D: How may I help you today?

P: I'm just bringing my son today because he's been how many episodes where I'm eat hell gets all this coughing fit and become wheezy and become shorter breath and I mean after a period of time it goes away, but it's been happening every so often.

D: Does he still have these symptoms?

P: Like right now he's OK. When the symptoms come on, they last for I don't know, maybe 30 minutes, 60 minutes or or even less. But yeah it happens maybe once or twice a week where and it's been going on for a, a couple of months now. Yeah, he actually had a viral infection like a few months ago and I thought it was just that. It leared up and then he's just had a few more of these episodes, but without those kind of symptoms so.

D: Hm? So all this started a couple months ago.

P: Yeah. 

D: Do you find that there and you mentioned that it happens about one to two times a week? Is there anything specific happening at that time? Any triggers that result in these symptoms?

P: Well I will say I think I like exercise. I find yeah like soccer practice. Yeah, after maybe, or even during a game, like when things are really intense. Yeah, I think during soccer I've I've kind of noticed it. And then at night time as well. It kind of randomly, he'll have this cough.

D: OK. So I guess it's do you feel like it's affected by cold weather as well or no?

P: Um, maybe yeah, like if he yeah completely in the winter time. Like I know when he goes outside if he yeah he takes like a deep breath or something like that. He'll talk about having shortness of breath or difficulty breathing in the cold weather. 

D: OK, other than the and I guess the cough. Is he coughing up anything, or is it kind of a dry cough?

P: It's dry.

D: OK. Does he have any like chest pain during these episodes.

P: No, he hasn't said anything like that.

D: Alright, any fevers?

P: No, he had a little bit of a fever at the that one time a few months ago, but he hasn't. So that's right. I think he had a some sort of illness then, but he hasn't had any fevers.

D: I see. OK, any headaches?

P: No, he hasn't said anything like that. 

D: OK. And how has he had any other symptoms so anything like racing heart or belly pain or muscle aches or any changes in his bowel movements or urinary symptoms? 

P: Uh no, I haven't heard him, uh, I complain about anything like that. I think I'll everything like that's been normal. 

D: OK. So when he has these episodes, how like how severe are they? So how difficult is it for him to breathe?

P: Ah, well, you certainly when it first starts, I mean for the first minute or two. Yeah, he that when I think particularly at soccer practice school have a really hard time catching his breath, but like he would, he stops playing and rests and really tries to make sure that he is I don't know, just trying to to breathe and it kind of goes away. He's been able to manage it OK.

D: OK, alright and I have these symptoms that have interfered with his daily activities? Does he for instance, try to avoid soccer practice. Or does he have difficulties falling asleep at night?

P: Yeah, definitely wakes him up a few and every once in awhile at night and he does have to take it a little easier at soccer for sure. So yeah, I am thinking it is affecting him.

D: OK. And otherwise has he been, has he had any medical conditions that he's been diagnosed with?

P: Uh, no, well he had some rashes when he was younger that he would get some some creams for, but that's mostly resolved now.

D: OK, any hospitalizations or surgeries?

P: No, he hasn't had anything like that.

D: OK, uhm. And just going back to his birth and your pregnancy, were there any complications at the time of pregnancy? 

P: Um, there was a prolonged labor, I think, but he was delivered vaginally and at term 

D: OK. OK, that's great.

P: And he, oh sorry, I was just going to say normal weight as well. 

D: OK good has, was he kept in the in ICU for a couple of days after, was he sent home?

P: I think they, like he was kept for not an ICU he was kept for one day I think so just monitor for infection because it was like prolonged labor but he was OK. OK, so yeah we were able to go home.

D: OK, and I, what was I going to say. Forgot what I was going to say. How yeah, how has this growth and development been? Has he been seeing his doctor regularly? Any concerns there? 

P: Yeah he's been good with with growth. No concerns for that and his developments been normal as well. He's reached all of his milestones.

D: OK, and is he going to school?

P: Yeah, yeah, he's been going to school. He hasn't really been, he hasn't missed well he's missed one or two days actually, because of the cough, like on nights that he just didn't sleep well, so in the morning he's just well, not not feeling good for school so he has missed a couple of days over the last few months.

D: Okay. And does he, is there any other any conditions that run in the family? Including things like asthma or eczema, or allergic rhinitis or allergies.

P: Yeah, sister does have some bad allergies. Her nose runs all the time and she also has that asthma. His sister uses and a daily inhaler and then also W1. 

D: I see. OK, and uh. How are things at home is he, is he doing well otherwise? Like at school and things like that, any stressors in his life?

P: No, he's been doing, uh, he's been doing well at school. He likes math and that that's been going, well. 

D: OK, great. Has he ever tried any puffers?

P: No, he hasn't actually. 

D: Has he been on any medications?

P: Um, he he has not. 

D: Any allergies that he has?

P: Not that I'm aware of, but I I think he might. I mean so like environmental or I don't know, something. He does get symptoms like a runny nose and itchy eyes sometimes, but usually go away pretty pretty quickly and he doesn't fuss about it too much so, yeah so. 

D: From the symptoms that you've described so far, it sounds like he might also have asthma, but we will obviously have to do some testing and confirm that. Uhm, and also, it's given sort of the results, or even just like giving his symptoms, prescribe some buffers to help with those symptoms. Clearly it's affecting his life. He can't go to school or can't participate in soccer, or sometimes wakes up in the middle of the night, and that's not good. So, we'll we can be prescribed some puffers and see if those help and also get some testing done. Do you have any other questions for me? 

P: Uhm, No, yeah I was just wondering about, so like the wheezing and all of that could be with from asthma too?

D: Uhm, yeah, I would think so, but again, we'll get the testing done and see if there are any other, any other causes.

P: Ok.

D: You said the wheezing sort of lasts only 30 to 30 minutes to an hour and then gets better?

P: Yeah, I don't notice that any other times.

D: Yes, it's possibly, I mean, I would think it's asthma, but then we'll get the testing done and see.

P: OK, great, thank you.