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Low peak flow

I am being treated as if I have asthma since I developed a cough at the end of July 2018. I have had 2 lots of steroids and I'm now on fostair inhaler that has stabilised things. I have a peak flow meter and am taking a reading 2x a day. When I started taking readings I was at 240, my lowest was 90 (when I needed nebulising) and I have now plateaued at 300. I understand that average peak flow for someone my age and height is 450. I'm feeling ok and not struggling with breathing but i'm worried that PF is still so low. I have no real baseline to know what my best is as I never took PF reading before I became unwell. Am I right to be concerned?

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Hi Mas1

If you’re feeling completely asymptomatic then don’t worry about it. Everyone’s best is different and the national average is just that - an average! I’m at the opposite end where my expected is about 440 (I think) but my best is 630 despite being a severe asthmatic- I have friends my age, gender and height who max out at 350 with no respiratory condition at all!

A lot of factors affect PF - time of day, technique, history of endurance/ high level sports, singing or playing wind instruments, chest size/shape, gender, age, weight, standing vs sitting etc etc etc, so it really is individual.

For example I was a national level gymnast at one point (hence it being so high) but I vary from 550-630 throughout the day even when I’m stable and asymptomatic, and the lowest I’ve ever dropped to is 170 (I think) when I was almost intubated. I will ‘gain’ 50 on my PF if I stand up vs sitting down. I know people whose PF improved after taking up singing (hence why singing groups are encouraged in the respiratory disease community).

You may find that you ‘best’ slowly increases as your technique improves. For me my ‘best’ was 550 after hitting that after an a&e trip, however as my technique and general asthma control improved so did my PF. I just tried to make sure I sought help when I felt bad - your PF reading is just 1 indication of an issue, and not the be all and end all! If you’re having symptoms, seek help and advice, if not use that as you ‘max’ until you hit a higher one (if you ever do).

Hope that helps with your worries and I’m glad things seem to be working for you. If you’re really worried about it try speaking to you GP, practice asthma nurse or the asthma UK hotline - someone will have any and all info/help/support you need! Any more questions feel free to fire away!

Emma

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Great reply Emma x

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Thanks for the advice Emma. I don’t feel any symptoms that i’m concerned about except my voice is quite hoarse. I am a keen cyclist and was pretty fit until the asthma started. I guess that’s why i’m surprised that my PF is relatively low. I went out for my first cycle ride in a month this weekend and found it tough but that’s as a result of losing fitness I suppose. I was completely focussed on my breathing, breathing very hard but not actually struggling to breathe. I am due back to the nurse for a check up so will discuss PF with her.

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Your welcome. The hoarse voice could be a side effect from the fostair, so worth mentioning esp if you ‘rinse and spit’ after using inhalers (unless this is a new thing and you’re getting ill 😕).

Glad you were able to successfully go cycling again! As you probs realised you may have to reduce ‘difficulty’ and build it back up again! Then hopefully you’ll be able to focus on the ride, not your lungs!

Yes it’s ‘unusual’ for a cyclist to have a low best PF, however as I said everyones different so who knows? Maybe it depends on how long you’ve cycled for, or how much you ‘push’ yourself when you ride (ie is it relaxed and casual or fast and competitive?) 🤷‍♀️. Bring it up with the nurse and see what she says!

Hope things go well for you

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I do rinse after using the inhaler, as advised by the nurse. The hoarse voice started when I started the inhalers. The nurse said it would reduce with time and it is slowly improving. I've cycled for a couple of years and I do push myself to go further, faster and steeper. Will take a bit of time to get back to my best, i'm guessing, especially as winter sets in. Thanks once again for the advice.

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