Poorly controlled Asthma?

Thanks in advance for any advice / help :)

41-year-old male who was has had Asthma since birth. For the most part, lead a perfectly 'normal' life, apart from occasions where Asthma flare-ups (combined with hayfever) slowed me down. More than my fair share of chest infections etc and didn't help that I smoked for 13 years (stopped 5 years ago).

I live in Saudi Arabia, so the air isn't that good, but recently I have had this feeling of chest pressure and the urge to use my blue ventolin more. This feeling has been with me for a few weeks now, and as a result, I am experiencing anxious feelings that things are getting worse. I haven't actually used the ventolin as much as perhaps I have wanted to because I wanted to see what difference my peak flows would be without the ventolin.

In the morning, at about 7.30 am, my peak flow is between 620 and 650 (roughly). It stays that way most of the day, and then drops to about 550 after a meal (about 4pm ish). It tends to stay at this level until the next morning when it circles back round to 620 - 650. I know you shouldn't really record a peak flow after a big meal, but I have noticed that whether I record the peak flow directly after the meal or later that evening, the results are similar. Sometimes, the peak flow in the evening can get back up to over 600. It depends. However, I don't tend to get any readings much lower than that.

The last time I went to the doctor, I was told that I had sinusitis and that seems to have gotten to the point now where breathing through my nose is 'laboured'. My sense of smell has also deteriorated.

So, do you guys think that my fluctuating peak flows are enough to highlight that my Asthma is not well controlled? I would expect far lower peak flows if the Asthma was 'out of control', I guess, but perhaps this 'small' variation is enough for me to feel worse.

No wheezing. No coughing. No sputum. Just this feeling of tightness on the chest.

Thanks again :)

2 Replies

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  • Hi. My daughter is 28, has severe asthma, bronchiectasis, chronic rhinosinusitis and allergies. Peak flow today - 270, slightly lower than normal but has 'grumpy lungs' because of changing weather. You mentioned not using your ventolin as much - this will have an effect. And becoming anxious, which can also affect symptoms. Should speak to your doctor if concerned. I would say that 550 - 650 is impressive though.

  • Some times it comes on as tightness other times wheezing sometimes both. If plain old albuterol (salbutamol aka Ventolin) relieves it within 15 minutes then it's probably asthma. Try some of the breathing exercises. In my opinion you should not hold back ventolin you should take it and relieve before it aggravates itself. My guiding light for 40 years has been you need to get it under control with your preventer medication to less than 3 ventolin a week. Really worked for me for a long time. They also say that nasal/sinus issues migrate down to asthma so stay in front of that - my medication of choice is phenylephrine combined with ibuprofen. Consider Qnasl if more severe. I'm personally not a huge fan of peak flows I've blown 750 when i know I am wheezing. Maybe for some where it's more subtle or to flag you that you are having a big drop without realizing it, but day to day I'm not sure.

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