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FAQs

Click on the questions below to learn more about environmental control and other related topics.

What are indoor allergens?

What are dust mites?

What can be done to reduce exposure to dust mites?

What to do about cats and dogs?

What are molds?

What can be done to reduce cockroach levels?

What are outdoor allergens?

What is pollen?

What are ionizers?

What to do with down pillows and comforter?

What can be done to avoid mold and mildew in the home?

Are allergen avoidance products covered by insurance?

How often should encasings be washed?

How should an air purifier be used properly?

Why monitor humidity?

What can be done to improve the air at work?

Is duct cleaning effective?

What does HEPA stand for?

What is the difference between hypoallergenic and anti-allergen?

What is Allergy?

What is an allergen?

What is an allergist?

What kind of diseases does an allergist treat?

What is a skin test?

Are allergies and asthma hereditary?

What are the sinuses?

Why do we have sinuses?

What is atopy?

What is an IgE antibody and what does it do?

What is allergic rhinitis?

What is non-allergic rhinitis?

What is sinusitis?

What is asthma?

What is exercise-induced asthma?

What is pediatric asthma?

What is Urticaria?

What is Anaphylaxis?

What is eczema?

What is Latex allergy?

What is insect sting allergy?

What are Antihistimines?

What are decongestants?

What are nasal steroids?

What is a metered dose inhaler?

What is a peak flow meter?

What is immunotherapy?

What are indoor allergens?
Millions of people suffer from seasonal allergy symptoms such as congestion, an itchy, runny nose and itchy, watery eyes. However, many also suffer from perennial allergies, which result in symptoms throughout the year. Perennial allergies are triggered by indoor allergens, including house dust mites, mold, animal dander, cockroach droppings and indoor molds.

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What are dust mites?
Dust mites are microscopic spider like creatures that have been demonstrated to be powerful allergens. The major allergens of dust mites come from their fecal waste particles and glandular secretions. Dust mites thrive in humid environments and feed off the dead skin scales of humans. They are most commonly found in pillows, mattresses, box springs, comforters, carpets and upholstered furniture. It is estimated that about 80% of people with allergies are sensitized (meaning they have a positive skin test response) to dust mites and over 70% of asthma patients are sensitized to dust mites. Studies have confirmed the relationship between dust mites and the development of asthma. Reducing levels of dust mite allergen to low levels can prevent sensitization to dust mites and the development of asthma symptoms.

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What can be done to reduce exposure to dust mites?
When trying to reduce exposure to dust mites, one should concentrate on the bedroom and more specifically the bed. The most affordable, effective and clinically proven environmental control recommendation is to encase pillows, mattresses and box springs in anti-allergen encasings. All bedding should be washed weekly in water above 130º F degrees. Remove dust magnets such as collectibles, books, magazines, toys, stuffed animals, trees or plants from the bedroom. Replacing upholstered furniture with leather, vinyl, wood or metal furniture should also be considered.

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What to do about cats and dogs?
Many people with cats, dogs and other furry pets do not want to comply with their allergist’s seemingly harsh recommendation to permanently remove the pet from the home. The most important thing you can do is reduce contact with the pet. It is estimated that over one third of the population has at least one or more cats in their home. This domestic pet has overtaken the dog in popularity probably because of the low maintenance requirements. Cat allergen is a very light allergen that can stay suspended in the air for five to six hours at a time. It sticks to walls, clothing, carpets, bedding and furniture. Even after removing the cat from the home, cat allergen levels can be measured up to one year later. Cat allergen can even be present in homes where there are no cats, indicating that cat allergen is brought in from outside sources on shoes and clothing. It is very important to at least keep the cat out of the bedroom. HEPA air cleaners are the best mechanism to reduce airborne cat allergen levels in bedrooms and living rooms. Frequent vacuuming with a HEPA vacuum will help reduce cat allergen in carpets as well. Reduced levels of cat allergen in the home will result in improved lung function and reduced asthma symptoms in patients with cat-induced asthma symptoms.

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What are molds?
Molds are microscopic fungi, related to mushrooms and mildew, but without stems, roots or leaves. Their spores float in the air like pollen, and are present throughout the year in many states. Unlike pollens, molds do not have a specific season, but are affected by weather conditions such as wind, rain or temperature. Outdoor mold spores begin to appear after a spring thaw and reach their peak in July in warmer states and October in the colder states. Molds can be found all year long both indoors and out.

