Snow STEMI

Posted on February 23, 2026 by Patrick Hercules

A powerful winter storm called a Nor’easter has brought blizzard-like conditions and a large amount of snowfall to our area.

When we get such large amounts of snow, the easy part is watching the beauty of the snow falling. Unfortunately, the most difficult part is having to shovel several inches of snow from the sidewalk and driveway.

A major worry when shoveling large amounts of snow is how it can affect our health.

According to the National Library of Medicine, heavy snowfall, cold temperatures, and low atmospheric pressure during the winter months have been associated with increased adverse cardiovascular events, such as “snow-shoveler’s ST-elevated myocardial infarction (STEMI).”

Snow-shoveler’s STEMI is a type of heart attack that occurs when there is a partial or complete blockage in one of the coronary arteries, which stops blood flow to part of the heart muscle. This can especially occur due to the over-exertion caused by shoveling snow.

Per the American Heart Association, shoveling snow can put some people at risk of a heart attack, but most people won’t have a problem. Sudden exertion, such as shoveling hundreds of pounds of snow or pushing a heavy snow blower after being sedentary for several months, can put a huge strain on the heart.

There is also a factor of cold weather, as it can increase heart rate and blood pressure, and make blood clots form more easily and constrict arteries, which can decrease blood supply. This can even affect healthy people. People who are over the age of 40 years old, or are relatively inactive, are especially at risk. Other people who are at risk of STEMI include:

Those with preexisting heart conditions:

Those with high blood pressure (hypertension)
Those who smoke tobacco products

According to Medical News Today, research indicates that heavy snowfall is linked to a 6% higher likelihood of hospital admission for men with a heart attack and a 34% increase in dying.

The National Safety Council recommends the following safety tips to shovel safely:

Know the signs of a heart attack, stop immediately, and call 911 if you’re experiencing any of them; every minute counts

The warning signs of a heart attack include:

- Chest discomfort that lasts more than a few minutes or doesn’t go away and returns
- Pain or discomfort in the arms, back, neck, jaw, and stomach
- Shortness of breath

Other signs of a heart attack can include:

- Breaking out in a cold sweat
- Nausea
- A rapid or irregular heartbeat
- Unusual tiredness
- Heartburn or indigestion
- Lightheadedness

Take it slow and stretch before you start shoveling
Shovel only fresh, powdery snow because it is lighter
Push the snow instead of lifting it. If you do lift the snow, use a small shovel or only partially fill the shovel
Lift with your legs and not your back
Dress in warm layers
Do not shovel after eating or while smoking
Do not work to the point of exhaustion

If you have a history of heart disease, do not pick up a shovel without the permission of your healthcare provider.

If you or a loved one is experiencing symptoms of STEMI, while, during, or after shoveling snow, you can receive treatment from a cardiologist at Flushing Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486. If you are experiencing an emergency, please call 911 immediately.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Appendicitis

Posted on February 19, 2026 by Patrick Hercules

Appendicitis occurs when the appendix becomes clogged, infected, and inflamed. It can cause acute pain in your lower abdomen; however, for most people, pain begins around the belly button and then moves. As inflammation worsens, appendicitis pain typically increases and eventually becomes serious.

Symptoms of appendicitis include:

Sudden pain that begins on the right side of the lower belly
Sudden pain that begins around the belly button and often shifts to the lower right belly
Pain that worsens with coughing, walking, or making other jarring movements
Nausea and vomiting
Loss of appetite
Low-grade fever that may rise as the illness worsens
Constipation or diarrhea
Belly bloating
Gas

Additional symptoms that may develop later in some people can include:

Malaise
Urinary symptoms- needing to go more frequently or more urgently
Bowel paralysis

The size and location of the appendix make it easy for it to become clogged and infected. Your large intestine is home to many bacteria. If they become trapped in your appendix, they overgrow and cause an infection. The bacteria then multiply quickly, causing the appendix to become inflamed and filled with pus. If it is not treated right away, the appendix may burst or break open.

