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-   -   Combined Asthma, peak flow, and spirometry thread (https://www.pprune.org/medical-health/338107-combined-asthma-peak-flow-spirometry-thread.html)

cats_five 18th Jun 2008 08:47

A PEF of 350 is *very* low, especially if it's on the old scales for a Mini-Wright, for women of most ages let alone men. Somewhere in the region of 600 would be more normal, depending on your height & age, and AFAIK to a degree on your ethnic group.

That leads me to wonder if 1) your technique for producing it is flawed and 2) are you undertreated?

Technique isn't hard - stand up straight, take the deepest possible breath & blow like crazy.

Being undertreated is another issue. You don't mention your current regime but I assume it includes an inhaled steroid. Have you taken PEF morning & evening to see if they are pretty much the same? If not, I'd say that you are almost certainly undertreated. Also, have you had a trial of Singulair or similar drugs? They didn't do anything for me, but I'm told they make a considerable difference to 1/3 of asthmatics, they help another 1/3 and for the final 1/3 (including me!) they make no difference.

gingernut 18th Jun 2008 10:53

I wouldn't get too hooked up on the numbers, at this stage. (A peak flow of 350lmin-1 is on the low side, but is normal for an 85 yr old female midget!)

It does have to be said, that with the info. you've supplied, your asthma is far from "mild" at this stage.

It's likely that the authorities will take into account the facts you've mentioned. Hospital admissions, exascerbations, time off work school, affect on normal activities, need for emergency doses of steroids etc.

Reading between the lines, as my learned friends note, your control is not yey optimal. The "asthma" component of your underlying problem should be reversible and usually responds well to treatment.

I'd suggest an expert opinion, - seeing a GP with a specialist interest, or respiratory nurse may be a useful starting point.:)

davo31 18th Jun 2008 10:59

Seritide
 
"You don't mention your current regime but I assume it includes an inhaled steroid"

My current regime is 2 puffs of seritide (morning and night) which is a corticoid steriod. After exercise i can blow 400 PFR. This is so frustrating becuase I am about to start a PBL and am not sure whether to submit my current reading or seek advice and testing from a specialist (re: new medication as you have suggested).

Should I go to a respirtory specialist and ask them to run some tests? Is the issue here whether I will have an asthma attack in flight and can this be tested in a lab?

davo31 18th Jun 2008 11:22

Seritide
 
'You don't mention your current regime but I assume it includes an inhaled steroid'

2 puffs in the morning and 2 at night (seritide 250) which is a corticoid steriod. Yes i think you have all suggested i should reconsider my medication. I have booked an appointment with my respirtory specialist. I havent seen him for 7 years since I was approved for scuba diving. He actually suggested I start using seritide. Its strange, it never occurred to me that I suffer from chronic asthma. I have always played compeditive sports and run half marathons (on a regular basis) and never thought i could have been performing at a higher level if my lungs were functioning as they should.

In the end if I've never had an asthma attack requiring hospitalisation then this should be ok? Can they test this in a lab so that I can be cleared??

gingernut 18th Jun 2008 13:29

I'm not sure what your national asthma guidelines say, but here in England, you'd be seen as being about 3 steps up the asthma treatment ladder.

(Seretide is a long acting bronchodilator+steroid).

There is probably some scope for improving your figures, but this may depend on what has been tried before.

In all honesty, at this level, it's probably difficult and unfair to offer such specific guidance on this forum.

I would have thought a good starting point would be to discuss the specific requirements with your aviation medical authority and work backwards from there.

I can't think of a test designed to test whether you are going to konk out in the air, but if this hasn't happened in the past, and you're running marathons, then this is a good start.

Previous posts regarding asthma seem to suggest that piots can fly with well controlled asthma, but it looks like the objective readings your doc. has obtained, have caused some concern.

As I've stated, there may be room for improving these readings- that's where the specialist comes in.:)

cats_five 18th Jun 2008 14:15

Seven years is an awful long time to not see your specialist. I get called to the asthma nurse every year, and she checks that I'm OK, my technique is OK and also measures my peak flow - which has hardly changed in the 12 years since I developed asthma.

Do you know if your peak flow has altered since diagnosis? That it goes up after exercise implies to me it could be better all the time.

And is your diagnosis asthma, or ashtma plus something else?

