Expert: Marc Rubin, RPh Asthma Educator - 9/1/2008

Question
Thank you for your time.   My question is about my son (age 13).   My ex-wife insists that he has asthma and I have never seen any issues with his breathing at all.   She takes him to a Dr. who puts him on inhalers with no investigation into any issues.   I think he has some allergic reactions to possible mold issues.   I am wondering what his lung capacity should be or maybe what is a normal range of lung capacity for a 100 lbs , 5 foot 3 , 13 year old.   I live in a rural area that is filled with pollen, dust, and probably every weed and flower and tree.    He shows no signs at all of any breathing issues.   I am also wondering if the allergic reactions he may have to mold could be confused with asthma that his mother MAY be seeing.       Thanks again for you time.....

Answer
Hi Doug,

Has your son been to an allergist? There are two aspects that a physician looks at in a history/workup: 1) patients story of symptom presentation, family history, description of symptoms, etc., and 2)testing: spirometry, which determines not only lung capacity, but is also repeated after the use of a bronchodilator to see what amount of improvement in readings are gained, if any. An improvement of > than 12% or 200ml volume increase post-dilator is an indication of reversible airway obstruction and probable asthma. The physician would also perform allergy testing to determine triggers.

With an environment high in mold and allergens, when combined with a spirometry test showing reversibility and positive skin testing would provide the diagnosis of asthma. Note that mold is a significant asthma trigger, and sometimes the only trigger.

When one considers asthma, the typical expectation is wheezing, or a whistling sound on breathing out (exhalation). In fact, the most common symptoms in children are coughing, tightness of the chest, and night-time awakenings.

If properly evaluated and the physician follows the guidelines based upon the degree of breathing impairment and the risk of an attack, the patient can lead a full, near-normal life. Near-normal in the sense that they need to be aware of their triggers so to take preventative action. Well-controlled, you would not be able to tell that anything is abnormal.

I suggest asking your ex-wife if you could go to the next doctor visit to learn more about his personal condition, so should he suffer an attack, you would be well-prepared to help him.

Also, for personal education, I'd suggest you go to http://www.aaaai.org/patients.stm

Hope this helps!

Marc