Some common causes of inflammation, swelling, obstruction, and infection in your appendix include:

Hardened poop (appendix stones)
Lymphoid hyperplasia
Colitis

Other factors that could block the opening of your appendix can include:

Tumors
Parasites
Cystic fibrosis

Risk factors for appendicitis include:

Age – anyone can develop appendicitis, but it most often happens in people between the ages of 10 and 30
Your sex – men have a slightly higher risk of appendicitis than women

To help diagnose appendicitis, a healthcare provider will likely take a history of symptoms and examine the abdomen. Tests used to diagnose appendicitis can include:

A physical exam
Blood tests
Urine tests
Imaging tests

Appendicitis may spontaneously resolve if the cause suddenly goes away on its own. This might happen if an obstruction in your appendix gets unblocked and passes through the intestines, or if an infection causing lymphoid hyperplasia in your appendix suddenly improves. However, you shouldn’t assume this will happen or that it has happened, even if your pain has reduced.

The standard treatment includes medicine such as antibiotics and surgery to remove the appendix. The surgical procedure to remove the appendix is called an appendectomy, and it can be performed using robot-assisted technology.

Appendicitis is considered an emergency, so it is treated in the emergency room.

If you are experiencing symptoms of appendicitis, visit Flushing Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486. If there is an emergency, please call 911.

A.I. Therapy

Posted on February 15, 2026 by Patrick Hercules

During the COVID-19 pandemic, access to healthcare services through telehealth and telemedicine was implemented to help limit the spread of the virus. It was also used for those who were using mental health services, as that time was very lonely and isolated for many people.

A 2020 review published in BMC Public Health concluded that telehealth improved the delivery of healthcare during the pandemic, minimizing COVID-19 transmission and potentially reducing morbidity and deaths.

Telehealth is a way to receive healthcare services remotely through electronic devices such as a computer, tablet, or smartphone. These telehealth services can come in various forms, including:

Live video or audio appointments

Secured text messaging with a healthcare provider

Remote devices that allow a healthcare provider to track blood sugar

Today, many people use telehealth to get support for any mental health challenges they may be experiencing. Unfortunately, obtaining professional mental health support can be challenging as there is a shortage of mental healthcare providers. There is also the daunting task of searching for and finding the right one. This has caused many people to turn to A.I. therapy.

A.I. therapy uses artificial intelligence to support mental health through chatbots, digital therapy apps, and A.I.-driven counseling tools.

Many American adults, 22% in fact, have found some relief by using mental health chatbots as a therapeutic tool.

There are many possible reasons why people are turning to A.I. therapy as a viable option to address their mental health, including:

Accessibility

Affordability

Anonymity

There are many A.I. therapy platforms. They include:

CBT-focused chatbots that use meditation and cognitive behavioral therapy (CBT) techniques that offer personalized recommendations and crisis support

Skill-building apps that teach CBT skills, provide personalized recommendations, and collect user data to improve the experience

Self-guided wellness platforms that combine A.I. chatbots with emotion tracking, journaling, and self-directed therapeutic exercises

Mood tracking apps that allow users to track their moods and symptoms, while sometimes receiving self-care recommendations

Conversational A.I. companions that provide daily support through advanced A.I. and adapt to the user’s needs. It is typically aimed at mild anxiety or overthinking, with CBT-focused conversations

A.I. can be a promising tool for enhancing mental healthcare, but it can’t replace personalized mental healthcare.

Although A.I. therapy can’t replace human therapists, it could be a helpful supplement for those who may need additional support, along with therapy.

There are several reasons why A.I. therapy might be helpful, including:

24/7 availability due to A.I. chatbots being able to provide additional support outside of therapy sessions and holidays

Affordability of A.I. therapy provides a low-cost way to get support outside of sessions

Discretion of A.I. therapy helping people explore mental health support in a low- pressure, judgment-free way

While A.I. therapy may have some benefits for those seeking support with their mental health, it also poses several potential risks, including:

It can cause A.I.-induced psychosis

It can give unsafe advice and misinformation

It engages in sycophantic behavior by validating a user’s emotions, which can be dangerous if they have suicidal ideation, delusions, mania, or hallucinations

There is a lack of human connection and empathy: A user might take a self-assessment without human input that can lead to false reassurance or dangerous delays in getting help. A.I. can miss nonverbal cues, and a user may take its output as definitive

A.I. therapy can offer those who are seeking support with their mental health a convenient way to do so. However, effective mental healthcare should be safe and provided by trained, human mental health professionals.