BTW thought you might find the UK guidance interesting:

http://www.nice.org.uk/nicemedia/pdf/TA138Guidance.pdf

The interesting stuff starts at paragraph 2.5.

saucy jack 18th Jun 2008 15:10

Am mildly asthmatic myself and, after leaving school in the 80s was initially turned down flat for a class 1 medical on these grounds. Around 2000 I found out that the CAA requirements were relaxing and decided to go for (and indeed passed) a class 1 check. Like you I had never had a major attack and always did plenty of sport, but with an inhaler to hand if necessary.

My goal was to be able to run round the CAA carpark at gatwick for 15 minutes and then pass a peak flow test (that is/was the criterion) and to do this I followed a simple plan of nothing more than running each morning for 15 mins for about 3 months followed each time by a self-tested peak flow until my re-found fitness and breathing technique left no ill effects such as wheezing, instead a positive attitude and a generally healthy feeling.

As it happens the test on the day of the exam proved to be a non-event after my preparation, easily achieving the required level (550-650 if I recall).

Incidentally my Dad (a GP) consistently reminded me that the technique for the peak flow test is not to blow.....rather to Huff with a very hard "H" for best results....could this explain the low readings you are experiencing?

My own AME tells me that many pilots (including me) carry a ventolin in their flight-bag so you are certainly not alone.

redsnail 19th Jun 2008 21:59

I carry a ventolin in my nav bag. I got a really cool Bart Simpson cover for it. :ok:

davo31 20th Jun 2008 00:05

Much appreciated
 
Thanks all for your thoughts. I think I should be fine once I speak to the respiratory specialist next week. Cheers again :)

davo31 21st Jun 2008 09:42

Interesting Read
 
That link was interesting cheers for that 'Cats 5' :ok:

PintofT 16th Jul 2008 11:22

Peak flow/Spirometry Advice
 
Hi Pprune!

Does anyone know what one should be hitting on a peak flow meter to be confident of passing the CAA spirometry test? :8

I plan on booking my medical later this summer and would appreciate having a ball park figure to work with.

Many thanks,

PoT

alphamikeecho 16th Jul 2008 13:46

This will give you a rough idea of Peak Flow - but Spirometry is a bit more than a quick blow ;)

Peak Flow - Normal Values

Good luck with the medical!

gingernut 16th Jul 2008 16:18

your readings will depend on a number of factors including race, age, sex and height.

Try a search-discussed recently.

more here... Guideline 101: British guideline on the management of asthma

PintofT 17th Jul 2008 11:39

Thanks for the pointers, guys! Much appreciated.

Kiev23 25th Jul 2008 18:06

Peak Flow Question
 
Hello,

Any advise on how to increase your peak flow will be much appreciated.
I know about like technique and all but i want to physically exert more air quickly. ?

gingernut 26th Jul 2008 01:02

Obtain a meter from your friendly nurse/gp/pharmacist,

and practice your technique.

Try a search using the term "asthma" or "peak"

LiverpoolFC 5th Aug 2008 12:18

Asthma
 
Hello! I'm a 14 years old boy. And of course i want to be a pilot in a A380 ,a B747 or somthing like that. But i have asthma and i wonder if I can be a pilot or if the asthma would stop me from that....
//Swedish Gurra

redsnail 5th Aug 2008 12:39

This is the answer you may not want,

"it depends".

It depends on how bad it is, how it's managed and so forth. If it's mild and under control, there's no problem (I have mild asthma and I fly a jet, not an Airbus though).

It's up to you and how you respond to your treatment. Do your best to keep yourself healthy and in good shape, listen to your doctor and most importantly, work hard at school. Have a chat with your doctor, make sure he/she is familiar with the medical requirements for flying. (They are less strict than for scuba diving)

Good luck.

LiverpoolFC 5th Aug 2008 13:16

Okey thanks I'm not sure but I think I just have mild asthma so I think itīs ok...thanks any way....I don't take medecin often...

uklocations 5th Aug 2008 15:36

try a search lfc, this has been covered a few times in the last year.

It seems many pilots fly with mild asthma, as redsnail states, it depends on severity, time off school, exascerbations requiring hospital admissions, history of collapse/use of steroids (tablets) etc.

The odd puff on a blue inhaler prior to footy probably 'aint gonna make a difference.

Good luck.:)


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