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7upatnight
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Ethical Question/CH Responsibilities/Harms Way
« on: Nov 1st, 2002, 7:36pm »
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I am new to this forum and would like your comments.
 
I am another military member disgnosed with cluster headaches.  They are debilitating.  The military either does not understand cluster headaches or dismisses them outright.
 
Either way, I do understand their impact because I do have to deal with them.  [/b] Should I be responsible for troops in hazardous duty conditions (harms way)? [b] I can say that I don't have a headache now, but I don't know when I will get one.  I like what I do.  This question is a real leadership challenge for me.  There could be other lives at stake.  To compund this issue, I have been getting similar cluster headaches lately after exercising.
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Re: Ethical Question/CH Responsibilities/Harms Way
« Reply #1 on: Nov 1st, 2002, 7:47pm »
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7up - welcome to the board. You didn't mention what you are doing about your HAs. There are preventatives (I use Verapamil) and abortives (Oxygen and Imitrex are the two most common).
While I am not in a military situation, I also find I must lead people. I am episodic, the CHs are not a full time thing, so I don't have the time pressure of command situations you are refering to. In my situation, I have had to go behind office doors for awhile (45 minutes max) while I rid myself of the beast. I have found that the folks who report to me simply carry on. I have trained them well and I know they can do what needs to be done without me.
Tough question and I wish you luck in finding answers
PFDANs
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7upatnight
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Re: Ethical Question/CH Responsibilities/Harms Way
« Reply #2 on: Nov 1st, 2002, 7:55pm »
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I have tried all of the meds you mentioned including sansert.  When at home prescriptions are not an issue.  My concern is out in the field.  Give me 45 minutes while the enemy advances?  I have had some less than understanding commanders in office environments too.  My actions there too impact mission completion and command readiness.
 
Your comments are appreciated.  But imagine if you will, if your job was not in an office, but in an industrial environment, laboratory, or if you carried a sidearm.
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Re: Ethical Question/CH Responsibilities/Harms Way
« Reply #3 on: Nov 1st, 2002, 8:09pm »
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I think Domm made a pretty good point here.  Leadership is not about always being there ... its about making sure the people you have trained are ready willing and able.  Good leaders don't do the work(and that includes leading), they train others to !!!!  Just because you happen to be fighting more than one enemy doesn't mean you cannot be a good leader.  
 
Thanks for all you do in protecting our nation.  You guys don't get nearly enough pats on the back.
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Re: Ethical Question/CH Responsibilities/Harms Way
« Reply #4 on: Nov 1st, 2002, 8:31pm »
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7up, Have you ever had a CH while doing training exercises or mock wars? (I've never been in the milatary so I don't know the lingo) I have found that stressful situations (enemy advancing) will stop a ch or even keep future ch's from coming. I have used stressing myself out to stop them before but I ussally have to make up the stress. In war you would be under real stress and hopefully not have any ch's.
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Re: Ethical Question/CH Responsibilities/Harms Way
« Reply #5 on: Nov 1st, 2002, 8:35pm »
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Have you tried a shot of imitrex?
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Re: Ethical Question/CH Responsibilities/Harms Way
« Reply #6 on: Nov 1st, 2002, 8:46pm »
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7, Being a former Marine in a postition of leadership and suffering from clusters in times when my Marines depended on me, I know how you feel.  However, don't take this wrong, but if you are concerned with your condition affecting your ability to make effective desicions, Quote:
There could be other lives at stake.
then your guys come first.  You didn't state how your desicions affect you unit as a whole.  Domm is correct good troops make a good leaders job easy in his absence.
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Re: Ethical Question/CH Responsibilities/Harms Way
« Reply #7 on: Nov 1st, 2002, 9:03pm »
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7 - actually, I run a chemical plant. I'm the plant manager. So, I spend large amounts of time planning to keep people out of harm's way. If I've done my job right, no one gets hurt, quality product gets made and the environment doesn't get harmed. The very old saying "plan your work, work your plan" is appropriate is many situations.
The clusters have never interferred with my work, but delegation can be very trickey if not done properly.  
 
I would not pretend to compare my situation with yours, only that sometimes if you think of your situation under different light, you may see a way to handle the process differently.
 
God bless you for spending your time defending me and my family.
domm
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Re: Ethical Question/CH Responsibilities/Harms Way
« Reply #8 on: Nov 1st, 2002, 10:14pm »
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Welcome to the board!  Sorry that the beast likes to blast away at your cranium with anti-tank shells.  Good luck!
 
PFDAN....................... Drk^Angel
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Re: Ethical Question/CH Responsibilities/Harms Way
« Reply #9 on: Nov 1st, 2002, 10:43pm »
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Welcome aboard and I agree that in a stressful situation all kinds of body chemistry takes over. I would be surprised if you were hit or had one continue in something like that.  
 
Just my opinion and thanks for your dedication.
 
Charlie
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Re: Ethical Question/CH Responsibilities/Harms Way
« Reply #10 on: Nov 1st, 2002, 11:05pm »
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7-up
 
Maybe i will come close enough...  I work as a supervisor for a law enforcement agency. I am a field Sgt and responsible for  
 
1.  The officers that are assigned to my shift
2.  The public that we are charged with protecting  
 
At times, it gets hectic, violent and even life threatening. I have been dealing with CH attacks since 1997 and there have been times when I have called off due to lack of sleep (not very often - 1 - 2 times / 6-month period).
 
