I'm new

[-Butterfly-]

Hi there, I'm new to this site and to asthma, in fact I haven't actually been diagnosed. Sorry for the long post.

I visited my gp a few months back after I was experiencing shortness of breath even when not really doing much. I also got the feeling that there was a tight band around my chest sometimes. He said it was likely down to taking time to recover from a cold and left it there.

I went back to my gp a couple of weeks ago after these feelings were still there and probably happening more often. I also had a scary moment after I'd been on the cross trainer where I really felt as though I just couldn't get enough air in.

He said it sounded as though it could be asthma so sent me for breathing tests with the nurse but when they came back normal, he said it's unlikely to be asthma. Apparently my level should be 430 (I think) but mine was 490.

He has given me a peak flow meter and told me to record morning and night and then before and after exercise and go back tomorrow but he doesn't think it will show anything.

Before I go back I'd just like to know in your opinion, what my results might tell him.

Morning results are roughly 470-490

Evening results are roughly 350-380

Before exercise roughly 460-480

After exercise roughly 300-360

Obviously they are lower in an evening and after exercise but is this normal? What should I be asking the gp?

I'd like to understand what I'm experiencing as it's at times quite scary and I'm reluctant to push myself on the cross trainer.

Thank you in advance

EDIT just corrected my figures, I managed to type them incorrectly first time!

[starveycat]

Welcome Butterfly the doc is doing the right thing they have to know what your readings are also your age height all play a part in the diagnosis so hopefully when you go back hr will be able to tell you more ♥♥♥

[-Butterfly- in reply to starveycat]

Thank you for your reply starveycat. I'm concerned that the results will come back as normal and that I won't find a reason for my symptoms, obviously I don't really want to find I have asthma but I'd like to understand what's going on.

I'm glad to hear the gp is doing the right thing.

[starveycat in reply to -Butterfly-]

I always feel the waiting is the worst part but they have to monitor your readings for a while. .try not to worry too much I know that's a hard thing to do ♥♥♥

[Minushabens]

Hi there & welcome

With the usual caveat that I'm not medically qualified I'd say that the fluctuation in your peak flow at different times of day is something that they might want to look into. The reduction after exercise would suggest asthma but lungs are complicated things!

I suspect that the doctor (or nurse) may try you on a reliever inhaler to see if your peak flow alters after taking it. That would be a strong pointer that it is asthma.

If you want to see what is the normal peak flow range for your age/gender/height there are charts widely available on the net to check against.

I hope you soon feel better & get to the bottom of it all

[-Butterfly-]

Thank you for your reply.

Yes I did think there was quite a bit of variation but I wasn't sure how much 'normal' lungs would fluctuate?

Some days are better than others and days that start off low are the days with more symptoms. Yesterday was 490 and I was OK all day but at bedtime it dropped to 360. I woke during the night with a heavy feeling in my chest and felt like I had to push air out of my lungs. This morning was 450 but after only 10 mins on the cross trainer I had to stop and it was 300 and I've felt rubbish all day.

The nurse did say that they can repeat the breathing test I did but after taking an inhaler, but she said that seen as the results were normal, she wasn't going to do it. Maybe I should ask to have this done?

Thank you again for your reply, hopefully I can update after my appointment tomorrow.

[I8tories]

A spirometry test may give a better indication. It's a test where you exhale into a machine, until your lungs are totally empty. Repeat it 3 times. It produces much more data, than just peak flow.

When doing peak flow, try to do it same way each time, whether standing or sitting, to give cosiest ant readings.

[-Butterfly- in reply to I8tories]

Is this the test you would repeat after having an inhaler too? I shall ask about it.

Yes the pharmacist showed me when I picked up the peak flow meter. She said I should stand up and imagine I'm blowing out a candle that's on the other side of the room. I should do it three times and record the highest value. If my results are low, I do try a few more times just to check it's not my technique!

[Minushabens in reply to -Butterfly-]

Sometimes full spirometry can be done before & after inhalers-I've done it that way on a couple of occasions.

[-Butterfly- in reply to Minushabens]

After today's appointment, the gp has requested this to be done.

[Butcjdb]

Could be exercised induced Asthma. If it is you will need to take a inhaler before exercise.

GP is doing the right thing.

[-Butterfly- in reply to Butcjdb]

Yes my symptoms do seem to be worse but not limited to exercise. Would it mean I need to cut back on exercise?

[Butcjdb in reply to -Butterfly-]

No not at all. Would just mean taking a quick couple of puffs on a inhaler before exercise. Exercise is good for asthmatics

I've been asthmatic for 53 years. If you are diagnosed with Asthma. Then there are many levels of Asthma and many individuals will experience many different triggers. You will begin to realise what is triggering your Asthma.

if you have a list of questions. To many to query with your GP/Asthma nurse. Then I would seriously suggest you contact Asthma UK. They are brilliant. Really can't praise them enough. They have much more time available than the NHS

[-Butterfly- in reply to Butcjdb]

Thank you for your reply, I will try the asthma UK people as I do have lots of questions!

[Coastwalker]

Hi -Butterfly-

Also consider low iron levels for breathlessness.

Low iron blood levels = low oxygen levels.