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What can be done to reduce cockroach levels?
Cockroach management and control is best accomplished by removing sources of food and household food wastes. Foods should be stored in sealed containers. Every attempt to reduce access to water should be made such as fixing leaking faucets or preventing condensation on pipes. Improving ventilation to eliminate damp areas is helpful. Caulking or sealing cockroach access and entry points is also helpful. Spraying cockroach runways around kitchen cabinets and drawers with insecticides known to kill cockroaches will kill the parent cockroach but will not kill their eggs. Therefore repeated spraying with bait stations every one to two months is necessary to effectively control cockroach populations. Finally, thorough and frequent housecleaning to remove dust and cockroach byproducts is necessary. If these interventions are maintained, recent studies have shown that cockroach allergen levels will decrease in the home after 6-12 months.

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What are outdoor allergens?
Seasonal allergic rhinitis, often referred to as "hay fever," affects more than 35 million people in the U.S. Seasonal allergies are caused by allergens. Airborne pollens and mold spores are outdoor allergens that commonly trigger symptoms during the spring and fall. During these times, seasonal allergic rhinitis sufferers experience increased symptoms—sneezing, congestion, runny nose, and itchiness in the nose, roof of the mouth, throat, eyes and ears—depending on where they live in the country and the exact allergen to which they are allergic.

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What is pollen?
Pollen is the male fertilizing agent of flowering plants, trees, grasses and weeds. Pollen is a central cause of many allergic reactions. Weather conditions affect pollen levels. The most variant factors influencing pollen counts are wind, humidity, and the proximity of the sampling equipment to pollen producing vegetation. Because pollens are small, light and dry, they can be easily spread by wind, which keeps pollen airborne and carries it over long distances. When the air is humid, such as during or after it rains, pollen becomes damp and heavy with moisture, keeping it still and on the ground.

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What are ionizers?
Ion generators act by charging the particles in a room so that they are attracted to walls, floors, tabletops, draperies, occupants, etc. Abrasion can result in these particles being resuspended into the air. In some cases these devices contain a collector to attract the charged particles back to the unit. While ion generators may remove small particles, they do not remove gases or odors, and are relatively ineffective in removing large particles such as pollen and house dust allergens. Ozone, a lung irritant, is produced indirectly by ion generators and some other electronic air cleaners and directly by ozone generators. While indirect ozone production is of concern, there is even greater concern with the direct, and purposeful introduction of a lung irritant into indoor air. There is no difference, despite some marketers' claims, between ozone in smog outdoors and ozone produced by these devices. Under certain conditions, ion generators can produce levels of this lung irritant significantly above levels thought harmful to human health. Although ozone can be used in reducing odors and pollutants in unoccupied spaces, the levels needed to achieve this are above those generally thought to be safe for humans.

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What to do with down pillows and comforter?
Encasing your down pillows and comforter in anti-allergen encasings will help. Whether you're allergic to down or to dust mites that live in the comforter and pillows, encasings will put a barrier between you and the allergen that's making you sneeze. Synthetic alternatives to down pillows and comforters offer very similar warmth and comfort characteristics with much better washability.

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What can be done to avoid mold and mildew in the home?
The most effective thing to do to avoid mold growth in the home is to keep the indoor relative humidity below 45% year round. Use a hygrometer to monitor relative humidity and dehumidify when necessary. Any structural problems that cause leakage should be fixed. Any materials that have been contaminated should be discarded if they cannot be adequately cleaned to remove mold. Molds are not only powerful allergens but they can also release toxins that can cause health related problems.

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Are allergen avoidance products covered by insurance?
While it varies from insurance company to insurance company, and plan to plan, insurance companies are increasingly reimbursing for environmental control products. A store receipt accompanied with a Medical Necessity Form from a prescribing physician will prove helpful when filing. It is recommended that if you are denied coverage on the first attempt, try filing the claim again.

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How often should encasings be washed?
Pillow encasings should be washed every three months. Mattress encasings should be washed twice a year. It is important to note that neither fabric softener nor bleach should be used when washing. Encasings can be hot water washed and dried on high.

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How should an air purifier be used properly?
If possible, the environment that the air purifier is working in should be isolated. That means in a bedroom doors should be closed and vent registers should be equipped with filters. During the day all pets should be evacuated, and the air purifier should be turned on high. At night when the room is inhabited the air purifier can be turned down to a lower level. Air purifiers should never be turned off.

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Why monitor humidity?
Overly humid conditions promote mold and dust mite growth while too dry air can irritate airways and cause coughing, dry skin and chapped lips. Monitoring humidity with a hygrometer will help maintain humidity between 30% and 50%. If your air is too dry, humidify. If your air is too moist, dehumidify.

