New to the forum Peak Flow questions

[Sallybones]

Hi and thank you for allowing me to join your forum.

Q: So I've done a peak flow diary over 22 days before I speak to GP tomorrow. My average readings are between 250 and 290. Is this poor?

I have a complex health history, many battles with health pros, lots of investigations and some firm diagnoses but my health continues to deteriorate over the last 20 years and my outstanding symptom which has got worse is breathlessness. Now its with me all the time and has brought me to a standstill. An xray about 3 years ago showed hyperinflated lungs but no lung damage. All previous hospital respiratory and cardio respiratory tests came back "normal' (a word i dislike). Apart from a slightly raised bpm and dropped beat. I have a type of heartblock but of no concern they say and various allergies/intolerances all my life. I've been given inhalers in the past usually to do with hayfever (which I don't get now) but never diagnosed with Asthma.

I saw Asthma nurse about 4 years ago before being referred on to cardio respiratory again by cardiac consultant. All normal apart from this type of heart block.

Then for about a year my bpm began to increase and stayed up at 140 bpm. GP sent me to A&E stayed overnight and sent home after usual tests. Wore a holter monitor for 2 days. Normal enough! In February 2021 just before first covid injections i got Shingles, took the antivirals and lo and behold my heart rate settled back to normal and has stayed so ever since!

When i told the cardiac consultant he was quite surprised and got me to wear the holter monitor again to make sure. In my own head I question wether I had had a virus all along.

I'm pretty clued up on vitamins etc and levels in all areas are good.

I get private blood tests done fairly regularly. Thyroid is the one I've never managed to get sorted and remains a problem.

Thats roughly how I've got to here and had lots of help on other forums over the last few years.

So all my sats are good, almost perfect but I keep going back to GP with breathlessness. I check them at home and they are good.

I have a dry cough and tight chest. When I breathe I want to cough.

Any views gratefully received. Thanks Sally

[Yumz199725]

Hi and welcome to this forum x do you have an asthma action plan? That will tell you if your peakflow is dangerously low I know for me my best is 520 and my worst is 250. Have you spoken to your GP about this??. Have they done a cardiologist referral? sorry if you explained this on your post it's just your symptoms seem like they could be heart related (obviously I'm not a doctor but please get checked out x

[Sallybones in reply to Yumz199725]

Hi thanks for replying Yumz199725 I've never been diagnosed formally with Asthma just that through the years i've been given inhalers at peak pollen times but never full time. But rarely needed them as a grew out of bad hay fever. I've told GP countless times this year that its got so bad I can hardly do anything but because my sats are good BPM blood pressure perfect it gets dismissed. I used to be extremely active but over the last 20 I've deteriorated more and more but the worst thing now is breathlessness.

I've got a phone consult tomorrow with GP so I shall have another go and this time if I don't explode I shall ask what she is going to do about it.

I can fight my corner but the breathlessness takes away my energy.

Apart from which our practice has been bought by big business and service is chaotic now.

I did speak to the clinical nurse at Asthma+Lung UK last week and she suggested it could be heart related too. I will call them again tomorrow before I speak to GP because I don't think I mentioned my peak flow diary to her. I was querying my hyperinflated lungs.

Thanks for you help

[Yumz199725 in reply to Sallybones]

That's good you appointment with your GP x keep us updated on how it goes. Is it possible it's both asthma and heart realated because that's what it's like for me can be hard to know whats what sometimes x

[Sallybones in reply to Yumz199725]

will do thanks

[Troilus]

It is hard to say if someone’s peak flows are low or not because they are based on height , age and sex. The link below will take you to an easy to read chart where you can look up your predicted scores.

emupdates.com/peak-flow-nor...

Individuals peak flows can vary from the norm - they can be higher ( some say it due to being athletic or singing etc - mine are above predicted but I am not athletic and have never been invited to join a choir.) Likewise they can be lower than predicted if someone is particularly inactive for example.

When I was first diagnosed my flows were well below predicted but once I got put on the correct medication for me they steady rose.

The gold standard for diagnosing any respiratory disease are primary lung function tests. GP surgeries used to do spirometry- usually a simple loop test which would diagnose asthma - they stopped during the pandemic but may well be doing them again.

Does the cough ease when you take your blue inhaler? Does the tight chestedness go? Does your peak flow increase? These would all be indications of asthma.

[Sallybones in reply to Troilus]

hi Troilus thanks for replying to me. I've had all the lung function tests and even some during covid though I didn't have covid. I've had them done twice through the hospitals too. Last time probably 2021. I've never been diagnosed with Asthma but seasonal changes / pollen occasionally given blue inhalers but not permanently but things would ease anyway.

The chest tightness is there all the time and I cough when I speak. Speaking makes me tired. Physically everything is like ploughing through treacle.

I don't know if my lungs are still overinflated but one GP said that just means you can get more air in. Well I know it also means you haven't been getting enough air back out so the lung loses elasticity.

Over 22 days peak flow always between 250 - 290. Which I will tell my GP tomorrow.

