October 4, 2022 gyn

We’ve all probably seen the fuzzy black and white photos that pregnant couples get when they’re expecting. Those keepsake photos are called sonograms. They are created when a pregnant mother gets an ultrasound from her doctor.


Ultrasounds are commonly used to help monitor the health of your fetus during pregnancy and detect any abnormalities. But what is an ultrasound exactly? And how many ultrasounds do you need throughout the course of your pregnancy? Do you get one at every pregnancy check-up or only at certain follow-up visits?


Keep reading to learn more about ultrasounds and how many ultrasounds you should have during pregnancy.


What is an ultrasound?

What is an ultrasound

An ultrasound is a type of body scan that uses high-frequency sound waves to create an image of the body’s internal organs and of a developing baby. Ultrasounds are used during pregnancies to capture an image of the fetus inside the mother’s womb. They are a routine part of prenatal care.


Since the human eye cannot see inside the womb, ultrasounds are essential to monitoring the health and development of the fetus. They can help assign your due date, determine your baby’s gestational age, identify any health problems or birth defects, monitor fetal health and development, and identify the sex of the baby.


You may have heard the terms “ultrasound” and “sonogram” used interchangeably before. What is the difference? Ultrasound refers to the procedure where the doctor performs the body scan, whereas sonogram refers to the printed picture that results from the procedure.


Are ultrasounds safe for pregnant women?

Ultrasounds are commonly used during pregnancies. They have been determined to be very safe for pregnant women and the fetus.


Ultrasounds are very safe to have because they utilize sound waves to generate the sonogram image. They do not use radiation or X-rays. Ultrasounds are so safe that they do not require any special preparation or personal protective equipment before use.


How many ultrasounds are necessary during pregnancy?

How many ultrasounds are necessary during pregnancy

While ultrasounds are completely safe for the mother and fetus, there is no medical reason to have more ultrasounds than necessary.


In general practice, it is expected that pregnant women receive a minimum of two standard ultrasounds throughout their pregnancy.


The first ultrasound is typically given in the first trimester to confirm the baby’s heartbeat, verify that the pregnancy is in the uterus and is not an ectopic pregnancy, and to predict the baby’s due date. A doctor may use a pregnancy ultrasound in combination with a pregnancy test to confirm a viable pregnancy.


The second pregnancy ultrasound is typically given in the second trimester, between 18 and 22 weeks, to monitor the fetus’ growth, assess the position of the umbilical cord and the placenta, do an anatomy scan, count the baby’s fingers and toes, and determine the sex of the baby.


If you have medical concerns or you have a high-risk pregnancy that requires more frequent monitoring, then you can expect to have additional ultrasounds during your pregnancy.


Therefore, different women may receive different numbers of ultrasounds throughout their pregnancy journey. There is no exact number that is right for everyone’s medical needs.


What are the types of ultrasound?

There are several types of ultrasounds that are used for different purposes and at different times during pregnancy. All of these types of ultrasound scans are safe for pregnant women and are used to monitor your baby’s growth and health.


A transvaginal ultrasound is an ultrasound that is performed through the vagina. A small wand, or transducer, is placed in the vagina up to the cervix and uses ultrasound technology to create an image of the inside of the uterus. A transvaginal ultrasound is often used for the first early ultrasound.


A pregnancy ultrasound done later in the second trimester is often performed with an exterior transducer placed on the outside of the pregnant woman’s belly. This is the ultrasound that most of us probably think of when we think of pregnancy ultrasounds.


A nuchal translucency (NT) ultrasound is an optional ultrasound given around 10-13 weeks. This optional ultrasound can be used to identify congenital disabilities and down syndrome. A mother may choose to have this ultrasound to alleviate any concerns she may have about the baby’s health. A doctor may recommend this ultrasound if there is a family history of congenital disabilities.


Who performs an ultrasound during pregnancy?

Obstetricians or ob/GYNs typically perform ultrasounds for pregnant women. Some obstetrics providers may also have an ultrasound technician on staff to assist with the procedure. All procedures should be performed by a trained medical doctor.


Visit your Ob/GYN for an ultrasound today

Are you pregnant or planning to be pregnant? Then you are in need of obstetrics services!


At Great City Medical, our board-certified ob/GYN Dr. Yelena Tsyba provides top-quality ultrasound exams and ob/GYN services to pregnant women in NYC. If you think you might be pregnant, Dr. Tsyba can provide your first-trimester ultrasound so you can monitor your baby’s development during early pregnancy and beyond. And get images of your baby to keep as a beautiful keepsake!


Call our offices to make your appointment for an NYC ultrasound today!


October 4, 2022 gyn

If you are looking for a women’s health doctor, then good for you for taking care of your health! You have come to the right place. Great City Medical specializes in women’s health and provides ob/GYN services in NYC.


But if you are confused or nervous—don’t worry! You are not alone.


Women’s health care can be confusing. You’ve probably heard of a gynecologist, an obstetrician, or an ob/GYN. But what do each of these doctors do? What health issues do each of them help with? Which type of doctor is right for your medical needs? Keep reading to learn the answers to these questions and more!


What is a gynecologist?

What is a gynecologist

A gynecologist is a medical doctor who specializes in caring for women’s reproductive health. This can broadly encompass many sexual health issues, including screening for sexually transmitted diseases, screening for cancers and other diseases of the reproductive organs, prescribing birth control, monitoring menstruation health, and more.


Gynecologists can care for patients from the age they get their first period or become sexually active through menopause. They help with women’s health issues through all ages.


While gynecologists specialize in many areas of the reproductive system, they do not specialize in pregnancy care and do not treat pregnant women.


What does a gynecologist do?

What does a gynecologist do

A gynecologist performs a gynecological exam or a physical exam that checks your overall reproductive health and wellness. Young women need to receive this exam annually starting from ages 18 to 21 or whenever they become sexually active. However, some irregularities like an odd menstrual cycle or severe pelvic pain can warrant a GYN exam sooner.

During an exam, gynecologists can help with a wide variety of women’s health needs. Gynecology includes but is not limited to:

  • Annual exams
  • Pelvic exams
  • Pap smears
  • Cancer screenings (ovarian, cervical, uterine, breast)
  • Breast exams
  • STD testing
  • Contraception
  • Urinary tract infections (UTIs)
  • Menstruations’ care
  • Infertility consultation
  • Uterine fibroids
  • Ovarian cysts
  • Endometriosis
  • PCOS
  • Prolapse of pelvic organs
  • Gynecological surgeries, including hysterectomy, tubal ligation, and labiaplasty
  • Any other medical conditions related to the female reproductive system, which includes the cervix, uterus, ovaries, fallopian tubes, or vagina
  • Reproductive health education


What is an obstetrician?

What is an obstetrician

While often confused with a gynecologist, an obstetrician has very different responsibilities and can help with different health needs. An obstetrician is a medical doctor who specializes in pregnancy care, including everything from prenatal care to postpartum care.


They will help you have a healthy pregnancy and deliver a healthy baby so that you and your family can feel your best. They help the process be safer and more predictable for you and the baby.


You only need to see an obstetrics specialist if you are pregnant or trying to get pregnant. They do not provide standard gynecology care services.


What does an obstetrician do?

What does an obstetrician do

An obstetrician is a pregnancy specialist. Your obstetrician will be with you throughout every step of your pregnancy journey. An obstetrician’s duties can include but are not limited to:

  • Family planning
  • Prenatal care
  • Fertility treatments
  • Routine pregnancy check-ups
  • Ultrasounds
  • Genetic screening
  • Monitoring for signs of fetal distress
  • Fetal medicine
  • Ectopic pregnancy
  • Labor care
  • Delivering a baby
  • Childbirth through cesarean section (C-section)
  • Premature baby and NICU care
  • Post-natal care
  • Postpartum depression care


What is an ob/GYN?

While it might sound like alphabet soup, and ob/GYN is simply an obestetrician-gynecologist, or a medical doctor who specializes in both fields.


Many women may prefer to visit an ob/GYN as their regular women’s health care provider because they can be with them throughout every step of their reproductive health journey and birthing process. The majority of women chose to see the same ob/GYN for many years once they find a doctor they like. This allows them to build a close, trusted relationship with their doctor.


Why do you need to see an ob/GYN?

Whether you decide to go with a gynecologist or ob/GYN, it is important to regularly visit a women’s health care professional. If you are planning to get pregnant or are already pregnant, than you should have a gynecologist and an obstetrician, or an ob/GYN.


These medical professionals can help improve your quality of life, provide life-saving care, and answer any questions you have about your reproductive health or pregnancy.


If you are feeling at all uncomfortable about visiting your gyno or ob/GYN for the first time, you’re welcome to bring a female family member or friend, or request a nurse chaperone to accompany you during your appointment. You never have to be alone with the doctor if you don’t wish to be.


Great City Medical ob/GYN services

Whether you’re looking for a standard annual gynecologist exam or surgical procedures, we can perform all our services at our state-of-the-art medical center and provide you with the quality gynecologic care you deserve.


Our women’s reproductive health specialists provide excellent medical care and help you take care of your overall health and wellbeing. Our Dr. Yelena Tsyba is a board-certified ob/GYN who can provide all of the services listed above.

Make an ob/GYN appointment today!

If you are looking for the best ob/GYN in the NYC area, you’ve come to the right place! Caring for women’s health is our specialty at Great City Medical. If you have any reproductive health concerns, our Dr. Yelena Tsyba is a board-certified provider who is happy to help.


NYC Obstetrics

NYC Gynecologist Exam


October 4, 2022 gyn

PCOS is a common and frustrating women’s health concern. Symptoms can be very general or confusing, so checking for this condition can be difficult. While it can be hard to diagnose, it is estimated to affect 1 in every 10 women of childbearing age and can even affect young women as early as their first period.


So, if you are suffering from symptoms of PCOS, know that you are not alone!


Speak with your healthcare provider at Great City Medical if you are concerned you might have PCOS. But first, to help answer some of the health questions you may have, here is some information about PCOS and how it is diagnosed and treated.


What is PCOS?

What is PCOS

Polycystic ovary syndrome or polycystic ovarian syndrome (PCOS) is a hormonal disorder in females caused by an imbalance of sex hormones. The disorder causes many small sacs of fluid, called cysts, to form on the ovaries. The cysts can be filled with immature eggs, preventing them from being released during ovulation in a regular menstrual cycle.


Therefore, common symptoms of PCOS include irregular menstrual cycles, long-lasting menstrual cycles, and infertility. Other common symptoms include unwanted hair growth including facial hair (also known as hirsutism), male pattern baldness or hair loss, acne, obesity, painful periods, abdominal bloating, and high levels of androgen (also known as “male hormones” but women also have them).


PCOS can be diagnosed at any age. Signs of PCOS can be apparent around a person’s first menstrual period, or they can first appear later in life.


Can a gynecologist check for PCOS?

Can a gynecologist check for PCOS

Yes, a gynecologist can help you determine if you have PCOS. If you are concerned you might have PCOS or if you have any questions about the disorder, you can ask your ob/GYN at your next visit.


Unfortunately, there is not just a single test for the diagnosis of PCOS. A diagnosis can sometimes take many tests and may also require a referral to an endocrinologist (a hormone specialist). That said, talking to your obstetrics and gynecology provider is a great place to start.


How is PCOS Diagnosed?

How is PCOS Diagnosed

To evaluate you for PCOS, your healthcare provider may start by asking you questions about your medical history. They’ll want to know more about your menstrual cycles, any symptoms you’ve experienced, if you’ve had any weight gain, any medications you are taking, any diagnosed medical conditions, and any family history of hormonal disorders.


Next, your doctor will likely perform a physical exam. The physical exam includes checking for signs of excess body hair growth or acne, and measuring metrics like your blood pressure and body mass index. A physical exam also includes a pelvic exam, where the doctor will apply pressure to the interior and exterior of the pelvic area to check your reproductive organs for any masses, growths, or abnormalities. If further physical examination is required, a transvaginal ultrasound can be used to examine the interior of the uterus, endometrium, and ovaries for any ovarian cysts or other signs of PCOS.


Blood tests are also commonly used to diagnose PCOS. Blood tests are used to check hormone levels (estrogen, progesterone, androgen) and insulin resistance (glucose or blood sugar levels).


For PCOS to be diagnosed, your doctor must detect three conditions:

  • Menstrual cycle irregularies
  • High levels of androgens
  • Growths or enlargement of the ovaries


What are other complications of PCOS?

