Peak flow recordings jumped from average 320 to 840. Is this possible for a 65 year old female, 5 ft 2?

[Nalathecat24]

Recently hospitalised with severe asthma, in for 8 days. Was close to being put on a ventilator. Been out since start of June 2024, on new regime of inhaler. On symbicort 200, 2 x puffs twice daily. Then increased to 4 x puffs daily, then 3 weeks ago 8 to 10 puffs per day. I also have been taking montelucast 10mg per night. My peak flow has started spiking up to double the usual reading from 260 to 340 up to 660, and yesterday it increased to 840. After blowing these high readings the 2nd and 3rd puffs are in my usual range of 260 to 340. Is this actually possible to have 840 as a genuine reading?

[Itswonderful]

Watching!

[Skeusenner]

What's the maximum possible peak flow rating?

[Mandevilla]

My peak flow meter doesn't even register anything higher than 800! I wonder if your peak flow meter is wearing out and this is making it give higher than usual readings?

But if you are on a new medication regime, you might also be seeing an improvement in your peak flow anyway. So it could be a combination of the two - inaccurate meter AND your lungs working better.

[Patk1]

Make an appointment for asthma review

[Don_Alejandro]

No, I'm pretty sure those are false readings.

I've experienced something similar. I'm male, 68 and 5'3".

I take Fostair 2x 2 inhalations a day - occasional use of Salbutamol.

I was struggling badly a few years back, my peak flow readings bumping along as low as 120 / 150. If I'm on top of things nowadays, then I'm usually about 300 to 340

However I also have freak readings with my first blow of 3. Initially this happened when my original peak flow meter started to age, so I was given a new and different manufacturers peak flow meter. But I still go through periods where my first blow gives a false reading, usually between 450 and 500 - not as high as your readings, but I can't repeat it the 2nd or 3rd time.

I've queried this with 2 asthma nurses, plus the ladies in my dispensary - so far nobody has a clue. However, I have experimented quite a bit and in my case I believe it's to do with my tongue getting in the way. I have a large and noticeably pointed tongue and if I accidentally poke my tongue into the peak flow meter as I blow I get a much higher reading. So I've become slightly self conscious about my blowing technique and the freak highs have stopped. I'm not 100% sure this is the explanation though.

My advice would be to try to see your asthma nurse, ask for a new peak flow meter, then see what happens.

I keep a paper chart and I put these false readings in pencil and use a pen for the normal readings. As the weeks go by you can see these freak readings follow the normal readings up and down.

It is puzzling and I'd love to know what the real reason for this odd phenomenon is.

[Asthmaa in reply to Don_Alejandro]

I think you summed it up quite well. Nobody has a clue! We need to research and decide for ourselves instead of trusting a system that is ruled by profit margins.

[Shaft1952]

I am 5ft 4 my peak flow is usually 600, my I have mild asthma I am down to 1puff twice per day, if I have a problem I increase to 2 puffs twice per say. If still having problems and reducing my peak flow , I then increase to 10-12 puffs per day, I am on Montelucast 10mgs at night. I try to just see gp and knock it on the head quickly. I hope this helps but your asthma nurse should be helping you from the hospital.

[Birthday60]

unlikely but interesting... award do 3 puffs anyway and take the most consistent

[flowerjunky]

I use a Mini-Wright peak flow meter (white with red mouthpiece) and have found that my first blow is sometimes much higher than normal (and subsequent blows) and there is a slight feeling of more resistance when blowing into it.

This normally resolves if I give it a good clean in warm soapy water, rinse and leave to completely air dry. I probably should do this more often than I actually do .

It might be worth either buying a new meter or asking your asthma nurse for a review.

[peege]

I bought a new peak flow meter from my pharmacist @ £8 (new gp had refused to prescibe along with a new spacer).

[runcyclexcski in reply to peege]

>>>£8 (new gp had refused to prescibe along with a new spacer).

That's one non-cooperative GP. Nice job saving 8 quid for the NHS, what a great short-term gain.

[peege in reply to runcyclexcski]

Exactly, obstructive, this was years pre covid can no longer see him. He's only in his 40s he even undiagnosed bronchiectasis so he wouldn't have to refer me to consultant and the other things in NICE guidelines. After many blood tests in 2016 for extreme fatigue his diagnosis "you've got CFS, no cure, you manage it" then got up and opened the door. Nothing else, no leaflet, no advice on how to manage. He has children, I feel sorry for them. Getting an appointment is akin to getting in Fort Knox. Regarding the refused spacer request , I'd used the same one for over three years. I've got to summon up the energy to walk to a decent surgery across town.

[runcyclexcski in reply to peege]

I hope you've found someone better since then! Took me 7 years of trying to get onto a biologic, and I only managed to get on one after seeing a private consultant.

[runcyclexcski]

I would get a new peak flow meter.

850 is my "baseline" reading, I am 6.0 and 48 y.o. My flow meter goes to 900. This is still considered too high for me, but I have big lungs, and this reading is reproducible with different peak flow meters.

[RJ1944]

Sorry for your problems, I can certainly sympathise. My current regime may not be relevant to you but I have had a good experience with Symbicort.

I have been on Symbicort 200, 2 puffs twice daily for 15 years. My first asthma attack was 30 years ago and I have now hit 80. My specialist at the time supplemented this with a saline nasal wash as he considered post nasal drip to be a contributing factor (wash bottle with one teaspoon of salt and 2 shots of flixotide spray).

I also combine 20 minutes of breathing exercises each morning which sets me up well.

I don't pay much attention to peak flow as I find it adds unnecessary stress if it is a poor result. The body usually let's me know how things are.

[Butterfly2honey]

the odd time I’ve managed to do this in front of my GP and he told me to do it again. He said that you can blow in to them in a certain way and it will give you a false high reading. I still don’t know how I’ve managed to do this.