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Peak flow numbers and when to call specialist.
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joleel posted:
Asthma is new to me-I've been on and off sick with viruses for over 2 months as my son had started daycare then. Just diagnosed about a month ago and I am now on symbacort am and pm, I have no allergies and use my rescue inhaler usually 2-3 times per day, and have started up my nebulizer treatments a couple times per day. I currently have a cold. I always feel strained for air by end of day and especially when it's humid and while running fter my son who is just 18 months. I recently purchased a peak flow meter because I am wondering if I am using my rescue inhaler too much-I use it when I feel winded or right in chest etc. my readings are always between 250-350, when it says it should be around 475. I got it to 400 once. Is this considered terrible? I'm 39 female non smoker. I have an appt with specialist in a month, should I contact them now? Or based on this wait my cold out that I have now and see or just wait the month. I just for know what is concerning. Thanks'!
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amcate responded:
I would call the doctor and let them know what is happening and they can decide if they want to see you sooner.

I can only tell you what has been done in my inidividual case. The doctor gave me a peak flow meter, told me how to use it and to blow into it 3 times, if any number is way different than the others...more than 10% difference, then throw it out and go a 4th time. Take the highest number of the ones that are within 10% of each other and record it. Do this every 12 hours for 30 days. Take the top number that appears at least twice, and that is my personal best. Then, he set up a plan based on the percentage of my personal best. The charts that say what your peak flow should be are describing a population, and it is normal for there to be some variation, but your numbers are way different than the norm, so I think it's worth a call to your doctor.

Generally, 80-100% of either predicted (in this case, 475) or personal best as described above is okay, 50-80% and you have to add medicine because something is wrong. 50% or lower is a medical emergency and go to urgent care or the ER right away.

Your rescue medicines, (typically, albuterol or some variation of that) should bring your peak flow up about 10%. If it doesn't, that is a bad thing and would indicate a possible trip to an urgent care center. My doctors tell me if my asthma is under good control, then I should be using my rescue inhaler two times a week or less. Also, controller medicines, which Symbicort is one, can take a few weeks to reach full effect. So, if you just started it, it will take time to fully work.
 
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joleel replied to amcate's response:
Thank you so much for your reply. Anytime I do my rescue inhaler or my nebulizer the numbers really don't change. I'm also just sick all the time so I guess I just need to call. I've been on all these meds for over a month now. Also had 16 days of prednisone and antibiotics. On an antibiotic now for a ruptured ear drum from a very sudden ear infextion. Seems I can't win these days! Hubby and I laugh it off as the soon to be 40 curse but this isn't funny really. I think I will call today.
 
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amcate replied to joleel's response:
No problem. Hope all goes well. In my case, the doctor gave me instructions of what to do if the peak flow doesn't go up after taking the rescue medicines, but his instructions to me are based on my individual circumstances (I don't have a heart condition, for example), so may not be applicable to you. The fact the rescue medicines aren't bringing your peak flow up normally would be considered a medical emergency by what my doctor has told me since it would mean your asthma isn't responding to the rescue medicines....but I don't know for sure if it is in your case since I don't know if your technique of getting peak flow numbers is good or not, etc. You may want to consider going to an urgent care clinic or an ER. I'ts impossible for me to know for sure if you should go to urgent care of the ER over the internet. I've had times when I had an infection and it wasn't responding to rescue medicines, but it was apparently due to all the congestion in my lungs from the infection, and my doctor had just started me on antibiotics to try to avoid a hospital admission. Your doctor would also want to know that the peak flow isn't going up after taking rescue medicines if you elect to call them instead. Best of luck to you.


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