PCOS can increase your risk for other related health conditions, including thyroid problems, heart disease, high blood pressure, high cholesterol, endometrial cancer, endometrial hyperplasia, stroke, Type 2 diabetes, sleep apnea, depression, metabolic disorders, infertility, and more.


Obesity does not directly cause PCOS, but it has been shown to worsen the symptoms of PCOS, such as insulin sensitivity. Therefore, lifestyle changes and weight loss may help reduce the severity of PCOS symptoms.


PCOS can manifest in many ways and affect your overall health and wellbeing. Therefore, it is important to speak with a doctor to receive a diagnosis and medical treatment for PCOS so that you can take control of your overall health.


How is PCOS treated?

Unfortunately, there is currently no cure for PCOS. However, there are many solutions to treat the symptoms of PCOS and lessen the severity of the disorder. The appropriate treatment for PCOS depends on which symptoms are your primary concern.


If regulating your period is a primary concern, your doctor may prescribe hormonal birth control pills or progestin therapy.


If infertility is your primary concern, your doctor may prescribe medicines such as Clomiphene, Letrozole, Metformin, or Gonadotropins to help you ovulate and become pregnant. In Vitro fertilization (IVF) can also be effective for some patients with PCOS.


If unwanted hair growth and acne are your primary concerns, hormonal birth control pills, acne medications, or androgen-blocking medications or creams can be effective. While often temporary, hair removal treatments can also help with these symptoms.

Other effective treatments also include lifestyle changes such as eating a healthy diet, exercising more often, getting high-quality sleep, and losing weight.


Later in life, menopause has been shown to help balance hormone levels and reduce the severity of PCOS symptoms.


Things to consider with PCOS and hormonal birth control

If you are currently taking hormonal birth control, such as oral contraceptives (birth control pills), it can be hard to accurately measure your body’s natural hormone levels. Hormonal birth control can also cause light or infrequent periods. This can make it difficult for your doctor to diagnose PCOS accurately.


Therefore, you may be required to stop taking any hormonal birth control for several months if you think you might have PCOS. That way your doctor can routinely and accurately monitor your hormone levels and menstrual period cycle.


Of course, birth control pills are a common treatment for PCOS symptoms, so your doctor may ultimately re-prescribe this medication if you are ultimately diagnosed.


Make an appointment with your ob/GYN today

We take women’s health issues like PCOS seriously at Great City Medical. We understand that PCOS symptoms and diagnosis can be a long, frustrating journey.

But don’t worry—our trained medical professionals are here to help you get the answers you need so that you can look and feel your best.

Call our New York City gynecologist offices today to make an appointment to speak with our health professionals.


September 1, 2022 Women

When taking birth control or oral contraceptives, as with anything that changes the way your body functions, you’ll need to know the answers to some very serious questions. For instance, does taking birth control lead to additional weight gain? Do birth control pills lead to water retention, or interfere with the body’s normal interactions with estrogen? These questions are at the core of the side effects of birth control, and worth exploring in greater detail to anyone considering taking it—especially hormonal birth control.


Does Birth Control Make You Gain Additional Weight Breakdown?

Does Birth Control Make You Gain Additional Weight Breakdown


To answer the first question off the bat, extensive reviews of birth control methods like oral contraceptives have found that hormonal birth control’s relationship with weight gain is difficult to establish. It’s true that older types of birth control methods and oral contraceptives in the past had higher levels of estrogen and progestin, which could potentially lead to issues like gaining weight. However, birth control has evolved over time, leading to different and potentially milder side effects.


For starters, individual response to birth control will always vary. And there may be some water weight fluctuations that come with birth control options like these. For the most part, some fluid retention will be generally harmless, although if you’re concerned about these issues, you should certainly talk them over with your healthcare provider.


Understanding Different Forms of Birth Control

Understanding Different Forms of Birth Control

Hormonal contraceptives are only one type of birth control. The truth is, issues like weight loss and weight changes can be avoided depending on the style of birth control you seek out. Let’s explore some of these forms of birth control so you can better understand them:


  • IUD. An IUD, or Intrauterine Device.  is a small device implanted into the uterus designed to prevent pregnancy. Intrauterine devices have obvious differences to contraceptive pills in that you won’t be taking contraceptives overally. However, some IUDs do come with hormones, so this is not always a hormone-free method of birth control. Copper IUDs may not have hormones. These are reversible devices too, meaning that when you want to begin having a family, you have that option.
  • Birth control pills. This is a wide-ranging category, which makes it hard to rate it as the “best birth control” option, as you will want to consult with a professional health care provider to ensure that you’re using the best options for your specific situation. Birth control pills can come in the form of combination pills, which have both estrogen and progestin, or progestin-only pills, which are less common. The hormones in birth control pills work by preventing ovulation, which in turn prevents a pregnancy from taking place.
  • Diaphgram. The diaphragm is a small, flexible cup that can be put inside the vagina during sexual intercourse. This covers the cervix to prevent pregnancy, rather than preventing ovulation or interfering with the menstrual cycle.


These are just a preview of the different types of birth control available. Other types, such as the vaginal ring, also can interfere with the fertilization process. However, for those concerned about the birth control pill’s effects on weight gain, it helps to focus in on combined oral contraceptives and their potential influence on the body.


How Might Birth Control Make Someone Gain Weight?

How Might Birth Control Make Someone Gain Weight

Not all forms of birth control have the same effects on women’s health or lead to weight gain. The primary concern for women isn’t whether a device like an IUD or a diaphragm is going to lead to weight gain—although an IUD may have hormones that affect the body. For many women, the primary concern is the effects of combined oral contraceptives on their long-term fertility and their overall health.


The truth about oral contraceptives and weight gain is complicated. The first question is: will hormones cause permanent weight gain or not? Most sources will likely tell you that oral contraceptives don’t cause permanent weight gain, as weight can fluctuate up and down over the long run. However, some birth control methods may directly lead to weight gain, such as medroxyprogesterone, according to GoodRX.


Another question is: what type of weight gain is this? Is it water weight, or do some people put on body fat as a result of taking birth control pills? Water weight fluctuations can be normal and even part of everyday life, being diet-dependent. Longer-term weight gain is typically the result of increased body fat.


You do have to be careful about the feelings of excess water causing bloating, which in turn adds to the “feeling” of weight gain.


Hormones will affect different processes in your body, which is important for anyone to consider. Non-hormonal birth control doesn’t have these same effects, but will have other trade-offs that you’ll want to weigh as you consider your options. While it’s possible you will experience weight gain as a result of taking birth control, individual responses always vary. Some other common side effects to hormonal birth control methods, for example, include migraines.


Why Does Birth Control Make Someone Gain Weight?

There is some thought that the hormones in birth control increase appetite and water retention, leading to the changes in body fat and body weight over time. It’s also possible that this relationship isn’t yet fully understand—hormones do have an effect on appetite, and not always in predictable ways.


To better understand your body and what it goes through when taking birth control, you’re going to want to know everything involved. Taking pills with estrogen and progestin can stop ovulation, and there can be side effects to the dramatic changes going on in your body to make this happen. That’s why it’s important to talk these side effects over with a licensed medical professional before you seek birth control. Understand what goes on in your body and you’ll have a better chance of knowing the best path forward for you in your particular journey.


Schedule your next birth control exam and more at Great City Medical today!


August 31, 2022 gyn

When you hear someone who is dealing with a significant health issue, they’ll likely never tell you that they’re glad they put off their gynecologist exams. Instead, they’ll probably tell you they’re glad they caught something early, or that they were able to have that pap smear or breast exam or even an annual gynecological exam when they did. That’s because good health isn’t just about reacting to the latest symptoms you’re experiencing—it’s also about finding out what’s going on with your body even if everything appears to be going well.


Why are gynecologist exams important? They do more than offer one check for cervical cancer or check the health of your ovaries. They do more than just one screen for breast cancer or check for abnormalities. They monitor the progress of your whole body. What they do is give you the potential to exercise preventative care, or catch a disease early, or give you a leg up on your medical history that people in your family may have never had. They give you the potential to live your life feeling free of any issues, or, if you do have an issue, to catch it early and take a proactive approach to treating it.


Dealing with a Family History Full of Potential Issues

Dealing with a Family History Full of Potential Issues

One of the first reasons gynecologist exams are important? Simple. You may have a family history that suggests you’re liable to run into a host of issues. Having gynecologist exams check for these issues, screen for cancers with hereditary traits, and ultimately gauge your overall health is not only going to make you healthier, but is going to give you peace of mind between visits. It’s also going to give you more confidence in your body and what’s going on underneath the surface.


There may be a wide range of issues that bring you into a gynecologist’s office. Pelvic pain. Irregularities in the menstrual cycle. HPV worries. The need for a mammogram. But a commitment to women’s health means knowing your family history for issues beyond what many associate with the gynecologist’s office. Make sure you take your full history into account when talking to your gynecologist, such as a family history of high blood pressure. Doing so will help you give an OB/GYN a full picture of your health—and your health risks.


Taking Appropriate Exams for Your Level of Sexual Activity

Taking Appropriate Exams for Your Level of Sexual Activity

Your reproductive health could very well hinge on the actions you take with your gynecologist, especially as it relates to your levels of sexual activity. Getting tested for STIs (sexually transmitted infections) and STDs (sexually transmitted diseases), for example, will not not only give you a clear treatment plan to take care of yourself, but it also impacts the health of others in your life. Chlamydia, gonorrhea—these issues can be devastating for your life, which is why screening tests are so important. And though exams like cervical cancer screening are vital for keeping an eye on life’s various risk factors, you shouldn’t forget the critical role gynecologists can play in a wide range of issues related to your reproductive health.


Screenings for Cancer

Screenings for Cancer

Catching cancer early—or simply screening for cancer to give yourself peace of mind—can be the best way forward for your long-term health. For starters, many cancers are treatable if you catch them early—and the earlier you catch them, the more treatable they will likely be. Gynecological health is about more than having an OB/GYN give you a physical exam or respond to issues like vaginal discharge. It can also be about identifying the most serious risks in your life and coming up with a plan of attack if you do find yourself struggling with a serious disease.


Cervical cancer, breast cancer, ovarian cancer—these all pose risks to women. And while other issues like cysts can also be serious, early detection for cancer can quite literally be a life-saver. The best way to ensure you have maximum peace of mind is not to avoid these issues, by to tackle them head-on with an OB/GYN you can trust. Have your regular checkup, consult with your doctor, and make sure that you keep the lines of communication open.


Critical Exams for Women Getting On in Age

Critical Exams for Women Getting On in Age

We all age—it’s a fact of life. But as you reach certain age milestones, you may be more at risk for future health problems that you need to watch out for. For example, bone density and osteoporosis issues should be at the forefront of your mind as you get older. Gynecological exams can help you identify these issues, take the appropriate treatment, and get on with your life, putting as much health and vitality into your years as possible.


There is a lot of time after menopause, after all. Your wellness—your quality of life—doesn’t need to have an expiration date on it, at least not as far as your ability to seek out the right treatment is concerned. Make sure you stay on top of your health care as you age. Continue to seek out the appropriate exams from an OB/GYN, and don’t simply respond to symptoms. Remain proactive with your health care, continue to get your regular pelvic exam, and always consult with your OB/GYN for the appropriate issues. Staying on top of these issues won’t only give you more peace of mind, but will improve your quality of life—something that pays dividends every day between your appointments.


OB/GYN exams can sometimes be intimidating, but the better you are at staying on top of them, the more you’ll see that they’re not scary—they’re good health care. The more proactive you are in seeking out a good OB/GYN and having the appropriate exams, the more your body will thank you. And that’s peace of mind that only comes when you’ve gotten a clean bill of health from a respected professional.


Schedule your next NYC gynecologist exam now!


August 31, 2022 gyn

Seeing a gynecologist can be a decision that’s fraught with all sorts of anxieties and uncertainties. You know that issues like women’s health or testing for sexually transmitted infections are vitally important, but you may have run into a life issue that’s thrown a wrench into things—such as switching your OB/GYN or worrying about how long it’s been since you last had a breast exam.


Fortunately, the process doesn’t have to be difficult—especially if you know the reasons to see your gynecologist in the first place. But what are those reasons, and how can they be a part of what you do to get in to see your gynecologist as soon as possible? Here’s why you’ll want to set up an appointment.


