How to Tell When I've Reached Maintenance Dose on Allergy Shots?

[starion]

Dear MedHelp,
I've been getting allergy shots 2x/week since January 2000.  (Of course, I don't get shots during an infection or exacerbation of my asthma or emphysema, but otherwise have been pretty consistent at having them 2x/week.)  With Vials 1-3, I had relatively few reactions to any of my allergy shots.
Several months ago, I reached "Vial 4" of my allergy and the shot medication--I have had reactions to my allergy shots in Vial 4 for every shot I've had for the past several months.  
I was wondering how I can tell when I've reached my maximum or maintenance dose in my allergy shots--I finished one batch of Vial 4 over the many weeks of injections & have now started a new Vial 4 & am now reacting with just .05 injections of allergens!  The reactions vary from 3-5mm weals to hot, itchy 3"x3" or larger welts.
I've asked the allergist & his nurse, but the only answer I have gotten is to be patient and allergy shots are more of an art than a science.  I've also asked them what I should be looking for to help decide when I've reached my maintenance dose and again haven't gotten any definite answers.  My allergist still wants me to keep trying to complete Vial 4 without reacting & also Vial 5 (the most concentrated allergens).  I've been trying to get my allergy shots only once a week (instead of 2x/week, to see if that made me not react to my allergy shots, but it doesn't seem to have made much difference).  
Should I seek a 2nd opinion RE when I've reached maintenance dose on my allergy shots?
Aloha,
Starion

[National Jewish]

This is a very difficult question to answer. Just the term "maintenance" is not an easy term to define. Traditionally this means when someone has reached the maximum concentration of materials that is made by the company and there is no higher dose available. However, in some cases this "maintenance" dose is the highest dose that is tolerated without problems and produces relief. That sounds like where you are at this point. This is a discussion that should be between you and your allergist. The two of you have to reach an understanding of what is expected and what is tolerated. If you are unable to have this discussion, I would suggest you have a decision to make regarding your future care.

[starion]

Dear LungLine,
Thanks for your response--it does give me a needed additional perspective.
Aloha,
Starion--HI