If you or a loved one needs the assistance and support of a mental health professional at Jamaica Hospital Medical Center, please call 718-206-5575 to schedule an appointment.

When is The Best Time to Drink Coffee? And How Late is Too Late?

Posted on February 13, 2026 by Patrick Hercules

Many people wake up and have a cup of coffee to start their day. And some people drink several cups of coffee throughout the day.

Depending on the type of coffee grounds and how they are brewed, an 8-ounce cup of coffee can contain close to 100 milligrams of caffeine. Caffeine is a stimulant, and it helps wake you up by increasing the amount of cortisol, the stress hormone, in your body.

Cortisol levels usually peak between 7 a.m. and 8 a.m. and gradually drop throughout the day, reaching their lowest point in the middle of the night while you’re sleeping. Cortisol helps the body maintain its sleep-wake cycle.

However, drinking caffeinated coffee first thing in the morning can increase cortisol production.

If you drink coffee later in the day or at night, it could affect your sleep. Depending on your metabolism, it may take two to ten hours to get rid of half the caffeine from one cup of coffee.

Certain people have a “coffee gene”, CYP1A2, that helps the body break down and get rid of caffeine, and some people have two copies of this gene, which helps them break down caffeine faster than those with one copy of the gene. If a person has two copies of the gene, they may not be affected after drinking a late-night cup of coffee.

There is no scientific evidence that supports a “best time” to drink coffee. However, drinking a mid- to late-morning cup of coffee between 9:30 a.m. and 11 a.m. may help you receive the most benefits from coffee. This is the range of time when cortisol levels begin to drop, and the caffeine in a cup of coffee may be most effective.

The best time to drink coffee is ultimately determined by your metabolism and how the caffeine in coffee affects your body.

If you would like to learn more about how caffeine may affect your body, you can schedule an appointment at Flushing Hospital Medical Center’s Ambulatory Care Center. Please call (718) 670-5486.

Common Myths About Robotic Surgery De-Bunked

Posted on February 11, 2026 by Patrick Hercules

The way surgical procedures are performed has evolved. Today, surgeons use advanced technology such as robotic surgery to perform delicate operations and improve patient outcomes.

During robotic surgery, a surgeon performs surgical procedures using a robotic device, which features a three-dimensional camera and a robotic arm that can hold small surgical instruments and is more dexterous than a human’s hand.

There are several myths about this surgical technique:

Myth #1: The surgical robot performs surgery on its own

Some people believe that robots perform surgery on their own. The truth is that robot surgery is robot-assisted. A surgeon is specially trained to control the robotic system and always controls it

Myth #2: Robotic surgery has more risks than traditional surgery

Robotic surgeries are minimally invasive and are safer and more effective than traditional open surgeries. Robot-assisted surgical technology is designed to reduce the physical impact of surgery on the body, as patients will experience:

Smaller incisions

Reduced pain and fewer complications

Faster recovery

Myth #3: Robotic surgery is only for complex or high-tech surgical procedures

Robotic surgery is often used for complex procedures; however, robotic-assisted techniques can also be used for routine procedures, such as hernia repairs and gallbladder removals.

Myth #4: Robotic surgery is always more expensive than traditional surgery

People commonly believe that robotic surgery is too expensive or that it isn’t covered by insurance. Like traditional surgery, robotic-assisted surgical procedures are typically covered by insurance providers when they are considered medically necessary. Robotic surgery may reduce overall healthcare costs because it is minimally invasive.

Robotic surgery has its advantages and disadvantages. The use of this surgical technique depends on the patient’s needs. This is why it is important to consult with a healthcare provider and surgical team, as they will deem what the best course of action for that patient.

For more information about robotic surgery or to learn more about other surgical options at Flushing Hospital Medical Center, call (718) 670-5000 to make an appointment.

National Children’s Dental Health Month

Posted on February 6, 2026 by Patrick Hercules

February is observed as National Children’s Dental Health Month, a month focusing on the importance of promoting good oral health habits among children and raising awareness about the significance of dental care.

