At MD 2.0, we provide patients with superior primary care. We want to be the first to know about any health concerns that may arise. Primary care is performed and managed by your personal physician, Dr. Poncy or Dr. Lubarsky who are available to you 24/7.
Drs. Lubarsky and Poncy believe in more than just treating you when you are sick. Our preventative medicine doctors want to ensure you are healthy year round by promoting a healthy lifestyle, yearly executive level physical exams, and helping to prevent disease.
At MD 2.0, our concierge physician practice focuses on providing high quality care and individualized attention to each patient. Our model allows us to spend more time with each patient, allowing us to work closely with you on prevention, diagnosis, and treatment of diseases and complex illnesses.
Board Certified Internist in Jupiter, FLDr. Amir Lubarsky's love of medicine allows him to listen compassionately and intently to his patients in order to provide the best outcomes.
Board Certified Internal Medicine Doctor in Jupiter, FLDr. Morgan Poncy is a board certified internist who was raised in the Jupiter area.
They’re called “forever chemicals” because they don’t break down fully in the environment, and this summer the Environmental Protection Agency (EPA) warned that they are more dangerous to human health than regulators knew.
Within weeks, the National Academies of Sciences, Engineering, and Medicine (NAS) weighed in with its own 300-page report on these chemicals, known as perfluoroalkyl and poly-fluoroalkyl (PFAS) substances, urging doctors to test high-risk patients for PFAS contamination.
Because of the heightened attention on these chemicals, our primary care concierge doctors in Jupiter want to summarize for you what we’ve learned about them, and offer tips on how to reduce your exposure.
The Problems with PFAS
In 1946, DuPont introduced its revolutionary non-stick product, Teflon. By 1950, studies by DuPont and 3M showed that PFAS could build up in the blood, but chose to keep these results secret, according to the non-profit Environmental Working Group (EWG).
Since 1998, when a class-action lawsuit against a West Virginia DuPont factory revealed the extent of the pollution from the factory, researchers have found probable links to such diseases as:
- thyroid disease
- high blood pressure
- kidney cancer
- testicular cancer
- breast cancer
- higher cholesterol levels
- ulcerative colitis
- weakened immune system
- vaccine interference
- weight gain
- changes in liver enzymes
- decreased fertility
- growth and learning delays in infants and children
The NAS report encourages doctors to conduct blood tests for these chemicals on patients who are worried about exposure or who are at high risk for exposure or who are in “vulnerable life stages”: during pregnancy, early childhood, and old age.
As we’ve seen with microplastics, PFAS can begin innocently enough and end up in unexpected places, including our water.
Recently, for example, Consumer Reports (CR) tested more than 100 food-packaging products from U.S. restaurants and supermarkets. They found dangerous PFAS chemicals in many of the products, including paper bags for french fries, hamburger wrappers, pizza boxes, molded fiber salad bowls, and single-use paper plates.
These chemicals are used in a wide variety of products, including waterproof and sweatproof makeup, nonstick cookware, cellphones, waterproof clothing, carpets, and—especially—fast-food containers, where their ability to make products grease-proof has led to their widespread use.
They are also used to make products water-repellent and resistant to high temperatures, as well as in fire-fighting foams used at military installations, floor wax, upholstery, and clothing. The qualities that make items containing PFAS so desirable, however, also make them long-lasting in the environment.
“These chemicals are ubiquitous in the American environment,” Ned Calonge, an associate professor of epidemiology at the Colorado School of Public Health and chair of the NAS committee that wrote the report, told CNN.
“More than 2,800 communities in the U.S., including all 50 states and two territories, have documented PFAS contamination,” he said.
Researchers have even detected them in the snows of Mt. Everest, apparently shed from climbers’ waterproof tents and parkas.
“You are not just exposed in one place or one source,” toxicologist Linda Birnbaum, former director of the National Institute of Environmental Health Sciences and the National Toxicology Program, told The Washington Post. “They are everywhere.”
The problem is that these chemicals build up (or “bioaccumulate”) in the body over time.
