Sorry me again peak flow on 43inch child - Asthma UK communi...

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Sorry me again peak flow on 43inch child

Skzittles profile image

I'm new to this and told to write down morning and nights best of 3... we couldn't get the peak flow meter for 2 days and the difference the inhalers made in that time symptom wise in terms of cough and mucus is amazing almost like a switch slight cough on exercise and if stressed or its cold outside which after 2 years of persistent cough and being told over phone tonsils I feel we are getting somewhere ... anyway peak flow first one I did with youngest is last night I got 125 125 145

This morning I got 110 110 125

I've looked up and I think peak flow for is is 147 but if that's wrong and someone knows before I speak to nurse again pls let me know thank you... what am I looking for when do I need to act I haven't been given a plan yet as it's provisional diagnosis based on symptoms now I'm reading up

I'm peak flowing before inhaler is this correct... should I do it afterwards too? Thanks any advice on this massively helpful anyone know if a decent app can track all this if I input the data found one but I can't add age and height etc x

19 Replies

Hi Skzittles,I can only speak from personal experience and I didn’t have asthma as a child, so I’m not sure how much use I can be to you, but I can certainly try.

When I was first diagnosed I was asked to take my peak flow 4 x per day.

In the morning before and after inhalers and the same at night. Some say leave 20 mins between but I found I got my best results about an hour after.

The point of this is it gives an indication of how you are without inhalers and the difference they make.

It is your after inhalers which to me is the most important and later on, it will be this measure that the clinicians will use to measure your little ones progress.

The 147 you mention, is that the predicted peak flow for your little one?

Predicted peak flows are very useful or at least I think so, although that seems to be a controversial statement😁Some say that predicted measures are out of date, that people can naturally have lower peak flows or high than predicted; all of which is perfectly true, but they are useful as a guide while you get to grips with things and get a better understanding of how your own, or in this case, your child’s asthma behaves.

When I first started out my peak flow was well below my predicted, but gradually increased over several months until it ended up above predicted.

When things have settled and the meds are working to full effect, as the asthma nurse for an action plan. This will give you steps to follow based on your child’s peak flow.

For now, I would work on symptoms- have I said this before? I have a feeling of deja vu as I write this 😁

Look out for your little one getting more breathless than usual as she goes about her normal activities, wheeze, fatigue,cough, night time wakening etc

It does take some time for the preventer inhaler to take full effect; the “official” timescale is somewhere between 6-8 weeks. (I started Fostair (preventer) in March and hit my personal best in June.)

Your daughter? is doing very well so far, and is having a good response to her inhalers, so I would guess that will continue.

If you haven’t already got one, I would get a spacer with a face mask. In the event of your little one having an attack or experiencing worrying shortness of breath, this is the easiest way to administer the blue inhaler. You would just press it to her face, activate the inhaler, and she would just breath “normally” through the face mask.

In an adult, they say 10 in the event of an attack, although I think I have had more than that. You might want to check that for a child.

If she does have a full blown attack that would be the way to settle it down, but you would need to seek medical advice afterwards.

I think the biggest message I can give as a final statement is, she will be ok😁

Just edited to add that when your child uses the blue inhaler, make a note of when and how much.

Skzittles profile image
Skzittles in reply to Troilus

Brilliant thank you I really appreciate you taking the time to help with my questions I don't know if that's her flow rate but I've calculated it on a online site probably jumping ahead of myself as trying to learn x thanks again

Troilus profile image
Troilus in reply to Skzittles

I’m pleased that you found some of that useful. I did exactly like you when I was first diagnosed. I am one of those people where the more I know the better. Unfortunately the medical professionals I meet don’t seem to understand that need for information!It was quite a while after my diagnosis that I came across predicted peak flows. I think that was a good thing for me. Once I had started on inhalers my peak flow was around 200. It was gradually going up which I was pleased about, maybe even happy 😁 I thought I was ok. It was later when I found out my predicted was 370. If I’d known that in the beginning, I think it might have caused me some concern.

Skzittles profile image
Skzittles in reply to Troilus

Yes this is why I'm here I'm reading but not sure exactly my oldest is 18 now and has complex condition reg blind .. I've always found these things easier to take head on with as much info as I can find but know u can't beat experience and I'm sure this forum will be an absolute life saver... no ones told me that's the peak for my child I've googled again lol ... I've got these stats so far not sure if good or bad but we only got given the peak flow meter 2 days into inhalers and honestly by day two it's like I've got a different child! Still getting the cough but I can see now the triggers (cold getting upset and walking the 3 flights of stairs up to our flat I feel bad for not getting this diagnosed sooner but equally been fobbed off on phone entire pandemic with antibiotics and tonsillitis assumptions do these look normal the dips in morning or what should I be watching for ... those are best of 3 figures 125 is often the other two numbers when I get the higher ones if that means anything... also blowing into it can also trigger a cough sorry loads. And prob rambling x

Peak flow stats last couple of days
Skzittles profile image
Skzittles in reply to Skzittles

Also the 155 was taken post blue inhaler as she wanted to peak flow nurse has told me just do morning and night tho

Troilus profile image
Troilus in reply to Skzittles

Hi Skzittles,I have found this which you might find handy

reference.medscape.com/calc...

but it comes with a bit of a warning. If your child has had undiagnosed asthma for a while, which it sounds like she has, then it might take sometime for her? to reach those levels.

Asthma can cause inflammation of the airways, which is basically a bit of swelling. This swelling reduces the speed/force of the air that we exhale. Put simply our airways are drama queens😁 Our systems respond to harmless substances as if they are likely to cause imminent harm. Our immune systems have a dramatic response, causing inflammation. We also produce mucus to package up and evict these harmless invaders.

