythmias (irregular heart rhythms) and, paradoxically, can actually cause headaches.  Yes, I know earlier I said that we use caffeine to treat headaches, but its use can also cause them. In fact, the number one side effect of caffeine withdrawal are headaches. 


If Someone Wants To Cut Back On Their Caffeine Intake, What Is A Healthy Way For Them To Make That Happen?


Cutting back on caffeine can be tricky because caffeine withdrawal is a real thing. Again, headaches are the main side effect reported, but people also complain of fatigue, irritability, and depressed mood.  If you want to cut back or need to cut back (for example in pregnancy it is recommended to consume no more than 200mg of caffeine per day), I would suggest gradually decreasing your consumption over one to two weeks.  If you do go through caffeine withdrawal, it will typically last less than ten days. However, if you “wean” yourself down slowly you really shouldn’t have much of a problem.

Dr. Lefkowitz is a primary care physician, and to make an appointment with him click here

SIMEDHealth Welcomes Dr. DeMori - Now Accepting New Patients!

SIMEDHealth Primary Care welcomes Gabriele DeMori, MD to our team. Dr. DeMori received his medical degree from the West Virginia University School of Medicine.  He completed his Internship and Residency in Internal Medicine at Shands Hospital at the University of Florida and is Board Certified in Internal Medicine. Dr. Demori will be available to see patients in our Gainesville office location beginning January 2nd

He is an expert in adult primary and preventative health and can help to diagnose and treat for: acute illness, cold/flu, blood pressure, diabetes and cholesterol management, vaccinations and physicals.

To schedule an appointment with Dr. DeMori, click here or please call SIMEDHealth Primary Care at (352) 224-2225.


Everything You Need to Know About Cholesterol

We hear it all the time: high cholesterol causes health problems. According to the CDC, 78 million U.S. adults (nearly 37%) have cholesterol levels where experts recommend cholesterol medicine or had other health conditions putting them at high risk for heart disease and stroke. We know that too much cholesterol is bad, but what exactly is cholesterol and how can we keep it under control?

We sat down with Dr. Shelley Roque of SIMEDHealth Gainesville Primary Care to learn more.


What is cholesterol?

A substance found in the blood that your body uses to build cells. The liver makes all the cholesterol for your body, the rest comes from animal products, such as meat, poultry, butter, cheese, and milk.  Some oils, such as palm oil, palm kernel oil, and coconut oil, can also trigger your liver to make more cholesterol. Foods high in saturated and trans fats cause your liver to make more cholesterol than normal, potentially bringing a person’s cholesterol level from a normal one to an unhealthy one.

How does it affect our health?

Since cholesterol circulates in the blood, if you have too much of the bad kind or not enough of the good kind, the cholesterol can slowly build up in the inner walls of arteries. This cholesterol build-up in the arteries can join with other substances to form a thick, hard deposit, potentially blocking arteries.  The narrowing  and decreased flexibility of arteries from the cholesterol build up is called "atherosclerosis". Atherosclerosis causes decreased blood flow to the organs that the arteries feed, putting people with atherosclerosis at a higher risk of heart attacks, strokes, and other health problems .

Is there good cholesterol and bad cholesterol?

Some call LDL cholesterol the “bad” cholesterol because having high levels can lead to atherosclerosis, and  increases your risk of heart attacks, strokes, and peripheral vascular disease (disorder of the circulatory system outside of the brain and heart) .

Some call HDL the “good” cholesterol because people with high HDL levels tend to have a decreased risk of heart attacks, strokes, and peripheral vascular disease. It is believed that HDL helps  carry excess LDL cholesterol away from arteries and back to the liver, where LDL is broken down and removed from the body. But only 1/3-1/4 of blood cholesterol is carried by HDL so it does not completely remove LDL.

What are symptoms of high cholesterol?

Sometimes people do not have any symptoms of high cholesterol since it can take time for cholesterol to build up enough in the arteries to become those hard atherosclerotic plaques, and start to cause significant blockages in the circulatory system. Overtime, however, as the blood flow to certain organs starts to decrease, organs will receive less and less oxygen. Your body needs oxygen, so when parts of your body do not get the oxygen it needs, it will not work as well.

