peak flow meter and asthma questions

Over the years, I have been told that I have reactive airway disease, asthma, bronchitis by various doctors including pulmonologists, allergists, internists.  I am would love to get a firm diagnosis and hopefully a better treatment plan than cross my fingers each time I get a virus that it doesn't trigger the airway symptoms.  Would you recommend an Allergist or Pulmonologist?

"My breathing symptoms which usually include (tightness, the feeling that I can't get a deep breath, wheezing and increased congestion) are triggered by viruses. I can go four or five months with no symptoms and no meds. It seems that this time of year, I get a virus or head cold and then I am in for a bumpy few months. I am now in the middle of another flare up. I just started using my peak flow meter yesterday.  Normal for me should be around 450 - 500. Yesterday my highest peak flow was 300. Today I did my peak flow in the morning and it was still at 300. I used the rescue inhaler and waited about 10 minutes before doing my peak flow again. After the treatment, it went up to 350, however after taking a deep breath I had a wet sounding cough which brought some stuff up. DOES THAT MEAN THAT THE INHALER IS WORKING? I am also started taking a short burst of prednisone and an RX cough medicine on Thursday and started using Advair yesterday. I have been using nasonex for about a month.

If I just sit and watch tv, do little things around the house and take it real slow, I can breathe without feeling overly winded. I just went to the supermarket to pick up an RX and 8 or 9 items. I can't believe how winded I am and the amount of coughing that little excursion triggered. After I got home, it took about 15 minutes for my breathing to settle down.

How long does it usually take for the meds to start to kick in?  I have been reading some worrisome things about Advair.  What is your opinion about that medication?

Thanks for your help

Amy
  

[National Jewish Health]

Your precipitating factor may well be a "…virus or head cold…" but we should not assume that to be the case.  Ragweed and other pollens are still in the air in many parts of the country.  And then, with our houses increasingly closed-up, there is the heightened exposure to indoor allergens, such as house dust and the dust mite, animal dander especially cat, but also dog, rodents and even birds and molds etc, and that too could cause your worsening.

What you describe suggests that your asthma has been sub-optimally controlled and requiring 15 minutes for your "…breathing to settle down", is especially worrisome.  You and your doctor would do well to not assume that your current breathlessness is from asthma and to consider other causes of such shortness of breath, including heart failure and clots to the lungs.

That you coughed-up some mucus after using your rescue inhaler is a good thing and suggests that the inhaler is working.

Short-acting rescue medicines should "kick-in" within 2 to 5 minutes

In future years, you and your doctor might want to consider starting your full panel of asthma medicines preemptively in late August or early September.