I'm sorry I keep coming back every couple of days with silly questions, it's just that I'm trying to sort this still new to me thing out over here. I am very confused about my peak flow numbers.
First, I tend to cough more than anything else with my asthma. I have read that with cough-variant asthma, peak flow meters are not generally useful. However, I do have other symptoms, like shortness of breathe, chest tightness and pain and recurrent infections, and tremendous amounts of clear mucous, and so assuming that the meter might be of some help in figuring out what is going on.
I first got the meter when I went to ER last weekend with my worst attack ever. I don't remember what readings were throughout my stay there, since I was busy with breathing, but I remember the therapist wouldn't send me home until I could get it over (I think) 450, or close to what I should be. My "normal" rate should about 497.
Did several days of prednisone, stepped up my albuterol use, got some antibiotics for an infection, and consistently got readings between 380-500 over the next several days. I still felt very poorly though. Easily short of breath, many frequent small attacks triggered by minor things. Figured it was the infection and rested, as per dr orders.
I missed doing the readings for a couple days--just got busy, and it wasn't yet a habit. I've been feeling much better and trying to catch household things up from when I was ill. Going for long walks and things, minimal trouble with asthma, although still some symptoms, especially with excess mucuousy-ness.
Did several peak flow readings today, and got between 570-640!
That is way higher than my average. And so, I'm left wondering why my "personal best"--although I realize that I haven't gotten a proper personal best yet as it requires a bit more consistency--is so freakishly high. How can I have an obstructive lung disease when I can expel so much more air than is normal? Is that much variation normal, or am I possibly overmedicated currently, or misdiagnosed?
It is likely that I will see a pulmonologist at some point in the relatively near future, just busy right now and focusing on an upcoming shoulder repair. Pulmonologist is the next fun medical adventure, but in the meantime, I'd appreciate any thought you all might have on this.
I do think that its a good idea to see a Pulmologist to get the full tests run and talk to a Dr. that specializes in lung disorders.
Also, have you or are you being treated for Acid Reflux at all? This can cause many of the same symptoms as asthma and can also make asthma much worse?
(I am 5'3 @ 128 pounds and my peak flows are 350 - 400 which my Drs. say is just fine???) - they are that when I feel bad and when I don't??? - so I don't use the peak flow meter anymore I just go by how I feel!!! Its too confusing for me!!!)
PS: You ask AS MANY questions as you need to - information and understanding are what you need right now!
Yes, I'm being treated for reflux as well, although I've felt really acid and burny since I started the prednisone/antibiotic combo last week. Didn't let up when I got off the prednisone. But right now it seems to not be just focused deep pain, not sob or bad coughing.
The higher peak flow numbers you mention could be average (if you're a 6' tall 30-year-old male) or way above average if you're a 5' tall 60-year-old male, and even then you'd just be comparing to national averages - age, gender and height all come into play in what the "average" range for a peak flow reading is.
What's more important is figuring out what your true average is, and that's best done with the help of a doctor (and an asthma treatment plan) - I wouldn't worry about them being too high, what's more important is figuring out what's average for you and responding if they start to go down.
snowdrift, the acid reflux (if you have it) can make everything worse. regarding your 'high' peak flow numbers...years ago when i first took readings i got over 700, around 750. then since my last flare, i have been regularily seeing an asthma nurse. she gave me a different peak flow meter to try. i was down below 400, finally when i got over 450 min to 540 max i was at a current best. i compared the two meters. my old meters readings were 100 pts higher than the new one. so i figure by that token, my personal best would be nearly 650. so perhaps if your readings are high, either it is the meter, or that is normal for you.
also, i decided when i first started recording readings a year ago or so, that i would not count the ones where you sort of spasm during blowing,which pushes a burst of air into the meter. that can also make the reading incorrectly high. my nurse agreed i shouldnt count those
I found the answer to my own question online today and thought it might be helpful to others, and it helps explain why footsiedee experience widely differing results with different meters.
It turns out that some people tend to somehow use their mouths to increase the airflow pressure. I'm not a physiologist, so I don't quite understand how, but the solution is to place the mouthpiece a little deeper, over the tongue. This has, in a recent study, yielded much more accurate results.
When I tried this, the result was 440, which is a little lower than the standard for my age/sex, but I have been symptomatic for the past two or three days, so I feel like that is probably a pretty accurate result.
snowdrift, i just wanted to clarify. the difference in readings between the two meters, was not in my opinion from using different techniques. the new meter is perhaps 15 years newer, and structured differently. in short, it is a better made meter. i use same technique, on same day with both. but i try to be sure it is a steady blow of air, not a cough spasm type as that creates a burst. i want to be consistently using same technique so i dont count these bursts. also, i am older now so my readings probably should be less than 15 years ago (i am 50and have gained 20 lbs), our town is becoming more polluted, and for 10 years i lived in a bulding i didnt know had mold issues. i have improved since moving. good luck with the specialists. i find i learn a new piece of the puzzle with each one. the first allergiest did nothing more than scratch test twice over several years. so my brother suggested a friend, she took blood tests and CT of the head, so i learned a reason for sinus problems now. sometimes second opinions are helpful
and that reflux is a major annoyance/aggravates or creates symptoms. i hope you learn lots from the pulmonologist. ask lots of questions.i found reading this board before hand gives me lots of ideas of what to ask. good luck
Yes, asking the doctor plenty of questions is the wisest thing. Try writing them down beforehand. I always forget something if I don't write them down and wind up remembering what I wanted to ask the doc on the way home.