Good oral hygiene is an essential habit for a child to learn at a young age. Teaching children good oral health habits such as regularly brushing their teeth, flossing, rinsing, and attending dentist appointments can help them grow up with healthy mouths.

These habits can help prevent them from developing cavities. Cavities are the most common chronic disease of children in the United States. According to the Centers for Disease Control and Prevention (CDC), more than half of children six to eight years old have had a cavity in at least one of their baby teeth. Additionally, more than half of adolescents aged 12 to 19 years old have had a cavity in at least one of their permanent teeth.

If cavities go untreated, they can cause pain and infections that may lead to problems with eating, speaking, playing, and learning.

Fortunately, cavities are preventable. According to the CDC, fluoride varnish can prevent 33% of cavities in baby teeth. Children living in communities with fluoridated tap water have fewer cavities than children whose water is not fluoridated. Additionally, children who brush daily with fluoride toothpaste will have fewer cavities.

The CDC also notes that dental sealants can prevent cavities for many years as well. Applying dental sealants to the back teeth prevents 80% of cavities.

There are several ways that parents and caregivers can help reduce the risk of or prevent babies and children from developing cavities, including:

Babies

Wipe their gums twice a day with a soft, clean cloth in the morning after their first feeding and right before they go to bed. This wipes away any bacteria or sugars that can cause cavities

When teeth come in, start brushing them twice a day with a soft, small-bristle toothbrush and plain water

Visit the dentist by your baby’s first birthday to spot any signs of problems early

Talk to your dentist or healthcare provider about putting fluoride varnish on your child’s teeth as soon as the first tooth appears

For children two years or younger, consult with your healthcare provider or dentist about the use of fluoride toothpaste.

Children

Brush their teeth twice a day with fluoride toothpaste

Help your child brush their teeth until they develop good brushing skills. If your child is younger than six years old, watch them while they brush, and make sure they use a pea-sized amount of toothpaste and always spit it out instead of swallowing it

Ask your child’s dentist to apply dental sealants when appropriate

Drink tap water that contains fluoride

It is important that your child regularly visits a dentist to ensure they receive the most effective treatment possible.

If you would like to learn more about cavity prevention for your child, you can schedule an appointment at Flushing Hospital Medical Center’s Department of Dental Medicine. Please call (718) 670-5521.

Meet Our Doctors- Dr. Andrew Bi

Posted on February 5, 2026 by Patrick Hercules

Flushing Hospital Medical Center is proud to introduce Dr. Andrew Bi, the newest member of our orthopedic surgical team.

Dr. Bi was born in Chicago, Illinois, and raised in East Lyme, Connecticut, and currently resides in Queens. He graduated from the University of Connecticut magna cum laude with honors. He then graduated from Northwestern University Feinberg School of Medicine summa cum laude with Alpha Omega Alpha honors. He then completed his orthopedic surgery residency training at NYU Langone Orthopedics, where he served as Executive Chief resident. Dr. Bi later underwent subspeciality training at Midwest Orthopaedics at Rush in a sports medicine fellowship, where he served as assistant team physician for the Chicago Bulls, Chicago White Sox, Chicago Steel, and DePaul University.

Dr. Bi has received numerous awards for teaching, clinical care, and research, including the Ralph Lusskin Senior Resident Teaching Award, the Marian Frauenthal Sloane Clinical Research Award, and the Rush Annual Thesis Day Award.

Dr. Bi treats all aspects of orthopedic injuries with a special interest in the management of all shoulder, elbow, hip, and knee conditions, including, but not limited to robotic-assisted joint replacements for arthritis, minimally invasive arthroscopic surgeries for sports injuries, such as anterior cruciate ligament (ACL), meniscus, cartilage, rotator cuff, and labrum injuries, and the fixation of fractures. His current research efforts involve anterior cruciate ligament injuries, meniscal allograft transplantations, rotator cuff tears, hip arthroscopy, and orthobiologics.

Dr. Bi is excited to begin at the Medisys family at Jamaica Hospital, bringing with him a sports medicine subspecialization expertise, as well as his Chinese heritage, to take care of the diverse population surrounding the hospital.