So, for instance, if there is decreased blood flow to the heart, a person may start to feel chest pain. If there is decreased blood to the brain, depending on which part of the brain is affected, a person may start to feel numbness, tingling, weakness, slurred speech. If there is decreased blood flow to the legs, a person may start to notice skin changes, such as darker skin, less hair, pain. There is a wide array of symptoms a person can feel from high cholesterol. It all just depends on the extent of build up in the arteries, and which organs are being affected by the blockages.

What are common myths (if any) associated with cholesterol?

LDL is not really a bad cholesterol. We actually need that cholesterol  to help make protective walls around cells and certain hormones, so it is necessary for our body to have. However, having too much of it is what makes it “bad” since its build up in the arteries is what can set off the cascade of events that cause atherosclerosis  (i.e. plaque build up in arteries, see above ).

Are their any foods that might help to lower cholesterol?

There are foods you can avoid, and those are the ones that have a lot of saturated fat, such as red meat, butter, fried foods, cheese. Foods that can help lower your cholesterol are those that have more soluble fiber, such as fruits, oats, barley, beans, peas.

Technically, a vegan diet doesn’t have any animal products, so that could help lower your cholesterol if you really wanted to avoid dietary cholesterol. However, being vegan is not for everyone,  so generally a healthy diet includes a lot of fruits, vegetables, whole grains, beans, peas, lentils, chickpeas, nuts, some fish, and some milk and milk products.

I often recommend a Mediterranean-style diet for my patients with high cholesterol because it is the closest to the American Heart Association’s dietary recommendations.


What tips can you provide to help patients keep their cholesterol in check?

Stay active, try to exercise regularly. Work on losing weight if you are overweight. Avoid foods high in saturated fats. Avoid other risk factors that can make cholesterol build up in arteries worse, such as cigarette smoking and high blood pressure. Finally, follow up with your primary care physician regularly to see if you need to have your cholesterol checked.


If you need help keep your cholesterol in check, be sure to request an appointment with your SIMEDHealth physician.


SIMEDHealth Electronic Check-in Now in Gainesville Primary Care

You may have noticed a few changes in our clinics, as SIMED has transitioned to SIMEDHealth. The biggest change so far is our new electronic check-in system.

After testing this system in our Gainesville Neurology, Neurosurgery and newly renovated primary care suite, we are excited to announce the addition of this system in our Urgent Care clinic and Gainesville Primary Care clinics.

This E-check-in system allows for less paperwork, secure transfer of health information and an improved patient experience. It may seem complex but is actually fairly simple.

As appointment times approach, patients will receive a reminder notification and be prompted to fill out paperwork via text message or email. Once patients arrive, they’ll need to briefly complete their registration on an electronic pad (shown above). This allows our patients to spend less time in a waiting room and more time with their providers. With less paperwork to sift through, clinic staff and physicians can focus on delivering personalized care to patients.

Our E-check-in system also allows patients to verify insurance coverage before exams and pay all remaining balances on their accounts.

The system is held to the Payment Card Industry Data Security Standard (PCI DSS), is registered as an approved solution with Visa and MasterCard, and uses top encryption and security technology to protect your financial information. Your credit card information will never be saved in the system, and staff members will also only be able to see the last four digits of your credit card number to ensure the data is unusable in the event of a breach. The new electronic check-in system meets the strict security requirements of the healthcare industry to ensure patients are protected. All the information you enter is private, secure, and never stored in a physical location.

At SIMEDHealth, we are always looking for new ways to make our patient experience more efficient and personalized. We’re excited to be able to offer this new feature in our Gainesville Primary Care and Urgent Care clinics and look forward to keeping our patients in the best of health.

Keep an eye out for more announcements about our E-check-in system as we introduce it to more clinics in our practice.

Have questions? Contact us here

Need an appointment? Click here

Simed Opens Clinic of The Future

Over one month ahead of schedule, SIMED has completed the renovation of its primary care clinic. The new offices of Dr. Lefkowitz, Svestka and Roque open Wednesday, February 28, and feature updates to help doctors and staff deliver the highest quality of care.  

