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Peak flow readings

I swear I've asked this before but I went looking for it and can't find the post or the answer so asking again...

Cons wants me to monitor PFs till I see him again in 6 weeks, in the hope that they might tell him something about what my asthma is doing. (Objectively that is - I can tell him otherwise!). He wants morning and evening before inhalers and any time it really feels like it's going down the tube.

This is all fine, and the morning one is no problem (though it does vary in time as I don't get up at the same time every day). It's the evening one - my asthma tends to kick off in the evening, so I can't do it last thing because by the time I go to bed I've generally had several puffs of reliever. So thinking early evening, maybe 6 or 7, but depending on the day quite often that's also not so long after an inhaler dose. Since starting doing the readings, even with asthma not so bad for me, I've often found myself really wanting my inhaler(s) but hanging on till early evening - which is not pleasant and I can't believe he meant me to do that. Plus I may well not be at home in the early evening.

Any ideas? Should I try to pick on a time and more or less stick to it and make a note that I've had inhalers? Take PF meter out with me? I have a feeling this shouldn't be that hard but I can't seem to get a clear time without inhaler use except when i wake up (and even that wouldn't always be except I'm never awake enough to take my inhaler even if I get SOB at night).

16 Replies

I would take it just before your bedtime medication or just as your going to bed as 6-7 indicates a tea time reading .....


random suggestion and probably a silly idea - but recently i took hourly PEF readings noting if i then took doses of inhaler. it was interesting to note the fluctuations. this is not what your Cons wants but it was a good way of working out which were my best and worst times of the day. i would suggest that you give him a range of readings and yes note when you felt the need to take your inhaler and what your PEF was at that time, as well as others when your lungs feel ok. its not indicative of your wellbeing or not if you only give him ""good"" readings. also he wouldnt want you to withhold medication use if your lungs need it... the objective isnt to make you worse. i suppose you could ring him and ask him to clarify what times he suggests? hope it goes ok and that you dont feel too much worse. xx ><>


Thanks both of you!

Gussypoo, that probably is too early...just thought that way I could avoid taking it just after inhaler, but a bit later, around 8, might work. But then I will have taken inhaler...arrgghh. Maybe just before bed and my nightly fortification with blue and green is the way forward after all.

Spiritedstream, not a silly idea at all re hourly readings but don't know if I will manage it! I think cons wants the 'bare' readings ie those where medication is not interfering with the readings, so basically the worst ones - I just have trouble finding any time remotely close to evening when I haven't been puffing away on my inhalers. Think I'll just have to take them last thing and note inhaler use. I feel like a drug addict the amount I take in one day - it didn't register with me quite how much I was taking before, but have had a 'good' patch recently which translates to about 3 lots of reliever use a day instead of about 6+ sets of both when feeling worse. But sure many on here are on more with nebs etc.


Know what you mean about taking loads of reliever Philomela. I can't believe the lengths of time I have been recently without taking it at all as I went such a long time using it several times a day - up to every two hours whilst awake, with a night awakening requiring multiple puffs to get back to sleep.

I think trying to take the reading just before last set of inhalers before bed is probably best and just making a note of what you had had during the evening. I tend to find even if feeling worse in the evening, my morning reading will be considerably lower whatever inhalers I have had.


Philomela, I try and take my evening PF and meds aprox 12 hrs after the morning dose, so that is between 7 and 8 morning and night, it tends to even out the meds better and reduce the drop but like you my evening pf seems to be the one that dips at the moment, I thik it's the cold air simply drying and/or irritating the lungs.


Another question

Thanks woody-som!

Another question - reading your post this has only just occurred to me.

Does the time you take preventer inhalers make a difference? I would have thought they'd make a difference long-term to PF but on a day-to-day basis? I always try to take PF readings before I have them in the morning/evening but just wondering as I'm on Intal 4x a day and have the 3rd dose around 7, wondering if that throws things out.

