A. j. is a 16-year-old who has just started soccer practice at school. she complains of increased shortness of breath with exercise, and describes having a hard time catching her breath when she runs, which she does five to six times a week. she does not wake up at night with a cough or shortness of breath, and has no problems at any other time except in the spring when the trees start to blossom. the soccer coach advised a. j.'s mother to seek health care because a. j. had a very difficult time breathing at practice that afternoon. a. j. also has a history of eczema and seasonal allergies for which she takes an over-the counter antihistamine when symptoms get severe.