[-Butterfly- in reply to Coastwalker]

Interestingly ...my iron levels are low but within range. The doc said as long as I'm not having heavy periods, that I don't need to do anything.

[Coastwalker in reply to -Butterfly-]

See my message below -Butterfly-

Think I forgot to press your reply button, just to make sure you get my reply.

[Coastwalker]

Find out your iron and ferritin (stored iron) levels if you can and pop them up on thyroid Uk, I always ask for my blood results and their important ranges, I too was told my ferritin (stored iron) level was fine, ('Within Range',) but I found out from members on Thyroid Uk that my level was classed as 'LOW' within range and my ferritin level needed to be far higher to help with my hair problems.

[-Butterfly- in reply to Coastwalker]

Thank you, I shall ask for these when I'm at the doctors although they are from a few months ago.

[johnsmith]

This may seem ridiculous advice, but it is worth seeing a McTimony chiropractor. The symptoms you describe could be due to a muscle or muscles in spasm which is preventing proper expansion of the lungs. Unfortunately GPs do not have the ability or knowledge to check for this.

Muscles can develop the habit of remaining in spasm leaving to long term problems. Another thing that can happen is the muscles on the front of the body can develop over contracting. This can lead to breathing problems. Worth seeing an Alexander Teacher to check if there is a posture and muscular behaviour input for your breathing problems.

It is well known among lung consultants that many inhalers only work effectively and efficiently in the short term and there is a lot of asthma type problems that start after a person has had a cold type illness.

Hope this has been helpful.

[-Butterfly- in reply to johnsmith]

Thank you for this information

[-Butterfly-]

UPDATE

After today's appointment, the gp has requested for a spirometry with reversibility to be done.

He is still reluctant to label anything but did say that my peak flow monitoring is suggestive of asthma.

He has given me a prescription for a salbutamol inhaler and told me to use this when needed only I'm not entirely sure when to use it! Do I use when I first get the tight feeling, or wait to see if it resolves by itself? And how much can I take at one time? He said take two puffs, will this resolve the symptoms straight away (if indeed it is asthma)?

I have to go back after my spirometry test and in the mean time continue measuring and also add in when I use the salbutamol and my peak flow before and after it.

[Minushabens in reply to -Butterfly-]

It sounds like your GP is taking a really sensible approach to all this. As starveycat says blue inhalers generally give more or less instant relief so if you take it & feel your breathing improve (or likewise if you see a marked improvement in your peak flow) then it's all pointing to asthma.

It is very important though that you learn good inhaler techniques. It never ceases to amaze me the number of people I see around & about who clearly have never been shown how to properly use one. If you haven't had it explained then pop into any chemist or see the practice nurse & they will show you.

Good luck!

[-Butterfly- in reply to Minushabens]

Yes both the gp an the pharmacist showed me how to use the inhaler and the gp checked my technique. I've also got a spacer to use but it's a bit big for my handbag so won't use it outside of the house!!

Anyway I used it this morning for the first time after going in the cross trainer and all I can say is WOW. Admittedly I forgot to use it beforehand but after about 15 minutes I became very short of breath and felt as though I was trying to breathe through a McDonald's straw, it was awful. Peak flow before was 440 and when I gave up at 15 minutes it was 310. So I used the inhaler, 2 puffs, and within a minute the tightness had really eased and my peak flow had increased to 380. I was so relieved as that feeling is very scary.

My only question is that I still don't feel 100% better, even now after an hour, my chest still feels tight but not as bad as it was. Do I have to wait to take any more? Is there a limit to how much I can take?

[Minushabens in reply to -Butterfly-]

You will probably learn over time how it affects you & when to take it. What I have been told by doctors is that if I'm having an attack that I shouldn't worry about how many times I take it if it's working. However if you are relying on it to keep your breath throughout the day then that's not good & the inhaler is not without its side effects.

I'm having a guess here but I think if you tell the doc that your peak flow shot up by over 20% after taking ventolin that (s)he will quite probably want to see how you get on with longer-term medication (a 'preventer'). The general goal is to get to a point where you are minimally dependent on the reliever but in my (again unqualified) opinion what you are experiencing does sound very much like asthma.

By the way (& others might shoot me down for this) but I could never be bothered with spacer devices. As you say they are utterly cumbersome to carry around & if you can breathe the inhaler in well enough without it that's probably ok.

[starveycat]

I usually take my blue inhaler when I start to feel breathless I shake it first take take two puffs and it works within minutes. I know you want to know now if if is asthma but you have to go through all this monitoring stuff to make sure. It took several weeks before I got a definite diagnosis. We are all rooting for you, take care ♥♥♥

[LittleMissFaffALot]

There is a range for peak flow readings which are considered 'normal' or 'average' but many people don't fall into these typical ranges, myself included.

I was just wondering if there is anything in your life than might give you higher than expected readings, especially when you are well. Are you a trained singer or wind / brass player? I've been a flute player for nearly 25 years so as a result i've got really good breath control and always get higher than predicted readings - i can even get a decent result when i'm suffering, what numbers don't tell you is how you actually feel!!!

After a while you'll get to know what YOUR 'normal' readings are and these are a far better measure of how your lungs are behaving