Peak flow good but SpO2 at 94?

Posted , 4 users are following.

I'm having a really bad time with asthma lately, I've been to A&E a few times but they havne't done much about it. The thing is I don't have the classic wheezing symptoms, but I do feel short of breath, with pain and pressure in my chest. I use my peak meter and pulse oximeter to measure my oxygenation. At this point I have become quite anxious because I'm using prednisone and oral salbutamol to control it and my SpO2 reading is still at 94-95, occasionally dipping to 93. Anxiety gets mixed in an I don't know if I'm actually not breathing or if it's the anxiety. Is it safe to be at this level? The thing is, my peak meter reads 560, so I don't understand how they could be so different.

0 likes, 10 replies

10 Replies

  • Posted

    I don't know about SpO2.  But I do know about asthma medications.  When you are on prednisone, do they stop your ICS and LABA, such as Fostair, Symbicort, Seretide/Advair?  How often are you needing salbutamol (Ventolin)?

     

    • Posted

      No, I keep taking them. I use oral Ventolin 2mg every 5-6 hours.
    • Posted

      Hmmm.  Because you said "they haven't done much about it" I assume you are looking for alternatives.  Oral Ventolin is not that common, but I did have it a bit when I was a kid.  Otherwise it seems normal.  Obviously your asthma is quite bad or you would not be on Pred.

      All I can offer is that there is a theory being promulgated online about silent reflux, seems to be controversial.  The idea is that if you have trouble breathing in it is silent reflux, but trouble breathing out is regular asthma.

      Meds to try are leukotrine blockers (montelukast) and cromolyn.  

      Otherwise as always trigger reduction, breathing exercise and lifestyle changes and stress management all help but none are silver bullet.  Let us know more about your allergies.

       

    • Posted

      Oral ventolin and prednisone is self-prescribed, like I said the doctors didn't do anything. If I don't take it I stop being able to talk so it is quite bad asthma.

      Could you tell me more about silent reflux?

      I started montelukast about a week ago. Would I be able to take cromolyn with it?

      I'm allergic to dust which is pretty much everywhere and triggers my asthma quite badly.

  • Posted

    Are you on any allergy meds to help with your allergies ? Your 02 numbers are that way probably cause you are anxious usually when you relax and breathe normal it will go up. Don't stop your prednisone it was given for a reason. You are just fine ... lots of people walk around with a lot lower o2 levels. 

  • Posted

    Your case seems pretty complex because some parts are atypical.  When you say "self prescribed" I'm not sure what that means.  I think you suspect you have been misdiagnosed, but being on a lot of prednisone is pretty serious.  Do you have an allergist you can go to and thoroughly discuss all your symptoms and triggers, and show them a log of your SpO2 and your spirometry results.

    I don't know much about silent reflux except a friend was told she had it (but not for asthma, for a cough that was not asthma).  It's very controversial so its a long shot I would rather rule out the above suspects first.  Basically they treat stomach acid even though you don't have obvious symptoms.

    • Posted

      Yes, I believe I've been misdiagnosed as I don't think the doctor realizes that I haven't moved from bed in a week because I get out of breath otherwise. I think a referal to an allergist would take months given the NHS' track records, that is even if I get a refferal.

    • Posted

      Hi albert96

      Every winter I have a couple of similar flare-ups.   In my case (and I am regular Symbicort) I have a minor cold which quickly escalates to what I call a chest infection (ie. producing lots of green gunk with coughing and feeling ill).   I probably don't go to the doctor fast enough as I always think the problem will clear up - and it doesn't.   I should really have learnt by now!   Anyway, I am quickly put on antibiotics and often Prednisolone.   It may take several courses of antibiotics to clear the infection (possibly my fault for not being treated fast enough...).

      The reason I am posting the above information is that during the above episodes, I have great trouble breathing and am pretty much out of breath all of the time;  I take far more Ventolin that is good for me;   my muscles are screaming in agony but... sometimes the doctors cannot hear a squeak in my chest.   I have never understood why this may be and feel a fraud but the copious amounts of phlegm that I produce shows there must be an infection.

      I have been asthmatic for many many years and think I know my own body after all this time but still do not understand why I don't produce the standard wheezes.   My theory - probably incorrect - is that I become so inflamed that there is not much open airway to squeak, although obviously if that were the case overall I'd be dead! 

      My peak flow shows that I am down about 20% (I can feel really breathless if only down 10% or so) but this is not deemed critical by my surgery.   I am sometimes given a nebuliser and this helps temporarily, especially if I have two consecutively.

      I wonder if your pain is caused by your chest muscles working overtime - all the time?   It really is hard work and very painful.   Have you tried standard painkillers to help your pain?

      The only other time I would add is that I would not countenance taking Prednisolone for longer than is strictly necessary.   It can do horrible things to you and should really be kept as an almost last resort.

      If anyone does have an idea why doctors can't hear the standard wheezes in a chest when the patient knows they are unwell, I would be very grateful!

      In the meantime, I am becoming depressed as the autumn is nearly here and that's when I know that my problems will re-occur.....!

      Try painkillers for your chest and possibly a 'steamer' for your nose and mouth.   I find this gives some benefit (essentially it is the same as putting your head under a towel over a bowl of steaming water.   Breathing in gives relief to your inflamed bronchi/bronchioles - a bit!).   There are several version of a more up-to-date product on the market.

      Wishing you a rapid improvement.

    • Posted

      Sorry I don't know what to say.  You'll just have to show them a log or video or something of your difficulty and try to get some spirometry.  GP should be able to do that.  Inhaled albuterol is more typical, puffer first nebulizer if you need it stronger.

    • Posted

      Don't worry green 881!   Hopefully I will survive.

      I thought I'd chip in as albert96 has a similar problem to me as in we do not seem to tick the correct asthma 'boxes', yet we do have problems.

      Although willing to believe I could be a hypochondriac/malingerer/anxiety-ridden individual, the um, er, secretions my body produces (notwithstanding the cough needed to excrete them) does not add up with my not having a noisy chest.   I was allaying this with albert96's 

      problem.   Perhaps we are just minor medical miracles.....!

      Thanks anyway

      Oh, by the way, I have had a spirometry test in the past, which was normal.   I will try and see a doctor earlier in these episodes in the hope I will need fewer antibiotics use of Ventolin and Prednisone.

      Thanks again.

      Regards

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