PF readings are actually pretty high atm - I can't work out why! Lungs are a little better behaved than a few weeks ago. It's a pretty small difference (means a couple fewer puffs of reliever a day and able to do a bit more) but wondering if it's down to finally having an Intal inhaler that isn't clogged - I didn't think it was making a difference but realise I was probably getting much less than I should for quite a while. Maybe it does work after all!


I think if your preventer is a combined LABA and steroid then it makes a difference what times you take it and is best to take it 12 hours apart to get the best coverage from the LABA. If it's just a steroid preventer I don't think it would make any difference.


Thanks spookymilo - it's neither! My lungs are snobs and have turned their noses up at 'ordinary' steroids and LABAs, so I'm on Intal which is neither, and which i have to take 4 times a day because it doesn't last as long (which may answer my question).

Just took PF before and about 15 mins after (without any relievers) and can't see much of a difference so maybe it is ok. I'll try it again tomorrow morning just in case.

urgghh there are worse things to asthma but this is annoying - my diary is going to be all over the place at this rate, he'll never manage to extract any useful info other than that I take my relievers a lot!


I was told to do mine when I get up before any meds and then about 6 or 7pm so approx 12 hours gap. I also had a fair amount of ventolin and atrovent 3 or 4 times a day. Did wonder why had I bothered for 3 months as he paid little attention to classic morning dip and later claimed it was in the evening but couldn't find it again in my notes.

Anyway, hope it comes out with some useful info.


Thanks TJ - that's a good time for me to do it plus more consistent. Will try to stick to that.

Ugghh 3 months, I hate doing it only for 6 weeks but he's trying to find some 'objective' way of working out what my asthma is up to which I know is needed. I don't think the PF is going to tell him though. This might sound funny but a consistent wheeze when things are heating up would be so helpful - it doesn't seem to mean being more severe necessarily but it would be a nice handy way of them telling and I wouldn't have to worry about the usual 'you must be fine' from some drs.

Plus I'm lazy lol and it might have saved me all this to-ing and fro-ing with the PF. Assessing a wheeze would be a lot quicker and less effort on my part, providing they're not into asking for contorted mouth-breathing. ;)


Philomela, perhaps he's interested in looking at the diurnal variation (the difference between morning and evening peak flow readings), and seeing if readings twelve hours apart can be used as an objective measure.



Thanks Ginny - this looks great. Though I have just noticed it's not available for Macs, grrr. Maybe I'll email them and say Apple freaks have asthma too!

I am using the AsthmaMD app to track atm - the PF chart is a little confusing, but the symptom thing is good.

I think you're absolutely right about him wanting to see the diurnal variation - I just don't know if there is any! Hence this thread as it's been so difficult identifying the right time, but I'll try early evening for now or about 12 hrs after morning - that might help as i get up at different times. The reliever's been the biggest hurdle, though noting how long it lasts and how much of an effect it has is how I keep track of things personally, so I might try and see if I can chart that.


philomela, the asthma assistant app is old and I think I was the first on the forums to find and start using it. It's brilliant but no longer supported by the developer. I assume it would run on a Mac under a virtual windows environment, I know it will run in Linux in a virtual environment.

Others have already answered the question about taking the meds 12 hrs apart, yes I think it's a good idea to try and get all the preventers around that time, althoough few hours later is the top end I think.


Hmm, don't know if I can do that...might need Boot Camp. I'll stick with AsthmaMD for the moment as I've started with it.

I take preventers last thing - well my 4th dose of Intal plus montelukast and lots of reliever. I shouldn't think the Intal makes a difference here but the rest helps with sleep - the montelukast in particular seems to help as I really notice if I forget.


an old app that appeared in the asthma UK magazine few years back has a website to view the charts is here


think I recall you have to contact them to request a code to register but it's all free.


Thanks Woody-Som! Will get in touch with them - technology is amazing as the paper chart just doesn't work for me especially as my handwriting is appalling.


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