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Allergy & Immunology on Madison
Evelyn Tolston, M.D.
"New York Top Doctor"

Girl in flowers Allergy and Immunology on Madison (AIM), based in New York City, has many years of experience building strong relationships between patients, doctors, and staff. We pride ourselves on using the newest, most advanced techniques in the fields of allergies, immunology and asthma. Our staff in our metro New York and New Jersey locations make every effort to ensure that your treatment and visits with us are positive. Our New York office is conveniently located in Midtown Manhattan.

You can reach us by phone, e-mail or fax with questions or appointment requests.

We post updates and reminders to our website regularly, so please check in frequently.


Attention

Please note: Pollen levels are extremely high this season. Please take all necessary precautions. Take your required asthma and allergy medications and carry your Epi pen, and make sure you follow-up with your physician for all your medical needs.


The Spring/Summer Allergy Season Brings More Than Just Sneezing And Wheezing...Are You Prepared?

WHAT'S NEW

We are expanding our practice to the meet the needs of our patients. Allergy and Immunology on Madison has added other locations that will allow us to treat the growing number of patients who are seeking specialized care for their specific condition. Adding more locations allows us to accommodate our expanding patient base and also offer our patients greater convenience.

We know the stresses of everyday life and medical illnesses can take their toll on our patients. On staff we have Dr. Sophia Gekker, specializing in adult and pediatric psychiatry. Dr. Gekker is here for all our patients' needs.

Our medical practice manager, Ms. Anne Scalogna, is available. She brings to our practice many years of her expertise and experience.

Great news!
The US Food and Drug Administration has approved a new anti-IgE drug called XOLAIR. This is a GREAT NEWS for people with a serious form of allergic asthma and could revolutionize how all allergic diseases are treated! Another new drug on the market is ASMANEX. Consult Dr. Tolston now!

Latest news!
According to latest studies, exposure to antibiotics in the first year of a child's life may double the risk of developing asthma later in childhood.

According to a group of Harvard researchers focused on nearly 1200 women and their babies during and after pregnancy - "what they found?" - for every 100 units of vitamin D consumed during pregnancy, there was a dramatic decrease in the risk of wheezing incidents and the high risk of asthma in babies up to age 3 (fortified dairy products like skim milk, low-fat yogurt, low-fat ice cream, or from a supplement).

Vitamin D has also been shown to have immunologic effects.

To our parents and students who are interested in having Dr. Tolston be a guest speaker at their school, please contact our office.

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Doctor with tissues

ALLERGY UPDATE & PATIENT INFORMATION!

Enjoy the Spring/Summer Season - Stay Ahead of Your Allergies and Asthma

This time of year can be very wonderful and yet can be challenging for people with allergies and asthma. The spring/summer season can present many health challenges, unique to this time of year. Now that your schedule is lighter, let's get back on track with a good healthy routine of exercise and eating right! Surviving--and enjoying--the spring and summer is easier when you plan ahead and take preventive action. Providing our patients with the most updated information and tips will help you get through this season.

Enjoy the spring and summer and relax on your vacation!
Knowing you have allergies, be prepared!

  • Call ahead to airlines, hotel, and restaurants and let them know you have certain food allergies. The chef can prepare all your meals without worries.
    Try to avoid buffets (hidden offenders).
  • If dealing with a child - let the staff have a picture of your child. This way you can have more peace of mind that he/she will not be given offending foods. If your child is going away to camp, let them know all the precautions regarding your child's allergies.
  • Watch out for the country forests and tropical rain forests. Try to avoid going out on humid, rainy days. Air conditioned environment is better.
  • Don't forget your epi-pen and medications. Carry them with you always, never in your suitcase in case it gets lost! Always know where the nearest doctor's office or hospital is.
  • Have your doctor give you written instructions for emergency treatment if necessary.
Now go ahead and enjoy the season ahead!

Have You Heard!!!
General Mills and Kellogg's Pop Tarts and cereal bars now have been reformulated with dried egg whites and will list all ingredients!
An allergen box has been added to the side panel.
Kraft announced that certain Jello brand sugar-free has undeclared pistachio nuts.
Thank you General Mills, Kraft, and Kellogg for caring!

Again, please read labels: cereal boxes and all food packages, skin products.

Apples for asthma - Keeps the doctor away.

Kiwis are loaded with Vitamin C.

Tomatoes, carrots, and leafy greens could lower your risk for asthma, according to a new study by the National Institute of Public Health. These vegetables are high in vitamin A, which helps regulate the immune system and maintain the lining of your respiratory tract.

Asthma: Do The Changing of Seasons Trigger Your Asthma and Allergies?

Asthma affects up to 20 million Americans, and sufferers are sensitive to environmental triggers. Some triggers are obvious such as allergens (pollens, pet dander, etc.), irritants (strong perfume, pollutants, chemicals), tobacco smoke, and infectious agents (viruses that cause colds). However, some triggers aren't obvious. Changes in atmosphere (colder temperatures, changes in humidity), physical exertion, and even emotionally charged situations that precipitate anxiety, crying, and laughter can cause an asthma attack.

When most of us think of asthma, we imagine a person who is fine one minute, then short of breath and wheezing the next. In fact, many with asthma feel pretty good until something exacerbates their condition. But because the illness is chronic, they need constant treatment, even when they feel well.

If you suspect that you have asthma, the first step is to have your doctor run a few tests to see how well you can move air in and out of your lungs. Once your doctor confirms a diagnosis, the treatment options vary widely depending on the severity of your symptoms. Having said that, treatment for asthma also needs to be individualized. Not everyone responds the same way to various medications that are available to treat the disease.