As for me, I follow Domms line of thought - trust your people and you will find that they are not as stupid as you may think.. As for life and death situations, it is my experience that when someone is shooting at you - a supervisor can yell until he is blue in the face, but it all comes down to if he has trained his troops well of not.
 
Another thought is that we have very brave and experienced ex-military, most certainly Vietnam Vets on this board that I am sure can tell you that many of the commanding officers during war time, lack sleep and are suffering from a multitude of "hurt". They might be able to give even more information specifically relating to your situation.  
 
wish you all the best
 
Marty    
 
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Re: Ethical Question/CH Responsibilities/Harms Way
« Reply #11 on: Nov 2nd, 2002, 1:20pm »
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Good question for DJ........ Lips Sealed
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Re: Ethical Question/CH Responsibilities/Harms Way
« Reply #12 on: Nov 2nd, 2002, 3:22pm »
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7Up,
 
First of all, my thanks to you and the soldiers working under you for defending all of us!!
 
My only question is: how well-informed are the military docs? And if they are well informed about clusters, can't they weigh in on this to assist you?  
Forgive my ignorance -- I have never served in the military.  Seems they have a responsibility to educate your superiors.
 
Just wondering...
 
Tough questions and sorry I can't be of more help!
 
God bless you and best wishes!
 
Stan
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7upatnight
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Re: Ethical Question/CH Responsibilities/Harms Way
« Reply #13 on: Nov 2nd, 2002, 9:19pm »
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The underlying question for me is liability.  I do believe I can handle the CHs with time.  However, we live in a letigious society even for the military.  The Navy has not given me a clear signal that if something were to happen during a CH, what is my responsibility?  More information:  Once when my career was going my way, the Navy removed me from a special program due to the diagnosis of Cluster Headaches.  Specific reasons were due to the incapacitating nature and drugs that have potential to affect mental judgement.
This time things are going well for me again and I seem to be getting glazed over by medical and slipping through the cracks and have an opportunity to go on to even more dangerous duty.  Navy medical however is not applying the same standard.  I have been observing and answering all medical questions.  However, I do wonder if the Navy would look at it as my responsibility to have said something and not slip through the cracks?  Since diagnosis and removal from the first program, I have deployed to an overseas and remote site (that's twice) and had a series of headaches and there was a lot of finger pointing by medical.  Luckily, I clearly indicated the condition during my screening.
I am doing the same thing this time around and clearly stating the condition and again am looking forward to being deployed.  
 
The feedback so far stated that stress helps prevent CHs.  I don't find what I do stressful.  I think I lead a relatively stress free life with exception of the CHs.
My current plan as of now is to ask these questions directly to medical.  Given that I was once removed from a special program due to CHs and have since managed to deploy to remote sites twice.  The sailors around me are true professionals.  Success is a team effort.  As a part of that team, I expect 100% from everyone else including myself.  The only thing to ever bring me down have been CHs.
 
Thank you all for your comments.  The forum is greatly appreciated.
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Re: Ethical Question/CH Responsibilities/Harms Way
« Reply #14 on: Nov 3rd, 2002, 7:22pm »
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I would fully document all attempts to get service on this issue.  Write down names and dates of who you talk to - the times involved, the medications used and their results......all of this is to protect yourself.  You are enlisted and perhaps have little other course of action.....question - have you discussed your concerns with the chaplain?  Some times they can assist  on the back end.  It is obvious you have had some duty time as you have command under you.  It is not as if you are trying to shirk responsibilities and trying to pull a Corporal Klinger to get out of battle situations.
 
Again, documentation is the key.
 
As far as my headaches, I have found I have them predominantly at night when I am in a rest mode.  I can't think of a time when I was heavily active mentally and had one.  I have had them when awake, but it has been when relaxing as much as I can think.
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Re: Ethical Question/CH Responsibilities/Harms Way
« Reply #15 on: Nov 4th, 2002, 8:58pm »
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First welcome to the board 7up.
 
2.  StantheMan...the military drs don't know shit about clusters.  Unless you can get to either Walter Reed or Wilford Hall, you will be lucky to even get oxygen out of the military HMO without a shitload of red tape.
 
I am not military, my husband is active duty AF and I have had a nightmare with the military medical society and their ignorance of this condition.
 
3. Not4Hire did an article for the newsletter on service members and CH's.  Maybe you can IM or email him to see if he has any inside info he can give you.
 
4.  Read this site through it's entirety, print out reams of pages of the impact and the emotional and physical affects of CH's and present them to your first sergeant and have him work with you to develop a strategy to deal with your troops/soldiers/sailors and commanders.
 
5. Don't be surprised when they write you off as migraines...be persistent and if necessary demand an appointment with Walter Reed or Wilford Hall headache clinic.
 
I've had good luck with Celexa as a preventative, with no side effects.  Unfortunately O2 on a mission - even portable I'm sure could be a real problem.  Try and get them to find you a fast acting abortive, Frova seems to be a good one so far.
 
Sorry I can't offer more.
 
Cat
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Re: Ethical Question/CH Responsibilities/Harms Way
« Reply #16 on: Nov 5th, 2002, 3:09pm »
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Hey. My clusters started in the Air Force.  Military doctors generally don't know much about them-neither do civilian doctors for that matter-we have to be experts on our own condition.  I only had one attack while on duty during a mobilization for Operation Just Cause) you remember Panama...Noriega... anyway-I went to the ER-no choice.  couldn't function---however-what effect did the exhaustion and depression have on my decision making abilities.  That was a concern of mine.  
PFDAN to you
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