can peak flow best change over time?

Hello again!

So for the last month or so my peak flow has been always in the yellow zone and usually at the bottom end of that. Also often in the red zone. But ive rarepy jad my life threatening symptoms more just the annoying type of being permanentpy tight chested and getting sob or wheezy easier than usual.

So I dont consider the readings to be reflecting thw truth of the level of help or meds i would need at that time.

So does anyone know if peak flpw personal best and therefore zones can change up or down over time? Will be talking to my gp about this on monday anyway. My lung cons thought i could be getting unreliable peak flpw due to reflux and/or VCD.

Anyone had this happen?

Thanks.

Rose xx

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  • i dont KNOW, but i know that for things like freeing me from costa my consultant uses my 'current best' which is the best ive got in the last year. but i think it can be a bit of a judgement call. i can have really low peak flows and my cons will let me go as i 'look too healthy to be in hospital' so i guess they can just go lower without it being too much to worry about.

    i always say that if your PF is high and you have symptoms you should ignore the PF, so surely if you dont have symptoms you can also ignore the PF! just what i would suspect but im sure your doc will know much more than me!

  • I wonder if it might be that you are getting better at coping with whatever that lower peak flow represents?

    A few weeks ago my peak flow was going from 430-460. When peak flow dipped below 400 I couldn't really do much more than just lie still and concentrate on breathing. But right now I can do a lot more at the same peak flow and mostly I feel as you say annoying symptoms - SOB, irritated lungs (slight burny feeling), tired muscles.

    If people accommodate to high altitude, maybe they can also accommodate to things like lowered FEV1? And that in turn makes the same PF less of a danger point?

    All the same, if the numbers are down close to the red zone, I would discuss it with your doctor, just to get a more experienced opinion from someone who knows you. If your doctor is also comfortable with the idea that this peak flow range is not a danger signal, then the action plan should probably be adjusted to reflect that. I think one of the reasons for action plans having hard numbers is to help us keep from rationalizing things away when we're under stress.

    Also, I think sometimes we can underestimate things once they feel like a new norm when in fact we are sicker than we really need to tolerate. If I hadn't actually seen those few days with the 430-460, I'd never believe I could blow a peak flow that high. Right now my best of three tends to be more between 380-420. I occasionally get to 440, but I haven't blown above 440 since the beginning of January.

    However, to say that this is the new normal would also mean saying that my body isn't capable of anything better than nearly constant symptoms. What has not changed is where symptoms start appearing. When peak flow is below 420, I'm experiencing mild asthma symptoms on a pretty continuous basis. When my peak flow was in the 430-460 range symptoms were non-existent or occasional and sometimes when I breathed it actually felt like breathing gave energy rather than having a sort of effort ""tax"".

  • Thanks peeps.

    Yes my doc is always telling me i look fine even on days i think are quite bad. Weird? I think he might just be trying to encourage me pr something...

    Beth I think paet ofthe probpem is that i have become used to bad breathing. Ive had a lung failure/copd label for 3 years but ot doesnt apways bother me. Maybe im a freak of nature lol. Will see what my doc says and post back (maybe thers wpuld find it useful?)

    Rose xx

  • This is an interesting question, as I think when feeling well, my best is much lower than it was too. On a similar note, I'm going through this rough patch at the minute and have been checking pf when feeling bad before taking Ventolin, when I feel better I stop having any more, whether it be 2 puffs or 8 puffs. One thing I haven't checked is what my pf is after the Ventolin has taken effect. So yesterday I tried this, pf before 370, 4 puffs , pf after 450, about a 20% increase but still below my 570 best. So my question is, hoe much improvement should Ventolin give, ie is 20% acceptable? And should it improve enough to give your best pf?

  • So does anyone know if peak flpw personal best and therefore zones can change up or down over time? Will be talking to my gp about this on monday anyway.

    I was told by Consultant that PF best relates to best in previous 12 months. So if your previous best PF hasnt been acheivable in the last 12 months then yes it will have changed. My best PF used to be 360 but its now 320 as this is the best I have got in last 12 months - and thats rare as hens teeth lol

    Lynda :)

  • My theoretical best is 400 but i dont remember the last time i got more than 300 and thats amazing enough. Wich is why im theoreticall permanently in my yellow zone so i suppose i need to get it changed.