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What can be done to improve the air at work?
Your workplace may contain molds in air ducts, dust in carpeting or storage rooms, fumes from photocopiers, traces of coworkers' perfume or cigarette smoke, and other allergy and asthma provoking substances. If you're having problems breathing, track your symptoms to see if you can pinpoint a trigger or time of day when symptoms occur. If you work near irritating fumes placing a HEPA air purifier near your desk will improve conditions.

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Is duct cleaning effective?
No. Duct cleaning can stir up allergens and make things worse. Many duct cleaning services sterilize the ducts with a chemical which has been reported to cause or aggravate asthma in some cases. A recent study examined the effectiveness of duct cleaning and found it to be of very limited effectiveness. While dog and cat allergen can be found in ducts, most is trapped in the furnace filters and very little allergen is released from the vent registers into the room.

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What does HEPA stand for?
HEPA (High Efficiency Particulate Air) filters are the highest efficiency air filters available for the filtration of small particles. Defined by the Institute of Environmental Science, a Certified HEPA filter must capture a minimum of 99.97% of contaminants at 0.3 microns in size. The first HEPA filters were developed in the 1940's by the United States Atomic Energy Commission to filter radioactive particulate contaminants. After World War 2, HEPA filter technology was declassified for use in the nuclear, electronic, aerospace, pharmaceutical and medical fields.

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What is the difference between hypoallergenic and anti-allergen?
People often confuse these terms. "Anti-allergen" describes products like anti-allergen encasements for bedding that are designed to prevent contact with allergens. "Hypoallergenic" describes products such as organic, undyed cotton or other substances that are non-allergenic, nonirritating and unlikely to provoke an allergic reaction.

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What is Allergy?
Allergy is defined as a "harmful, increased susceptibility to a specific substance," also known as hypersensitivity while immunity is characterized as a "protective, enhanced resistance." When someone has an allergic reaction, the reaction occurs as a result of a specific immune response. Different types of immune responses can occur depending on the specific allergic reaction. When discussing allergies in terms of respiratory symptoms, the IgE-mediated (allergic antibody) is what makes people genetically susceptible for developing allergies. These people produce specific IgE antibodies in direct response to different allergens such as dust mites, trees, grasses, ragweed pollens, mold or animal dander.

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What is an allergen?
An allergen is a substance such as a protein that provokes an immune response, including IgE antibodies. Allergens are often common, usually harmless substances such as pollen, mold spores, animal dander, dust, foods, insect venoms and drugs. Allergens are microscopic and not visible to the naked eye.

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What is an allergist?
An allergist is a physician who has completed three years of residency training after medical school in the field of pediatrics or internal medicine, who has completed an additional two years of training in allergy and immunology at an accredited training program and passed the examination given by the American Board of Allergy and Immunology. Many doctors such as ear, nose and throat surgeons, pulmonologists (lung doctors), pediatricians and family medicine doctors practice allergy after taking supplemental training but do not go through a formal allergy training program.

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What kind of diseases does an allergist treat?
Allergists treat many types of diseases including allergic and non-allergic rhinitis, asthma, sinusitis, recurrent ear infections, hives, drug reactions, eczema, immunodeficiencies and other less common immunologic disorders.

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What is a skin test?
The skin test is used to confirm hypersensitivity to a wide variety of allergens. It is the most convenient and specific method for detecting IgE antibodies. This test is done on the surface of the skin. A tiny amount of allergen is scratched across or lightly pricked into the skin. If you have an allergy, the specific allergens that you are allergic to will cause a chain reaction to begin in your body.

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Are allergies and asthma hereditary?
If one parent has a history of allergies then the odds of the offspring developing symptoms is 25%. If both parents have allergies then the risk of an offspring developing allergies increases to 50%.

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What are the sinuses?
The sinuses are 4-paired cavities located in the front of the face. The frontal sinuses are above the eyes in the forehead. The maxillary sinuses are in the cheekbones below the eyes and above the upper teeth. The ethmoid and sphenoid sinuses are between the eyes, with the sphenoid deeper toward the brain.

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Why do we have sinuses?
Sinuses play important roles. They are not simply holes in the head that get infected. They function to warm and moisten air we breathe and help to remove pollen and pollution. They help us to vocalize sounds. The sinuses make our skull lighter by providing air-filled pockets which do not carry as much weight as bones. They also help to provide compensation for changes in pressure like you experience when a weather front comes through or you fly in an airplane.

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What is atopy?
Atopy is a term that refers to the genetic tendency to develop allergic diseases, namely, allergic rhinitis, asthma and atopic dermatitis. Atopy is typically associated with a genetically determined capacity to mount IgE responses to common allergens, especially inhaled allergens and food allergens.