Reason #1: An Ounce of Prevention is Worth a Pound of Cure

An Ounce of Prevention is Worth a Pound of Cure

Many people wait until they notice symptoms before they go in to see a gynecologist. But if you’ve ever heard that old phrase—an ounce of prevention is worth a pound of cure—then you know how imperative it can be to see your gynecologist for regular checkups. Don’t wait until there’s an issue with your menstrual cycle like irregular periods, or whether you might have an STI, to schedule to come in. Instead, think about all of the great services they can provide you to give you confidence in your health.


Keep in mind that there’s no issue too small that you can’t bring it up with a professional gynecologist. Don’t wait until a checkup to bring up issues like vaginal discharge, for example, or incontinence. Your gynecologist is there specifically to help you with these issues, and by seeking out their care, you’re demonstrating that you’re committed to your own health care.


Reason #2: Gynecologists Can Help in More Ways Than You Might Think

Gynecologists Can Help in More Ways Than You Might Think

For many people, going to a gynecologist is something that they regard as only for serious matters. But when you review just how many things gynecologists can help you with, you’ll see that they can potentially improve your life in many ways—not just for major, life-changing health issues or fertility planning. Let’s take a look at some of the services you might seek out when you go to a gynecologist:


    • Fertility and infertility consultations. Planning on having a child in the next few years? Or even longer-term than that? Now’s the time to consult with your gynecologist about your plans, including basic checkups on your fertility wellness and screening for potentially threatening issues like cervical cancer or problems caused by the contraception you’re taking.


    • Screening for breast cancer. Catching breast cancer early is a critical issue for any woman. It’s becoming increasingly treatable in many cases—but you do yourself a favor if you try to catch it as early as possible. Regular screening for breast cancer with a gynecologist is one of the best ways to de-mystify this process and stay on the lookout, increasing your chances of treating the disease if it ever becomes an issue.


    • Vaginal issues. Dryness, discharge, other health concerns—it’s not always a pleasant topic to talk about, but it can lead to serious discomfort. It deserves your full concern and attention, especially when treating it effectively with your gynecologist could improve the quality of your daily life in immeasurable ways.


    • Screening for sexually transmitted diseases. No one wants to risk an STI or STD, but if the issue comes up, you need to know—not only for your own health, but for the health of others. Knowing whether you’re positive for certain STDs or STIs: Can give you a treatment plan and put you on the path to leading a normal life again.


    • UTI treatments. A UTI can be a distressing and uncomfortable experience, and seeing a gynecolgoist right away can ensure that you not only get the best possible treatment, but that you aren’t misdiagnosing it as something else. Once you have your UTI under control, you can get back to living a full and comfortable life.


  • Other issues.  including checking for thyroid problems or cervix issues, or engaging with your gynecologist for family planning during your regular visits, can also be important to bring up. For example, you may come in for a checkup without any specific symptoms, but still have questions to ask of your gynecologist that could impact your future decisions. This is another reason to visit with your gynecologist and engage them fully while you’re in there for your appointment—you never know when one question and answer might change your life for the better.


It’s good for your overall health, of course, if you regularly seek out services like these. But it’s also important to know that visiting a gynecologist is also about what you don’t know. Fibroids, endometriosis, or abnormalities—there may be issues that you weren’t aware of that are causing the troubles you’ve been having. Seeking uot a care provider and fully engaging them is the best way to give yourself a path back toward health.


Reason #3: Minimizing Your Risk Factors

Minimizing Your Risk Factors

There are risks for everything in life. In some cases, you might take care of yourself and find that something can still go wrong. In consulting with your care provider, make sure you get tested and screened for all age-appropriate issues that you should be aware of. This will help you minimize your risk factors and live a more healthy lifestyle, especially if you take your gynecologist’s advice for maintaining your physical health.


Urinary tract infections, menstruation issues, breast health, perimenopause, dealing with what you think might be growths—there is a lot that seeing a gynecologist can help you with.


Schedule your next NYC gynecologist exam now!


August 23, 2022 gyn

Gynecology is the field of medicine related to women’s health, especially in relation to the female reproductive organs. Gynecology focuses on women’s health and related diseases, while obstetrics focuses on pregnancy care. The two fields are often lumped together or easily confused, but they are two different medical specialties. However, a doctor can specialize in both areas and become an Ob/GYN.


While it can sometimes be uncomfortable, gynecology is an important medical profession that provides comprehensive care to women of all ages. Its origins date back thousands of years before it became the modern medical field that it is today.


So why was gynecology invented? And what are the benefits of seeing a gynecologist in today’s modern world? Keep reading to learn more about this piece of the history of medicine, how gynecology helps women, and why you should see a gynecologist.


The History of Gynecology

The History of Gynecology

The word “Gynecology” comes from Greek origins, meaning “the science of women.” It is said to have been established as a modern field of medicine around 1889. However, evidence of gynecological science can be traced back thousands of years to ancient Egyptancient Greece, and Ayurvedic medicine.


While there is a lot of dark history around the origins of American gynecology regarding a man named J. Marion Sims in the 19th century (known as ”the father of modern gynecology” although he performed unethical, experimental surgeries on enslaved Black women) — the modern field of gynecology helps women everywhere.


Important Women in the History of Gynecology

Important Women in the History of Gynecology

Despite being a male-dominated field for a long time, several notable women impacted the history of gynecology.


For instance, Metrodora was a woman in ancient Greece whose book, “On the Diseases and Cures of Women,” is the oldest known text written by a woman. Her medical writings were used by doctors for centuries, advising them on practices such as performing pelvic exams with a speculum and testing for STIs.


Another researcher and writer, Marie Stopes, published an informative resource titled “Wise Parenthood” in 1918. This resource educated women about contraception and fertility and was made widely available and free to the public.


And, of course, history cannot ignore the Black women who served as Dr. Sims’ subjects, such as Anarcha Westcott. While the nature of their participation in his medical experiments is unknown, the medical breakthroughs that resulted from their treatments served as essential contributions to medical science.


What Are the Benefits of Gynecology?

What Are the Benefits of Gynecology

Gynecologists provide critical, life-saving health care to women of all ages. Gynecology has brought many medical breakthroughs and a better understanding of women’s bodies and health. Inventions such as the speculum help gynecologists examine the internal female anatomy for any concerning abnormalities or health issues.


Regular visits to a gynecologist will help you monitor your female health and wellness, better understand your reproductive system, and help you make informed decisions about your body. Building a strong, trusted medical relationship with your gynecologist can help keep you healthy and thriving throughout all stages of your life.


What Medical Services Do Gynecologists Provide?

What Medical Services Do Gynecologists Provide

In modern gynecology, gynecologists undergo extensive training in four years of medical school, and then they must also complete a four-year residency program. Gynecologists are board-certified medical practitioners. They provide a wide variety of essential women’s health services, including:


  • Cancer screening including for cancers of the cervix, ovaries, uterus, and breast
  • Birth control and contraception
  • Physical examinations, including a pelvic exam
  • Treatment for absent, painful, or heavy menstrual periods and cramps
  • Fertility testing and fertility treatment
  • Family planning assistance
  • Ultrasounds
  • Pap smears
  • Diagnosis and treatment of infection, such as vaginitis
  • STI testing and treatment
  • UTI testing and treatment
  • Incontinence treatment
  • Menopause treatment
  • Prescription of medication
  • Diagnosis and treatment of reproductive disorders, including endometriosis, ovarian cysts, pelvic pain, and more
  • In some cases, on-site surgical treatment includes hysterectomies, tubal ligations, cyst removals, vesicovaginal fistulas, and more.

As you can see, gynecologists provide many essential, beneficial services for women that other doctors cannot. They are specially trained to be experts in the female anatomy and common reproductive health issues that women can experience throughout their lives.


When Should You See a Gynecologist?

It is generally recommended that young women around 15 book their first appointment to see a gynecologist. They may wish to start seeing a gynecologist earlier if they are sexually active or experiencing any issues with their hormones or menstrual cycles.


It is recommended that women over 21 see a gynecologist every one to two years. It is vital to be screened regularly for STIs, cancer, and other reproductive health issues.


As women age, regularly seeing a gynecologist is still essential, as they can help guide you through menopause and other hormonal changes associated with women’s aging.


Make an Appointment with a Gynecologist in New York City

At Great City Medical in NYC, we care deeply about providing comprehensive women’s health care and aim to eliminate any disparities in women’s care. Using modern techniques and best practices, Dr. Tsyba offers comprehensive and personalized gynecological care to her patients across NYC.


Looking for the best gynecologist in NYC? Call our offices to set up an appointment with our trusted medical professionals and take control of your women’s health and wellness today.


Dr. Tsyba is also a certified obstetrician and can provide additional women’s health care for those who are pregnant or planning a family.


August 5, 2022 cosmetic

It is common for deep vertical lines — sometimes called smoker’s lines, lip lines, or lipstick lines — to form around the mouth and on the lips as our skin ages. While they are called smoker’s lines, they can happen to anyone at any age, even those who don’t smoke.


Several treatment options to get rid of these fine smoker’s lines around the mouth include microneedling, chemical peels, and laser treatments. However, these procedures can be intense, painful, and require multiple sessions to achieve the full effect. They also might not be suitable treatments for sensitive or aging skin. Some at-home lip plumping treatments are available, but these only treat the surface and are minimally effective.


Instead, we recommend lip fillers, also called dermal fillers, as the best treatment to eliminate smoker’s lines. Lip fillers are a gentle, non-surgical, anti-aging treatment that can eliminate lip wrinkles, provide fuller lips, and encourage your body’s natural collagen production. But how exactly does lip filler help with smokers’ lines? 


What Causes Smoker’s Lines?

What Causes Smoker’s Lines

Smoker’s lines are fine vertical lines around the sides of the mouth, on the lips themselves, and in the upper lip area. They can be stubborn and hard to conceal because lipstick and concealer tend to sink into the deep lines and creases, making them appear more pronounced.


These lines are primarily due to aging and genetics, despite their name. As we age, the collagen and elastin in our skin break down, causing the skin to lose elasticity and form wrinkles. The lips and area around the mouth are susceptible to these effects, and some people’s genetics make them more prone to forming these lines. Loose collagen and elastin can happen to people as early as in their 20s.


While often caused by aging, the likelihood and severity of the appearance of these wrinkles and creases can be affected by other lifestyle factors. Harsh lines and wrinkles can be more pronounced if your skin has had significant sun damage, you smoke cigarettes, or you frequently tense your facial muscles (out of stress, to play an instrument, or any other reason).


How to Get Rid of Smoker’s Lines

How to Get Rid of Smoker’s Lines

Lip fillers, also called dermal fillers, are one of the best treatments for smokers’ lines. They are a quick, non-surgical lip augmentation treatment that eliminates wrinkles fast and has little downtime or side effects.


They are administered with an injector by a doctor. The lip filler is injected into critical areas around the lips and face that will plump up to fill out your facial features and eliminate the wrinkles. The procedure is generally not considered very painful, but numbing cream can help mitigate discomfort.


If you aren’t interested in an extreme lip-plumping effect, don’t worry. Lip filler treatments are customizable to you and your goals. Your doctor can work with you to focus on getting the anti-wrinkle, rejuvenation effect that you desire from your fine lines treatment without overplumping or drastically changing your appearance or facial expressions.


How Do Lip Filler Eliminate Smoker’s Lines?

How Do Lip Filler Eliminate Smoker’s Lines

FDA-approved hyaluronic acid fillers like Juvederm, Volbella, and Restylane Silk help eliminate smoker’s lines by hydrating the lips from the inside out and encouraging your body’s natural collagen production. Creating a fuller pout through hydration and collagen helps tighten the skin’s surface and eliminates the appearance of fine lines and wrinkles around the mouth.


The injections themselves provide plumpness to the lips, but they also encourage the body to produce more collagen, prolonging the effectiveness of the treatment. However, the effects of lip injections fade over time, so regular treatment is required to reduce the severity of or eliminate smokers’ lines. Depending on your specific treatment plan, you should get lip filler treatments every 6-8  months to achieve and maintain the best results.


Since the treatment is just a series of injections, there is little recovery time, and it is suitable for most skin types. Read more here to learn about lip filler aftercare.


How to Prevent Smoker’s Lines

In addition to a lip filler treatment, positive lifestyle changes can help prevent or get rid of smokers’ lines. Taking good care of your health can go a long way to protecting and transforming your skin for years to come.

Healthy habits such as staying hydrated, wearing sunscreen and protecting your lips from the harsh elements, and prioritizing a hydrating skincare routine can help your skin look and feel your best. If you do smoke, it is best to stop smoking.