“I will miss my colleagues in suite 11, but I am looking forward to working with the new staff in Suite 7 and working with a new system that will enhance patient care and the patient experience,” said Dr. Shelley Roque referring to SIMED's new electronic check-in system.

With this system, patients can securely check in for appointments, fill out paperwork and send their medical history directly to their primary care doctor. They will also be able to verify health insurance and securely pay for their visit.  

The patient's medical and financial information is private, secure and never stored in a physical location. Click here for more information on this technology.

"I am most excited about beginning the process of shifting our patients' time at their doctor's office to a more welcoming, relaxed and enjoyable experience," said Dr. Eric Svestka 

Suite 7, in SIMED's Gainesville 4343 location, has been redesigned to improve convenience and accessibility for primary care patients. With a new color scheme and lots of sunlight peering through the windows, this suite will provide a calming atmosphere to current and future SIMED patients.


Take a look at the new primary care suite below!


Lose Weight and Eat Healthy: Learn How

Eating a healthy breakfast can lead to weight loss

Eat Healthy and Lose Weight: New Year’s Resolution

Thank you to everyone who submitted their New Year’s resolution for the Health Goals 2018 Project. New Year’s Resolution #3 was submitted by Nina of Ocala. Nina wants to “lose belly fat and eat healthy!”

Dr. Eric Svestka, a SIMED Gainesville primary care physician who loves healthy eating, provided advice on how to achieve weight loss and a healthy food lifestyle.

How to Lose Weight

The one way to lose weight and belly fat is through dietary restrictions. Evidence has shown that you can’t exercise off weight because exercise only burns a minimal amount of calories when compared to your much larger basal metabolic rate. Exercise is still a cornerstone of a healthy lifestyle and reduces your risk of heart disease, high blood pressure, high cholesterol, cancer, and similar issues.

There are two ways to approach weight loss through dieting. The first way could be called nuclear change. On day one, the individual would change everything about their entire diet. The second, more effective way, is to make gradual changes.

Making Gradual Changes


Making gradual changes is more likely to stick in the long term. To do this, you would pick a small victory or adjustment to make to your diet each week. For example, you could add a vegetable to every meal or try not to get calories from liquids (aside from milk). Only tackle one change at time. When you have successfully made that change for a period of time, approach an additional change, like eating fruit for dessert instead of a cupcake.

Your goal is to limit and remove as much processed food as possible and substitute it for unprocessed natural foods. You should also be limiting how much you actually consume.

How to Make Healthy Eating Affordable

1. Drink water. – Water is free. If you increase your water intake, you’ll feel fuller. Drinking 16 ounces of water before a meal will make the meal feel more fulfilling to you. Studies have shown that drinking water right before a meal can lead you to lose up to four pounds.
2. Buy healthy food in bulk. – Plan ahead and make batches of snacks. Package your lunches for the week in advance to make sure you don’t end up calling a fast food place at lunch time. When you wake up, just grab your prepackaged lunches and go.
3. If you’re planning to indulge, make the food at home. – Instead of buying brownies or cookies, make them yourself. There’s less sugar, fat, and salt in homemade baked desserts. While eating desserts isn’t going to help you lose weight, homemade is a better alternative to store-bought.

The Difference Between Healthy Eating and Eating to Lose Weight

Losing weight only pertains to calories. Healthy eating means giving your body high quality fuel, ideally in the form of unprocessed foods. In an ideal situation, you would combine the two.

Reusable water bottles like those below are perfect for weight lossMonitor Your Liquids

Liquids are one of the biggest problems for both unhealthy and overweight eaters. Liquids don’t make you feel as full but still give you calories. Drinking milk and black coffee is okay, but everything else should be avoided or considered with discretion.

Smoothies are a really good opportunity to work healthy fruit and vegetables into your diet. Try to add in vegetables like kale and spinach and proteins like almond butter and peanut butter to diversify and add more nutrition to your smoothie. Be cautious of how many calories you’re putting in as you can quickly reach and top 500 calories with only 3 or 4 ingredients.


If you would like additional advice on weight loss and healthy eating, you can schedule an appointment with Dr. Svestka in Gainesville. You can reach him at (352) 377-1874 or by requesting an appointment online.