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What is an IgE antibody and what does it do?
Normally, the immune system functions as the body's defense against invading agents such as bacteria and viruses. In most allergic reactions, however, the immune system is responding to a false alarm. When an allergic person first comes into contact with an allergen, the immune system treats the allergen as an invader and mobilizes to attack. The immune system does this by generating large amounts of a type of antibody (a disease-fighting protein) called immunoglobin E, or IgE. Each IgE antibody is specific for one particular allergenic (allergy-producing) substance. In the case of pollen allergy, the antibody is specific for each type of pollen: one type of antibody may be produced to react against oak pollen and another against ragweed pollen, for example. IgE molecules are special because IgE is the only class of antibody that attaches tightly to the body's mast cells, which are tissue cells, and to basophils, which are blood cells. When the allergen next encounters its specific IgE, it attaches to the antibody like a key fitting into a lock, signaling the cell to which the IgE is attached to release powerful inflammatory chemicals like histamine, cytokines, and leukotrienes. These chemicals act on tissues in various parts of the body, such as the respiratory system, and cause the symptoms of allergy.

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What is allergic rhinitis?
Allergic rhinitis, commonly known as hayfever, refers to a clinical condition where people have constant upper respiratory symptoms consisting of all or some of the following symptoms: nasal congestion (stuffiness), post-nasal drip, sneezing, runny nose, itching of the eyes, ears, nose, throat, headaches or sinus pressure, ear popping and fatigue. People with allergic rhinitis make specific allergic antibodies (IgE) to allergens that lead to their clinical symptoms. Allergic rhinitis may be seasonal such as during the spring, summer or fall or it may occur year round (perennial). Allergic rhinitis can lead to several complications such as sinusitis, ear infections and asthma.

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What is non-allergic rhinitis?
Non-allergic rhinitis is a chronic nasal condition characterized by constant nasal congestion and post-nasal drip. These symptoms typically occur year round and may be associated with ear popping, sinus pressure or headaches and sore throats. Non-allergic rhinitis, if not treated with the proper medications can lead to recurrent sinus and ear infections. Common triggers of non-allergic rhinitis include weather changes, barometric/atmospheric pressure changes, temperature changes, postural changes, irritants such as tobacco smoke, chemical solvents and paints, cleaning agents, perfumes, cosmetics and smoke from burning wood.

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What is sinusitis?
Sinusitis is an inflammation of the nasal sinuses. The inflammation is usually caused by inadequate draining due to an allergy, infection or obstruction. Common symptoms include thick yellowish/green nasal discharge, headache, feelings of facial fullness, congestion, fatigue and fever.

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What is asthma?
Asthma is a chronic lung condition characterized by inflammation and swelling of the bronchial airways. Patients with asthma often experience wheezing, chest tightness, shortness of breath or coughing. Some patients with asthma are totally symptom-free, meaning they don't even know they have asthma. Patients are often misdiagnosed and incorrectly told they have reactive airways, asthmatic bronchitis or recurrent pneumonia, when in reality their condition is asthma. The three features that define asthma are: inflammation, improvement in lung function after a bronchodilator medication such as albuterol and airway hyperresponsiveness which means that lung function goes up and down depending on exposure to various triggers. Triggers include dust mites, mold spores, pollen and animal dander.

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What is exercise-induced asthma?
Exercise-induced asthma (EIA) is the narrowing of the airways that causes difficulty in moving air out of the lungs. Chronic asthma is an inflammatory disorder. Most patients with chronic asthma will have a flare when they exercise. Other individuals appear to have a flare of asthma only when they exercise and do not otherwise have chronic asthma. Symptoms include coughing, wheezing, tight chest, and prolonged and unexpected shortness of breath after about 6-8 minutes of exercise. These symptoms are often worse in cold, dry air. Warm and humid air may lessen the symptoms. Unfortunately, pollens and molds are present at the times of the year when the air is warm and humid and these substances in the air may also trigger asthma attacks.

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What is pediatric asthma?
Asthma is the most common serious chronic disease of childhood, affecting nearly five million children in the United States. Characterized by coughing, chest tightness, shortness of breath and wheezing, asthma is the cause of almost three million physician visits and 200,000 hospitalizations each year. In infants and children, asthma may appear as cough, rapid or noisy breathing in and out, or chest congestion, without the other symptoms seen in adults.

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What is Urticaria?
Urticaria also known as hives, are raised, red itchy bumps of varying sizes in the shallow layers of the skin. They are caused by a chemical in the body called histamine which is released from certain cells. Hives are a particularly vexing problem—the intensity of the itch can completely disrupt normal activities.