These healthy habits will help prevent harsh smoker lines from forming and help your lip filler treatment be most effective.


Make an Appointment to Get Rid of Smoker’s Lines Today

Are you interested in removing your smoker’s lines with lip fillers? At Great City Medical, we want you to look and feel your best. Our Dr. Yelena Tsyba will work with you to find the proper lip filler treatment for you to target those pesky upper lip lines and vertical lip lines. She can also discuss positive lifestyle changes you can make to help take care of your skin for years to come.


We also provide Botox injections and other dermatological treatments. Ask our doctors how they can help you keep your skin looking its best with no need for plastic surgery or other extreme cosmetic procedures.


Call to make an appointment in New York City with us today and say goodbye to smoker’s lines!



May 13, 2022 cosmetic

As we age, the collagen and elastin in our skin break down. This breakdown can cause the skin to lose elasticity, forming wrinkles and aging our appearance.


Wrinkles and deep creases can also form in our skin from sun exposure, smoking, and when our facial muscles are repeatedly tensed when we frown, smile, furrow our brow, or squint.


Luckily, botox injections can help relax the facial muscles and rid wrinkles and fine lines. But how does botox work to get rid of those pesky wrinkles, and how long does it take for wrinkles to disappear? Keep reading to learn the answers.


How Does Botox Get Rid of Wrinkles?

How Does Botox Get Rid of Wrinkles

Botox is one of the most popular anti-aging treatments for both men and women of all ages because it effectively gets rid of wrinkles. But how does it work?


Botox treatment works by temporarily immobilizing and relaxing specific facial muscles that we tend to keep tense. Preventing muscle movement in those areas prevents those muscles from causing fine lines and wrinkles to form in the skin. This causes the skin to look smoother and more youthful, allowing your natural beauty to shine.


Regular botox injections can eliminate or reduce the appearance of dynamic wrinkles such as crow’s feet, forehead wrinkles, frown lines, and more. Botox can also treat static wrinkles caused by natural aging, sun damage, smoking, and more.


How Long Does it Take for Wrinkles to Go Away after Botox?

How Long Does it Take for Wrinkles to Go Away after Botox

Wrinkles will not immediately vanish after your first botox injection. However, you can expect to see positive results from your treatment very quickly. Most patients observe a significant decrease in the appearance of facial wrinkles after just 3–4 days. Patients can expect to see the full effect around 14 days after their botox injection. First-time Botox users might need to wait longer than regular users to see great results.


Fine lines and shallow wrinkles will disappear first, while deeper, harsher lines and wrinkles like forehead lines and frown lines will take longer to fade. Around 14 days, all the treated areas will look smoother, fuller, and more youthful.


Botox treatments use chemical messengers to tell your facial muscles to relax and stop specific muscle contractions. It takes time for the message to get to all of the treated areas, so it can take up to two weeks to see the full results.


Does Botox Remove All Wrinkles?

Does Botox Remove All Wrinkles

Botox injections will rejuvenate your skin and make you look like you’ve gotten a facelift without the need for plastic surgery or other drastic measures. It helps relax your facial muscles and smooth your skin to eliminate or soften wrinkles and fine lines.


While no one wants to have skin covered in deep wrinkles, some wrinkles are natural on the face. They help define our facial expressions and are a key to natural-looking skin. Skin without any wrinkles can appear overly shiny, swollen, and unnatural. Therefore, botox injections should never eliminate all wrinkles from your face.


Our dermatologists will work with you to achieve the aesthetic results you desire while maintaining your skin’s healthy, natural appearance. We can work with you to use botox to remove fine lines altogether while softening the appearance of deep wrinkles and creases.


What Does Botox Tend to Treat?

Botox is excellent for treating and eliminating the appearance of those stubborn wrinkles and fine lines. However, did you know that botox can also be used to treat other medical conditions?


One other FDA-approved use of botox is to treat migraines. Patients who experience frequent and severe migraines can get a series of botox injections around the temples and head. This treatment reduces the severity and frequency of migraines.


Since botox helps relax facial muscles, it can also be injected into the jaw area to reduce painful jaw clenching and tooth grinding.


Finally, botox can be injected into the armpits to treat hyperhidrosis and reduce excessive sweating. It works by blocking the nerves in the sweat glands and preventing them from producing sweat.


Make a Botox Appointment

Are you interested in getting safe, effective botox injections in New York City? Dr. Yelena Tsyba can work with you to achieve and maintain the youthful appearance you’re looking for. Contact us today to add botox to your skincare routine and get the best botox treatment in NYC!


We also provide dermal fillers and other dermatological treatments. Ask our doctors how they can help you keep your skin looking its best with no plastic surgery or other extreme cosmetic procedures.


May 11, 2022 cosmetic

Dermal lip fillers are a great, easy way to enhance your natural lips’ shape and eliminate signs of aging like fine lines and creases around the upper lip and mouth — all without plastic surgery!


Lip fillers are an FDA-approved lip enhancement product that has been used for multiple decades. They work by enhancing lip hydration and locking in moisture in the lips. Lip fillers have also been shown to increase the body’s production of collagen, resulting in more youthful, plump lips.


If it is your first time getting an injectable treatment, you may have many questions about the aftercare and healing process. Lip filler may cause the treatment area to feel swollen, hard, or lumpy at first, but this is all part of the healing process, and the fillers will soften and settle over time. Keep reading to learn more about what to expect in the days after getting lip fillers.


Are Lip Fillers Supposed to Feel Hard?

Are Lip Fillers Supposed to Feel Hard

Your lips may feel stiff or rigid immediately after injection with dermal fillers. Don’t worry — this is entirely normal, and the lip fillers will soften with time. Your lips may also be swollen and tender, which can contribute to the lip filler feeling hard under the skin.


Dermal filler treatments like Juvederm and Restylane are made of hyaluronic acid. This gel-like product naturally occurs in the body in places such as the skin, connective tissue, and the fluids of the eyes. Immediately after injection, the hyaluronic acid will be sitting on top of your cells, and it is designed to break down, bind with your lip tissue, and settle over time.


How Long Does it Take for Lips to Soften After Fillers?

How Long Does it Take for Lips to Soften After Fillers

Luckily, hyaluronic acid fillers should soften and settle pretty quickly. Immediately after lip injections, your pout will be fuller and fine lines around the mouth like smoker’s lines and marionette lines may soften or disappear.


There is little to no downtime after receiving lip fillers. The swelling around the injection sites will go away, and you will begin to see great results after a few days, with the maximum results after 14 days.

Lip fillers are a long-lasting treatment. Once softened and healed, you can expect to enjoy the full results for up to 6–9 months. After that time, you can make a follow-up appointment with your doctor to maintain your results.


Does Massaging Lip Filler Break it Down?

Does Massaging Lip Filler Break it Down

Your doctor will provide you with aftercare instructions after dermal filler injections. Depending on which treatment you receive, your anatomy, and your desired aesthetic results, they may give instructions to massage the lips carefully. Do not massage the lips if you are not instructed to by your doctor, as this may interfere with your final results.


Aftercare should also include drinking plenty of water, staying hydrated, avoiding strenuous exercise, and wearing sunscreen outdoors. You can also use specially designed ice packs to lessen any discomfort immediately after injection.


Is it Normal to Have Lumps after Lip Fillers?

Small lumps can be an average side effect after receiving lip fillers and are not cause for immediate concern. They can be caused by swelling or bruising at the injection site. They can also be caused when you receive a large amount of filler in one area, and the filler will soften over time. Most lumps should go away on their own within a few days.


If the lumps persist, they can be massaged or removed by your doctor at a follow-up appointment. After your first injection has settled and healed, any undesired aesthetic effects can be fixed with a touch-up injection. Your doctor may use hyaluronidase, an injectable enzyme that will break down large lumps of the hyaluronic acid.


If the lumps are extremely painful or appear to be infected, see a medical professional right away as it may signify something more serious.


Make an Appointment for Lip Filler Today

Our professional NYC doctors will work carefully with you throughout the lip augmentation procedure to achieve an enhanced but natural lip shape that works for your unique facial features and makes you look and feel your best.

If you are in NYC, call us and make an appointment for your consultation for lip filler today! Skip the plastic surgeon — our services are the best professional lip augmentation NYC offers.


May 11, 2022 cosmetic

Botox treatments, scientifically called botulinum toxin, are a fast-acting, non-surgical cosmetic procedure that will eliminate wrinkles like crow’s feet, fine lines, unwanted creases, forehead lines, and frown lines. We understand that you want to eliminate these wrinkles fast. But how long does it take to see the effects of botox?


You may see immediate improvements at the injection site, but it can take 10–14 days to see the full results after a botox injection. Keep reading to learn more about what results you can expect after your botox injection and how long it takes for botox to work.


Can You See Botox Results Immediately?

Can You See Botox Results Immediately

Botox injections do not work instantly, but you can expect to see positive results quickly from your treatment. Most patients observe significant improvements in the appearance of their skin after just 3–4 days. Patients can expect to see the full effect around 14 days after their botox injection. First-time Botox users might need to wait longer than regular users to see great results.


The appearance of fine lines and shallow wrinkles will lessen quickly, and deeper, harsher lines and wrinkles will take more than 14 days to fade. Around 14 days, all the treated areas will look smoother, fuller, and more youthful. Wrinkles and fine lines will disappear or appear smaller and softer.


Botox treatments use chemical messengers to tell your facial muscles to relax and stop specific muscle contractions. It takes time for the message to get to all of the treated areas, so it can take up to two weeks to see the full results.


How Long Does Botox last?

How Long Does Botox last

Over time, all of the chemicals from the botox treatment will get used up, so the results usually only last about three to four months. To maintain the maximum results, patients should schedule a follow-up treatment no more than four months after their first treatment.

At Great City Medical, your specialists can discuss your ideal treatment plan to ensure you maintain your desired aesthetic and always look your best.


What Can I Expect Immediately after Botox?

What Can I Expect Immediately after Botox

While you will not see the full results from your botox treatment immediately, you will notice differences in your skin immediately after a botox injection.


Botox is an FDA-approved cosmetic procedure with almost no recovery time and few reported side effects. Immediately after botox, you may experience some swelling and notice small red dots or bumps at the injection site immediately after treatment. Still, these should go away entirely within a couple of hours of treatment.


Try not to touch or rub the injection sites so that the Botox is not disturbed and does not spread to other facial areas. To prevent spread, it is also recommended to avoid exercise for 24 hours after your treatment and to keep your head elevated at night for the first few days for best results.


How Can You Tell if Someone Has Had Botox?

How Can You Tell if Someone Has Had Botox

It might be entertaining to point at celebrities on TV and guess if they’ve had botox and filler — but it is pretty difficult or impossible to tell if someone has had botox when appropriately administered by a medical professional.


Botox treatment will enhance the natural look of your skin with subtle anti-aging effects. It should not interfere with your normal facial expressions or muscle movement. People may compliment you that you look great, but they won’t know you had botox!


Why Does Botox Make Your Forehead Shiny?

Light naturally reflects off of smooth surfaces, so the smoother your skin, the more light will bounce. Botox injections smooth the skin, which can cause it to appear shinier, especially if it is overdone.
Patients tend to struggle with forehead wrinkles the most, as these wrinkles can be profound and apparent. Therefore, it is tempting to request a large dose of botox in this area. At Great City Medical, we recommend dosage levels that will reduce the appearance of forehead wrinkles without causing the forehead to look unnaturally smooth and shiny.


Make a Botox Appointment

Are you interested in getting safe, effective botox injections in New York City? Call us today to set up your botox injection appointment with one of our medical professionals. We also provide dermal fillers and other dermatological treatments. We’ll help you get beautiful results with no plastic surgery. Our doctors help you stay healthy and keep your skin looking its best!


March 18, 2022 primary care

Working as a commercial truck driver can be a very demanding job. Operating a commercial motor vehicle (CMV) is a large responsibility, as you are responsible for both your own safety and the public safety of many others. CMV drivers often have to manage long hours, intense physical demands, and mental stress.

That’s why CMV operators are required to pass a Department of Transportation (DOT) physical exam to ensure that they are fit to perform their job safely under all conditions.

If you have to pass a DOT exam to perform your job as a commercial driver or are just interested in learning more about the exam, keep reading for all the information you need and learn how to make an appointment today.


