Hi,

I would really appreciate advice on how to make changes to help manage
my asthma.

Details - 45 yr female, severe adult onset asthma (dx 1998)

Meds - Symbicort, Bricanyl, Singulair, Nasonex, Estradot, Prometrium,
and the otc drugs Loratadine, Advil cold & sinus (per sinus attack
only), and milk thistle

Household - we moved here 2 years ago and have no plans of selling, 1
1/2 story old house (1/2 story thought to be first addition, back back
addition second, front porch enclosure third addition to form great
room), sits on shallow crawlspace (mold ???), great room fully carpeted,
new carpeting in both bedrooms, forced air gas furnace, central AC,
newly installed furnace humidifier et to 22% humidity, leather living
room furniture, oh and we found out the previous resident had several
cats and dogs in here but we think we have got rid of most of the dander

When I was first diagnosed, it took quite some time to get my asthma
under control.  The doctors simply gave me the puffers, no education,
and sent me on my merry way.  I finally saw a specialist who got my
asthma under control.  For quite some time it has been what I thought
was under control.  I have not had a proper asthma assessment since 2000
until last week.  My GP of 5 years simply listens to my lungs each time,
asks if I have any problems, then writes out the refills.  In February,
I had a cold which turned quickly to pneumonia.    I realized then that
my action plan should be updated and I needed to take a more assertive
approach.  I asked my GP for a referral to the asthma clinic.

I saw the respiratory therapist Friday.  She did a full assessment that
showed my asthma has been out of control for quite some time.  Tests
showed bronchial at 64% and bronchioles at 52%.  Peak flow was in the
yellow range.  Apparently I have ended up doing what a lot of people do
when diagnosed with a chronic disorder.  They take it serious at first
then slack off.  I was "ashamed" to admit that sometimes I forget a dose
of medication and I had taken a rather "ignore it, it will go away"
attitude.  Somehow in that time period I had also become embarassed over
having to take my reliever so I had developed a tendency to put of
taking it and I had also becomed embarassed to admit I couldn't do
something because of my asthma.  She said that was human nature and at
least I recognized I wasn't looking after my asthma as I should enough
to ask for help.  She went through the details of what asthma was, why
it is important not to miss doses, checked how was using my turbuhalers,
changes to make in the household, gave me an asthma assessment tool, and
has me keeping a diary and using my peak flow meter daily. I came home
with a large folder of information.  I really wish the doctors had done
that for me when I was first diagnosed!  She will follow-up monthly for
the first year then every 6 months after that to make sure there is no
back sliding.

Here's my problem with the changes to the household and where I really
need advice.  There is no other way to describe it, the house is a dust
trap!

Carpeting - We have a waterbed so changing the carpet in the bedroom
would be difficult right now.  I bought Bissell's Allergen Reducing
Steam Cleaning solution.  We have a steam cleaner for carpets.  On their
site, they have a product Acarosan Dust Mite Powder to kill dust mites
in carpet.  Would I use the dust mite killer first, vacuum good, then
use the steam cleaning solution?  Or would the steam cleaning solution
do the same job?  The great room is open concept consisting of 4 areas.
 The area is carpeted. We plan to remove this carpet within the next
year or so.  We plan to seal the main floor with an additional barrier
so no air transfer can occur between the crawlspace and main floor.  The
main constraint is all the flooring for this area would have to be
purchased at the same time and since we are planning on using the same
flooring in the other main floor rooms, it is a large outlay of cash as
well as time. How do I deal with the carpet situation in the meantime?
If I can use the above mentioned treatments until we replace the
carpets, how often should I use them.  How often should the carpets be
vacuumed?

Bedroom - we have feather pillows and duvet (yes I know, but I thought I
would be ok),  I have already purchased allergen covers for the pillows.
 The RT said that covers are available for the duvet.  Where would I
look for these?  I would prefer an actual store rather than online.  Can
anyone recommend a brand?

Dust - In general, what can I do to reduce the amount of dust?  It is an
old house.  We have an electrostatic cleaner on the furnace.  I use
swiffer dust cloths and vacuum fairly regularly.  I added filters to the
room vents and air returns.  What else can I do?  Any recommendations
would be greatly appreciated.

Air - Our house is on a large waterway.  For that reason, there are few
days during the summer that we need AC but the RT said the AC is my
friend by reducing humidity and keeping allergens out.  My concern is
the air inside will become stale.  I understand the need to keep
allergens out so is there a way I could get fresh air in without the
allergens?  I don't want to become a hermit either.  Do you pre-treat on
smog, high pollen, or high humidity days and then use the reliever as
needed?

Sorry to be so long.  I really need to get back on track and treat my
asthma as the serious disease it is.  I appreciate any help you can offer.