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What is Anaphylaxis?
Anaphylaxis is the most severe form of allergic reaction. It is a rapid, immune-mediated, systemic reaction to allergens that a person has been previously exposed to. The reaction occurs rapidly and often dramatically, and is usually unanticipated. Signs and symptoms arise systemically and may include faintness, severe difficulty breathing and throat closing. After exposure from the allergen, symptoms generally start within 15 to 30 minutes, occasionally begins after 1 hour, and rarely occurs hours later. Anaphylaxis is an urgent medical emergency and immediate care is needed.

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What is eczema?
A common allergic reaction often affecting the face, elbows and knees is atopic dermatitis, also known as eczema. This red, scaly, itchy rash is usually seen in young infants, but can occur later in life in individuals with personal or family histories of atopy, meaning asthma or allergic rhinitis ("hay fever"). Eczema may at times ooze, or at times may look very dry.

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What is Latex allergy?
Latex allergy occurs when the body’s immune system reacts to proteins found in natural rubber latex. Natural rubber latex is a processed plant product derived almost exclusively from the sap of the tree hevea braziliensis found in Africa and Southeast Asia. Natural rubber latex should not be confused with butyl- or petroleum-based synthetic rubbers. Synthetic products, including latex house paints, have not been shown to pose any hazard to latex-sensitive individuals. It is estimated that 1% to 6% of the general population has been sensitized to latex compared to 5% to 10% of healthcare workers.

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What is insect sting allergy?
Insect sting allergy occurs when the immune system overreacts to the venom injected by a stinging insect. After the first sting, the allergic person’s body produces an allergic substance called Immunoglobulin E (IgE) antibody, which reacts with the insect venom. The individual does not usually experience a severe allergic reaction from that first sting—but if he/ she is stung again by an insect of the same or similar species, the insect venom interacts with the IgE antibody produced in response to the earlier sting. This triggers the release of histamine and other chemicals that cause allergic symptoms. For a small number of people with severe venom allergy, stings may be life threatening.

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What are Antihistimines?
Antihistamines are the most widely used medications for allergic diseases. They are used to treat symptoms of allergic rhinitis, or "hay fever," which affects more than 50 million people in the United States. Antihistamines can lessen your symptoms by preventing the effects of histamine – a chemical substance produced by the body during an allergic reaction. Many different antihistamines are available, either by prescription or over-the-counter. Various forms include eye drops, nose sprays, liquids and pills, either as an antihistamine alone or mixed with other medications, especially decongestants, to relieve a larger range of symptoms.

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What are decongestants?
Decongestants promote drainage of the nasal passages to help relieve symptoms such as congestion, swelling, pressure and discomfort in the sinus areas that can be caused by nasal allergies. Your physician may recommend using oral or nasal decongestants to reduce congestion along with an antihistamine to control allergic symptoms.

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What are nasal steroids?
Topical nasal steroids are anti-inflammatory drugs that stop allergic reactions. They reduce the number of mast cells in the nose and reduce mucus secretion and nasal swelling. A combination of antihistamines and nasal steroids may be a very effective way to treat allergic rhinitis.

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What is a metered dose inhaler?
A metered-dose inhaler (MDI) is a propellant-driven delivery mechanism for inhalation of asthma medications. MDIs are just one of three basic types of devices used to deliver inhaled medications. Nebulizers deliver fine liquid mists of medication through a "mask" that fits over the nose and mouth, using air or oxygen under pressure. They are frequently used to treat people with asthma who cannot use an inhaler, including infants, young children and acutely ill patients of all ages. Rotary inhalers and dry powder inhalers have been introduced to deliver asthma medication without using the propellant chlorofluorocarbon (CFC), which damages the earth’s ozone layer.

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What is a peak flow meter?
A peak flow meter for asthma is like a thermometer for a fever. It’s a tool that helps monitor what’s going on inside your body. In some cases when you are not feeling well, you may feel "hot" or "feverish," but when you take your temperature with a thermometer, it is normal. With asthma, sometimes you may feel your breathing is fine, but when you measure it with a peak flow meter, your lung function is slightly decreased. A peak flow meter can help you determine airway changes and thus, better manage your asthma.

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What is immunotherapy?
Immunotherapy, also known as allergy shots, is an effective vaccination program that increases immunity to substances called allergens that trigger allergy symptoms. Allergen immunotherapy involves administering gradually increasing amounts of an allergen to a patient over several months. The injections are first given on a weekly or bi-weekly basis, and when the maintenance level is reached, on a monthly basis. This process reduces symptoms that are otherwise triggered by allergen exposure.

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