What is the Exam?

what is the exam

The DOT medical exam is an extensive health check-up that is required by the Federal Motor Carrier Safety Administration (FMCSA) for jobs requiring a commercial driver’s license (CDL). The point of the exam is to certify that commercial drivers are fit to perform their jobs safely and that they do not have any medical conditions that will interfere with their abilities.


The exam consists of two main parts: a medical history review and a physical examination.


When is a DOT Physical Exam required?

when is the dot physical exam required

The DOT physical exam is required for many drivers with a commercial driver’s license (CDL). You’ll need a medical exam if you drive a vehicle that:

  • has a gross vehicle weight of over 10,000 pounds;
  • is paid to transport over 8 passengers, including the driver;
  • is used to transport over 15 passengers, including the driver;
  • or hauls hazardous materials that require a placard.


What is included in a DOT Physical Exam?

What is included in a DOT Physical Exam

The DOT exam includes a comprehensive review of your medical history and a physical examination by a certified medical examiner.

For the medical history portion, you must fill out medical history form that includes questions about:

  • any current medications
  • any history of health conditions
  • if you’ve ever had surgery
  • use of illicit substances and drug testing history
  • any current symptoms
  • other relevant parts of your health history


To help make your visit quick and efficient, you can fill out the medical history form in advance of your visit.

During the DOT physical examination, your certified medical examiner will check things such as:

  • height and weight
  •  blood pressure
  • vision test
  • hearing test
  • vascular system and pulse rate
  • mouth and throat
  • urine test
  • blood sugar levels
  • hernias
  • skin
  • lungs and breathing
  • nervous system and reflexes
  • and more


How often do you need a DOT Physical Exam?

Why is a DOT Physical Exam Required

In most cases, if you pass the exam, you’ll receive a DOT medical card that is valid for up to two years. You’ll need to have an exam every two years as long as you drive a commercial vehicle.

In some cases, if you have an underlying medical condition you’ll be required to have an exam more frequently. Some conditions that require annual or quarterly testing to monitor your health include:

  • diabetes
  • very high blood pressure (hypertension)
  • heart disease

While more frequent testing can be a bit inconvenient, it helps keep you healthy and minimize the risk of impairment or injury while operating a commercial vehicle. If over time your treatable health condition improves (such as high blood pressure), you may be eligible to receive a medical card that is good for one to two years.


Is it possible to fail your DOT Physical Exam?

It is possible to fail your DOT exam if your health does not meet the DOT physical requirements. Reasons for failing the exam might include:

  • failed vision or hearing test
  • narcolepsy
  • epilepsy
  • poorly managed health conditions such as very high blood pressure, diabetes, or heart or lung disease
  • controlled substance abuse or failed drug testing


If you fail your exam and believe you are fit to operate a CMV, you have the right to receive a second opinion from another doctor. Also, you can re-apply if your medical conditions improve. However, you cannot apply again if you fail a second time.


How to prepare for your DOT Physical Exam?

To prepare for your DOT exam and maximize your likelihood of passing, you should do your best to take care of your health and wellness. Focus on eating a healthy diet, exercising regularly, and avoiding excessive smoking or drinking.


What do you need to bring to the DOT Physical Exam?

To help the exam run quickly and smoothly, it is best to bring anything you think might be relevant to your health and ability to perform work. Things to bring might include:

  • A complete list of your doctors and their contact information
  • A complete list of any medication you are taking, including the dosage and prescribing doctor’s name
  • A letter from your doctor if you’re taking any medicines that can cause sleepiness
  • A letter from your doctor if you’re taking the blood thinner called Coumadin
  • Eyeglasses, contact lenses, and/or hearing aids, if you use them
  • If you have diabetes, recent Hemoglobin A1C (HgAIC) test results and blood sugar logs
  • If you have a sleep disturbance such as sleep apnea, a data readout from your machine of at least 90 days
  • If you have a history of heart disease or other heart health issues, a letter from your cardiologist and/or results from any recent stress testing
  • If you have any history of brain injury, a letter from your neurologist
  • A letter from your doctor if you’ve lost permanent use of an arm or leg, including any work restrictions


How Much Does a DOT physical cost?

Many employers who require a DOT exam will cover the cost for you. However, the cost of the exam will be $100. Call our offices today and we can help you determine the cost of getting a DOT physical exam.


Where can you get a DOT Physical Exam?

At Great City Medical in New York City, we provide DOT Physical Exams. Call our offices today to make an appointment!




March 18, 2022 primary care

In order to operate a commercial vehicle professionally, drivers must obtain two very important documents: a commercial driver’s license (CDL) and a valid Department of Transportation (DOT) medical card. These documents help certify that commercial motor vehicle (CMV) drivers are medically fit to safely operate large vehicles and minimize the risk of safety incidents.

To obtain a valid DOT medical card, truck drivers must successfully complete the DOT physical exam every 1–2 years. The DOT exam can be performed by any licensed medical examiner who is listed in the Federal Motor Carrier Safety Administration (FMCSA) National Registry.

So, CMV drivers need to pass the DOT exam in order to maintain employment, but why is it required? Keep reading to learn all about why the DOT physical exam is required and how to obtain a DOT medical card.

What is a DOT Physical Exam?

what is a dot physical exam

The DOT medical exam is a physical examination required by the FMCSA. It certifies that CMV drivers are physically and mentally fit enough to perform their jobs safely and that they do not have any medical conditions that will interfere with their job performance.

The exam consists of two main parts: a medical history review and a physical examination.

Who needs to get a DOT Physical Exam?

Who needs to get a DOT Physical Exam

The DOT physical exam is required for CMV drivers who operate a vehicle that:

  • has a gross vehicle weight of over 10,000 pounds;
  • is paid to transport over 8 passengers, including the driver
  •  is used to transport over 15 passengers, including the driver;
  • or hauls hazardous materials that require a placard.


What is included in a DOT Physical Exam?

What is included in a DOT Physical Exam

The DOT exam includes a comprehensive review of your medical history and a physical examination by a certified medical examiner.

For the medical history portion, you must fill out the medical history form before your visit.

During the DOT physical examination, a certified medical examiner will check things such as:

• height and weight
• blood pressure
• vision test
• hearing loss
• vascular system and pulse rate
• mouth and throat
• urinalysis
• blood sugar levels
• hernias
• skin
• lungs and breathing
• neurological issues and reflexes
• sleep apnea and narcolepsy
• and more


How often do you need a DOT Physical Exam?

In most cases, the DOT medical examiner’s certificate is valid for up to two years.
However, in some cases, an underlying medical condition will require a CMV driver to have an exam more frequently. Some conditions that require annual or quarterly testing to monitor your health include:

  •  unmanaged diabetes
  • very high blood pressure (hypertension)
  • heart disease


If health conditions are well-managed and improve, then a driver can be cleared for a medical card that is good for one to two years.

Why do you need a DOT Physical Exam?

Operating a CMV is no small feat! With the intense schedules, long hours, and mental stress and exhaustion, becoming a CMV operator can put the driver’s life at risk, as well as the lives and safety of the general public. Not just anyone is qualified for this job — drivers must be in good health with high awareness of surroundings, quick reflexes, and sound judgment skills.
Therefore, the DOT physical is a comprehensive health evaluation. The goal is to identify and prevent any medical reasons that could interfere with the safe operation of a commercial vehicle and keep everyone safe.

The exam includes things such as vision and hearing tests to ensure that CMV drivers can see and hear well enough to be aware of their surroundings, safely operate a vehicle, and avoid potential accidents. Screening for health conditions such as diabetes, heart disease, epilepsy, high blood pressure, and hernias is important to minimize the risk of a driver having a medical emergency while driving. Finally, while the DOT exam does not include a drug test, questions about the use of controlled substances is included in the medical history section in order to minimize the occurrence of impaired driving.

How to prepare for your DOT Physical Exam?

To prepare for your exam and minimize the risk of disqualifying for a DOT card, you should do your best to take care of your health and wellness. Focus on eating a healthy diet, exercising regularly, keeping your mind sharp, and avoiding excessive smoking or drinking.

It is also best to regularly see a healthcare professional and keep up to date with things like your vision prescription and any medications or treatment regimens (if prescribed).

What do you need to bring to the DOT Physical Exam?

To help the exam run quickly and smoothly, it is best to bring anything you think might be relevant to your health and ability to perform work. Things to bring might include:

  • A complete list of your doctors and their contact information, including your primary care physician and any specialists
  • A complete list of any medication you are taking, including the dosage and prescribing doctor’s name
  • Eyeglasses, corrective lenses, and/or hearing aids, if you use them to drive
  •  Any letters or medical records from specialist doctors regarding special health conditions and your health history


How Much Does a DOT physical cost?

Since the DOT physical is a requirement of the job, many employers will cover some or all of the cost for you. Otherwise, the cost is $100.  Call our offices today and we can help you determine the cost of getting a DOT physical exam.

Where can you get a DOT Physical Exam in New York City?

At Great City Medical in New York City, our doctors provide DOT Physical Exams. Feel free to give us a call if you have general questions about DOT exams, or if you want to schedule an appointment!


November 19, 2021 gyn

PMS symptoms and period pain can cause exercise to be the last thing on your mind during your time of the month. It probably seems like exercise would only make symptoms such as back pain, bloating, heavy periods, mood swings, and low energy levels worse. You’d much rather stay in bed with a heating pad and lay low.


But did you know that there is no medical reason not to exercise during your menstrual cycle? Physical activity can actually help greatly reduce period symptoms such as pain, menstrual cramps, bloating, depression, fatigue, mood swings, low energy levels, and more. It can also help to release endorphins (“feel good” hormones) and reduce stress to make you feel better and improve your feelings of overall wellbeing. Regular exercise routines may even help reduce the overall intensity and negative symptoms of your period over time. 


Keep reading to learn more about which exercise routines are best for you and your health during your period.


Is it Harder to Work Out on Your Period?

is it harder to work out on your period

While it can be beneficial to workout during your period, it can be harder to workout during this time than the rest of the month. The first day of your period tends to be the hardest day to work out. During your period, hormonal changes cause your progesterone levels to be high and estrogen levels to be low, which can cause low energy levels and low motivation. If you’re already struggling with your fitness routine, finding the motivation to workout on your period can feel impossible. However, some women report feeling stronger during their period, so don’t let your time of the month prevent you from working out if you feel up for it.


If you are worried about workouts being harder on your period, consider sticking to workouts that are easier than your usual workout routine. Also stick to exercises that are familiar to you instead of trying something new and extra challenging. This can help get you moving and feeling your best.


What Exercise is Best During Your Period?

what exercise is best during your period

The best exercises to do during your period are exercises that you will actually stick with and enjoy doing! Pay close attention to your body to figure out what you feel capable of and adjust your exercise routine accordingly. 


If you are suffering from intense cramps and pain, gentle exercise such as walking, yoga, pilates, or gentle stretching can help relax tense muscles in the hips and back and ease pain. Exercises such as walking, yoga, and stretching can also be done at home and at your own pace. This can be very attractive if you feel the need to slow down, take your time, and avoid any extra stress that might come from visiting a busy, public space like the gym or fitness studio. Water activities such as swimming can also feel especially great, as the water can make you feel weightless and ease pain.


Do You Lose More Weight on Your Period?

Everyone’s bodies and menstruation cycles are different, so weight fluctuations throughout the month will vary for each individual. In the time leading up to your period, increased levels of cortisol can stimulate your metabolism. However, researchers have determined that the impact of this on weight loss is probably negligible. 


If you weigh yourself regularly, you may find that you weigh less immediately after your period ends. However, this is likely not due to true weight loss. Many women bloat or retain more water around the time of their period. It is normal to gain as many as 3–5 pounds of water weight before your period. After your period ends, you will stop retaining water and this “extra weight” will shed off. This may make it look like you lose more weight on your period, even though it is just water weight. 


Please Make an Appointment with our Gynecologists’ Today

At Great City Medical, our women’s health specialists are here to answer any questions you may have about staying healthy during your menstrual cycle. If you want to learn more about how to stay healthy and feel your best on your period, give us a call today. Make an appointment to speak with an ob/gyn about managing your period and PMS symptoms.


November 19, 2021 gyn

If you find yourself getting strong food cravings and the urge to eat more around certain times in your menstrual cycle, you’re not alone! About 1–2 weeks before your period begins, fluctuations in your hormones can cause many side effects, including food cravings, increased appetite, bloating, fatigue, sleep disturbances, mood swings, and irritability. These side effects are collectively known as premenstrual dysphoric disorder, or PMS. 


