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dynogyno
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old guy with new diagnosis
« on: Sep 11th, 2006, 9:18pm » |
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I'm a physician (can you guess what kind?) in my sixties and never had a headache in my life until 2 weeks ago. Over my eye, stabbing, coming in volleys, nauseated. I developed Horner's Syndrome, eye was tearing. Was downing Advils like M&Ms with no relief. I tried to work but could not help reacting when it would hit. My wife, not a medical person, said "maybe it's a cluster headache". I said no way, why should they start now, at my advanced age? Of course the Neurologist agreed with her, put me on Toradol and Prednisone for ten days and after 2-3 days I was fine. I'm having an MRI on Wednesday. So here I am, assuming MRI is negative looking for tips on aborting the next one...Do I get an Oxygen tank?? Thanks for listening... 
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George_J
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Re: old guy with new diagnosis
« Reply #1 on: Sep 12th, 2006, 12:00am » |
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Assuming the MRI is negative for some other problem, it sounds as if oxygen is your next best thing to try. See the "oxygen tips" link at the left of your screen. The flow should be 10-15 lpm with a non-rebreather mask.
I don't medicate (a personal decision), so I think it's best that I leave more detailed comments about treatments to others. Sorry you've had to find us, but welcome. I sincerely empathize with your recent introduction to CH--I've been episodic since 1966, but I haven't forgotten what it was like when I first encountered them.
You might want to check in with BB here out of New Zealand--she's a physician as well. Not a sufferer, but a supporter of her husband who gets cluster headache.
Regards,
George
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Ah! The foreigners put on such airs
Wearing the tangerine suits
And their harlequin eyes.
The pain they inspire
Draws in harmonica melodies
And the feathers of birds
Which flame up at their touch.
It all comes to light in the sheer
Debonair.
(Ellen)
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BB
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Re: old guy with new diagnosis
« Reply #2 on: Sep 12th, 2006, 12:35am » |
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Hi Dynogyno
I am Annette and a GP in Sydney Australia. My DH has CH and I am learning all I can about CH first to help all sufferers , second to argue with various doctors about CH! LOL
PM me and we can chat more when you are ready.
And yes, grab an oxygen tank and imitrex.
Painfree wishes to you. Take care.
Annette
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MJ
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Re: old guy with new diagnosis
« Reply #3 on: Sep 12th, 2006, 12:52am » |
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Hi dynogynodoc.
Heres a site you may find informative. check all the links therein.
http://www.clusterbusters.com/index.html
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MJ
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Bob_Johnson
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Re: old guy with new diagnosis
« Reply #4 on: Sep 12th, 2006, 8:56am » |
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MANAGEMENT OF HEADACHE AND HEADACHE MEDICATIONS, 2nd ed. Lawrence D. Robbins, M.D.; pub. by Springer. $59 at Amazon.Com. It covers all types of headache and is primarily focused on medications. While the two chapters on CH total 42-pages, the actual relevant material is longer because of multiple references to material in chapters on migraine, reflecting the overlap in drugs used to treat. I'd suggest reading the chapters on migraine for three reasons: he makes references to CH & medications which are not in the index; there are "clinical pearls" about how to approach the treatment of headache; and, you gain better perspective on the nature of headache, in general, and the complexities of treatment (which need to be considered when we create expectations about what is possible). Finally, women will appreciate & benefit from his running information on hormones/menstrual cycles as they affect headache. Chapter on headache following head trauma, also. Obviously, I'm impressed with Robbins' work (even if the book needs the touch of a good editor!) (Somewhat longer review/content statement at 3/22/00, "Good book...."
================= www.headachedrugs.com
HEADACHE 2006 IS HERE!
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This 64-page booklet has cutting edge ideas and opinions from Dr. Robbins about the meds and non-med therapies for migraine, chronic daily, and cluster headache. There is also a section on headache in children and adolescents.
Major revisions have been done, including the latest on meds and therapies for refractory, difficult to treat headaches including options for when nothing is working. There are also new sections on Bipolar, ADD, Insomnia, and Personality disorders, as well as Biofeedback. Click here for the complete table of contents. (Requires: Adobe Acrobat Reader - A free program)
Headache 2006 is the latest edition, based upon Dr. Robbins' 2 bestselling books. You will receive this latest work by Dr. Robbins and also help to support this non-commercial website, for only $16.95 (includes shipping).
