Worried and any advice welcome!


When they first diagnosed my asthma, my peak flow was 480, supposed to be 500+ The last few times I've been down to 360-380. How low can it go and be safe?

I'm on clenil modulite 200 2 puffs twice a day, and ventolin when needed.

I'm feeling tired a lot but chest doesn't feel tight or anything. Even when I wake up i feel tired.

What step am i at? I'm new to all this

Any reply would be welcome!

6 Replies

  • HI,

    When I was diagnosed I had PF readings of 280, may have been lower at some point and looking at your profile, were the same age so don't worry in that respect, all I had was ventolin back then, and still cycled over 100 miles one day. Do you have an action plan, when peakflows fall below 80% of predicted or personal best you generally double the clenil in your case, and somewhere around 70% of your best/predicted you really should see the doctor at that point, but if you record peakflows of 50% or lower, then hike yourself to A&E not usually a good sign.

    The tiredness could be a number of things, not asthma related, but high dose inhaled steroids (and you're on a low dose) can cause adrenal suppression and one of the symptoms is tiredness, but best have a chat to your GP.

    Regarding what step you're at, well treatment wise step 2, but really depends on what the peakflow/fev1 was at point of diagnosis and/or how often you had symptoms.

  • Thanks!

    Thanks! I've not got a peak flow meter at home. Work in GP surgery so used a peak flow meter at work to see if different when been to my gp. At GP surgery weather was v v cold so put it down to that. I've been told in 3 weeks to drop to one puff twice a day! Beginning to realise this is a bit scary. Not sure when to get help for me though at work book anybody in whose struggling! :)

  • Hi I would continue witht he meds and follow the instructions from doctor. When I was put on the brown inhaler years ago know I remember my peak-flow dropping but the cold weather is always a biggy with a dropped peak-flow. The cold aspeats asthma in so many people with asthma so keep yourself warm and well wrapped up and hopefully the asthma shoudl become controlled and managed. Good luck and I hope the asthma starts to imporve soon and once controlled stays controlled for a long time

  • I definitely support the Action Plan. I did not have one for the first couple of years after being diagnosed and used to worry about what I should be doing at different points. Because it is never easy seeing a particular GP at my practice at short notice, I would also worry about having to see someone that I disagreed with (including one ""no wheeze - no asthma"" GP!!!).

    Having an Action Plan completely changed all that. It put control with me. I had the guidance I needed -the answers to the questions you are asking now. It gave me authority. Nowadays, I email my GP to tell him that I am doing a particular thing, not to ask what I should be doing. It's in the plan. It also means I can start additional action much quicker and, hopefully, more effectively than having to wait for an appointment. I can be over half way into a new course of preds in the time that it took me to wait for an appointment previously, and that usually means avoiding the dangers of lowest of the PF dips.

    Thoroughly recommended.


  • AJBlackswan, I'd question the stepping down of your steroid inhaler, you certainly don't sound in a position to be doing that and what AlanJ has said about an action plan, they are certainly the way to go as you'd know to actually increase the dose to prevent further deterioration in symptoms.

    The cold weather can and does play a part for many, and has knocked me big time and I've been on double steroid dose for ages and holding steady, but slightly getting worse but nothing to worry about (yet), but if you had an action plan it will give you the confidence to react to symptoms.


  • Update!

    Well I managed to calm my lungs down and then I dropped my brown inhaler down. Things not superb and used blue more! Then the nasty cold snap arrived. After a few days struggling and being shaky I went to my asthma nurse! I'm back up to 2 puffs of clenil twice a day. If I get worse, double those up, which is safe. If I'm still using blue a lot, go back because my preventer is low and my need changing. Once I've not used my blue inhaler, in back to one a day. Feel a lot happier and that I know what I'm doing and what I can do if it get worse!

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