Understanding the symptoms of premenstrual syndrome and why they happen can help you understand your body and prevent food cravings from controlling your life. Keep reading to learn more about why women experience PMS food cravings and what you can do to lessen the impact they have on your diet and wellness. If you’re struggling with severe PMS symptoms, consider making an appointment today with our expert women’s health team at Great City Medical in New York City.


Why does PMS cause increased appetite?

why does pms cause increased appetite

During the 1–2 weeks leading up to the start of your period, dramatic hormonal changes can cause an increase in your appetite. There are three main hormone changes that are responsible for this: estrogen, cortisol, and serotonin.


Estrogen levels increase in the days before your period begins. When estrogen levels increase, so do your cortisol levels. Cortisol, also known as the stress hormone, puts your body in a state of high stress during this time. This can put your body on high alert and stimulate your metabolism, increasing your appetite and causing cravings for foods that are high in fats and carbohydrates. 


Also during this time, serotonin levels can drop. Serotonin is a hormone associated with happiness, feeling good, and overall feelings of well-being. If your serotonin levels are low, your body will signal to you to seek out things that can help you feel better, such as eating your favorite comfort foods. With the effects of the combination of high cortisol and low serotonin levels, it is no wonder that period cravings and increased appetite are such common symptoms of PMS.


How early can PMS cravings start?

how early can pms cravings start

PMS cravings tend to start around 7–10 days before your period begins, but they can start as early as 2 weeks before your period begins. The exact timing and intensity of your PMS cravings will depend on your individual hormone levels and cycle schedule. PMS cravings tend to start at the same time that any other PMS symptoms begin. If you start to notice any other PMS symptoms, this can be a helpful sign that you need to start being aware of your cravings and being more intentional about what you eat. The cravings can last for several days and usually disappear once your period begins.


Is it Good to Indulge Your Food Cravings?

Is it Good to Indulge Your Food Cravings

You may have been taught to feel shameful about your PMS cravings, but there is no need to be ashamed of your body’s natural cycles. It is important to listen to the signals that your body is giving you. An increased metabolism and other changes in your body may mean that you do actually need to eat more calories than usual during this time. Undereating can also raise cortisol levels and worsen your PMS symptoms, so be sure to give your body what it needs.


That being said, it is important to provide your body with the proper nourishment and nutrition. Instead of reaching for comfort foods that are high in sugar and simple carbs that can cause spikes in your blood sugar levels, reach for complex carbohydrates that are high in fiber. Try replacing sugary snacks like ice cream, chocolate, or potato chips with whole grains, dark chocolate, fruit, brown rice, oats, lentils, and other healthier foods. Watch your food intake and try to avoid binge eating or overindulging regularly to avoid excessive weight gain and other negative side effects from letting your cravings take control of your diet.


What foods help with PMS?

Eating big meals with too much refined sugar, simple carbs, and salt can actually worsen PMS symptoms and make you feel awful. These comfort foods might give you a temporary boost in serotonin while you’re eating them, but the effects will be short lived. The resulting drop in blood sugar levels that inevitably come afterwards can leave you feeling more depressed and sluggish than before. 


Eating several small meals throughout the day can help keep hormone and blood sugar levels stable (this can help keep your mood and energy levels stable too!). Focus on eating plenty of lean proteins, complex carbs, fruits, and vegetables. Foods that are rich in vitamin B, magnesium, calcium, thiamine, and riboflavin have been shown to help reduce PMS symptoms. These foods can include whole foods such as whole grains, brown rice, legumes (beans, lentils, peanuts, etc.), nuts, seeds, dark chocolate, and dark leafy greens (spinach, kale, etc.).  If you are concerned about your nutrient levels, you can also talk to your doctor about talking supplements such as a magnesium or calcium supplement. It might sound counterintuitive, but drinking plenty of water can also help reduce cravings and bloating.


Other lifestyle changes such as increased physical activity and better quality sleep can also help curb PMS cravings and other symptoms of PMS. 


Please make an appointment with our gynecologists today

At Great City Medical, our women’s health specialists want to help you stay healthy and feel your best throughout your entire menstrual cycle. We are here to help answer any questions about your sexual and reproductive health and find healthy solutions that work for you. Contact us today to make a NYC gynecologist   appointment and speak with a doctor about managing your PMS cravings and other PMS symptoms.



November 19, 2021 gyn

When you visit your NYC gynecologist or ob/GYN, you may be asked to take a urine test as part of your physical exam. This is a regular test conducted by your health care provider to help take care of your overall health. Urine tests are especially common during prenatal visits and pregnancy visits, but they can be performed during an annual checkup too. While they can be a little uncomfortable or embarrassing, urine tests can tell your doctor a lot about your health and wellness and are nothing to be embarrassed about. 


What can a doctor tell from a urine sample?

what can a doctor tell from a urine sample

Urine tests can provide a lot of helpful information about women’s health. They can be used to screen for health issues such as urinary tract infections (UTIs), bacterial infections in the urethra or vulva, kidney stones, bladder cancer, liver disease, sexually transmitted diseases (STDs) such as gonorrhea, and other abnormalities. Urinalysis can also be used to monitor health indicators such as glucose levels, ketone levels, white blood cell and red blood cell counts, nitrites, and bilirubin levels. Urine tests are also a reliable method for pregnancy tests and can be more accurate when performed by a doctor than at-home tests.


For prenatal visits and pregnant women, frequent urine tests are critical for ensuring the overall health of the mother and the child. They can be used to screen for health issues such a preeclampsia and gestational diabetes.


How is a urine test performed?

how is a urine test performed

Providing a urine sample for a urine test can feel a little strange or embarrassing — but luckily they can be provided quickly, easily, and in privacy. Your gynecologist or a nurse will provide you will a sterile urine cup and sanitary wipe. You will take these items into a private restroom. 


Use the sanitary wipe to clean yourself and then begin peeing over a toilet like you normally would. Hold the urine cup underneath you and collect the urine inside the cup as best as you can. Once you are finished, seal the cup with the provided lid and place the cup in the designated location specified by your nurse or doctor. Remember to wash your hands when you’re finished.


What does the color, clarity, and odor of urine mean?

In addition to testing your urine for diseases and health indicators, simply the appearance of your urine can tell gynecologists a lot about women’s gynecological health. The color, clarity, and odor of urine can provide information about your hydration levels, diet, and overall health. 


Dark-colored urine can indicate dehydration, especially when there is only a small amount at one time. Cloudy urine can indicate a UTI, especially when combined with discomfort, pain, or burning sensations while urinating. Red-tinted urine may indicate that there is blood in the urine, which may require additional testing to diagnose if you are not on your period. Bright yellow urine can be caused by taking vitamin B supplements and is not usually anything to worry about. Clear or pale yellow urine is a good indicator of good health and hydration levels.


Urine odors can change depending on your diet. Certain foods can cause your urine to smell differently, such as asparagus or coffee. Fasting can cause urine to have a sweet or fruity smell to it. Very bad or unusual odors can indicate bacterial infections and may require additional testing to diagnose.


What Can an Abnormal Urine Test Indicate?

Urine testing is typically a very fast process. After taking a urine test at your ob/GYN’s office, you can expect to get your test results back within 3 days Your doctor’s office will likely send your urine sample out to a laboratory to do the testing and call you as soon as the results come back.


In pregnant women, abnormal glucose (sugar) levels in the urine may indicate gestational diabetes. Abnormal protein levels, especially when combined with other symptoms like high blood pressure and headaches, may indicate preeclampsia. Frequent urine tests are important during this time to closely monitor for these and other health risks.


In all women, abnormal ketone levels may be a sign of undereating or dehydration. Abnormal white blood cell counts may be a sign of a bacterial infection, and abnormal red blood cell counts may be a sign of kidney stones or a bladder infection. Abnormal nitrite levels may indicate a urinary tract infection, especially if you are also experiencing burning, pain, or discomfort during urination. Abnormal bilirubin levels may be a sign of liver disease. If you receive abnormal urine test results for any of these factors, your doctor will likely ask you to come back and follow up with additional testing before making a diagnosis or treatment plan.


Make an appointment for a urine test today

It might be a little embarrassing, but urine testing is a routine and important part of gynecological care. These tests can tell you a lot of information about your reproductive health and overall health! 


If you would like to get tested for STDs, UTIs, pregnancy, or other health conditions, or you are experiencing any unusual smells, colors, or pain while urinating, contact us about urine testing today. Call us to make an appointment with our team of women’s health professionals and take control of your gynecological health. If you already have an appointment scheduled, a urine test can also be performed as part of your annual checkup and pelvic exam.



October 25, 2021 primary care

It is essential to be fully informed about your health and wellbeing. The best way to be informed is to ask important questions when you visit your primary care doctor for your annual doctor visit. But it can be hard to know what questions to ask, especially when seeing a new doctor with whom you haven’t built a robust doctor-patient relationship yet. 


Don’t worry! Open communication with your primary care doctor is a critical part of your preventative healthcare journey. Keep reading below for some ideas to help you know what questions to ask when you visit your doctor’s office for your annual checkup and be informed about your healthcare decisions. 


What should I ask my doctor during a checkup?

It is common to feel nervous or embarrassed talking to your doctor, but your doctor’s visits are the perfect time to open a conversation with your primary care doctor and ask them questions about your health. Asking questions is a great way to be involved in your healthcare and make informed decisions with your doctor. Asking questions can also help you feel confident and relaxed at your next doctor’s visit.


So, before your next visit, think about some questions that you might like to ask your doctor. You can even write the questions down on a notebook or piece of paper and bring them in with you if that is helpful.

Some critical questions to ask your primary care doctor at your next annual physical might include:


  • What do my cholesterol levels mean?
  • What does my blood pressure number mean?
  • What can I do to better take care of my health and wellness?
  • Are there any over-the-counter medications I should be taking?
  • Am I at risk for any medical conditions, such as breast cancer, heart disease, heart attack, etc.?
  • Should I be tested for any medical conditions or illnesses?
  • What causes certain medical conditions or diseases?
  • What are the treatment options for this medical condition or disease?
  • How long will treatment take?
  • What is my prognosis?
  • Should I take any precautions to prevent spreading this disease to others?
  • Do I need any vaccines?
  • What symptoms should I look for?
  • What side effects might I experience?
  • If there are side effects, how can I manage them?
  • What does this medical condition mean for me and my lifestyle?
  • What does this medical condition mean for my family members?
  • Do I need further medical tests?
  • When will I know my test results?
  • How do I receive my test results?
  • Can you explain my test results?
  • How safe or accurate is the medical test?
  • How can I get a second opinion?
  • Is surgery a necessary part of my treatment plan?
  • What are the benefits and risks of this surgical procedure?
  • Do I need to schedule any follow-up visits?
  • How much will this test or operation cost?
  • Will my insurance plan cover this test or procedure?
  • Can you explain what you are going to do before you do it?
  • Where can I find more information?


The questions above are a good starting place, but feel free to ask your primary care physician about anything else that is on your mind. They are there to help you and take care of your overall health, so come up with meaningful questions and your specific health concerns.


Should you ask your doctor to explain your test results?

Your primary care physician is there to help take care of your overall health, so yes, you should ask your doctor to explain your test results in a way that you understand. When a doctor reads off medical information, it might be intimidating to speak up, but they will always be happy to explain further. Don’t worry about asking too many questions. It is essential that you fully understand any information that your doctor gives you about your health.


Be sure to ask questions about anything that you don’t understand or would like more information about. This extends beyond just test results. When your doctor discusses your medical records, family history, risk factors for certain health conditions, health insurance, treatment options, side effects, or anything else related to your health and wellness, be sure to ask follow-up questions about anything that you don’t understand. Your doctor will be happy to explain further.


What should you not tell your doctor?

Your doctor needs accurate health information from you to provide you with the best healthcare. Therefore, you should never tell your primary care doctor (or any doctor) anything that is not 100% truthful. You should also not intentionally hide any information that could be relevant to your doctor. Be honest and forthcoming about your medical history, family history, lifestyle habits like diet and supplements, mental health, and more. 


Many things you discuss with your doctor might feel embarrassing or shameful, but your doctor will not judge you for your answers. They need truthful information to make accurate decisions about your healthcare, so don’t be embarrassed!


Make an appointment to see your primary care doctor today!

At Great City Medical, our board-certified doctors are passionate about providing you with the best primary care and preventative care experience. We want to help you take excellent care of your overall health and wellness so that you can live your best life. Call us and make an appointment for your annual checkup today! Your best self is just one doctor’s appointment away.



