Peak flow questions

[GFloss]

Hi all, just wondering how others are measuring their peak flow/getting on with this...

- Do you use the standard peak flow meter (as pictured) or an electronic version? - And which chart do you tend to use to track your target peak flow against your age & height (if this is something you do)?

I know it's very individual and I'm guessing that as asthmatics we won't all be able to hit the 'ideal targets'.

That said, I can't help but feel a bit frustrated at my own performance, haha! I'm using one of the pictured peak flows but can never hit anywhere near my best asthma clinic reading, that was completed on an electronic version. I've only had access to the electronic machine once in my last asthma review and now I'm wondering whether that's a more accurate reflection or if it was just a bit of a fluke.

Chart wise, I've been using the EU one on the 'My Lungs My Life' site: mylungsmylife.org/wp-conten... and I'm always under for my age/height on this despite thinking my asthma is mild and relatively controlled.

Would love to hear others' experiences, thanks so much for reading!

[twinkly29]

I can't get near my lung function test pf using a pf meter.

I keep a record of my morning and night pf but don't ever relate it to my age/height/etc. In theory it should be related to your best, but I tend to have a more realistic best in mind - but only use it in conjunction with other factors. For me, solely using pf would be unhelpful.

I was told to breathe right out, then take a big breath in, make a seal round the mouthpiece with lips and breathe out as hard and fast as possible. Best of 3. Being totally honest I don't always do 3, if I've got a couple of good ones and I feel ok for example, although if it's not great I sometimes do more to try and make it better 😂

[GFloss in reply to twinkly29]

Thank you so much for the helpful reply - it certainly sounds as if you're taking the right approach! You also made me laugh when you said about the extra goes. Just before I wrote this question yesterday I'd done a load in a row...and made myself feel a bit squiffy in the process! I know, definitely not recommended but pleased I'm not the only one who's tried to up their reading! ☺️

[Troilus]

Hi GFloss,

Yes I have a Wright peak flow monitor, but I rarely use it these days. I bought a Microlife peak flow meter from Amazon. It was £30 odd pounds with discount.

I prefer that because it also records your Fev 1. You can also transfer the data to a pc and it graphs it out for you. It will also add the traffic lights to your peak flow graph.

I take one reading before I take any of my meds as soon as I get up, then another a couple of hours later, and a final one just before bed.

I always take at least three readings. If the reading is good, I usually stick at three, but if it’s on the low side I keep trying to get a higher reading, until finally the penny drops that that is as good as it is going to get!

[GFloss in reply to Troilus]

Ooh, I like the look of the Microlife, thank you. I've only had the Fev 1 recorded once in clinic and found that really interesting. Can't help but like the fact it all graphs out too! I can tell from the below replies I've probably been paying too much attention to this aspect but can't help but enjoy the odd spot of tracking, haha! And yes, as above, I'm also guilty of trying to keep going before I eventually get the message that my sore is sticking or going down with too many attempts, not up!!

[Gentlechelle11]

I use the peak flow devise as shown in your post. According to the chart I should be reaching 420 however so far my best has been 360 and that is with taking double my current inhaler dose. I am currently self isolating due to suspected covid19 as I have not been asked to shield. My peak flow at present is 280

[Js706 in reply to Gentlechelle11]

Try not to get too hung up on the values on charts. It’s always important to remember that the graphs to work out “predicted” peak flows are based on an average for the whole population - which will include people without asthma.

The most important thing is to know your personal best and the variation around that 😊 most asthma plans advise you to contact your asthma nurse/GP when your peak flow is around 70-80% of your personal best. Yours is currently about 77% so it might be worth ringing your GP to inform them and ask for some advice if you haven’t already - they might change your inhaler or prescribe a short course of steroids to help settle things.

Also having a higher personal best doesn’t necessarily mean your asthma is better controlled as loads of different things can affect it - my mum has mild to moderate asthma and her best is only around 300, whereas my asthma is severe and mine is 480.

I hope that explains things a bit and take care while you’re having to isolate! 😊

[EmmaF91 Community Ambassador in reply to Js706]

I quite agree. My best is 630, my predicted is 440. I have a friend with the same predicted but a best of 300. I have severe asthma, she has no resp conditions at all. My lungs are just larger 😅. Go off your best score, and don’t worry too much about the predicted

[GFloss in reply to EmmaF91]

So interesting, thank you for adding this!

[GFloss in reply to Js706]

Thanks ever so for adding these super useful comments - I haven't wanted to increase anyone else's concern by mentioning charts. I can see from all of the below that I've been paying too much attention to them and getting (unnecessarily!) competitive with myself, haha! So interesting to read everyone else's experiences too. Thanks again.

[GFloss in reply to Gentlechelle11]

I must apologise if I've added any concern by mentioning the charts - I know that Js706 is right in what they say about not fixating on these and I've clearly been paying them too much attention. That said, I think it's really useful that your still taking your readings while unwell as per the Asthma UK guidelines. I also agree that it's worth contacting your GP or asthma nurse to update them on your scores, just in case you need any additional meds or similar. I read on here that some people are being given antibiotics to avoid secondary infections. They may say to simply keep monitoring your symptoms and scores and/or up your usual med dose. Thank you for replying and wishing you a super speedy recovery!

