Totally confused

I don't know if anyone can explain this for me. I just took my peak flow (standing up and on old scale) and reached 600! My previous best is 570 and my predicted is 470. All sounds good but after blowing 600 my chest felt tight almost imediately, got quite tight (for me) too.

How come i managed to blow so high? Could it be cuz i've just started a new inhaler (symbicort 400/12 - only taken 2 doses so far)? And why did my chest go tight so quickly?

A lot of questions i know but i'm a totally confused by it :o/


11 Replies

  • Don't know why you're blowing higher now, could be the Symbicort, but getting tight after doing a peak flow is not unusual.

    Basically if your airways are sensitive, air rushing through them rapidly will cause them to reflexly tighten. That's why hyperventilating (like in a panic attack) can cause an asthma attack, and why peak flows do.

    When I go for spirometry I always find that my first reading is by far the best one, cos after that my chest just tightens. I also find that sneezing violently causes me to get instantly tight chested for the same reason - anyone else noticed that?

    When I was a Med Student we had to demonstrate getting a patient to do a peak flow for an exam (hmmmm, I really struggled with that one!) and they had to get a non-asthmatic patient to do it as an asthmatic would probably be suffering quite a lot after 50 students!

    As to what you can do about it - not a lot except to have a few puffs of salbutamol afterwards. Hopefully as your Symbicort kicks in and you stablize, you should find that your airways are less irritable and you're less affected by doing peak flows. For me, it's quite a useful early warning system - even when my peak flow is reasonable, I know I'm heading for a bad patch if the post-peak flow wheeziness is worse - just means the airways are that bit more sensitive!

    Hope the Symbicort works for you

    Emily H

  • Thanks emily, that has really helped :o)

    I remember when i was in the 6th form doing a GNVQ in science there was a unit of work which involved us taking peak flows, being the only asthmatic in the class i showed them how to actually take a peak flow properly lol

    I hope the symbicort works. I was on it until the start of the year, then started having problems, tried seretide then beclometasone with severent now back to symbicort but on max dose, ho hum, all good fun (apparently lol)

    Thanks again


  • Moose, it was a joke that after my post PF's at RBH I needed another neb to get over them! If you really do them well you will end up coughing and probably tight. I found it was just temporary. I did once do a spiro that left me seeing stars literally I put so much effort into it.

    I am still amazed how many people do PF's wrong, thinking that they need to blow long and hard rather than one short sharp hard blow or simply not really putting enough effort into it. I used to wonder at the Debbie at RBH insisting that a nurse watched all PF's now I know why, so many people have been badly taught. Even simply things like standing up can make a difference. I have been teaching my son how to do them correctly and we have started with just gentle short sharp blow to get the technique right before working that up into a big one that will blow someone off a cliff!

    I once blew 550 so when people ask what my all time best that is what i say, good for me is around the 450 and I accept that as my average PF. Yes it is possible to randommly suddenly do an amazing PF if everything is going right, technique, lungs being good, etc etc.


  • I got a piko electronic meter - and if u don't blow for long enough.......

    it tells u off!

  • Snap Shadowcat lol

    My Piko likes telling me it in the red zone though lol

  • Piko's as I understrand it require a different technique to the standard PF meter.


  • Yes, I only used a Piko once but don't you have to do sort of a cross between the 'short sharp' blow that you'd do on a normal peak flow meter and the longer blow that you do for spirometry, so it can get the FEV1 as well?

    I seem to remember I wasn't very good at it!

  • I can't get my head around the old FEV1's I don't know what is good or what is bad! RBH seem quite happy with me just doing standard PF's so I see no point in changing.


  • FEV1

    If you do want to find out what your predicted FEV1 is, go to and scroll down to the table at the bottom, put the values in that you're getting and it will give you your percentage of predicted. If your meter doesn't give you a value for FVC just make one up that's roughly 3 and larger than the FEV1, it won't affect your predicted FEV1.

    I agree though, I'm not sure it adds much for most people, maybe if you're one of these people who can be quite unwell with a decent peak flow it might help, I don't know.

  • Wow with the beneift of having done enough spiro to sink a battleship over the past couple of weeks I can remember roughly what my FEV1 and FEC's were at best within a point or 2 they come out as low even when using the best ones.


  • hello,

    When I did peakflows (don't do them anymore due to muscle dysfunction) I got a faulty peakflow. When I blew it would flick up, the spring had broke or something as for a while I got PFs of 650, which for my height (I'd of been about 12) was alot higher than the expected plus the state my lungs were in there was no way my PF was 650. I then took it to my resp nurse and she saw it happen and determined the spring was faulty. My average peakflow was about 260 my expected for my height at that time was 400. As for technique mine is very poor now due to the dysfunction I can blow 200 then 300 as the amount of air I can get in on a breath varies so my dr decided there was no point doing them as they don't give an accurate picture for me.

    Emily - sneezing and then feeling tight I get it almost everytime I sneeze or laugh for that matter too!

    tks xxxxxxxx

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