October 25, 2021 primary care

Primary care doctors, also known as general practitioners or pediatricians for children, offer patients a broad range of general health care services. They help you stay healthy with services such as regular annual checkups and referrals to medical specialists. 


Your primary health care provider can help with many health problems and disease prevention by identifying risk factors for various health issues, performing disease screenings such as cancer screenings and tests for high blood pressure, and keeping you up to date on the proper immunizations. They can also help manage chronic disease and improve your quality of life in the long term.


Primary care physicians are an essential part of the health care system and can take care of a wide range of health needs. They can be one of your most valuable assets when taking care of your health and wellness. Please keep reading to learn more about the benefits of primary care and why it is so crucial for everyone to visit their primary health care provider regularly.



Why is it important to have a primary care doctor?


Primary care physicians are critical for taking good care of your overall health and wellness and for providing good preventative care to keep you healthy in the long term. They can help with good health maintenance practices and help you manage many health conditions.


Often, diseases and other health issues can easily be treated or prevented if your doctor detects early warning signs before the disease progresses. Your annual physical is a great time to build a patient relationship with your doctor and keep your doctor informed about any new symptoms, lifestyle changes, or warning signs in your life.


Primary care doctors and family physicians are familiar with your family and medical history and work to build a strong patient relationship with you so that they can provide you with the best, most comprehensive, overall medical care possible.



What is the Value of Primary Care?


Primary care is more than just your primary care doctor. The primary care team at Great City Medical and other doctor’s offices can also include registered nurses (RN), nurse practitioners (NP), and physician assistants (PA). These medical professionals go to rigorous medical school and can provide high-quality generalized health care on various health topics and prescribe any needed medication. 


Your primary care doctor can refer you to other medical specialists that specialize in your health needs for any health issues that fall outside of the realm of typical primary care. With most insurance plans, referrals from your primary care provider are required to visit other medical specialists. Your doctor should have high-quality recommendations for medical professionals in your area in your health insurance network. This can be a hugely valuable service that helps you get the comprehensive medical attention you need without paying you extra for out-of-network services.



Does primary care save you money?


Most health insurance companies cover annual primary care checkups, and it may not cost you any money to go for your yearly visit. However, depending on your health needs and insurance plan, you may need to pay a small copay at the time of your visit. 


Some tests recommended by your doctors, such as blood tests or extra health screenings, may cost an additional fee. However, these fees are minimal compared to the cost of needing to pay for significant health issues that you may develop down the line if you neglect your primary care today. 


The preventative care that you receive from your health care provider can save you time, money, stress, and even years in your life! That is invaluable. They can provide screenings for health conditions such as cancer, heart disease, high blood pressure, mental health conditions, chronic conditions, and more and catch signs of disease early enough to save you a lot of money down the line.



Make an appointment to see your primary care doctor today!

At Great City Medical, our board-certified doctors are passionate about providing you with the best primary care and preventative care experience. We want to help you take excellent care of your overall health and wellness so that you can live your best life. If you are in the New York City area, call us and make an appointment for your annual checkup today, or ask about seeing one of our nurse practitioners for your health needs! Your best self is just one doctor’s appointment away, so call us today and come in for your annual visit.


Also, check out what is a primary care doctor if you have additional questions!



August 30, 2021 Women

Visiting a gynecologist can be a bit uncomfortable, especially for the first visit. But gynecologists are an essential part of any women’s health care. They can help answer any questions and make sure that you stay healthy down there.


If you aren’t sure what to talk to your gynecologist about, keep reading for some ideas to help you get the most out of your next doctor’s visit and take care of your reproductive health.


What should I talk to my gynecologist about?

A gynecologist specializes in women’s reproductive health needs. They provide regular check-ups, including pelvic exams, pap smears, breast exams, testing for sexually transmitted diseases, treating urinary tract infections, and more. They can help you figure out what birth control options might be suitable for you.


And there is no need to be embarrassed! Your gynecologist is there to answer any questions that you might have about your sexual and reproductive health. 


Typical discussion topics people have for their gynecologist include:


  • Painful periods
  • Irregular periods
  • Other questions about the menstrual cycle
  • Birth control and contraception
  • Vaginal discharge
  • Vaginal dryness
  • Sexual activity
  • Pain during sex
  • Low libido
  • Pimples caused by hormonal acne
  • Sexually transmitted diseases
  • Yeast infections
  • Ingrown hair
  • Endometriosis
  • Ovarian cysts
  • Uterine fibroids
  • Menopause 
  • And much more!


If you’re feeling nervous or confused, you can also ask your gyno to explain everything they are about to do before doing it.


What questions do they ask you at the gynecologist?

If you are getting ready for your first visit to the gynecologist, you might be wondering what kind of questions your doctor might ask you. As far as questions go, a visit to the gynecologist should not differ too much from other doctor’s visits.


A gynecologist will start by asking you questions about your medical history and your family history. These questions will help give the doctor some background on your health and bring awareness to any potential health issues that they should test you for. 



Questions about your medical history and family history might include:

  • Has anyone in your family had breast cancer?
  • Has anyone in your family had cervical cancer or uterine cancer?
  • Have you been vaccinated for HPV?
  • Do you have any concerns about your sexual health?


After they ask about your medical history, questions a gynecologist might ask you include:

  • When was your last period?
  • How long does your menstrual cycle typically last?
  • Do you experience irregular or painful periods?
  • Are you sexually active?
  • How many sexual partners have you had?
  • When you are sexually active, do you use condoms or any other form of birth control?
  • Do you experience any pain or bleeding during or after sexual activity?
  • Are you looking for a new birth control method?


It is vital to find a gynecologist that you feel comfortable talking to. Any questions they might ask you intend to provide the best medical care for you. The questions are designed to evaluate for any medical conditions. The doctor will not pass any judgment on your personal sex life.


What should I wear to a gynecologist appointment?

Wear whatever clothing makes you feel comfortable to your gynecologist appointment. Most gynos will ask you to take off your clothes privately and wear a special robe or gown for the exam, so it should not matter what you wear into the appointment. The only type of clothing to avoid might be difficult for you to remove by yourself.


Many people might feel the need to prepare ahead of time for their appointment out of anxiety or embarrassment. This is a personal choice, but it is best not to shave wax or groom before your gynecologic exam excessively. A simple shower is all that is needed to prepare for your exam. Again, the doctor is there to evaluate you for medical conditions rather than pass any judgment on your physical appearance.


Please make an appointment with our gynecologists today

At Great City Medical, our women’s health specialists are here to talk to you about your sexual and reproductive health. Call and talk to our specialists today to learn more about how to prepare for your first NYC gynecology appointment.


August 23, 2021 Women

NYC Labiaplasty is a plastic surgery procedure, commonly known as a type of vaginal rejuvenation, that is used to reduce the size of the labia minora tissue. This surgical procedure is growing in popularity with women in NYC and across the U.S. 


The labia minora, also known as the inner labia or inner lips of the vulva, come in all shapes, sizes, and colors. Some women have very small vaginal lips that might be hard to see, and other women have very large vaginal lips that overflow to the outside.


The appearance of the labia minora can change naturally as women age, lose a lot of weight, or go through childbirth. Some women might even experience pain, discomfort, reduced sensitivity, or low self-confidence from certain anatomical conditions. 


At Great City Medical, gynecologists are here to help you look and feel your best. We provide personal labiaplasty consultations and perform some of the best labiaplasty procedures in NYC.


When is labiaplasty medically necessary?

Excess tissue can make it difficult for women to feel comfortable wearing form-fitting clothing, such as yoga pants or bathing suits. It can also make women feel self-conscious in the bedroom.


But, the most common reason for women to get labiaplasty is not actually for cosmetic reasons. While it can be a cosmetic surgery, most women who get labiaplasty do so because it can be medically necessary.


Excess tissue can cause severe pain, irritation, chafing, and itching during activities such as exercise, sexual intercourse, and more. Women with enlarged labia minoras may not be able to participate in physical activity such as riding a bike or jogging, which can be reasons that the surgery is medically necessary. Labiaplasty is also considered medically necessary when the labia minora tissue gets tucked or pulled into the vaginal opening during sexual intercourse.


Excess labia tissue can also cause difficulties for maintaining proper hygiene and increases a woman’s risk of urinary tract infections. Many women with this condition may suffer with infections their whole life. Increased risk of infection is another reason that labiaplasty can be medically necessary.


What does a labiaplasty consist of?


The goal of labiaplasty surgery is to reduce the size of the labia minora so that it does not hang down below the labia majora. Labiaplasty is a relatively minor, minimally invasive  outpatient procedure that is performed under general anesthesia (sedation). 


The most common type of labiaplasty is the trim procedure. With a trim labiaplasty, the extra labia tissue is trimmed off linearly around the outside edge of the labia minora. 


Another popular labiaplasty is the wedge procedure. With the wedge procedure, the surgeon will remove a v-shaped section, or a wedge, of the labia minora and then suture the tissue back together. This method helps maintain some of the natural shape and wrinkles of the labia minora.


When getting a labiaplasty, a clitoral hood reduction can be performed at the same time if you also suffer from extra tissue folds around the clitoris.  Either surgical method can help reduce the overall size of the labia minora. Both methods can also help remedy asymmetry.


Since it is a surgical procedure, patients must allow for some recovery time after labiaplasty. After surgery, you should allow 1–2 weeks for recovery time at home and avoid any strenuous physical activity for several days after your procedure. Do not use tampons or have sexual intercourse of any kind for 4–6 weeks following their surgery, or until cleared by a doctor.


Labiaplasty patients may experience some discomfort for a few days after surgery. Some swelling and bruising around the operation site is common. Your doctor may prescribe pain medication to help manage any pain or swelling. Most swelling will disappear within 6 weeks of surgery. Any scars from the surgery will be nearly invisible once fully healed.


How common is labiaplasty surgery?

Labiaplasty is not the most common plastic surgery (when compared to surgeries such as rhinoplasty or breast augmentation), but its popularity is on the rise.


While many women may opt for labiaplasty as a cosmetic procedure, the most common reason women receive this surgery is for medical reasons and to improve sensation. As this surgical procedure grows in popularity, women who have perviously struggled with labial pain, discomfort, and infections are now aware that labiaplasty can be a great solution for them.


Does labiaplasty affect sensation?

Naturally, many women are concerned about reduced sensation after getting labiaplasty, but in general there is nothing to worry about. As with any surgery, there is some risk of decreased sensitivity, numbness, dryness, and permanent scarring, although these risks are relatively very minor.


Many women who opt for labiaplasty do so because they already suffer from discomfort or reduced sensation during sexual activity, so labiaplasty will actually enhance sensation for these women. The excess labia tissue, especially when paired with excess folds in the clitoral hood, can interfere with sensation in the bedroom. 


Getting labiaplasty to remove that excess labial tissue should actually increase sensation and pleasure for women. Many women report that removing the excess tissue is positively life-changing.


Book a labiaplasty consultation

Call us at Great City Medical today and book your labiaplasty consultation our gynecologists will discuss labiaplasty and help you determine if this surgical procedure is right for you! 


We want you to look and feel your best, so we will provide you with the best medical advice and treatment we can offer. 


If you do decide to book a labiaplasty procedure with us, our NYC gynecologists will walk you through it every step of the way. We care about your recovery and provide follow-up appointments after the procedure to make sure everything heals properly and you are completely satisfied.


