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Frequently Asked Questions

Get the answers to your HCA questions

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Welcome to Hill Country Allergy + Asthma
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  • Allergies
  • Asthma
  • Hill Country Allergy & Asthma
  • Immunotherapy
Should I be Tested for allergies?

Testing done by an allergist is generally safe and effective for adults and children of all ages. Symptoms which usually prompt the allergist to perform skin testing include: itchy eyes, nose or throat; nasal congestion, runny nose, watery eyes, chest congestion, cough or wheezing; hives, itchiness or atopic dermatitis; cramping and diarrhea or constipation consistently after eating certain foods; Severe reactions to stinging insect stings (other than swelling at the site of the sting); Anaphylaxis, a serious allergic reaction that affects many parts of the body at the same time.

What are the benefits of allergy testing?

Allergy tests, combined with the knowledge of your allergy specialist to interpret them, can give precise information about what you are as well as what you are not allergic to. Allergy testing should always occur along with a physical examination and a discussion about your past and current symptoms.  For instance, if you wheeze when you are at home and don’t know why, you don’t have to get rid of your cat if your allergy testing shows you are allergic to dust mites but not cats. With this information, you and your allergist can develop a treatment plan to manage or even get rid of your symptoms.

What are the symptoms of allergies?

Allergy symptoms occur when your immune system overreacts to an allergen—something that usually is harmless, such as plant pollen, dust mites, molds, insect stings or food. If you have an allergy, your immune system acts as if the allergen were dangerous, releasing chemical mediators that cause allergy symptoms. Learn more about allergy symptoms here

What can an allergist treat?

At Hill Country Allergy and Asthma we treat allergies and asthma, in addition to many other types of illnesses. Learn more here

How is Asthma Treated?

Although there is not a cure for asthma, the symptoms can be with medications and trigger avoidance.  New medications make it possible to lead a normal life.  There are quick-relief medications to help short-term asthma symptoms and controller medications that help treat and control asthma in the long-term.  A high percentage of asthma patients suffer from allergies.  Controlling allergies can be the first step to controlling their asthma.

What Happens if my Asthma Goes Untreated?

It is extremely important to seek medical attention for asthma.  Airway inflammation is more likely to occur and become more severe the longer asthma is left untreated.  Asthma is not a medical condition that goes away.  Not treating airway inflammation and constriction may cause you to lose lung function and prevent you from being able to do your normal daily activities.  For those individuals with allergic asthma, identifying and treating your allergies is instrumental in treating your asthma.  An allergist can help you determine your allergies and prescribe an effective treatment plan.

What About Children and Asthma?

Asthma is the most common chronic illness among children.  If a child’s asthma is left untreated, it can result in loss of sleep, exercise limitations, missed school days, emergency room visits, and, in a few cases, death.  The good news?  Just like adult asthma, a child’s asthma can be effectively treated with medications and “trigger” avoidance.  Again, receiving medical help for asthma is essential!

Where are you located?

View our locations and hours here:

Do you offer telemedicine?

Yes, at Hill Country Allergy  and Asthma we offer telemedicine services. Learn more here:

Where can I find new patient forms?

You can download new patient forms here:

What is Immunotherapy (IT) or a Allergy Shots/Drops?

Immunotherapy (IT) is a series of injections (shots). In each injection you are given a small amount of a mixture containing extracts to which you are allergic. You start out at a very low concentration and gradually build up to the highest concentration or what we call the “maintenance” strength. Depending on the series your doctor orders, you will go through 5 or 6 concentrations until you reach the maintenance strength.

How Does Immunotherapy (IT) Work?

IT causes changes in the immune system so when your body is exposed to the allergen (what you are allergic to) you have less of a reaction (fewer symptoms).  The mechanism by which IT works is believed to be related to a desensitization process where your immune system is made more familiar to allergens you come in contact with and prevents this overreaction. After going through the course of IT prescribed by your physician, your symptoms should lessen and you should require less medicine (essentially turning this immune switch off).

How Often Will I Receive Allergy Shots?

When you first start IT you should receive a shot at least once a week. When you are receiving the lower concentrations you may receive an injection as often as three times a week allowing 48 hours between injections so you can get through these lower concentrations faster. Once you reach the highest concentration or maintenance strength, the interval can be extended up to once a month depending on how well your symptoms are controlled. Our nursing staff will give you information on spreading the time interval of your shots when you reach your maintenance dose.

What if I Miss My Allergy Shot?

It is not a problem if you miss a short period of time (one to two weeks) however, it may lengthen the time necessary to reach your maintenance dose. If you wait more than 2 weeks between injections, your dose may stay the same or decrease. Our providers will determine the appropriate dosage based on your previous reactions to IT and the number of days missed.

How Long Before I Will Start Seeing Improvement in my Symptoms?

This will vary from patient to patient. As a general rule, you will not begin to notice significant improvement until you have been on your highest concentration or maintenance strength for several months. Most patients will reach maximum benefit after they have been on their maintenance for a year to a year and a half. You should continue the allergy medications your doctor has prescribed until advised to reduce or discontinue them. You should also continue the environmental control measures recommended to you. This combination of treatments will provide the best results and a decrease in your symptoms.

How Long Will I Be On Immunotherapy (IT)?

