Does anyone else get this peak flow pattern?
In the past few years, when I've had a respiratory infection (and for a while after), my peak flow behaves like this: the first blast sends the indicator up to the top of the scale.
Then each blast after that goes to somewhere around 425-450, no matter how hard I exhale.
450-ish is my normal reading when I haven't been sick.
When I regularly get 450-ish on the first blast, I figure my lungs are back to normal, or _their_ normal.
Hi burviji, and thanks for your post. You may be aware we cannot provide medical advice or diagnostics over the internet (for your own safety), but your concern certainly warrants a reply.
Generally speaking, when someone is not having any kind of obstruction, peak flow rates (even on the home units), should be consistent with each effort. That seems to be what is occurring in your case, with the consistent readings with each effort.
Your initial effort, driving the reading to the top of the scale, is puzzling for me. I have not seen that.
In some cases, there can be an initially good effort which sometimes deteriorates when the patient is somewhat compromised.
I am hopeful others in the community, with this type of clinical experience ( John Bottrell, RRT and Lyn Harper, RRT ), will weigh in with their opinions too.
Have you had a chance to discuss this with your pulmonary physician?
Wishing you well,
Leon (site moderator asthma.net)I have mentioned this to my respirologist, but he doesn't seem particularly interested in the phenomenon. He wants to know whether the action plan works. And it does.
Hi again, burviji, and thanks for your response. I am sorry to hear about the disinterest of your specialist. That is both surprising and disappointing.
Having said that, I guess the 'take away' message is that the action plan is working for you. There is real value in that!
P.S. I am still hopeful that my colleagues,and will have a chance to see our conversation and chime in with their thoughts as well.
Warm regards,
Leon (site moderator asthma.net)
At my stage of asthma/ COPD ( my doc says I actually have a bit of both), 450 is my often best reading, when I'm not sick, congested or otherwise impared... I saw 500 once or twice, and was amazed!... At any other time, I start being concerned when I'm under 350, because I know something is amiss..
Hi Dzo, and thanks for joining in the conversation here. We appreciate you sharing your own personal experience using a peak flowmeter, to assess your asthma/COPD, with the community.
It sounds like you are well aware of your own disease. Gauging that something is amiss, when the peak flow is starting to be compromised, probably gives you a good jump on early treatment, when needed.
Keep up the good work!
Leon (site moderator asthma.net)
Hi. I see has given you some great responses here, and has nudged me for a response. To be honest, the same thing happens to me. And, like you, my doctor's showed little interest and just said it was odd. So, you are not alone in experiencing this. That said, a pulmonologist friend of mine (not my doctor) once said he had a theory. And he said the reason may be because my asthma is occurring in my smallest of smallest airways, and therefore is not measurable by the peak flow meter. So, in that way, even though I feel short of breath (sometimes really short of breath) my peak flows stay relatively normal or above normal. I like that theory and that's what I go with. Although, there's no way to prove it. Sometimes asthma is weird and all we can do is speculate as to what is going on. Perhaps some day the wisdom will be available to get better answers. What do you think? John. asthma.net community moderator. It was following that episode that I got referred to a respirologist (by the Emerge doctor), who switched me from Flovent (which hadn't been preventing my breathing from worsening) to a Symbicort turbuhaler.
Hey John - thanks for chiming in here. The 'theory' makes a lot of sense to me too! I've heard that from other physician colleagues of mine as well. As you said, sadly, we cannot measure it but it just seems to tie the whole puzzle together with a reasonable explanation.
Warmly,
Leon (site moderator asthma.net)
So, are those tiny, furthest airways swelling, or spasming, and trapping air? And it's that air I'm releasing on my first forceful expiration?
Hi burviji - thanks for following up. The smallest airways to which John is referring are the respiratory bronchioles. They are actually the areas of the lung in which gas exchange takes place. It is virtually impossible to measure what is happening volumetrically at that level of the lung. All that to say, I wouldn't be able to determine for certain if that volume is included in your first forceful exhalation. I am sorry. I guess you might be able to learn more if you were to connect with a physiologist whose detailed knowledge focuses on the pulmonary system.
Have a good weekend!
Leon (site moderator asthma.net)Great question. And I would tend to agree with Leon. Also, I would imagine that any of the three, or all three, are going on. I mean, it's really difficult to know what's going on inside our lungs. I do know that researchers are learning so much so fast about our disease that it's hard to keep up. Although, I would imagine there are doctors out there who do keep up and may have answers for you (us). Wishing you all the best. John. asthma.net community moderator.