And according to the Centers for Disease Control and Prevention (CDC), which has been conducting studies of the U.S. population, PFAS has been found in the blood of nearly all people they’ve tested. Since the risk appears to rise with the amount of exposure, it’s important to try to limit the amount we come in contact with.
What You Can Do
Because PFAS chemicals are found in so many consumer products, they’re next to impossible to avoid. But there are ways to reduce the amount you’re exposed to.
“The most dangerous way that people are exposed to PFAS is through drinking water,” says Don Huber, director of product safety at CR.
That’s why the NAS report recommended filtering tap water as a major step consumers could take to protect themselves.
“The water filters that are most effective for PFAS are reverse osmosis filters,” David Andrews, a senior scientist for the EWG, told CNN, adding that some carbon-based filters can also reduce some levels.
“The important part is that you have to keep changing those filters,” he said. “If you don’t change that filter, and it becomes saturated, the levels of PFAS in the filtered water can actually be above levels in the tap water.”
The NAS committee also offered these tips:
- Stay away from stain-resistant carpets and upholstery, and don’t use waterproofing sprays.
- Look for the ingredient PTFE or other “floro” ingredients on product labels.
- Avoid nonstick cookware. Instead, use cast-iron, stainless steel, glass, or enamel products.
- Boycott takeout containers and other food packaging. Instead, cook at home and eat more fresh foods.
- Don’t eat microwave popcorn or greasy foods wrapped in paper.
- Choose uncoated nylon or silk dental floss or one that is coated in natural wax.
Last month, the World Health Organization (WHO) declared the newly spreading monkeypox virus a global health emergency.
This has prompted many to fear we’re heading into another coronavirus situation, as our concierge primary care doctors in Jupiter have found from talking with our patients.
While this is a debilitating, painful, and—occasionally—deadly virus, there are many reasons why it’s very dissimilar to the SARS-CoV-2 virus, the virus that causes COVID-19.
The history is different
Although both originated as “zoonotic” diseases—that it, they began in animals and spread to humans—we have a far longer history with monkeypox, meaning we know more about it than we did when the coronavirus first appeared.
According to the Centers for Disease Control and Prevention (CDC), monkeypox was first discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research, thereby giving the disease the name “monkeypox.” Its typical animal hosts, however, are rodents and other small mammals.
The first human case of monkeypox was recorded in 1970 in the Democratic Republic of Congo during a period of intensified effort to eliminate smallpox. Since then, monkeypox has been reported in humans in other central and western African countries.
Although relatively new to the U.S., a large monkeypox outbreak occurred here in 2003 as a result of imported rodents.
Transmission is different
Next, the ways the two viruses are transmitted are completely different.
Unlike the largely airborne transmission of SARS-CoV-2 through aerosols that linger in the air, the monkeypox virus can only be spread through close contact with an infected person or animal, or materials such as bedding or towels that are contaminated with the virus.
In addition, monkeypox appears to be far less transmissible than COVID-19. One study found that just three percent of those in close contact with an infected person would develop monkeypox.
It appears at this time to be spreading primarily among gay and bisexual men following sexual encounters, but anyone who comes into close and prolonged, direct contact with the pox sores can become infected.
Even women, and at least two children, have been reported to have contracted monkeypox, as a result of being in close proximity to men who have sex with other men.
The symptoms are different
Unlike the stealth infections of the coronavirus, it’s very apparent when a person is infected with monkeypox. As with COVID-19 and other viruses, they develop fever, headache or body aches, chills, muscle aches, and exhaustion.
These symptoms are also similar to those of smallpox, a cousin of monkeypox, with one difference:
“A feature that distinguishes infection with monkeypox from that of smallpox is the development of swollen lymph nodes,” the CDC says.
Otherwise, however, both smallpox and monkeypox exhibit the same signature fluid-filled lesions (the so-called “pox”), which the coronavirus doesn’t produce. Some individuals have these sores all over the body, while others may have only a single lesion. This rash can be extremely painful.
The vaccines are different
When COVID-19 first appeared two-and-a-half years ago, it was a brand new virus (i.e., “novel” coronavirus).