This again will vary from patient to patient. However, the usual minimum course is 3 to 5 years. Some patients will remain on IT longer.

How are My Extracts Prepared?

Your extract is individually prescribed and contains protein extracts of what was positive on your skin tests. Pollen and environmental extracts are diluted in saline. Venom extracts for stinging insects are mixed with small amounts of human albumin. If you have any religious objections to receiving a very small amount of human albumin in your extract, please discuss your concerns with your physician.

What Are the Side Effects of IT?

We are not aware of any long-term side effects. However, there may be some immediate reactions. The immediate reactions can range from local swelling, redness and itching at the injection site to typical allergy symptoms of itchy, watery eyes and running nose. More severe reactions may include shortness of breath, difficulty swallowing or skin rash. Rarely patients can have a severe reaction with lowered blood pressure. Studies have shown patients who are going to have the most severe reactions begin to experience symptoms within 20 to 30 minutes after receiving an injection. That is why we require you have your injection in the presence of a provider and you wait for 30 minutes after an injection. These reactions can occur regardless of how long you have been on IT. If you should have any symptoms other than irritation at the site of the injection, you should let the staff know immediately.

What Should I Do if I Develop a Reaction to My Allergy Shot After I Leave the Office?

If the reaction is at the injection site only with increased swelling or redness, you may apply ice and take an antihistamine if the reaction is bothersome to you. This should be reported to the nurses prior to your next injection as your dose may need to be adjusted. If the reaction involves an increase in allergy symptoms, hives or shortness of breath, call the office immediately. If you are experiencing severe shortness of breath, go immediately to the nearest Emergency Department or call 911. Do not attempt to drive yourself or child to the Emergency Department if you are in severe distress, instead call 911.

When Should I Not Get an Allergy Shot?

If you are acutely ill, have a fever or increased asthma symptoms you should not receive an allergy shot. If you are experiencing severe allergy symptoms, please notify the nurse prior to your injection. If you are taking beta-blocker medications (usually for high blood pressure, heart conditions, glaucoma or migraine headaches) prescribed by another doctor you should not receive an allergy shot. Notify our staff immediately if these medications are prescribed for you.

Can I Receive IT if I am Pregnant?

Yes. You cannot start IT if you are pregnant. If you are already on IT and tolerating shots well then you may continue. If you become pregnant while you are still building up on your concentration then you will be maintained at your current strength without further increase until after your pregnancy. Please notify our office as soon as you know you are pregnant.

I Know Someone Who Only Takes Allergy Shots Once or Twice a Year, Why do I Need to Take Them so Frequently?

That person is not getting “allergy shots” with allergen extract but rather probably some sort of steroid. These are not the same things. The steroid shot only improves allergy symptoms temporarily while IT with allergen extract has long-term benefits.

When Can I Begin my IT?

Your allergen extract is individually prepared for you in our antigen preparation lab. It usually takes approximately two weeks to prepare. We will contact you when your extract is ready at the office. If you have not heard from us in two weeks, please call our office. Your extract expires one year from the time it is prepared so it is best to start your shots as soon as they are ready. Check with our office for walk-in shot clinic hours.

“My son has been going to Dr. Mery for over a year.  I always appreciate how attentive the nurses are to him when checking him out before he is released after his shot.  This office is very clean and organized as well.”

Stephanie H.

“My whole family goes to Dr. Mery.  He has been a major factor in our family’s health and well-being.  Dr. Mery is compassionate and understanding.  He is determined to help those who come to see him and truly cares for his patients.”

Susan D.

“Hill Country Allergy has been a very good experience for me these last few weeks. A great team has been providing me with a thorough job of evaluating my allergy needs and implementing a specific plan to reach my specific goal of setting my allergies under control. All staff is efficient, courteous, and very knowledgeable of my specific concerns. I am very pleased with my current service.”

Sandra B.

“The staff at Hill Country Allergy & Asthma is nothing short of amazing. They greet you with a smile and they actually remember my name; you are not just another face. They are patient and take the time to explain things even if you ask them the same questions every other time you are there. The technicians providing the shots are extremely careful and service is usually quick due to the check in system they utilize. They are well organized, with excellent customer service.”

Ditrell B.

“Whenever Julie is the one who gives me my shot, I almost look forward to getting the shot. Her sunny disposition brightens my day. I did say that it almost makes me want to get a shot!”

Bob B.

“I have been very pleased with the great care I have received from Dr. Mery, as well as his entire staff. They are all great!”

Cindy M.

“I look forward to getting my allergy shots every month. The office staff is so friendly and professional. It is a very nice and relaxed atmosphere too.”

Maria B.

“Dr. Mery saved me! I struggled for months with a skin reaction that three other doctors were unable to get under control.  It was clear from the onset that Dr. Mery is truly invested in his patients as he spent so much time with me trying to understand my situation and helped me tremendously with my condition.  Dr. Mery and his staff genuinely care for their patients!”

Krista H.

“My son saw Dr. Mery years ago for his bad allergies.  He was tested, started shots and has been on shots for a couple of years now.  We cannot begin to express our gratitude to HCAA for helping our family.  Our son is completely different kid – he can now play on sports teams and enjoy playing outside with his buddies!  THANK YOU DR. MERY!”

Sandy H.