To see another SIMED primary care doctor in Gainesville, Ocala, Chiefland, Lady Lake, or McIntosh, call (352) 224-2225 or schedule an appointment online.

Thank you Nina for submitting your resolution. We can’t wait to see you achieve it.

Weight Loss Tips for Healthy Weight

Weight loss and maintaining a healthy weight are important to avoid health problems

January 18 – 24 is Healthy Weight Week, and at SIMED, we want to help make sure you reach and maintain your healthy weight.

We spoke with Dr. Eric Svestka, a SIMED Primary Care doctor in Gainesville, about when, why, and how to lose weight and succeed. Dr. Svestka answered and helped with some of the common problems and questions people have when they realize they might want to lose weight.

How can I tell if I should lose weight?

Finding your healthy weight isn’t a one size fits all situation. It varies depending on the person.

Talk to Your Doctor

If you’re worried about your weight, you should probably meet with your primary care doctor and go over what would be good for you. Any SIMED Primary Care doctor can help you figure out a weight loss plan.

Depending on whether or not you have issues with blood pressure, blood sugar and/or heart disease, you might find that staying overweight is fine for you or you could find that you need to be more aggressive and bring your weight down.

Calculate Your BMI

A BMI calculator can indicate whether you’re in the normal weight range for your height. You can find a BMI calculator for free online. An overweight BMI falls between 25 and 29.9 on the scale. An obese BMI is 30 and above.

Everyone benefits from getting out of the obese range, but your goals beyond that may differ. For example, a football player may need a higher BMI than a rock climber, but both are still healthy weights.

Consider Your Wellness

If you have no health problems, you may not see a benefit in losing enough weight to bring you into the normal range, but you could still benefit from a healthy lifestyle.  However if you have a health issue like diabetes, losing weight could help you ease off the medications. Or maybe you just want to be more comfortable with your physical appearance. Whatever your motivation is, losing weight in the end could still improve your overall wellness, so if you’re considering it, you should go for it.

Think about Your Overall Health

Your healthy weight could be a little bit more than average. That's why it's important to talk to a doctor. An overweight woman is smiling confidently.

If your weight is causing diseases like high blood pressure, diabetes, high cholesterol, heart disease, or others, losing weight could help you become healthier.

Your weight could also be limiting your activities.  For example, you might not be able to get down on the floor and play with your children or play pickup softball with your friends. You might even find that you can no longer bend down to tie your shoe. A heavier weight increases your risk for diabetes, sleep apnea, heart disease and other health problems so changing your lifestyle could go a long way.

How Do I Start Losing Weight?

 SMART Goals

SMART stands for Specific, Measurable, Actionable, Realistic, Time-based goals. Let’s break that down.

  • Specific – Typically a standard goal for most people is to lose about 5% of their body weight over a three to six month period.
  • Measurable – Weight is measurable. You would measure your weight in pounds or kilograms.
  • Actionable – To lose weight, you are going to diet. Dieting is the only action that will work.
  • Realistic – Setting a goal to lose 5% of your weight in six months is realistic. If you weighed 300 pounds and tried to lose 100 pounds in six months, that wouldn’t be very realistic. You could change that goal to five years, and you’d be back at losing about 5% of your weight in six months.
  • Time Based – Usually a three to six month period is a pretty good amount of time to see results. Losing about a pound or a half a pound a week is a sustainable goal.

Track Your Weight

If you have a scale you should:

1. Weigh yourself once a week
2. Weigh yourself first thing in the morning when you’re undressed
3. Record your weight and track it over time

Keeping a log will help you hold yourself accountable and see whether what you’re doing is working for you. If it isn’t working, that doesn’t mean you’re doing it wrong. It just means you haven’t found the right method of weight loss that works for you. Don’t get frustrated or become hard on yourself. Just try a new method of weight loss and avoid the one that didn’t work.

If you don’t have a scale:

1. Weigh yourself when you visit the grocery store
2. Know your weight will fluctuate based on time of day and what you’re wearing
3. Look for overall patterns when recording your weight

Again, keep a log, and if something isn’t working. Don’t give up; just try a new method.

Reach your healthy weight infographic with tips to lose weight and stay a healthy weightHow Do I Maintain a Healthy Weight?