[Troilus in reply to Sallybones]

Hi Sally. Just wondering if they gave you some blue inhaler and repeated the loop test when you did spirometry? This is the test for asthma. Without it asthma can’t be diagnosed, just obstruction.

[honeysuckle78]

I had clear x rays for years in spite of breathing difficulties and respiratory illnesses . It was a c.t. scan that eventually diagnosed bronchiectasis.

[Sallybones in reply to honeysuckle78]

oh that's interesting honeysuckle78. There's definately something going on.

[Patk1]

Hi Sally bones.. I like Yr name! Welcome to the forum.have u had a ct lung scan? If itslung related,it picks most things up.have u changed meds since breathlessness began? Some b blockers can cause problems.iv svt+ sinus tachy too - is it related to heart going bit fast? Ru physically fit + active? It helps to b as active as possible.i see Yr b12 - has it and fbc been done recently - anaemia can cause breathlessness? It maybe worth ringing nurse helpline0300 222 5800

[Sallybones in reply to Patk1]

Hya Patk1 ha ha thank you - I have osteoporosis hence the bones name.

I don't tolerate meds at all so tricky one for me. I've gradually become very inactive over the last 20 years but lots of things went undiagnosed for a long time and I've just become weaker. If the health pros were better at joining the dots it would be amazing but you have to do it yourself mostly. I self inject with b12 and have been taking D3 + K2mk7 for many years, magnesium etc so I've done all the right things but always feel they're all connected.

I found the helpline nurse brilliant too thank you for that

[Nula2]

Hi Sallybones and welcome to this lovely supportive forum 🙋‍♀️. Can't help you much with your question but just wanted to say hello. My peak flow is very low (lucky if I reach 200). Was told by resp team to be concerned if it drops below 150 consistently. Don't know why mine's low but guess we're all different. I also am very breathless which has got a lot worse but specialist seems to think the increase is to do with very low muscle tone because I'm very thin (despite eating well). Hope you get some answers soon. Take care 🙂xxx

[Sallybones]

not sure how to edit post but thought I'd send an update this way. Thankyou to all who have replied to me. Its all really helpful and I feel more supported and less alone.

My GP rang me this afternoon and is sending me for a chest x-ray first to compare with one I had a few years ago which showed the inflated lungs. Then she will send me for CT scan. She's also prescribed blue inhaler to try and that should come this afternoon.

I did stress how limited my life has become and that I had spoken to the clinical team at asthma+lung uk and they had mentioned possible heart conditions too.

So I'm please with some progress even though its taken months yet again to make some headway.

I will update again when I have results.

I'm so glad I've joined the forum xx

[Ergendl]

My normal peak flow is around 240 now and has been low for a long time. But running a singing for lung health group every week helps keep my lungs fit, so most people don't notice I have a problem until I start rushing or doing heavy work.

[Sallybones in reply to Ergendl]

I can identify with that. Ergendi. My friends mostly think I'm ok because I can sit with them for a coffee in a cafe for an hour and chat. They forget I have to get a taxi door to door now and collapse when I get home. I try and sing along at home to my favourate old records but with many stops.

[Biker88]

Hi Sally, peak flow is a measure of the strength of your lungs, the average reading for my age group male 70+ is 500, my average is 240. It’s an indication if the lung function is getting better and or worse. Any chest condition will affect peak flow readings. For breathlessness if you haven’t already done so, research correct breathing techniques i.e. diaphragm breathing and look at pulmonary rehab courses

[Alberta56]

Welcome to the forum. I have bronchiectasis, diagnosed after extensive testing at our local hospital, including the vital ct scan. Xrays won't show up bronchiectasis and perhaps some other conditions. My best peak flow is 250, but I still function after a fashion. I think you need to find some not too strenuous form of exercise, very mild to start with. One of our local retirement villages invites non-residents in for gentle exercise, for instance. There might be something suitable in a local care home perhaps. I do Chair Pilates at a local studio at the moment, but it is surprisingly energetic. I think the instructor would understand if I had to take little rests. Just a suggestion. I hope your medical team can come up with something positive. Best wishes.

[Sallybones in reply to Alberta56]

hi Alberta56 thanks for responding. I've kept kind of functioning but knew my body was like really winding down no matter what I did, but this year I've definitely hit a brick wall that I can't get round this time without intervention of some sort. It's like I have nothing left to call on.

But I'll wait and see what the next x-ray shows compared to the last one with inflated lungs and I will push for ct scan if they say x-ray shows 'normal'.

In my early 40s I was still hill climbing and doing aerobics. What a come down and hard to imagine that was me.

You are all so helpful with your comments and its so reassuring.

[Alberta56]

It's frustrating when your body can't do things you used to do effortlessly years ago. I never used to be a gym bunny until I found my body needed more regular maintenance, preferably indoors in the winter months because the cold triggered my bronch. I think you should push for a CT scan- it will tell the docs more about what is going on. Then push for pulmonary rehab. Most of us here have found it useful.

[Sallybones in reply to Alberta56]

will do Alberta56