    Thanks everyone

    Butterfly i dont think vento has to apways get you back to absolute hest but dont really know tbh.

    Rose xx

  • My best peak flow has changed over the years, and therefore my red, yellow and green zones. Of the doctors I've seen some go by last year some 2 years. There's still one GP at my surgery who goes off my predicted (440) rather than best (520), grrr. Last time I saw her even though my pf was 52%/270 she wasn't forthcoming with a prescription for steroids, I had to ask and even then she said ""if there's no improvement in 2 days time then you can take them""! Suffice to say I took them almost straight away and have not seen her since lol.

    I've also been told that I look fine, but they often change thier mind when they listen to my chest and do a pf. I also think Rose that you can become used to bad breathing or a low pf.

    Beth- I climb mountains and go to altitudes (4000/4500m) where I have to acclimatise to the lack of oxygen, with my body making extra red blood cells to more easiely absorb and transport oxygen around the body. I've also wondered if this is something my body does when I have an exacerbation, but not really talked about it with a healthcare professional to ask their opinion.

    Butterfly- 20% sounds like a good response to ventolin. In my experience, ventolin does not resolve all airway restrictions and take me up to pb pf. If my pf drops quickly then ventolin will raise it fairly quickly, but if pf is dropping slowly then ventolin has less of an effect for me and I need to take a lot more of it to have a positive effect, but I think this is down to the fact that the restrictions are caused more by inflamation which needs steroids to improve rather than airway muscles for which ventloin is good.

  • Butterfly- 20% sounds like a good response to ventolin. In my experience, ventolin does not resolve all airway restrictions and take me up to pb pf. If my pf drops quickly then ventolin will raise it fairly quickly, but if pf is dropping slowly then ventolin has less of an effect for me and I need to take a lot more of it to have a positive effect, but I think this is down to the fact that the restrictions are caused more by inflammation which needs steroids to improve rather than airway muscles for which ventloin is good.

    Like you, if I have a sudden flare-up the ventolin helps a lot more than if peak flow drops slowing over the course of a week.

    Another pattern: the improvement due to ventolin seems to go only up to the ""best for this exacerbation"". For example, when I'd been blowing 450/460 and then had a sudden flare-up, if peak flow pre-ventolin was 400, then post might be 440/450 (10%). But if PF before ventolin was already 440, then it would only go up to 450/460.

    But right now where I can't seem to get PF above 420 with any consistency, it tops out at 420. When I woke last night the peak flow jumped from 350 pre-ventolin to 420 post-ventolin. (70/350=20%). But when it is already up at 390/400, then ventolin still only gets it up to 420.

    I suppose the gap between 420 and 460 is the component due to inflammation?

  • Like you, if I have a sudden flare-up the ventolin helps a lot more than if peak flow drops slowing over the course of a week.

    Another pattern: the improvement due to ventolin seems to go only up to the ""best for this exacerbation"". For example, when I'd been blowing 450/460 and then had a sudden flare-up, if peak flow pre-ventolin was 400, then post might be 440/450 (10%). But if PF before ventolin was already 440, then it would only go up to 450/460.

    But right now where I can't seem to get PF above 420 with any consistency, it tops out at 420. When I woke last night the peak flow jumped from 350 pre-ventolin to 420 post-ventolin. (70/350=20%). But when it is already up at 390/400, then ventolin still only gets it up to 420.

    I suppose the gap between 420 and 460 is the component due to inflammation?

    Ah yes, this would describe what I am finding. It would make sense that the gap between the ventolin improved value and the very personal best is down to inflamation due to the flare up.

  • Stray I dont know what my fev1 is as I dont have a piko and my cons keeps saying it would be pointless? I think maybe she means she knows its rubbish so disnt need spiro to confirm it lol? ;-)

    thanks forthe interesting and useful input everybody! My appt woth gp tomorrow is supposed to be just re reflux but i have so much to discuss. Am gonna male a list! :-P

    Rose xx

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