To order, call 847 480-9510 (Mon. thru Fri. 9 to 4 CST) and order with a credit card (Visa, MasterCard, and Discover accepted), or send check (or Visa info) for $16.95 to:
Robbins Headache Clinic
1535 Lake Cook Rd.,
Suite 506
Northbrook, Ill.60062
You can also fax your order with your credit card information to: 847 480-9044.
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| « Last Edit: Sep 12th, 2006, 9:00am by Bob_Johnson » |
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Bob Johnson
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RichardN
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Re: old guy with new diagnosis
« Reply #5 on: Sep 12th, 2006, 1:47pm » |
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Hi Doc and Welcome to Clusterville
The key to using 02 is to use at the on-set of the attack . . . DON'T wait til you're "dancing". I can usually kill the beast in minutes at the KIP 2-3 stage. A middle-of-the-night KIP 5-6 . .. 10-20 min. You obviously have 02 at the office (8 lpm regulator not totally useless, but not near as effective . . . you need 12-15 lpm) and you'll want several at the house, depending on frequency and intensity of attacks. I keep 10 "E" tanks and two "B" tanks . . . getting 7 refills today.
Identify your triggers. Alchohol is major trigger for most of us . . . including me. A real beer or shot of brandy will bring on an attack within 15-20 min. Exhaust fumes, chemicals, certain foods . . . I'm sure you'll be paying attention to possibilities.
You will read numerous accounts here from folks who are/have been hostile towards the medical community for not understanding the anger/frustration of sufferers when told, "try this and see me in six weeks". When I came here 2/02, I was having 6-8 attacks daily, KIP 5-9, 20-45 min., some 1 1/2 - 2hrs . . . . and sometimes 3-5 attacks per night . . . I was a basket-case . . . this place gave me my life back.
Having said that . . . on the other hand we heartily welcome doctors and other members of the medical community who are either here as sufferers or supporters or interested in the condition. Several months ago there was a post from a lady heart surgeon who also used 02 to abort and had the experience of aborting (with 02) three attacks during an eight hour heart transplant. It is a miracle for those of us it works for (60-70%).
Please let us know how you're doing and if the 02 does the trick for you. Feel free to PM me or anyone else if we can help get you on the track to managing "the beast". I can live with the beast as long as I don't have to "dance" with the bastard.
Always someone here . . . 24/7 . . . no appointment necessary.
Be Safe, PFDANs
Richard
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I can live with the beast as long as I don't have to "dance" with the bastard.
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mcf69
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Re: old guy with new diagnosis
« Reply #6 on: Sep 13th, 2006, 4:08pm » |
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Welcome to the board doc dyno, sorry you had to come here under the circumstances. This is cool, as a nurse, I usually don't get to give doctors advice, but in this case I hope I can help. You've gotten some great advice on o2, listen to it, the best stuff you can get your hands on, no side effects and very effective. Stay away from that Advil during a CH, it won't do a bit of good, and as you know, the risks for hepatotxicity and rebound pain just aren't worth it. Pred has proven to be very effective for quite a few CH patients, but you know the bad stuff about that too, enough to make your own descision on that. If you need anything, advice, experience, or just some support, please let us know, we're all in pretty much the same boat here. Best of luck, and please let us know how you make out.
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E-Double
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Re: old guy with new diagnosis
« Reply #7 on: Sep 13th, 2006, 7:09pm » |
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Hiya doc
This is a great resource to know like the back of your hand...print it out and give it to the doc
http://www.brightok.net/~mnjday/chtherapy.pdf
It will present the appropriate treatments that you should seek and your doctor should know!!!
If you want an abortive with the least amount of side-effects O2 should not only be requested but demanded from your doctor!!!
http://www.maplefallswebdesign.com/misc/oxygen/oxygen.htm
I have used Zyprexa as an abortive and have found it to work (for me) as fast as Imitrex and without the "hangover"
http://www.clusterheadaches.com/cgi-bin/yabb/YaBB.cgi?board=medsarchive2 005;action=display;num=1120904753
If you do have the "typical" wake you up in the middle of the night horrors then.... Melatonin might be very helpful
Many of us (myself included) have found that taking 6-9mg (some take more) about a 1/2 hour to 45minutes prior to bed have Knocked out the night visits and can finally get sleep.