If you are experiencing any conditions or injuries affecting your bones, muscles, ligaments, and tendons, you can schedule an appointment at Flushing Hospital Medical Center’s Ambulatory Care Center. Please call (718) 670-5486.

Winter Skin Care

Posted on February 4, 2026 by Patrick Hercules

Winter can be difficult to deal with when temperatures drop to bone-chilling levels and are accompanied by frigid winds. The temperatures and wind can also be difficult on our skin due to low humidity, causing it to become cracked and dry. Even the heat in our homes and cars makes skin dryness worse because it removes moisture from the air.

According to the Columbia University Irving Medical Center, the outermost layer of the skin, called the stratum corneum, acts as a protective barrier that helps retain water. As the stratum corneum loses moisture, the skin can become red, irritated, and cracked. This especially affects older adults as their aging skin is thinner and produces fewer natural oils, which makes it more prone to losing moisture.

Here are some dermatologist-recommended tips to help prevent any further loss of water and restore moisture to your skin barrier:

Using a humidifier at night to help prevent your skin from drying out

Wearing gloves while cleaning or washing dishes to prevent hot water and detergents from stripping away the skin’s natural oils

Using a cream instead of a lotion to moisturize your skin

Using moisturizers containing hydrating ingredients such as hyaluronic acid, ceramides, and cholesterol

Applying moisturizer after showering to help lock in moisture while your skin is still damp

Using a petroleum- or lanolin-based ointment and apply at night to the hands and feet, and covering them with cotton gloves or socks

Drinking water helps you stay hydrated from the inside out

Here are some tips on what to avoid as you try to care for your skin this winter:

Scented products and some anti-aging ingredients, as fragrances, can draw moisture from the skin and cause irritation

Long showers using hot water can worsen dryness. Dermatologists recommend using lukewarm water and avoiding prolonged baths or showers

Wool fabrics can cause itching and irritation when it rubs against the skin. The National Eczema Association recommends wearing layers that are cotton-based in the winter and removing any damp clothing immediately

If you are having issues with your skin, you can receive treatment at Flushing Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486.

Foods You Should Not Eat with Gallbladder Problems

Posted on January 30, 2026 by Patrick Hercules

The gallbladder is an organ that plays an essential role in digesting the foods we eat. Some foods we eat can be good for our gallbladder, while others can harm it. If you have gallstones or if your gallbladder is inflamed or infected due to gallbladder disease, you may need to follow a specific diet to protect your gallbladder.

If you are experiencing problems with your gallbladder, various foods can increase your risk of developing diseases, including:

Saturated and trans fats increase the risk of gallstones

Refined carbohydrates increase the likelihood of developing gallstones

Ultra-processed foods increase the risk of gallbladder disease

Sugar-sweetened beverages increase the risk of gallbladder cancer

If your diet consists of these foods, a healthcare provider may recommend following a diet to help improve the health of your gallbladder. A healthcare provider may suggest a diet that consists of:

Fruits and vegetables that contain essential nutrients such as fiber, vitamins, minerals, and antioxidants may reduce the risk of gallstones

Whole grains are a great source of dietary fiber that can help your digestive health and gallbladder, which may reduce the risk of gallstone disease

Healthy fats may increase bile secretion and prevent gallbladder disease, benefiting gallbladder health

Lean protein that is low in fat, such as poultry, fish, low-fat dairy, and especially plant-based protein, may lower the risk of gallbladder disease

Two types of gallbladder diets may help lower your risk of gallstone issues: the Mediterranean diet and the Dietary Approaches to Stop Hypertension (DASH) diet.

Mediterranean diet- focuses on eating whole foods and healthy fats

DASH diet- focuses on high-fiber, heart-healthy foods that are low in sodium, which lowers your risk of hypertension

A gallbladder diet may be difficult to adhere to at first. However, here are some meal-planning tips to follow to help:

Controlling your portion sizes and the frequency of meals may protect against gallstones by helping empty the gallbladder and preventing bile build-up

Adding specific foods to your diet can reduce your risk of and protect against gallbladder disease

Maintaining a food diary to keep track of any symptoms you have and what you ate before the symptoms started, as it is important to know what foods may trigger symptoms.