However, your child is now on medication to reduce the swelling, open the airways and ,as you have already noticed, reduce mucus production.

Hitting her personal best and reaching predicted values will happen a bit later down the line.

Also, she is very new to taking inhalers and peak flow readings. I found this

youtube.com/watch?v=055fSYX...

which I thought might be helpful. You will also find vids on how to use an inhaler on the main asthma U.K. website. There are various techniques shown there. I would choose the one that best suits your child.

Is your child school age? If so, I would get your GP to prescribe another blue inhaler that she can keep at school(or permanently with her school things, depending on her age. Also make sure they know her triggers. If cough is one of them, many teachers do not recognise this as a symptom of asthma.

Another thing worth mentioning, I think, is getting into the routine -for now- of using the blue inhaler when you know she is going to come into contact with a known trigger - for example the stairs up to your flat.

Does this chart help? researchgate.net/figure/pea...

Skzittles profile image
Skzittles in reply to hilary39

Thank you so much yes massively the highest she's blown on peak is 155 so far and lowest is 105 but on best of 3 she came up to 125 x thanks again for that so still off where we need to be?

Peak flow results
hilary39 profile image
hilary39 in reply to Skzittles

Does her device have color coding for green yellow red zones?

Apart from medication, general fitness can effect peakflow as can being a singer or playing a wind instrument. Predicted peakflow is for the average person of a particular age but everyone has their own "normal" or best which you only find over time.

Skzittles profile image
Skzittles in reply to Gareth57

Brilliant thank you

I cant really add to your replies above however, this may be useful for the future ( & I stress for the future when you and your child have got used to inhalers and peak flows) ..... my granddaughter has been asthmatic since tiny and had the soft little silicone mask attached to her spacer which was so helpful then. She progressed to just using her spacer with her twice daily inhalations of ventolin and beige preventer. It was explained to my daughter that the peak flow was a very useful tool to predict if something's amiss (ie a brewing chest infection or a bug) if it drops below the child's normal. Another useful tip was to wait 30 seconds before depressing the inhalers to allow the medication to drop through the propellant.

May I commend you on searching for information to understanding asthma to help your child, knowledge is the key 😃

Skzittles profile image
Skzittles in reply to peege

Thank you we have the spacer they're brilliant we are making it a bit of a game now so she's not too reluctant was,scared of the sound at first of the pump (also dental phobic) similar mask we are getting there thanks so much for help

It's great that your daughters symptoms are finally improving. You are doing the right thing doing the peak flow before her inhaler morning and evening. Try and keep the times the same as peak flow varies during the day (usually lower in morning but not always). You can also get her to do her peak flow before she needs her blue inhaler and then again about 15 minutes afterwards to see the response. Keep a note of these readings and her use of the blue inhaler & any possible triggers as well as the regular twice daily readings as they will be helpful to the nurse when she reviews her.

The asthma UK website is very useful and has videos for inhaler technique etc and also you can download an asthma care plan from there which her nurse can help you fill in. Her personal best peak flow will be her best when she's well but normal is considered 80-100% of this, if this isn't known then they can use a predicted one but she would not be expected to be at this level all the time some variation is normal. With time you will get to know what is normal for her but also remember to treat the symptoms not just the peak flow as sometimes that doesn't drop when symptoms start. The Asthma UK whatapp service is really helpful and they also have a helpline too.

It can feel like there's a lot to learn especially at the beginning but you are doing a great job. I hope your daughter continues to improve.

Skzittles profile image
Skzittles in reply to AJP2

Brilliant thank you x

I been taking monkelaust for 4 years now for the allergic part of my asthma. I very allergic to house dust mites. It definitely helped my asthma. No side effects to report.

Hi,

Peak flow is entirely personal ... and the "predicted" best is an average for the average person (and only takes into account for age,height and gender )

So I wouldn't get too hung up on peak flow yes its a good tool but it's one of many "tools" and only provides part of the picture couple the increased peak flow with an improvement in symptoms and your starting to get a picture of what's going on , can I ask Is it just blue or blue and brown inhaler you've been given?

Also I see from your results the peak flow is lower of a morning this is typical and will vary throughout the day slightly but morning and night time symptoms are typical in asthma as is a lower peak flow (everyone's will be lower of a night and morning however its how much lower they look for a percentage drop )

Also I wouldn't get hung up on predicted peak flow not everyone is "average" and at my fittest I could swim 25 meters underwater and hold my breathe while doing it for quite a considerable time ..... I never ever (even to this day) have got my "predicted peak flow" its always been quite considerably lower

But I know that my peak flow is pretty consistently between 570 and 580 (it should be 627) so if it starts to drop and or I develop a cough I know something is going on at 450 I really know there's an issue and normally can't stop coughing and feel like I've been hit in the chest with a sledge hammer .... however my sisters peak flow is 400 and thats good for her (she's a very very mild asthmatic who runs marathons and very rarely uses an Inhaler)

Chip

Skzittles profile image
Skzittles in reply to Chip_y2kuk

Thanks we have blue and brown preventer for morning and night

Chip_y2kuk profile image
Chip_y2kuk in reply to Skzittles

Ah OK the blue is salbutamol and takes 20 mins to work but only lasts up to 4 hours.... the "reliever" (it actually starts to work in 60 seconds)

The brown is a corticosteroid, beclomethasone and works to fight back inflammation this has a "cumulative" effect and can take up to 3 months to take "full effect" ... but should start to work in a few days ... also known as a preventer as they are to prevent symptoms over the long term

Hope that helps

Chip

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