Possible new diagnosis, low peak flows

[51startingtorun]

Hi, I got admitted to hospital last week after a bad episode of SOB, wheeze, cough while on nightshift as a paeds nurse, lucky place to happen ! First ever episode like this and I'm 55 ! Very scary !Anyhow I needed two salbutamol nebs , a combi neb and oxygen before I could properly breath and needed oxygen overnight.

I'd been unwell for 4 to 5 weeks after a virus and couldn't shift cough and was getting more breathless and wheezy

Got home next day with brown and blue inhalers and 5 day course of prednisilone.

My predicted peak flow is 398 but the highest I've reached is 310 after 5 puffs salbutamol, my pre inhaler ones range from 150 to 250.

Does it usually take a while for peak flows to increase after these types of episodes ?

I've not had formal asthma diagnosis yet and see asthma nurse on Friday

Any advice appreciated

[Homely2]

The predicted peak flow is very much an average, so you might find your final peak flow is very different from the predicted peak flow.

It took three months or so before they got me up to my top peak flow.

They kicked me off with brown and blue which helped, but not enough, so they then substituted the brown for a stronger inhaler, in my case, fostair.

Make sure the asthma nurse checks how you use the inhalers, and talks about spacers etc.

All the info you need is on the asthma UK website. They also have a helpline on 0300 2225800, office hours, the nurses there will be happy to chat it through.

Asthma as you have found can be scary, so find out everything you can, do not get fobbed off

[51startingtorun in reply to Homely2]

Hi, thanks for advice, I will speak to asthma nurse tomorrow and ask her to check my technique.Overall I feel so much better and have went from using blue inhaler every 4 hours to first thing in morning and maybe twice during day. My peak flows during day are slowly improving but first thing in morning they range from 110 to 150 and I have a bit of a cough and wheeze.

Would I be better checking peak flow a while after I wake ? I've read it can often be lower in morning

[Homely2 in reply to 51startingtorun]

I would as a minimum take your peak flow, first thing in morning and last thing at night. Record it on a sheet of paper or spreadsheet. . Variability in the peak flow is one of the indicators of asthma

Some medics like you to record it pre and post taking inhaler, so they can see the effect of the inhaler. Again this is an easy way of showing if asthma is a likely diagnosis.

In early days of asthma diagnosis a good record of your peak flows makes it much easier to have a useful conversation with the nurse.

If the asthma nurse decides it is asthma she should give you a written asthma plan telling you what to do in different circumstances.

[2uWallowa]

Am curious if they did other sorts of tests on your lungs? Blood tests? Encourage you to increase your fluids hopefully your provider will find answers to help you.

[51startingtorun in reply to 2uWallowa]

Hi, no I've had any other tests apart from a chest xray which was clear but showed some hyperventilation. I saw asthma nurse last week but was waste of time as she said I'd need to do a month of peak flows then see gp again for formal diagnosis, so she basically gave me no advice and said I can use blue inhaler if I feel I need it , I mentioned peak flows were low and she agreed they were but no advice.

Feeling a bit confused now and not really sure if the gp is going to diagnose based on the peak flows or if further investigations need done.

[2uWallowa in reply to 51startingtorun]

Encourage you to do what the nurse recommends but keep records if your symptoms get worse please seek medical attention am surprised that labs weren’t ordered. Write down everything that you are doing to keep yourself healthy that way the doctor can’t fob you off to keep trying other home remedies if and when labs are ordered make sure that Esenophil lab is included. It took me researching my symptoms to approach my pulmonologist to order it he also ordered allergy testing. Felt vindicated when everything came back positive. Stay positive and don’t give up!🙏🙏

[Horse459]

Hi there. This sounds very similar to what I just went thru. I have had asthma for 10yrs now, 54yrs old. My peak flow is normally 460 / 470. Started feeling unwell , wheezing, breathless with a brutal cough that had mucus.. mucus was extremely thick and after a week my lungs and body were exhausted. Ended up breathing treatments, oxygen, pred.. every 4hrs for 2 days. Then weened to every 6hrs, etc...it has been 3 weeks and my peak flow is slowly returning to normal. It got down to 380. Keep doing your breathing exercises to strengthen lungs, meds and rest.