Planning meals and snacks can ensure you have the proper foods available when it is time to eat, instead of going too long between meals, which may increase the risk of gallstones

Staying hydrated can help bile flow from your gallbladder to your small intestine, aiding in digestion

If you have been diagnosed with gallbladder disease and are considering surgery, robotic surgery could be an option. Robotic gallbladder surgery has many benefits, including:

It is the best way to relieve gallbladder-related symptoms, such as belly pain, nausea, and vomiting.

It lowers the risk of developing complications, such as infection or inflammation of nearby bile ducts or organs

It prevents gallstones from returning, as well as any future gallstone attacks

There are many potential advantages of robotic-assisted surgery over other types of surgery, including:

Robot-assisted surgery provides surgeons with 3D images of the abdomen and pelvis, creating a clearer picture to reference during the operation

Under the surgeon’s direction, the robot can move more freely and with more versatility than a human hand

You’ll have a few tiny scars

You’re more likely to experience less pain and less bleeding after surgery compared to open surgery

A shorter hospital stay

To learn more about our robotic surgical procedures or schedule an appointment, contact Flushing Hospital Medical Center at (718) 670-5000.

Hepatitis B

Posted on January 28, 2026 by Patrick Hercules

Hepatitis B is a serious viral liver infection that is caused by the hepatitis B virus (HBV).

The hepatitis B virus can be passed from person to person through various ways, including:

Sexual contact

Sharing of needles

Accidental needlesticks

Pregnant person to newborn

There are two types of hepatitis B: acute hepatitis B and chronic hepatitis B.

Acute hepatitis B is a short-term illness that occurs within the first six months after being exposed to the hepatitis B virus.

Chronic hepatitis B is a longer-term illness that lasts more than six months after exposure.

Most adults who develop hepatitis B will make a full recovery even if they have severe symptoms. However, infants and children are more likely to develop chronic hepatitis B infection.

Hepatitis B symptoms can range from mild to serious and usually start about one to four months after being infected with the hepatitis B virus, but can be noticeable as early as two weeks after the initial infection. Symptoms of hepatitis B include:

Abdominal pain

Dark urine

Fever

Joint pain

Nausea and vomiting

Fatigue and weakness

Loss of appetite

Jaundice

Although anyone can get hepatitis B, certain people have an increased risk of infection if they:

Have sexually transmitted diseases such as HIV

Take immunosuppressants that keep the immune system from mistakenly attacking healthy tissue

Are currently receiving dialysis treatment

Have another type of liver disease

An acute and chronic hepatitis B infection can cause several complications, including:

Acute liver failure

Chronic liver failure

Cirrhosis of the liver

Liver cancer

Reactivated hepatitis B

Hepatitis D

A healthcare provider can diagnose hepatitis B by asking about your symptoms and performing a physical exam. They will also ask if there is any family history of liver disease. They may ask:

If your work exposes you to the virus

If you use any intravenous (IV) drugs

If you have unprotected sex with anyone who may have hepatitis B

A healthcare provider may also perform tests to help diagnose hepatitis B, including:

Blood tests

Imaging tests such as an elastography

Liver biopsy

Treatment for hepatitis B is dependent on your situation. A healthcare provider may prescribe prophylactic treatment, which is medication to prevent a disease, if you were exposed to the virus within the past 24 hours. Medications for prophylactic treatment include:

Hepatitis B vaccination

Hepatitis B immune globulin (HBIG)

Acute hepatitis does not have a specific treatment. A healthcare provider may prescribe IV fluids to prevent dehydration if you have been vomiting or experiencing diarrhea.

Treatment for chronic hepatitis B varies, as it depends on your symptoms and overall health. Treatment options can include:

Monitoring your overall health

Medications such as antiviral drugs or immunomodulators

Surgery to remove part of your liver if hepatitis B causes cancer, or a liver transplant if your whole liver must be removed

The best way to reduce the risk of or prevent a hepatitis B infection is to get vaccinated. It takes three doses of the hepatitis B vaccine, administered over six months, to achieve complete protection from infection. You can also reduce your risk by practicing safe sex and needle use and not sharing personal items.

If you or a loved one is experiencing symptoms associated with hepatitis B, you can receive treatment from a physician at Flushing Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486.