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Weird results in PEF control, maybe

Hello

I am in process of being diagnosed: do I have asthma or some other breathing related problem. Currently going through the 2 week long PEF control, where one records the peak flow before and after the opening medication twice a day.

I have this weird problem. Almost always, but not always, when I blow into the device the first blow is clearly stronger than the blows to follow. E.g., the first blow can be 650-800+ liter per minute while the following ones land around 550. (Sometimes there is no difference.)

First I thought the device must be faulty and it can be, however my girlfriend does not have the same thing  happening to her when we tested the device with her, in 4 different occasions.

Assuming the device is not faulty, any ideas why this is happening or what does is imply?

 

 

 

 

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Comments 9

  • Kathy P

    I have had that happen sometimes. For me, it seems like the first blow kind of loosens things up in my lungs. Then when I try for a second reading, my lungs have mucus in there that is causing lower readings. Often the first try will make me start coughing if my lungs aren't clear.

    Have you talked with your doctor about the different readings?

  • LK

    Welcome!    

    Sorry you are having to deal with breathing issues.  I have adult onset, cough variant asthma.

    I have the same thing happen.  

    My first numbers on the peak flow meter are usually the best followed by lower numbers.  Blowing that hard sets off my asthma cough so, for me, that indicates that my airways are closing up some. 

    Is the "opening medication" you refer to a rescue inhaler helping to open up your airways like ProAir (albuterol) or Ventolin?  

    I understand why you did it but, just a suggestion, do not share your peak flow meter with anyone else.  I know you can wash peak flow meters but just for good hygiene  I don't share any device that I blow into or inhale medicine out of.

  • displayName
    Kathy P posted:

    I have had that happen sometimes. For me, it seems like the first blow kind of loosens things up in my lungs. Then when I try for a second reading, my lungs have mucus in there that is causing lower readings. Often the first try will make me start coughing if my lungs aren't clear.

    Have you talked with your doctor about the different readings?

    Not yet. I have an appointment when the PEF control is done where we will go through the findings. (One week in currently)

    Thing is that I am not seeing specialist currently, this was kind of a random finding in a general health check, so if this is something that is not common, there is change I am not getting answers anytime soon from that direction.

  • displayName
    LK posted:

    Welcome!    

    Sorry you are having to deal with breathing issues.  I have adult onset, cough variant asthma.

    I have the same thing happen.  

    My first numbers on the peak flow meter are usually the best followed by lower numbers.  Blowing that hard sets off my asthma cough so, for me, that indicates that my airways are closing up some. 

    Is the "opening medication" you refer to a rescue inhaler helping to open up your airways like ProAir (albuterol) or Ventolin?  

    I understand why you did it but, just a suggestion, do not share your peak flow meter with anyone else.  I know you can wash peak flow meters but just for good hygiene  I don't share any device that I blow into or inhale medicine out of.

    Yes, I am using Ventoline and it opens up the airways near the target level. (635) But usually not even with the opening medication can I reach the results that I get with the first blow.

    Thanks for the hygiene tip.

  • LK

    Might be worth a call to your doctor even so.  Are you supposed to record the numbers from several tries?  Write down the highest number?  

    I used to not want to bother my doctors with questions but I have learned that if they don't hear from me, they assume I understand everything and that everything is going according to plan.  So now I try to call them when I am unclear on something.  Even just talking to them about what is concerning me helps me.

    Please let us know what you find out!  Hope your breathing keeps improving.

  • displayName
    LK posted:

    Might be worth a call to your doctor even so.  Are you supposed to record the numbers from several tries?  Write down the highest number? 

    I am to write down 3 blows in a row where the max difference of the two highest ones is 20 (l/min). From that data the form autimaticaly calculates daily fluctuations and differences before and after Ventoline using avg of two of the highest results in these sets of 3.

    Because the first blow is so much stronger it gets discarded from this listing. They are marked as "problematic blows" in the form, with details. So the data goes to the doctor eventually, but it does not affect the automated calculations.

  • Emelina

    Welcome! I’ve experienced that occasionally. When that happens to me I discard the result as well. Sometimes I’ll accidentally do more of a cough blow or have the meter slightly tipped down. I think I got a 750 once and was like, umm, I don’t think that’s right! Normal PEF variation is about 10-20% between morning and night. Anything more like 20-30% could be suggestive of a breathing issue. 

    If you don’t mind me asking, are you having any symptoms? If so, it can be helpful to look for triggers or timing to your symptoms (ie worse in am, night, after eating, after exercise, cold air, dry air) and if you develop inspiratory or expiratory wheezes, sputum production, etc. all clues to help your doc nail down the diagnosis as asthma has many mimics and many conditions that co occur with it like allergies, post nasal drip and reflux.

  • displayName

    Apparently the peak flow meter I used was somehow faulty. Got myself a new one and no more spikes. (Also the values vent up a bit (ratios staid the same), but that is off-topic.) So, mystery solved.

     

  • Melissa G

    Glad you figured out the problem! How are you doing? Is there anything else we can help you with?