We knew nothing about it, and at the time had no way to combat it in the form of either effective treatments or vaccines.
Because of our long history with monkeypox, however, we do have vaccines and antiviral treatments. Monkeypox and smallpox come from the same family of viruses (although monkeypox is not as severe as smallpox). That has allowed us to utilize the stockpile of smallpox vaccines and antivirals to fight monkeypox.
And, unlike the coronavirus vaccines, the vaccines for monkeypox are effective even after infection, if given within four days of exposure. Even if the vaccine is given as late as two weeks after exposure, it can still lessen the likelihood of severe illness.
Not to worry?
Does all this mean we don’t have to panic about monkeypox? Panic is never a good idea because it prevents thoughtful responses in a crisis. But at this time the monkeypox outbreak still appears to be confined largely to men who have sex with men and those who are closest to them and who may come in contact with the open sore or infected linens.
If you fall into one of those categories, it’s important to take precautions until the supply of vaccines and antivirals becomes sufficient to cover everyone at high risk of exposure, because cases are spreading rapidly in the U.S. At the end of July, the Centers for Disease Control and Prevention (CDC) reported more than 3,500 confirmed cases but noted that is probably a significant undercount.
Experts advise that, if you’re at risk, you temporarily reduce your number of sexual partners, reconsider sex with new partners, and exchange contact details with any new partners to enable follow-up, if necessary.
Infected people are encouraged to self-isolate from other humans as well as pets, and to wear a mask and long clothing over any sores.
Although there is currently a limited supply of vaccines in the U.S., the government has purchased 2.5 million doses, which should be available in the coming weeks. This means it isn’t yet enough available to offer shots to all high-risk individuals.
So until there is, take precautions, and let us know if you think your symptoms might be those of monkeypox. It’s a painful, debilitating, and sometimes deadly disease, but we can treat it if it’s caught in time.
My husband and I have been patients of Dr. Poncy for over ten years and have been extremely pleased and happy for him. He is not only a brilliant internist, but also a wonderful person. Now that he and his partner, Dr. Lubarsky, have opened the concierge practice it is better than ever. The nursing staff is superlative as is the front office staff. The office is very well appointed and comfortable. We feel very fortunate to have such a competent and caring physician.
About 11 years ago, I first met with Dr. Poncy. I came away from my appointment with him confident he understood my problem and contributed some thoughtful suggestions. Over the years, he has never changed. The outstanding staff Dr. Poncy has put together, along with his partner, Dr. Lubarsky, are the best! I honestly feel, when I have an appointment, it is like visiting "family".
I recommend Dr Lubarsky emphatically. He is a true professional: thorough, compassionate and an excellent diagnostician!
We have been concierge members for only 6 months but so far we have been very pleased. The office atmosphere is very relaxed and the doctor is able to give us the time we need. Time in the waiting room is minimal and we have been able to obtain spur of the moment appointments with no difficulty. We are happy that we joined
The new practice has a very warm, friendly, feeling to it. We don't have long waiting times. Everyone is very prompt.
I have been a patient for over 30 years. I actually look forwarded to a visit. Pleasant, professional in every way, I consider myself very lucky.
A great Dr. & great staff, minimum wait time. Spends as much time with you as you need. Same day appointments.
Dr. Poncy has been my primary care doctor for over 8 years. I've known Dr. Poncy for over 8 years. My neighbor recommended him for my diabetes and heart problem. The staff at Dr. Poncy's office is always very pleasant and Dr. Poncy is very patient to my concerns.
I have been a patient of Dr. Lubarsky since 2004. He has been such a great physician to me and my wife for several years. Recently, I was hospitalized at Jupiter Medical Center. My wife contacted him and he immediately responded and came to the hospital. Without Dr. Lubarsky's support, I don't think I would be at the health level I am at today.
I'm a big fan of Dr. Lubarsky! After moving from New York, I researched area Internist throughout Jupiter and Palm Beach Gardens. Dr. Lubarsky was a home run!