AIBU to think peak flow drop isn't wasting GP time

[lalalalyra]

AIBU to think that someone who has had a heavy cold for 3 weeks that they've been treating at home, but has now made a GP appointment because their peak flow has dropped by 60 (from 380 to 320) they aren't "running to the Dr for a cold"?

Apparently the fact their barking cough has gone away is a sign they are getting better. I think the slightly wheezy cough they have now is more worrying.

I'm so fucking pissed off. Now I'm going to have to fight to get them to the appointment tomorrow because Mr bloody Know-It-All brother has made them feel like they are wasting the GP's time.

That's a 15% reduction in peak flow

DD's trigger point for GP (or to take antibiotics or steroids which she keeps at home) is quite a bit lower (25-30%)

But the cough sounds concerning so I'd go with an appointment

As a practice nurse we advise patients to double up their preventer and use reliever regularly as first step if peak flow drops consistently by about 25%, alongside an increase in symptoms. Then seek review if no better after 48 hours. Would always err on side of caution with children though.

They've done the usual of upping their preventer and using the reliever regularly. Their asthma is usually very well controlled and they don't see the doctor for much. The asthma nurse sees them once or twice a year.

This peak flow drop since yesterday combined with the cough is making me super twitchy.

Maybe he's right and I've twitched too soon. It just doesn't feel right, which I suppose is no reason for a GP appointment.

I wouldn't mess about with asthma. Yes if you feel it warrants GP then it's right to go

Someone I know died of asthma a few weeks ago, suddenly, unexpectedly. Normal healthy adult, leaving children fatherless. If in doubt, doctor.

I have to say I don't even act on peak flow until it's 75% or below. Doctors maybe under 50%. For reference, pneumonia put me down to around 30%, and my current is around 80-85%.

Three weeks of a cold is pretty miserable but in the absence of other underlying health problems I'd consider it a bit soon to visit the GP. A drop of 60 in an adult is barely outside normal variation, surely?

Different if it's really difficult to get an appointment, or if there are other significant symptoms such as a wheeze. A productive cough is "healthy" by comparison.

How many times have they taken their ventolin today? Do they feel like they are struggling to breathe? Is there any tugging at the throat or under the ribcage?

Oh is it a sudden drop? That is a bit more weird. I thought you meant gradually over the three weeks.

Sorry, I was too wound up by Mr Smug to be totally coherant in my first post

The drop is yesterday to today. He's been hovering about 380ish for the past week. We've had cross words because he doesn't know/doesn't remember what it was the week before or what it normally is.

He's 17 so it's like mumble bloody city. He's taken his ventolin today at least 4 times that I've noticed.

Is the wheezy cough they now have relieved by the inhaler? If it is relieved, does it stay away for a few hours?

X posts. I don’t think you’d be wasting GP time at all then.

Rafals It does seem to relieve it. I'll keep a note of how long.

It just doesn't feel right. Which probably sounds ridiculous. I don't panic about asthma, there are 4 asthmatics in the house including me (although I'm super, super mild).

He didn't argue when I first broached the appointment. Which isn't like him at all.

FFS. One of these days I'll not be rattled by brother. Thanks.

A drop like that on the upped medication, along with the wheezy cough, means he needs to see GP IMO.

Whilst there, you can get advice on what sort of peak flow reduction should trigger a GP visit in future, and that in itself is a perfectly valid reason to see a GP. What is a worrying drop in a young, fit, normally symptom-free person would be nothing to worry about in an older, frail, person with chronic asthma, for example - so what other people do isn't really a valid guide. For instance, on asthma.org.uk you will see they suggest seeing your GP if you need to use a reliever more than 3 times a week. Some people use one 3 times a day routinely - and need to.

If I knew his normal PF I'd be more confident. I'll know after this! (DN, he hasn't lived here that long and hasn't had asthma issues while he's been here).

I know DD's drops exactly, but she's only little and has other issues on top.

GP I think
reduction over night & lots of ventolin plus change in cough = GP

If it’s relieved by the inhaler then it’s likely an asthma symptom rather than anything to do with the previous infection. At which point I would go to the GP.

He's 17? In that case I'd assume his normal PF is considerably higher than 380! If he's sporty or plays a wind/brass instrument then it would likely be more like 500+.

Daft bugger not knowing his own normal PF Any chance it would be on his medical record from asthma clinic? The doctor would then have a good frame of reference for comparison.

I'm so pissed off he doesn't know his PF. Apparently he only checks it when he's ill... looks a bit sheepish at the "and what do you balance it against?" (Apparently when he last has a chest infection the nurse gave him a set number that he was to call then if it got down too, helpfully he can't remember what it was). His mum really did deal with everything.

It must be way higher than 380. I blew 480 at the asthma clinic and I'm a fat short arse. He's a tall, fit, young guy.

Apparently parents don't know his usual either (inc big mouth know-it-all). He had an asthma review last September when his preventer was changed so hopefully they'll know.

He's a tall, fit, young guy.

DH is nearly 18" taller than me but only blows around 50 higher. It can be deceiving. Which is why it's so important to know your own!!!

My asthma nurse advises me to go in if it drops by 15/20% but I have to go when ever I get a cough/cold/sinus etc as I seem to be able to develop pneumonia at the drop of a hat but she recommends that for any asthmatic aswell. It's better to be safe than sorry OP. I hope everything's ok xxx

See GP. I didn’t and ended up with pneumonia which took months to shift.

Thank you for the support last night. DN has a chest infection, as well as an ear infection.

Apparently his PF is usually around 530 so it was quite a bit down.

We've both had another lesson in 'ignore him' as well (we had a family funeral so NC is back in place for us all). So, all is well. Well, will be after he's better. Thanks all.