I went to Great City Medical for an immigration medical exam. Very friendly staff! The lady who worked with me was so sweet, explained everything and answered all my questions. I spent 15 min in my first visit there (blood work and fill out forms).Bring your immunization records to avoid extra charges for vaccine shots.UPD: I received I-693 in a sealed envelope as well as a copy of I-693. The whole process was smooth and straightforward.
Ksenia K
Ksenia K
17:23 26 May 23
Amazing service and fast !!!
White P.
White P.
20:21 23 May 23
Our experience was great we had great service and would recommend anyone with immigration medical examination to try this service. Thank to Great City Medical.
Joe V.
Joe V.
17:53 23 May 23
Excellent service. Great staff.
Ivette T.
Ivette T.
17:18 22 May 23
Super friendly and efficient. They know their stuff.
Chris S.
Chris S.
15:48 22 May 23
Great. Wait was surprising ok. Everyone was very nice 👍 Always a pleasant experience 😊
Lex G.
Lex G.
15:28 22 May 23
The wait was a little long, but worth it. They were great. Very nice ladies😁
Amanda P.
Amanda P.
16:55 17 May 23
Me encantaron las atenciones de principio a fin. Especialmente el trato de Anthony que se mostró muy empatico con mi caso y SUPER servicial y amable.También son muy considerados con lo que realmente a uno le hace falta y lo que no. Ellos hacen las cosas como se debe sin importar que cobren más o menos dinero.En general la experiencia fue excelente.
Nicanor N.
Nicanor N.
11:27 17 May 23
Great visit. Very efficient
Glenda C.
Glenda C.
21:05 15 May 23
Son muy amables las chicas del front desk y las doctoras también
luisaa L.
luisaa L.
19:31 08 May 23
From the front desk to the medical assistant, to the lab, and down to the doctor and whoever you passed by, it was excellent customer service. It was topnotch. I think the entire staff took extra customer service classes.Even the way they accommodate those who do not speak clear English is impressive. I must confess, I have never seen nor experienced such courtesy, patience and civility amongst healthcare professionals.The quality of service was also excellent. Very humble people. The doctor, very humble, accommodating, and HIGHLY professional.I’m glad I found this place. I highly recommend! 👍
Victoria A.
Victoria A.
19:31 04 May 23
Didn’t have an appointment and the money but I was taken care of staff where very friendly I do appreciate your service thank you.
Abdul M.
Abdul M.
16:31 01 May 23
They were so nice and patient and caring the best Clinic in New York
Stephanie H.
Stephanie H.
10:00 27 Apr 23
I love this place. The staff is the best, fluent Spanish, great service. I would come to their facility any day of the week!
Paul C.
Paul C.
16:09 26 Apr 23
Started my journey with Great City medical early this year, and it has been a positive experience soo far. Great team
Laila B.
Laila B.
18:35 18 Apr 23
Always have a pleasant experience with Dr. Granna.
Guillermo P.
Guillermo P.
17:40 17 Apr 23
Very professional all the staff in the front. My doctor the best and I am so thankful him. I have improved in my health. I so happy that get better and go part time job when 68 year in September turn 68years old.
Bevelynn T.
Bevelynn T.
17:29 14 Apr 23
Fue mi primera vez y me gusto mucho dan Excelente atención, las recepcionistas,la enfermera y la doctora muy amables, atienden muy rápido, dan un magnífico servicio, lo recomiendo al 💯
Zery M.
Zery M.
23:13 12 Apr 23
Great people great service
Ac B.
Ac B.
12:55 07 Apr 23
Very professional I recommend going to this facility. Staff was very friendly and courteous…
Charles Hackett J.
Charles Hackett J.
21:11 06 Apr 23
Always good service and kind people over there. I had 3 year’s going to there and I had good service with good doctors. Thank you for all the staff.
Yaneth P.
Yaneth P.
22:45 05 Apr 23
As a holistic & integrative practitioner, my PCP, Dr. Marly Grana is Amazing, has ALWAYS been & Is totally Respectful, Wise, patient, Gifted, extremely Understanding & smart treating me!Her staff, from the front desk-to-the-back is always accommodating & Extremely Professional as well!The facilities are clean.I’m blessed to have been invited to this new establishment when they began building.In this community, I’m fortunate to visit Amazing Acupuncturists, & GrowNYC.Sometimes it’s a win-win excursion.The gynecologist & her NP, on the other hand, does not support my insightful wholistic approach to healing & sustaining.
Bonita B.
Bonita B.
21:03 05 Apr 23
This is the best doctor office I have ever been ,the staffing it’s so professional and welcoming specially patricia I love her she’s amazing. My doctor Mikhail AkselRuD it’s the best ,he always give all the details about what you have and what treatment you need god bless all of them.
adalgisa S.
adalgisa S.
00:04 31 Mar 23
Great staff and service. Dr. Tsyba is the best!
Jackie L.
Jackie L.
20:05 30 Mar 23
Fast service, understanding. My Questions were answered and I felt very comfortable. Will definitely go again for follow up. Many blessings 🙌 🙏
Juanita E.
Juanita E.
23:17 29 Mar 23
I had a deadline to submit my I-693 and Great City medical came through just right for me. Timely and speedy process and the best customer service nurses I’ve experienced.
Ralph M.
Ralph M.
14:06 24 Mar 23
I received such courteous and expedited services from Great City Medical, Staff was so friendly and helpful, The best for immigration medical forms!!
gayle W.
gayle W.
15:15 22 Mar 23
Great service. Fast turnover. Reasonable prices. Highly recommend for immigration services.
Ania P.
Ania P.
16:20 15 Mar 23
Una atención muy buena, gracias por su ayuda, en especial a Antony , me aclaro todas las dudas. Muy buena atención
Martha Echeverri I.
Martha Echeverri I.
18:12 10 Mar 23
La doctora y todos los que me atendieron muy amables y educados
virginia F.
virginia F.
22:51 21 Feb 23
Siempre están para uno ! El personal es muy amable y servicial y mi Doctora siempre dispuesta ayudarme , gracias Marly grana por siempre estar ahí para mi 🙏
21:53 20 Feb 23
I’ve been using Great City Medical for more than 5 years now. I use their services because their staff is professional, and Drs Grana and Axelrud are caring, compassionate, thorough and take their time. The facility is spotless and clean. They follow up and make referrals when necessary. There are always patients but never overcrowed or long wait times. What more do you need? They’ve got it all!! I highly recommend them.
21:13 14 Feb 23
I really appreciate you guys
deboria G.
deboria G.
20:21 13 Feb 23
Todos bien.,Me la atención de mi doctora y las muchas son muy amables.
Mildred E.
Mildred E.
22:12 09 Feb 23
Been going to Dr. Yelena Tsyba for my Reproductive health for years, I see her and/or other medical staff/NPs who are just as wonderful and attentive as her I feel comfortable with them all. Im grateful to have found Great City Medical and wont change them for the world. They take great care of me, their clinic is clean and cozy, and their bedside manner and staff is exceptional!
Shay L.
Shay L.
15:20 08 Feb 23
Excelente atención
18:02 24 Jan 23
I think Dr. Akselrud’s bedside manner is exceptional. It mimics the hospitality depicted in movie, s yet rarely experienced in actual life. As such, I appreciate his expertise and welcome his opinion regarding my health and well-being.I consider him to be a Grade A physician without question!
latia H.
latia H.
20:23 19 Jan 23
Me gusta mucho ir a esta consulta todos son muy profesionales y amable.
Aurys H.
Aurys H.
17:21 13 Jan 23
It was a good experience.
Randy G.
Randy G.
21:29 12 Jan 23
They are so polite and pay very close attention. They know how to make you feel comfortable.
aggie U.
aggie U.
19:35 06 Jan 23
The place is very clean and nice and staff is very professional the doctors are Great I have been going there for few years now all is good
04:37 06 Jan 23
Gilberto P.
Gilberto P.
20:55 04 Jan 23
Excelente servicio
Paola A.
Paola A.
18:03 20 Dec 22
friendly staff 🙂 and its a quick transaction. thank you
Mark Anthony L.
Mark Anthony L.
21:39 14 Dec 22
My experience is always top notch here! Thank you…
18:58 07 Dec 22
These team of professionals are the best, so happy they are taking care of me.
Elsa N.
Elsa N.
21:46 06 Dec 22
They are very professional and treat with care.
Uptothe T.
Uptothe T.
19:31 05 Dec 22
I saw Dr. Yelena Tysba and she was very professional and courteous. She took her time with me and listened to my concerns. In addition, she was very gentle during my procedure and was very knowledgeable on various gynecological conditions. The ultrasound tech, Pat, was also very professional. During my ultrasound she was very kind, patient, and gentle. The two receptionist at the front desk and the nurse were also very professional while making my follow up appointment. I have been to this doctor’s office before and her diagnosis was accurate. I would recommend the GYN office to my family and friends.
Mary S.
Mary S.
22:09 01 Dec 22
Excellent service it’s a lot better than what it used to be and I am grateful for that.. doctor is wonderful.. and the PCA’s that work there are the best all of the women are caring and patient.. they make you feel welcomed..🙇‍♂️
Thomas R.
Thomas R.
22:30 28 Nov 22
Awesome service & very professional staff. I highly recommended this place.Specially Patrisha she is so helpful.Thank you so much!!
21:43 28 Nov 22
Everyone at the office is always very pleasant. The office is always clean, which is always top on my list. The doctor is always very thorough when explaining herself and also takes her time with you. I would highly recommend great city medical.
Luisa M
Luisa M
16:36 23 Nov 22
It was a great visit.
Willie E. A.
Willie E. A.
18:57 17 Nov 22
This is the best clinic I’ve been! The nurses and doctors treat you with kindness. They are all super friendly. Will definitely keep doing my check ups here!
Yikaury H.
Yikaury H.
23:56 15 Nov 22
I’ve been coming here for years and my doctor shows true concern about all my health issues staff here are also great
Trina M.
Trina M.
23:35 10 Nov 22
My visit was very quick for the first time I didn’t have to wait,
23:21 09 Nov 22
Great service.
Diego V.
Diego V.
21:16 07 Nov 22
Todos el personal es muy amable gracias
Tony D.
Tony D.
23:52 02 Nov 22
Great hospital
Fatoumata K.
Fatoumata K.
20:02 02 Nov 22
Professional, clean, not wait depend on time schedule appointment. I love evening hours appointment that do rush morning when traffic lot cars out there. I get keep my same doctor when Montefiore Oscar because not in New York so happy that my doctor professional his work, losing 200 pounds so happy after 410 for longest time. My diabetic 2 improve so much went from 8.9 too 5.7 that very jump. So his staff for very professional, and polite with me.
Bevelynn T.
Bevelynn T.
20:38 28 Oct 22
Very professional and friendly. Offices and waiting rooms are always clean, the employees work fast and effectively. They make sure your comfortable and understand what’s going on.
18:26 28 Oct 22
Very nice always very professional
Madeline C.
Madeline C.
23:52 25 Oct 22
Great experience each time I go . Professional clean and very respectful office. Staff always pleasant. Doctors very caring.
Juanita R.
Juanita R.
17:40 05 Oct 22
Amazing staff. Little to no wait time. Worth the experience was in and out within a heart beat and all my questions and concerns were answered. MA and Doctor made me feel really comfortable. 10/10
Fatoumata K.
Fatoumata K.
22:17 04 Oct 22
Muy buena atención y el personal muy amable.
Linet Leyva B.
Linet Leyva B.
18:28 03 Oct 22
Great attentions !!!!!👍🏼👍🏼👍🏼👍🏼
Jonathan S.
Jonathan S.
17:15 12 Sep 22
I have a great experience this was my first time and I recommend the staff are all welcoming
Oneisha R.
Oneisha R.
19:55 09 Sep 22
I’m very happy that I choose this clinic for my medical exam for green card. I was afraid about my not perfect english and that I can’t understand everything correctly but all nurses and doctor were very patient and attentive. All procedures were made very professional and quick.
iren H.
iren H.
19:28 08 Sep 22
Very Professional Thanks
Saury G.
Saury G.
21:02 07 Sep 22
I love they how the staff was really friendly to me. Making me feel more comfortable with my visit, just love how pretty the place was and clean💕.
Andala M.
Andala M.
21:30 06 Sep 22
Great service. The intake with the nurse was pleasant and fun. The time with the doctor was very comfortable, she listened very attentivet all my concerns, she was very gentle and professional.They have late afternoon appointments wich is a plus.The final step was the scheduling of the next appointment wich was fast!My mom was right to recommend her and I recommend them as well.
Juana G.
Juana G.
22:07 30 Aug 22

Doctor in New York City

Looking for a primary care provider in New York City that you can depend on? Make your appointment with the physicians at Great City Medical by calling (212) 281-8600


68e 131st Street Suite 100, New York, NY 10037

Phone: (212) 281-8600

Monday: 9am-5pm
Tuesday: 9am-5pm
Wednessday: 9am-5pm
Thursday: 9am-5pm
Friday: 9am-5pm


1513 Voorhies Ave 3rd Floor, Brooklyn, NY 11235

Phone: (212) 281-8610

Wednessday: 9:00AM-5:00PM
Thursday: 9:00AM-5:00PM


68 East 131st Street, Suite 100
New York, NY 10037

Call us anytime

Phone: (212) 281-8600
Fax: (212) 281-8601

Patient Portal

Copyright © 2020 Great City Medical. All Rights Reserved.

Copyright © 2020 Great City Medical. All Rights Reserved.