Asthma medications fall into two broad categories: those used for long term control and those used to treat acute symptoms. Short-term bronchodilators, used to treat an acute attack, open the airways by relaxing the muscles that have constricted around them. There are some long-acting bronchodilators, but the most effective asthma treatment programs should incorporate anti-inflammatory medicines.

Regularly using anti-inflammatory medications (the second broad category of drugs to treat asthma) decreases the frequency and severity of the attacks. Examples of anti-inflammatory medicines include corticosteroids, leukotriene modifiers, and mast cell stabilizers, which can be used to more effectively control underlying inflammatory problems.

Another thought: many people who suffer from asthma also have allergies. Effectively treating the allergies (even with allergy shots) improves the asthma.

Of course not all asthma medications are alike, nor are they meant to be. By working with your doctor, you can customize a treatment plan that will be the most effective for you, which in turn will help you breathe more easily.

Cool air/windy, rainy days can be less delightful for people with asthma and other breathing difficulties. Please wear your hats and scarves over your face or consider buying a warming mask. Also, you are under the usual stresses and emotions are running high. If you work or have outdoor activities that keep you outside for long periods of time, consult your physician for the best preventive course of treatment.

Symptoms of asthma are:

  • Coughing
  • Chest tightness
  • Shortness of breath
  • Wheezing

Mold Allergies: April Showers Bring More Than Flowers
Whether working outdoors or in your garden, from planting flowers to raking leaves, to choosing logs for the fireplace, you need to be prepared! Clear all wet leaves and dirt from areas surrounding the foundation of the house, to prevent outdoor mold from building up near windows and doors that would eventually enter the home. Keep firewood outside the house. Wear protective clothing and keep your medications on hand. Mold flourishes indoors if humidity is high! Keep humidity below 50%. Keep your house dust to a minimum. Take precautions when mowing the lawn and when tending to your garden.

Food Allergies:
Many people live for this season, especially for the bountiful buffets, BBQs, and delectable desserts. However, this season can prove to be troublesome for people with food allergies.

The chance of an accidental ingestion of the foods that can cause an allergic reaction may increase during this season. It can take only a tiny amount of the offending food to trigger a potentially dangerous reaction.

Remember, the most common food allergies are:
milk, legumes, eggs, soy, wheat, various nuts, fish, etc.
Hint: Watch out for the baked goodies and picnics-there is no ingredient list! There could be hidden allergens that can cause severe reactions to those with mild or sensitive allergies!

Be prepared by having "self injectable epinephrine" when attending parties and PLEASE inform family and friends of your condition. If you have children, remember to pack their snacks so they don't feel left out. This will insure that your child has something safe to eat.

AVOID the following foods if you are allergic to their main ingredient (such as eggs, milk, wheat and nuts):

  • Baked goods/pastries
  • Meatballs
  • Cheese
  • Quiche
  • Glazed rolls/breads
  • Ice cream
  • Macaroni mixes
  • Salad dressings (that might contain fish- e.g., Caesars)
  • Mixed nuts
  • Vegetable and chip dips

Symptoms of food allergies can be:
Tingling in mouth, swelling of the tongue and throat, difficulty breathing, hives, vomiting, abdominal cramps, diarrhea, drop in blood pressure and unconsciousness. Symptoms usually appear within minutes to a few hours.

Remember, the best treatment for a food allergy is strict avoidance of the allergy-causing foods.

Immunodeficiency

Let's talk about immunodeficiency. How do you know if you are immuno deficient? Generally, everyone gets infections but people who are immuno deficient have more frequent infections and they can be severe with snore complications. In addition, the infections usually do not go away without being treated with antibiotics and most often reoccur after antibiotic treatment. These patients may need several courses of antibiotics during the course of the year. The infections can develop in certain areas of the body: bones, joints, liver, heart and brain. Remember that the frequency of infections is very important.

Your Allergist/Immunologist can determine if you are immunodeficient. Take for instance: a preschooler can get several ear infections, which can be normal for that age group. But for someone who is older it is abnormal.

  • If your child requires more than 4 courses of antibiotics per year or in adults more than twice a year
  • More than 4 ear infections per year
  • More than 3 bacterial sinusitis infections or chronic sinusitis
  • Antibiotics prevention treatment to reduce the number of infections
  • Any unusual infections that do not occur with people of your age group
  • Malaise and fatigue that never really go away

If you have experienced any of the above please contact Dr. Tolston's office or your family physician, who can refer you to an Allergist/Immunologist. Then you can have a complete evaluation. Your doctor can give you more information on recurrent infections, immunodeficiency and treatments like IVIG--intravenous immunoglobulins. Basically, it replaces the antibodies that your body cannot make. Remember that early treatment can prevent serious complications, reduce the number of infections and make your immune system stronger.

Travel Health Tips

  • Always remember to avoid exposure to smoke when traveling.
  • Call ahead for special meals or pack your own.
  • Drink plenty of fluids.
  • When eating out, watch out for sulfite additives.
  • Check the vents in your car before long trips.
  • Have medications/epi-pen on hand when exercising or traveling.
  • With new airline security regulations: having a medical note from your doctor when traveling allows you to carry medications, food, and water during your flight.

As always, Dr. Tolston and staff are here to answer all your questions and concerns. We only want the best care for all our patients.



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Allergy and Immunology on Madison

www.AllergyAsthmaOnMadison.com

161 Madison Avenue, Suite 3a
Madison Medical Building
New York, NY 10016
Tel: 646.424.0400
Fax: 646.742.0092
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19-21 Fair Lawn Avenue
Medical Arts Building
Fair Lawn, NJ 07410
Tel: 646.424.0400
Fax: 646.742.0092

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