[SheilaC]

I have a rather elderly meter almost the same as the one in the picture. I dug it out again as I decided to monitor my health under the present circumstances. I normally struggle to get 300 but have managed to get to 330 recently. I am pretty sure this is due to a reduction in pollution. My lungs feel pretty good compared to my normal. Has anyone else found this?

[Poobah in reply to SheilaC]

I believe that the older style PF meter has a different chart. Not sure when everything was updated. Couldn't find an old chart on Google.

[GFloss in reply to Poobah]

I can see I've been overthinking these charts too! I guess there's a reason the NHS/Asthma UK don't include them on their own pages...they don't want people like me coming along and paying too much attention to them, haha!

[GFloss in reply to SheilaC]

Fab to hear that you're breathing better - I bet you're right about the drop in pollution. They say it's been significant in some regions. My asthma has been up and down lately, but I'm definitely feeling the hay fever effects and am worse on more sedentary days!

[Beefull8]

I’ve been breathing better too. I’ve been thinking maybe I’m less anxious which would be weird since it’s an anxiety provoking time. But I couldn’t figure out why I haven’t had trouble breathing at all.

[GFloss in reply to Beefull8]

So interesting & good to hear! I wonder if the pollution reduction is helping you too, though agree if you're feeling less anxious that could be making a huge difference. Haha, I guess we're all different in our anxiety triggers and I def know some people who fare better during bigger life events than in their general day-to-day life. I found my anxiety worse just before and during the first week of lockdown but since it's generally been calmer too...touch wood!

[watergazer]

I use the peak flow meter as in the photo. I use my action plan given to me by the nurse at our GPs to monitor myself. Have you got an action plan and if it may be wise to get one when all of this covid 19 is over. Take care, x Anita

PS I rarely hit the target on the charts but my plan has my best and when to take further action.

[GFloss in reply to watergazer]

Thank you so much Anita, you're clearly following the right approach judging by all these helpful replies! It's funny as I feel it's only in the past year or two that my asthma nurses have really offered more guidance (rather than getting me to simply puff in the peak flow, note my score and send me on my way). I haven't got a formal action plan but I think we got a little closer to it last time. The nurse told me a target reading to do at home as my normal and then said if it's half that then I know I definitely need to contact them and the same if I can only hit 100 less but 'otherwise feel well'. Nothing was written down but I noted a load of her comments as soon as I left the surgery, which I've found helpful to refer back to. I like the idea of requesting a formal plan in future though. Thanks again & take care too! x

[watergazer in reply to GFloss]

I’ll try to post my plan. I’ve only had mine a couple of years. I find it helpful to refer to instead of trying to remember what the nurse said.

[GFloss in reply to watergazer]

That's so kind of you, thank you!

[watergazer in reply to GFloss]

Unfortunately it won’t paste on to here x

[GFloss in reply to watergazer]

No trouble at all, it's really kind of you to try & I see Asthma UK have an action plan to download, so I'll take a look!

[Js706 in reply to GFloss]

The asthma UK template is a really good starting point! You should be able to fill most of it out yourself and anything you’re not sure about you can ask your GP or asthma nurse 😊

[Lysistrata Administrator Community Ambassador]

I use it sometimes but it's not the most useful for me by itself- I can get 'ok' results above 50% best in the middle of a severe attack. Despite having severe poorly controlled asthma, I have a personal best much higher than predicted so I use that - I can still hit it on good days/post neb! I use the manual one as I found it hard to get the electronic one right. I always find electronic ones give a higher result - I had an even higher personal best on that and the peak flow during spirometry is always better.

However my peak flow overall doesn't necessarily reflect what's going on. I find it more useful to see how it responds to reliever medication - usually a big bump. As I get worse that bump reduces and lasts for less and less time until it goes - then I know I need to do something.

Don't forget peak flow only shows you what's going on in your larger airways - the smaller ones won't really show up in a peak flow reading. As others have said it's only part of the picture, and can be more useful for some people than others as a monitoring tool.

[GFloss in reply to Lysistrata]

That's so interesting, thank you, especially the reminder about the smaller airways. I suppose this explains how people like yourself can achieve better than expected readings during attacks. This has all really helped me see I need to rethink my approach and expectations. Thank you again.

[Singinglouder]

Just to be awkward, I’ve always had higher peak flows on the meters as pictured than on electronic.

Also, I had full lung function tests at the hospital 4 weeks ago, and the technician said current best practice is to do peak flow 4 times a day (am, lunchtime, early evening, bedtime), and that’s what I’m supposed to be doing until I see the consultant - which under current circumstances could be a very long time!

[GFloss in reply to Singinglouder]

Ooh, that's intriguing about the manual vs. electronic! Always great to get another experience in the mix! I wonder, have you ever done the electronic at home? Just thinking the clinic setting can sometimes feel less relaxed and will generally have a different environment. Though I guess you could just be a whizz on a manual! So interesting to hear about the recommended 4-a-day too, thank you.

[Singinglouder]

Yes, I have an electronic meter at home - asma-1. I generally get much better readings at the surgery, both now and when I had a manual pf meter from the doctor. Don’t ask me why, cos other things get worse - my blood pressure readings go sky high, I’m a proven whitecoat!

[GFloss in reply to Singinglouder]

That's so intriguing! Perhaps a surge of adrenaline gets you firing out those readings, either way, I think it's fascinating!