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What could explain shortness of breath that responds to albuterol, but with a normal Peak Flow Reading?
Yesterday morning I was out doing my rabbit chores and I was having shortness of breath upon exertion (lifting, etc). I went inside and checked my Peak Flow Reading and it was a little lower than usual, but not in my yellow zone; I used my rescue inhaler anyway. I went back outside and my shortness of breath was better. Later yesterday evening I started coughing and had chest tightness. My pfr was in my yellow zone. I woke up during the night once.
What I don't understand is how come I had shortness of breath that responded to albuterol, but had a pfr that was relatively ok? Was it a precursor to what happened later that evening and at night?
Thank you.
What I don't understand is how come I had shortness of breath that responded to albuterol, but had a pfr that was relatively ok? Was it a precursor to what happened later that evening and at night?
Thank you.
41 yr old, Female
asked Jun 04, 2010 at 12:24PM in Asthma
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4Votesanswered Jun 04, 2010 at 01:26PMthough peak flows do correlate with asthma symptoms, they are far from perfect. In children, for example, even some of the most severe asthmatics have normal lung functions. The purpose of doing peak flows was to identify an attack before it happened; however, this process is far from perfect. That said, current guidelines do recommend peak flow monitoring for patients with moderate to severe asthma. However, new methods are needed. An exciting area of investigation is exhaled nitrous oxide or eNO, which directly measures inflammation in the lung. In some studies, eNO performs better than lung function measurement. For the meantime, adjusting medications based on both symptoms and peak flow is the best way to go.
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3Votes
answered Jun 04, 2010 at 01:31PMAlso, Peak flow measurements represent the function of the larger airways. When your smaller airways are obstructed ( from inflammation, mucus or constriction), it's not always reflected in your peak flow numbers. You might also have some air-trapping, which could make you short of breath while still having near normal peak flows. In either case, albuterol usually helps. -
1Votesanswered Jun 05, 2010 at 07:53AMIf it makes you feel any better, in February 1998 my asthma got so bad I required a breathing treatment every hour for about a week. However, my peak flow readings never wavered below my predicted normal. As a kid my peak flows were reliable predictors of oncoming asthma symptoms, yet as an adult this doesn't seem to be the case. Why?
My theory for this would coincide with what Steve said, that as a kid my airways were small, and the increased inflammation that occurs during an attack caused both my upper and lower airways to become obstructed. As an adult, my airways are bigger, and thus increased inflammation is more likely to effect my smaller airways. At least that's the theory we'll stick to for now. -
0Votesanswered Jun 05, 2010 at 09:54AMThank you all for answering my question.
Generally, my peak flow readings correlate to my symptoms. Shortness of breath is kind of weird, though. There have been times when I've woken up in the middle of the night in the lower part of my yellow zone and there have been times when I'm short of breath, but I'm in the bottom of my green zone.
One time I was at the doctor and my spirometry was only 18% lower than my normal and I could barely walk down a hallway, I was so short of breath. It was awful. My inhaler wasn't doing a thing for me. I was given a neb treatment and felt so much better. I did nebs at home for a week and did a treatment at night for a few days afterwards.
It makes sense that the smaller airways can get obstructed from inflammation, mucus or constriction. I've been told that I get bronchoconstriction very easily, as opposed to a lot of inflammation. I can attest to easy bronchoconstriction...as much as I love an extra-coffee-caramel-frappacinno, I have to use my rescue inhaler before indulging in one or it'll send me into a bad coughing fit. (I can't deal with really cold beverages, ice cream, cold air, etc.) -
0Votesanswered Jun 05, 2010 at 10:04AMHave you considered doing SARP? You could probably learn a lot about your asthma while at the same time, helping advance asthma research.
http://severeasthma.org -
0Votesanswered Jun 05, 2010 at 11:10AMI'd think a *different* word than "annoying" would describe severe asthma ;)
I'll check out where the test sites are compared to where I live...anything I can do to help. Are they looking for genetic information? Does anyone in your family have asthma? My mom does and she uses a rescue inhaler once every 5 years or so and has never used controller medication. I'm not sure what happened to me because my asthma is nothing like hers. Are they looking for physiological data? Is severe asthma in some way different than moderate asthma?
Ok, done with the questions.
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