Peak flow confusion!

Montgomery · 05-08-2003, 03:57 AM

I am a sixteen year old girl. I'm about 5' (60") tall. I'm relatively active, I play a sport on my high school team and get somewhat regular exercise otherwise. I get tired, but I rarely have real problems with my asthma; if I stay hydrated, I don't have any problems at all. However, whenever I use a peak flow meter, I can't get anything over 350 - and that's on a REALLY good day. Generally, I get between 230 and 270.

I handle my asthma using Accolate, and it's been just fine since I started. I became concerned with my peak flow readings when I found this: [url="http://www.shs.unc.edu/medservices/specialty_services/asthma/pflow.html"]http://www.shs.unc.edu/medservices/specialty_services/asthma/pflow.html[/url] which says that my breathing is worse than a 70-year-old's should be!

How should I look at this? I feel fine, I'm not having trouble, but I'm concerned that there's something I'm not seeing. Is it possible to be healthy and have peak flow readings as low as mine are?

AngeInBoston · 05-08-2003, 08:15 PM

Hi Montgomery, what does your Dr. say about your Peak Flow? I've never kept track of mine, until this last acute attack I'm recovering from right now, where they gave me my own Peak Flow Meter in the ER to take home...at the time I was testing in the 230 range, and I was huffing like I'd just run a marathon! My Dr. wanted me over 300 ASAP, but it took quite a few days of alot of rest and meds...even right now my hardest huff just measured only 370...I think I'm supposed to be able to go into the mid 400's but I can't really imagine that unless I start deliberately trying to stretch my limits....are we supposed to do that?

wrin · 05-08-2003, 08:30 PM

1. Are you sure you're doing the peak flow correctly, as in, no air leaking out the corners of your mouth, etc, etc?

2. Are you properly controlled? Peak flows can vary a lot when you're improperly controlled.

3. Look not only to the numbers, but to the rest of your body too. Cardiovascular conditioning can dramatically improve your peak flows. Very healthy people (especially men) can often have peak flows higher than their predicted range.

4. Look at the characteristics of your peak flows and how they relate to each other. When are they at their lowest? When are they at their highesT? Is the first peak flow you take (using the best out of three method) always your highest? Do you feel progressively nastier after every reading? The act of doing a peak flow can cause bronchoconstriction in some people. This might mean you're better managed by symptoms and not peak flows. Do you take them at morning and at night, not just once during the day? If you do, do they vary a lot from morning to night? This is known as diurnial variation and is also a useful indicator of asthma control. Do your peak flows improve after you take a bronchodilator?

These are all things your doctor should know! If you need to write them down to remember them, by all means do so!

An idea that makes tracking these trends easier is to do yourself an asthma diary, and chart for a few months. If you put in symptoms and exposure to triggers, colds, as well as peak flows, and this might give you a better idea of what makes your peak flows vary. Take this in to see your doctor, and with the knowledge that your predicted is in the neighborhood of 420 lpm, ask him what HE thinks. You might just NORMALLY be like that. You never know!

[This message has been edited by wrin (edited 05-08-2003).]

AngeInBoston · 05-08-2003, 09:41 PM

Thank you Wrin! You are such a valuable fountain of information! I really enjoy all I'm learning from you!

Montgomery · 05-09-2003, 09:53 PM

I've asked two doctors about it (I should go more often than I do), and they both basically said try harder. I know I'm doing it right. My peak flows var by the day, by the hour, even, I would say, between about 230 1nd 270. I feel mostly neutral about using my meter, I don't really consider what my results are to be too awful if I feel all right.

When I have a really bad attack, and I go to the hospital, my peak flow still doesn't get above 350 after several treatments - usually not even that high - unless I cheat (I learned when I was younger and went to the hospital more often).

I think that's just my normal reading - I mean, if I've NEVER (to my recollection, that is) gotten above 270 on a regular day, I don't think I'm supposed to. I *do* think I'm going to see a different doctor soon.

Thanks Wrin!