1.Establish the habits

You don’t want to think about making healthy choices for the rest of your life. It should become a part of your daily routine. Just as you shower and brush your teeth, you can establish a habit of eating healthy.

Make sure you’re staying away from refined sugars and processed foods. Eat fruits for desserts and vegetables with every meal. You can treat yourself when it’s a special occasion, but every night does not deserve cookies.

Eating healthy is easier than it sounds. The more you work on eating clean, the more your pantry should reflect the goals you’re trying to meet. You shouldn’t have chips, cookies, and candy or other packaged foods in your cabinets. Instead you should have foods like nuts (almonds, for example), dried fruits and vegetables, you can even make your own home made trail mix. In your fridge, you should have fresh fruits and vegetables like, broccoli, cauliflower, carrots, sweet potatoes, and other healthy foods.

You’re going to do whatever is easiest and most convenient for you no matter how strong willed you are. Make eating healthy easy and accessible and put barriers between you and your “weak spots”. If unhealthy food isn’t in your house, you can’t eat it.

2. Drink Water

Always keep a bottle of water with you. You should drink a minimum of a half a gallon of water a day and make water your default beverage of choice. Not soda, not tea, not coffee, just regular water.

3. Exercise

While exercise might not be key to losing weight, it is very important for maintaining weight. Exercise 30 minutes a day regularly every week. Similar to the dieting rule, what you like best is what you should stick with.

If you enjoy carbs, you probably shouldn’t go on a carb free diet. If you enjoy red meat, you don’t have to cut that out. The same thing applies to exercise. If you hate running, then don’t run. If you’re someone who loves to run, keep running.

High Intensity Interval Training

Scientifically the type of exercise doesn’t matter, but the way you do it does. You could begin to practice high intensity interval training where you do short bursts of high energy exercise and then rest.  The goal during the bursts is to get your heart rate near your maximum.

For example, you would jump rope for a minute, then rest for a minute, then jump rope for a minute, then rest for a minute. Or you could sprint for thirty seconds and then walk for 30 seconds and repeat.

Exercising with high intensity interval training has proven to be the most effective way to burn calories. You even continue to burn more calories after you’re done exercising.  You should check with your Primary Care doctor first, to ensure your health condition allows, but if you’re trying to maintain your healthy weight, it can help.

Strength Training VS. Cardio

There isn’t really a difference in overall health benefits between anaerobic (like lifting weights) and aerobic (like running) exercises. In fact, anaerobic exercise might be more beneficial for you because it increases lean muscle mass and increases your basal metabolic rate. The misconception is that the person running is more in shape, but that’s not necessarily the case.

4. Maintain a Clean Diet

1. Avoid Restaurant food 

Both fast food and sit down restaurants could hurt your health. Restaurants don’t want to help you lose weight. They want you to come back so they can sell you more. Restaurant food is usually high sodium, has high levels of bad fats, and has high levels of carbs because those foods are addicting. Even the green or healthy options at restaurants can still be oversized and full of salt.

2. Foods in cans and bags

While a can of beans is acceptable, food that has a long shelf life and is highly processed should be avoided. Try to keep the shelf life under a week to reduce the amount of food with sodium and preservatives. So don’t go for the can of Chef Boyardee.

3. Buy fresh produce and eat home cooked mealsCooking vegetables in a pan to lose weight and be healthy

Establish a routine of eating home cooked meals. You only need to know three recipes to make the first few weeks of your diet bearable. From there you could add an additional meal a week to build up your options. You want to plan to make sure you’re ready before you start trying to lose weight. Try a few recipes and figure out what out what you like so when you switch to a healthier, more sustainable diet, you set yourself up for success.  You could even delay your plan to eat healthier food a week or two to prepare, find recipes you like, meal plan out your entire first week and have you pantry and fridge stocked with these healthy options.  Don’t forget that what you don’t buy can be just as important as what you do, so let you pantry run out of things like candy, chips and cookies.

What Happens if I Feel Like It’s Not Working?

1.Don’t Beat Yourself Up. It’s Totally Okay.

