Expert: Marc Rubin, RPh Asthma Educator - 9/3/2008

Question
Hello- my six year old step-daughter always seems to have croup. She had a bad bout of it this past weekend where she could barely breathe! I never heard of kids getting croup in the summer! During the winter she gets it about 3 times usually, and the coughing is pretty bad. I have noticed that when she is healthy, she seems to get a touch of a cough when she is being very active, like bike riding and such. Could this be asthma? How can we tell>? What sorts of tests would the DR do to determine this? are there any tests? Please respond. Thanks! Cynster29@gmail.com

Answer
Hi Cynthia,

Sorry for the delay. I answered the question, but we first get a preview screen, then have to click again to actually send the answer. Missed it this time. ( I just wished it had kept what I had instead of wiping it out. Oh well, my fault :(  )

Anyway, yes, it certainly sounds that she needs to be worked up for asthma. The work-up is not very time-consuming, and with the exception of the allergy screening, minimal discomfort.

First, I'd seek out a board certified allergist. You can locate one in your area by going to either:
http://www.aaaai.org/physref/ or
http://www.acaai.org/LocateAllergist/

What you can expect is the physician interviewing for a full patient and family history (parents and grandparents) to determine if there is a genetic pattern. This is a very common occurrence. So it is advised to prepare about allergy and asthma issues on both sides of the family.

The physician will probably do a spirometry exam to determine your child's lung function, and then giving a bronchodilator treatment and retesting to see how much improvement in lung capacity is gained. If it exceeds 12% improvement, this is an indication of reversible airway restriction, and likely asthma. Keep in mind that, if she has had no difficulty recently, it may not improve  > than 12% but that does not mean she doesn't have asthma.

The next likely testing would be skin testing to look for allergic response. This can be a bit uncomfortable, but is necessary to determine if there is underlying allergic disorder.

The combination of history, spirometry and allergen testing will make the determination of the existence of asthma.

Should the determination be positive for asthma, get back to me and I will give you a number of educational resources for both you, your families and your child. This is nothing that, with education, will prevent her from having a normal, full life.

Good luck!

(And again, sorry for the delay)

Sincerely

Marc