With the exception of 10-12 times.....I have slept through the night since August '04 (went chronic in March 05).....Still get hit during the day but my overall quality of life is better because I am not as exhausted all the time.
Some people report that it seems to make them worse....The fact is that we are all different and respond differently to everything therefore it may or may not...
The one thing I will tell you as far as my experience was that I had to stick with it...The first night I took melatonin, I was awoken with a doozy only I was too groggy to find my O2 .....It got a lot better for me....I then slept through the night but would get slammed about 1/2 hour after waking up....kinda like knocking the beast off schedule.....then again I was peaking and this cycle has been all over the place with no real pattern.
I stayed with melatonin and have had decent sleep overall. (Maybe I should start folowing my own advice again hahahaha!)
It may help and it is natural with not too many sideeffects....also ask your doctor b/c if there are any side effects or contraindications...I think they have to do with mild depression.....
Like I said we are all different.
Best wishes, good luck & stay as positive as you can!!!!
Eric
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I can't believe that I have to bang my
Head against this wall again
But the blows they have just a little more
Space in-between them
Gonna take a breath and try again.
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dynogyno
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Re: old guy with new diagnosis
« Reply #8 on: Sep 13th, 2006, 8:30pm » |
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My thanks to you all for your understanding and advice. I feel like a crybaby after reading about how long many of you have suffered with this. MRI was OK. Took a peek at my chart and Neuro. thinks I might have SUNCT-sudden onset unilateral something something with tearing. Very sobering experience for an MD. If this doesn't kill me it's already made me a better doctor.
dynogyno
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Barry_T_Coles
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Re: old guy with new diagnosis
« Reply #9 on: Sep 13th, 2006, 9:18pm » |
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Hi Dyno
Welcome to the site, sad you have to be here but your among people who understand what your going through.
As far as age goes I didn’t get my first cycle until I was 51, second cycle aged 56 & turned chronic, had no previous bad headaches other than well orchestrated hangovers.
My fav abortive is o2 for the big ones & Red Bull for the littlies when needed.
on Sep 11th, 2006, 9:18pm, dynogyno wrote:| I'm a physician (can you guess what kind?) |
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YEP
Kind Regards
Barry
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Worry is like a rocking chair it gives you something to do but gets you nowhere.
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Jonny
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Re: old guy with new diagnosis
« Reply #10 on: Sep 13th, 2006, 9:28pm » |
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on Sep 13th, 2006, 8:30pm, dynogyno wrote:| Took a peek at my chart and Neuro. thinks I might have SUNCT-sudden onset unilateral something something with tearing. |
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Excuse me if im out of line here, but you are a doctor and you have no idea what the neuro thinks you have?
Just what kind of doc are you if I may ask?
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It is up to YOU to educate yourself and then help your doctor plan your treatment. If you just sit down in front of your doctor and say "make me better" you are setting yourself up for a great deal of pain.
- Guiseppi
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nani
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Re: old guy with new diagnosis
« Reply #11 on: Sep 13th, 2006, 11:10pm » |
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dynogyno
Jonny, it appears his specialty is, um, NOT the head.
Welcome dynogyno, I'm glad you found us. Now what, besides HRT, can I use for my hot flashes?  Just kidding (kinda).
pain free wishes, nani
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Others may come and go, but MY power is MINE.
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Charlotte
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Re: old guy with new diagnosis
« Reply #12 on: Sep 13th, 2006, 11:29pm » |
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Doc, did your doc suggest a trial of Indomethacin. I've heard that SUNCT is one of the trigiminal autonomous cephalalgias that respond to that.
It is defintely worth trying, taking care to protect your stomach.
Charlotte
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E-Double
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Re: old guy with new diagnosis
« Reply #13 on: Sep 14th, 2006, 7:08pm » |
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Actually SuNCT is responsive to Neurontin and.......
http://www.ninds.nih.gov/disorders/sunct/sunct.htm#Is_there_any_treatmen t
The difference is that you will be having 100's of short lived attacks, however short lived means seconds or minutes vs the short lived for CH which is defined as 20minutes to 3 hrs
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I can't believe that I have to bang my
Head against this wall again
But the blows they have just a little more
Space in-between them
Gonna take a breath and try again.
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chopmyheadoff
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Re: old guy with new diagnosis
« Reply #14 on: Sep 15th, 2006, 7:16am » |
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welcome dynogyno - how i would love your job !!
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