We need to stop criticizing ourselves and beating ourselves up if we don’t lose weight on the first thing we try. We’re our worst critics. Keep up the mentality that you still want to lose weight and realize that while what you were doing wasn’t working for you that doesn’t mean losing weight isn’t for you

2. See How You Can Fix Things.

Sometimes you can sabotage yourself. Make sure to check serving sizes. Were you accidentally taking two servings without realizing it?

You might also need to reduce your daily caloric intake even more. With dieting and weight, there is no one size fits all. People have different metabolic rates, even if they are the same height and weight. We all have that friends who never exercises, eats the worst food, and is still the same size as they were in high school, and there are also people who must consciously think about everything they eat. Your path to health may be more or less challenging than those around you and that’s ok.

having an accountability buddy or friend to tackle healthy eating and weightloss3. Have an Accountability Buddy

Have a partner who is also on board with you who you can understand when you feel frustrated. You can both go through everything together and inspire each other to stay the course on the journey.

Humans are relational creatures so if you feel like you’re on an island and there’s no other person with you, you’re going to want to leave. That’s the reason why programs like Weight Watchers and Jenny Craig are so successful. It’s not because of some magical dietary formula, but because it’s a community where your voice is heard and you can feel accepted.

Having a social support system or someone that will cheer you on and help you stay on top of your diet can guarantee success. Whatever happens, don’t give up on trying to be a healthy weight. Stay with it, and try new things.


If you have more questions about your weight and weight loss, you can schedule an appointment with Dr. Svestka or any of our other Primary Care doctors in Gainesville, Ocala, Chiefland, Lady Lake, McIntosh, and Lake City. Call (352) 225-2225 or schedule an appointment online today.

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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Common Cold: Guide to Treatment and Medication

Tips to Treat Your Common Cold

As we approach winter, you might have noticed people coming down with the common cold. You might even experience symptoms like a cough, sore throat, or runny nose. Even if you don’t have a cold yet, it doesn’t hurt to be prepared.

We talked with Colleen Crabbe, a SIMED Primary Care ARNP in Gainesville, about what a cold is and how you can treat the symptoms.

Symptoms of the Common Cold

The symptoms of a cold include:

  • Runny nose
  • Cough
  • Congestion
  • Sore throat
  • Headache
  • Malaise

If you have these symptoms, you probably have a cold, but you might also have the flu.

Flu VS. Cold: What’s the difference?

It can be tough to differentiate the common cold from the flu because both have similar symptoms like cough, runny nose, congestion, headache, sore throat, and malaise (ill feeling). Flu symptoms, however, tend to be more severe and likely to cause fever and body aches.

Three Basic Elements to Treating the Common Cold

You’ve figured out you have the common cold. Now what?

1. Get rest
2. Drink plenty of water
3. Use over-the-counter medicine

These are the best things you can do if you have the common cold.

Medications: What Should You Look For?

There are many choices of medications at the drugstore these days, and finding what you need can be overwhelming. Looking at the “active ingredients” on the back of the box or bottle can help you choose medications that have been proven in research to work for symptoms of the common cold and flu.

  • Treating the Cough with Dextromethorphan.
    • This ingredient can help reduce your cough. It is found either alone or in combination, liquid, or pill formulations.
    • Dextromethorphan won’t make you drowsy like prescription cough medicine can.
  • Reducing Fever and Aches with Analgesics
    • Analgesics like Acetaminophen and ibuprofen can help with reducing fever and aches.
    • Acetaminophen tends to have fewer side effects, but both have risks to those with certain conditions. Discuss the use of these medications with your physician prior to use.
  • Relieving Congestion with Decongestions
    • Decongestions are commonly used and commonly feared over-the-counter medicines.
    • Pseudoephedrine is more effective and can be found behind the counter where you will need to show your identification.
    • Phenylephrine is not as effective as pseudoephedrine and is found in many over-the-counter cold medications.
    • Both pseudoephedrine and phenylephrine can help with symptoms of cough, congestion, ear pressure, and pain. Use them with caution if you have high blood pressure or heart conditions.
    • Make sure to check your active ingredients to see whether the medication has pseudoephedrine or phenylephrine.
    • Topical formulations in sprays such as Afrin or generics can improve nasal congestion, but should be used a maximum of twice a day for 3 days.
  • Improving Sleep with Antihistamines
    • Common antihistamines like Benadryl (diphenhydramine) and chlorpheniramine or doxylamine are found in many nighttime cold medicines and sleep aids.
    • The medications help with drying and can sooth congestion, runny nose, and cough while sedating to improve sleep.
    • There is some evidence that using antihistamines with decongestants is more effective for moderate to severe cold symptoms.
  • Reducing Mucus and Cough with Guaifenesin
    • Guaifenesin is a popular expectorant in Robitussin and Mucinex products and can also be used by itself. It helps with coughing and thinning of mucus.
  • Reducing Congestion and Cough with Saline Sprays
    • Saline sprays irrigate the nostrils during a cold and can provide relief of congestion and cough in combination with other therapies.
  • Other Possible Remedies Include:
    • Vitamin C, Vitamin D, Echinacea, zinc, and heated humidity have limited evidence for improvement in cold symptoms and need more research.

