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Peak Flow & Asthma Attacks

Hi, Can anyone tell me whether it is possible to be having an asthma attack whilst still having a good peak flow reading? I explained to the asthma nurse last time I saw her that sometimes I experience symptoms such as SOB and tight chest but still have high readings (on one occasion I even got my personal best! :-S ) and she told me that it wasn't worth me using my reliever inhaler in these situations as they probably wouldn't do much good. The nurse did ask if I thought it could be anxiety, however I am not having any other symptoms of anxiety and I am not doing anything stressful when some of the symptoms come on.

Last weekend I ended up having my first experience of nebs, after what I though was an attack in which my symptoms had last over 12 hours throughout the night. However again when I presented at the hospital I got my best peak flow reading of 450 and my oxygen was 100%??? They gave me the nebs to be on the safe side and then sent me home again. Could this be because I had used my reliever 6 times or so over the leading up hours before I presented at A&E?

I am so confused! (and yes probably a bit anxious about my whole situation) Just about to go on my 4th week of Pred’s and still awaiting respiratory specialist appointment to come through.

5 Replies

hi, yes had that a few times also.And could happen if got a cold or bad chest.Go by how you feel and pf just to give you a idea how your lungs are doing.But see doc if needed and reliever not helping xxx



My peak flows never seem to match up with how I'm feeling - can be feeling tight and SOB but PFs are high (never helps things - very hard to convince anyone your asthma is acting up with a PF of nearly 600 and sometimes a little over - best is 660).

I was talking to one of the AUK nurses yesterday though and she was very reassuring - told me I wasn't the only 'atypical' one and when I said my PFs weren't really a good indication of how things were going she accepted that - had the feeling she has heard it before and didn't try to insist there was a figure I should be using as a guide, as some people have said before (the one they gave was ridiculously low too - I would be ringing OOH well before it dropped to half given that it doesn't tend to drop much if at all). I also find reliever tends not to work when I start getting worse, though in my case it's slow-burn, I don't really have 'attacks'.

Also, my PF wasn't tested on this occasion but I did once go to OOH as the reliever didn't seem to be working after I'd had loads and OOH dr said my airflow was good and I was fine - did wonder if the reliever had been doing something...

Maybe worth ringing the AUK nurses for a chat if you have time next week? I've found them very good generally.


I'm from the 'my PF rarely drops' club too!!! I've never had a medical person see me when having bad symptoms, well they did but I'd had 6 puffs of ventolin not long before and so my symptoms had temporarily gone. I did speak to NHS direct though, and he said I should go to OOH because I 'sounded' like I was having an asthma attack (and I don't wheeze, he said he could just hear it!!) but on that occasion, my PF hadn't dropped significantly. So I think it's perfectly possible to have symptoms without dropping PF, and I personally would've said it'd be silly to not take your reliever, what would happen if you didn't, then a while later you fell into big difficulties because you'd taken a turn for the worst? The benefit of taking it, far outweighs the risk of side effect etc. If nothing else, if it takes away your symptoms its worth taking it!

Hope the pred helps and you get to see a specialist soon and get some answers and get your lungs to behave! xxx


I have had similar problems, in that my PF only drops a small amount even when my symptoms are at the point of affecting my talking and walking. I can have minor symptoms without any drop at all, and I know that if my PF drops by about 60 I need to see a doctor although my ""official"" plan says a bit lower than that.


Thank you for all your replies! Its reassuring to know that other people have had similar experiences to myself and makes feel like Im not going crazy when I actually feel like I cant breathe but my pf tells me something different. Am going to discuss all of this when I get my appoint,just hoping this comes soons! xx


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