Reconsideration of peak flow as asthma deterioration measurement

[M-A-000]

I think doctor should reconsider the peak flow device as main effective method for asthma diagnosis, I think such device is only helpful in patients with non inflammatory asthma like COPD or lung fibrosis, I remember when I was 15 I had lost consciousness due to severe asthma flare up, and I remember the air seemingly strong when expiration, but I was ranting, last time I remember when entered ER then lost and I woke up on chair and nebuliser on my mouth and IV access in my hand, also before one week felt like going to faint and I went seaside 8 days until now feeling very good, peek flow all the time 650 to 750. Does anyone think same me ?

[Newasthmatic]

Definately agree. My peak flow does not reflect asthma flare up at all and this is the question I keep asking the CNS and GP. All quite new to me but it appear that this is not unusual?

[Poobah]

It may be time to discuss the possibility of dysfunctional breathing with your doctor and ask for a referral to a respiratory physiotherapist. It's not uncommon for asthmatics to have odd breathing patterns that can exacerbate asthma and cause other respiratory problems, but have high peak flow results. The respiratory physiotherapist will be able to assess the matter and recommend breathing exercises. Practice makes perfect. It takes determination to change things, but it's so worth it.

In the meantime you could look at the Buteyko technique, just to understand how it's possible to learn bad breathing habits and how we'resupposed to breath. This is general info, definitely important to be assessed by a specialist physiotherapist.

[Celie1]

Hi,

I know for a lot of asthmatics Peak Flow works well, but for me it doesn’t really help.

My peak flow measurement is not a good indicator of my asthma deteriorating. It doesn’t alter very much even when I’m really short of breath.

Luckily my doctor’s have always treated me according to my symptoms and how I am in the surgery i.e. If I can’t breathe, they give me oral steroids (even though my sats are ok, PF ok and chest clear).

I used to feel very confused with this and feel that I had been misdiagnosed and it wasn’t asthma. But I’ve learned on this forum that it’s not just me who doesn’t fit with the ‘normal’ expectations for asthma. It helped a lot to know I wasn’t on my own with this.

I also learned that it’s possible that my problem is in my smaller airways, rather than my large airways, meaning that I can blow a ‘normal’ PF but can still be breathless because my small airways are blocked.

Hope this makes sense. Good luck

[LittleMissFaffALot in reply to Celie1]

I'm similar, PF really doesn't reflect how I'm feeling. I had an 'asthma review' a couple of weeks ago but it wasn't very useful - not a reflection on the nurse. My mum died last month and we only had the funeral this week (we waited FIVE weeks!!) so my asthma has been pretty poorly controlled. The nurse knew all this before I went as they sent me a questionnaire to fill in prior to the appointment.

She asked me to do a PF and I told her it's not a good indicator for me. I did it anyway and blew a good score but "oh, it makes you cough". Normally you have to do best of 3 but she didn't make me do it again, she probably thought it was pointless and didn't want me to cough any more than I already was.

I've got to go back and see her again in a few weeks when I'm more emotionally settled and hopefully my asthma is more settled too

[twinkly29 in reply to LittleMissFaffALot]

So sorry for your loss 😔 I hope that things are a bit.....calmer (no idea what the right word here is!) now that you've been able to have your mum's funeral. Stress and emotions can indeed affect asthma in some people (some people find it helps theirs though!) but they can also cause symptoms that mimic asthma - so it might be that it looks and feels as if it's asthma but the symptoms are actually caused by stress or anxiety or emotional trauma. This is probably why they want to see you again when things are calmer/less raw for you. Bereavement is a huge thing though - it's understandable that it might cause such emotional trauma. Have you got some support? Not necessarily professional support (although that's hopefully available if and when you are ready for that), but friends and family?

[LittleMissFaffALot in reply to twinkly29]

Thank you, you're right - there are no 'correct' words at the moment. I actually realised the other day that right now I don't want words at all, I just want people to hug me when I cry 😭People keep sending me things with 'nice' sentiments but none of them help, they just make me cry more. I think in time to come I will appreciate them but just not yet.

Stress has always been an asthma trigger for me so it's completely expected. There was also a very large scrapyard fire just a mile away from me the week before my review so that didn't help at all - there were reports of the smoke / fumes being smelled up to 5 miles away

I've got lots of support from friends, I seem to turn into a big blubbering mess every time I go to church - and there are lots of people to hug me there <3 I've also cried on the phone to friends quite a few times recently - usually around 10pm it hits me 🙄

[Celie1 in reply to LittleMissFaffALot]

So sorry to hear about your mum 😔. That’s such a long time to wait, it’s no wonder your asthma’s playing up.

Hope things start to improve for you now the funeral’s over. Sending a hug. X

[Newasthmatic]

Thanks all and celie1 thank you as I have been doing the same so reassuring to hear your story. Thank you 😆

[Celie1 in reply to Newasthmatic]

You’ll get some great support and advice on this forum 👍😁

[ck101]

Peak flow is zero use in COPD where one needs to get an understanding of FVC and FEV1 to make a diagnosis. I can’t breathe and nearly get the peak flow guide to the max every time. Office spirometry kit is so cheap there’s no excuse for all GPs not to have one!