Exercise-induced asthma.

? My 14-year-old daughter swims for the high school team, which has been working hard four days a week for the last three months. For two months now, she has been coughing in the middle of practice and needs to slow down or just kick with the board. She doesn't ordinarily have breathing problems, except occasionally while jogging. The coaches suggest that changes in the weather, in combination with working hard and inconsistent levels of chlorine in the pool, are causing this. What are your thoughts?

Rodney Lipkis, Wilmington, DE

This sounds like Exercise-Induced Asthma (EIA), or sports asthma for short. The pool water would most likely affect other swimmers too, and the fact that the coughing occurs sometimes during running suggests EIA. Have her doctor give her a chest x-ray and maybe an in-office pulmonary function test before and after a nebulizer. You may try an albuterol trial 30 minutes before swimming, or the new medicine Advair, to decrease airway inflammation. You will know in three or four days if these work.

Peter Mendel, MD, Woodbridge, VA

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