Symptoms but high peak flow

[CotswoldSquirrel]

Hiya,

I'm still waiting to be diagnosed but due to Covid-19, I haven't been able to meet the asthma nurse again. They think I have allergy induced/seasonal asthma as my main triggers are aerosols, hay-fever and tomatoes (intolerant). They suggested I track my peak flow so they have good evidence when we can finally meet again.

My highest peak flow is 620 (I'm a flute player). Sometimes I get wheezy and tight chested and my peak flow drops (around 400) other times I'm struggling and it's still up around 500-550.

Is this 'normal'? I'm still learning and trying to find my new normal. Are there any good Web pages to read up on to understand exactly what my body is doing?

P. S. I am going to phone my nurse today for a chat as I think I need to up my brown inhaler again. Hopefully she can forward me some resources too.

[Mariachristina76]

My normal peak flow is 350 maybe the best is 370 to 380.so you are doing good if it is in the 600

[CotswoldSquirrel in reply to Mariachristina76]

Yes, I think it's because I've played woodwind instruments my whole life. I used to be able play long phrases before I took a breath, now I can't

I was just wondering whether it's normal to get symptoms yet still have a high (for you) peak flow reading.

[Mariachristina76 in reply to CotswoldSquirrel]

Everyone peak flow Is total difference for them.just write down your peak flow everyday and keep a eye it.if worried contact a asthma nurse

[Claire_ALUK Partner ALUK Asthma Nurse]

Hi CotswoldSquirrel, peak flow is really useful but always go by your symptoms first and seek medical help. It looks like you have variability (lack of consistency) in those readings which could point towards asthma but without having an in-depth chat to see whats going on it's hard to say. Either way it sounds like you do need some help, do contact your GP/asthma nurse today about this. You are also always welcome to call the helpline 0300 2225800 or Whatsapp us on 07378 606728 - I would recommend giving us a call sometime I think we can help you understand things better and get you on the right track 👍

asthma.org.uk/advice/manage...

asthma.org.uk/advice/diagno...

[CotswoldSquirrel in reply to Claire_ALUK]

Thank you for the info, that's really helpful. My PF seems to change with the pollen level so low numbers when high pollen (or other allergies) and higher when low pollen.

I've got a phone appointment with my asthma nurse in a bit but will save those numbers on my phone for when I get questions that Google can't help me with.

[Claire_ALUK Partner ALUK Asthma Nurse in reply to CotswoldSquirrel]

Yes don't be afraid to ring us - we are nice !

[twinkly29]

Good idea to speak to your nurse, or to the Asthma UK nurses as above.

An important point (which you may well know) is that your peak flow is only good or bad or whatever in relation to your own "scores" and to your own best. It's absolutely not relevant to what anyone else can achieve!

[CotswoldSquirrel]

Thanks Twinkly29. That's a good reminder.

[hilary39]

Even when my asthma is bad my peak flow doesn't change much. For some of us asthmatics it's because the disease affects our lower airways which aren't measured by the peak flow--it only measures the large airways.

How great all your flute playing has toned your lung muscles!

[CotswoldSquirrel in reply to hilary39]

Thanks hilary39. That's good to know.

I sometimes feel guilty for using my inhaler because my flow is good even though it feels tight and like there's a rock taking up space. I'll stop feeling guilty!

[hilary39 in reply to CotswoldSquirrel]

I feel like it's always better to listen to your body than to make decisions strictly according to your peak flow reading.

The next time you get a spirometry, ask your doctor how your small airways look. Mine are usually around 60-75% even when my symptoms are under control. It's a helpful reference point when I try to understand why I feel so awful even when my peak flow is fine.

[CotswoldSquirrel in reply to hilary39]

Thank you. I will. I'm looking forward to being able to actually getting some tests etc done.

[DANCE2ME in reply to CotswoldSquirrel]

Hi I joined this forum for the same reason; average pf 350 - 380 but this last week my breathing has been quite poor and was questioning what is going on with me. Completely makes sense now knowing about the larger and smaller airways, this had never been explained to me before and I was diagnoised 16 years ago.

[madonbrew]

This happens to me often! My best PF is only 380 but averagely is between 320-50, but sometimes I feel I can hardly breathe and do my PF and it’s over 350. I don’t really get it!

[EmmaF91 Community Ambassador in reply to madonbrew]

If your symptoms improve with your reliever it’s likely that your asthma is affecting your smaller airways and not your larger ones. This can give unreliable PF readings as they don’t measure up to the level of attack it is (I think I know someone who once had a yellow PF so ‘moderate’ attack but her bloods showed it was actually a life threatening attack).

Hope this explains the phenomenon you experience. Usually if you’ve been diagnosed with asthma and the reliever relieves (and PF has a minor drop then improves after reliever) you can straight up say asthma, just in the smaller airways.

[CotswoldSquirrel in reply to EmmaF91]

This is so reassuring to read. Not that I'm glad to read that anyone else is experiencing it but that I'm glad to hear it's not all in my head.

Yesterday was horrible. My chest was so tight yet peak flow was 550. I ended up using my reliever any way and felt better.