Medications and Home Remedies for Cold Symptoms

Treat Your Symptoms of the Common Cold Flat Design Infographic

Here is a summary of different treatments that will work for each of the common cold symptoms.


  • Dextromethorphan
  • Antihistamines
  • Honey
  • Warm Liquids

Sore Throat:

  • Salt-water gargles

Aches, Pains, and Fever:

  • Acetaminophen
  • Ibuprofen

Nasal Congestion:

  • Saline nasal spray
  • Humidified air
  • Topical or oral decongestants
  • Antihistamines in combination with
    • Decongestants
    • Guaifenesin

If these treatments aren’t working and you feel your symptoms worsening, you might want to consider the next step.

When You Should See a Doctor

For most people with colds, symptoms are self-limited, meaning they will go away on their own eventually. Because the cold is caused by a virus, antibiotics will not help, but some people can have complications from the cold like acute sinusitis, pneumonia, bronchitis, and ear infection. These complications may need additional prescription medicines from your provider or even antibiotics depending on the patient.

You should see a doctor if you:

  • Develop significant face pain
  • Have symptoms prolonged over one week
  • Experience shortness of breath
  • Wheeze
  • Have another unmanageable symptom

Those who are most at risk of these complications are diabetics, smokers, and those with poor immune systems.

Avoid Transferring the Cold

Colds can spread quickly amongst family, friends, and people in a work place. Take these steps to ensure you avoid giving and getting a cold:

  • Wash your hands often
  • Cover your coughs and sneezes
  • Avoid others until you feel better

Following those tips, you will be able to reduce the spread of the cold virus. If you have a fever or an uncontrollable cough and sneezing, you should consider staying home from school or work to help reduce the spread of the cold.

To schedule an appointment with Colleen Crabbe, ARNP, in Gainesville, call (352) 332-7770 or schedule an appointment online.

For SIMED Primary Care in Gainesville, Ocala, Chiefland, Lady Lake, or McIntosh, call (352) 224-2225 or request an appointment online. If you could like to schedule an urgent care appointment for cold or flu symptoms, call (352) 373-2340 or request an appointment online.

If you have the flu or a cold, we hope you feel better.

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Construction Begins on New Clinic with Improved Patient Care

Construction began at Gainesville SIMED building 4343 on the new and updated primary care unit
As SIMED continues to grow to meet the needs of our community, we are excited to announce the construction of our new “clinic of the future”. 
Suite 7 in our 4343 Building in Gainesville is being redesigned and will become a Primary Care suite and the future Gainesville location for Drs. Lefkowitz, Svestka, and Roque.  These physicians and their staff have agreed to participate in a new pilot program which will introduce new technologies and clinic efficiencies into our workflow.
“We are always implementing ways which we can provide higher quality care to our patients, and we believe these new technologies and clinic design will improve patient access, flow, and convenience.  We’re hopeful that we will be able to expand the successes of this new clinic throughout all of our patient care areas,” said Daniel Duncanson, MD, Chief Executive Officer for SIMED.
Construction begins on December 4th and is expected to be completed in only 135 days. Our staff will be making every effort to minimize any inconvenience to our patients. 
SIMED Primary Care Physicians Dr. Svestka, Dr. Lefkowitz, and Dr. Roque break ground on the new improved primary care unit in Gainesville