Advice on peak flow meter?!

[Stephyjane]

Hi, Ella has been having a lot of chest tightness amongst other things, she has constant nose problems Allergic rhinitis which then becomes infected.
We are on our second course of antibiotics within 2 months and then Ella will start using a Beconase nasal spray.
I always put her chest pain down to heartburn but it has been going on for a while now and she is just so tired, she has been falling asleep earlier and even when she is on the couch, which is so not Ella.
Anyway the dr has asked Ella to use a Peak flow meter and take measurements am and pm and before and after exercise. She has not been able to get it above 260 on the meter, 220 in the mornings, when I looked up what she should be blowing it was 427.
My qu is should it matter that that she isn't able to get higher results? She's doing everything correctly so I know that's right.
I'm wondering whether this could all be linked to her nose problems.
She complains that her lungs ache?!
I'd really appreciate any thought on this.
Thank you Steph

 

[Catherine]

Is Ella taking any asthma medications?

 

[Sascot]

My son had to use the peak flow meter during bad hay fever episodes. It is important to try to get the breath over the 400. We had to use the blue inhalers at the time to get the numbers up.
Her symptoms sound a little similar to mine. I have chest pain but it feels like the lungs are inflamed and my breath flow is reduced at the moment. I can understand why you could assume heartburn, as it does almost burn in the middle of the chest too. My GP mentioned costochondritis which is inflammation of the ribs and sternum. Unfortunately the best treatment is anti-inflammatories which are not recommended in Crohns (I cant take them either).
Does she have a puffer? The other things you could try would be an anti-inflammatory gel - there are ones suitable for kids. I wouldn't use too much, but try some over her sternum. Also try heat, I love those packs you heat in the microwave and it does help a bit.

 

[Stephyjane]

Thank you for the quick responses.
Ella doesn't have an asthma diagnosis and isn't on any treatment for her chest pain. Apart from the antibiotics flucloxacillin and then going to start the nasal spray.
I think because I'm always assumed it was heartburn or linked to her Crohn's I've never pushed it.
Sometimes I feel like we are constantly going to the drs with more symptoms.
They've started athletics at school and Ella says she really struggles to run any distance.

 

[my little penguin]

https://www.nhp.org/provider/asthma/Survey_ACT_child_EN.pdf

Ask her allergist about a lung function test with albuterol and without albuterol.
Much more accurate than a cheap plastic flow meter .
Both my kiddos have had asthma for a long time .
Peak flow meters are not used by many pediatric pulmonolgist or allergist anymore.

 

[my little penguin]

Albuterol is a rescue med - not to be used everyday.
If she has asthma she would need a daily maintence med ( inhaled corticosteroid ) to keep the inflammation down .

 

[DanceMom]

We use a peak flow meter because it is a great way to measure how well the rescue meds work and differentiate between heartburn and asthma symptoms. Ours isn't a "cheap plastic meter". It is digital and works well.

I'm not quite sure where you got your norm values from, but take a look at this link : http://www.sh.lsuhsc.edu/fammed/outpatientmanual/PeakFlowTables.htm

A is 9, 49 in, and when she isn't experiencing asthma symptoms she blows about a 240. The chart seems pretty accurate. I'd continue using the peak flow and recording your results, but I'd also make an appointment with a pulmonologist. They can do pulmonary function tests in office and determine if she has asthma or some other respiratory condition.

 

[Catherine]

We also use the peak flow meter as dd has unusually presentation. The meter allowed dd to know when she needed to use her rescue med before her preventer medication.

 

[Stephyjane]

Thanks all,

Dancemom, I used a chart that I found on uk asthma site and there was also I site I went on which you put the details in and it worked it out.
Using your chart Ella would be 64" at 12 years old so hers would be 354 so a bit different to 427.
I shall do our peak flow graph and give it back to the dr and go from there.
In the Uk on the NHS there are pathways to go through to see specialist drs and I don't have the means of paying to go privately.
I think from what I've read Ella perhaps isn't asthmatic as she recovers from her breathlessness.
I think she sounds similar to you and your child Sascot. Maybe the Rhinitis is worsening her symptoms.
Thanks again for all your advice.
Steph

 

[positivemum]

Hi
My son had pain in his chest when playing football. After seeing a respiratory nurse it is clear he has exercise induced asthma and his inhalers made a huge difference.

 

[Stephyjane]

We've kept a peak flow diary for a week now, I shall drop it back to the drs tomorrow.
Ella has managed to blow 260 at best and has at least a 20% drop after exercise. Her am and pm readings are a bit up and down, mornings being a little lower but not hugely.
The pollen count has been high this week and we have both been suffering, so maybe that's had something to do with it. We'll see what the GP says.