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Pfunk
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Please Help!
« on: Mar 6th, 2007, 3:09am » |
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Hello all and sorry that I have been away for a while but things have been very hectic for me lately. As some of you may remember, I got into a pretty bad car accident on Jan 13. I injured my already damaged neck pretty bad as my head hit the window a couple of times and my neck whipped around quite a vbit during the wreck. As a result, my HAs, which had begun to slow down at the time have gotten worse and occur more often than ever in my life. I am going to the doc and PT twice a week. We have tried the Prednisone taper 2or3 times with no success, surprisingly. I have missed a total of almost a month of work and have missed quite a few classes and am in danger of having to take a medical withdrawl from college again. Work is not that much of an issue but I realy can't afford to drop out of school again as this was the reason I had taken 10 years off without finishing before. Some of my professors are very understanding and allowing me to work at my own pace but two of them are not giving at all.
My question is: are thereany painkillers that I can take, for the pain in my neck is totally unbearable at times. If not, are there any sugestions on what I can do for the pain?I have a script for vicodin but, of course,every time I tae it, I have to chase it with imitrex for the obvious reasons. The only pain killers that I have evr taken that gave me any sort of relief from the monster was morphine but doc wont give me any more than 10-15 of them and not often enough to give much relief anyway. Plus, I really can't do too much after I have taken it and definitely should not be driving down the interstae for the 20-25 mile trip I make every morning to go to class while hopped up on morphine. The guy that hit me was on something as he had fallen asleep at the wheel. Which bring me to my next point. I had to go get one of those injury lawyers because allI was asking fot was them to pay my medical expenses. I even signed papers saying that they could make the payments directly to my doc, which they agreed to at first. Now they said they would settle with me but will not pay the doc. So, I got the lawyer and he says he's going to get every thing possible and then some. Pain and suffering, missed time and wages, payment of the doctor bills, reimbursement for the classes that I have missed and or had to drop yet still paid for, lawyers fees and reimbursement for the wages that I have had to pay out as I have two schedule two employees to be there during the time when I cannot, etc. I really hated to do it this way as I hate court and am definitely a sue-happy person who jumps out of the car and immediately screams my neck hurts. But, I already have nerve damage in my neck and this had made it much worse. I am getting hit 4-6 times a day now rather than 1-2. And doc says that he is not signing the MMI form for the lawyers until we are convinced that this cycle has come to an end for this years, which should have been about 3 weeks ago.
Well, I guess I have rambled on long enough; felt good to get it off my chest. Any suggestions or advice on any or all of these matters would be greatly appreciated. Much luv anf PFDANS to all.
Pfunk  
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LeLimey
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Re: Please Help!
« Reply #1 on: Mar 6th, 2007, 3:41am » |
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Hello Pfunk,
I'm so sorry you are still suffering so much. I don't know enough about pain relief to be able to give you any advice but I'd like to welcome you back 
The light is always on as you know and support is always here for you, I am sure you have had more than enough to cope with in the last few weeks but we will always help you through this - hang in there. More knowledgable people will be along soon
Take care
Helen
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BB
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Re: Please Help!
« Reply #3 on: Mar 6th, 2007, 7:36am » |
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Hello Pfunk
Sounds like to you are having it tough at the moment  . I pray that things get better for you soon.
One word on morphine, its very highly addictive and it has been known to change episodic CH to chronic CH. It can also lengthen a cycle. I would stay away from it if at all possible. Anti-inflammatory such as brufen and nurofen may help, both in the form of tablets as well as massaging ointment.
Have you tried physiotherapy, massage therapy for your neck? Was it a whiplash ? Whiplash has a natural time frame of being really bad in the first 3 months but then as the tendon sheath in the neck healed it will taper off and generally be almost gone by 6 months. Neck exercises and stretching help too.
Take care and painfree wishes to you.
Annette
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nani
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Re: Please Help!
« Reply #4 on: Mar 6th, 2007, 10:41am » |
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on Mar 6th, 2007, 7:36am, BB wrote:
One word on morphine, its very highly addictive and it has been known to change episodic CH to chronic CH. It can also lengthen a cycle. |
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Really? I hadn't heard this. 
Pfunk, damn, I'm sorry you're having such a rough time. I think I agree on trying some non-med pain relief efforts. I'm sending vibes and pf prayers... hugs, nani
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Sean_C
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I don't know about it changing your ch pattern, never did mine, but I do know forsure it never stopped my ch attack.
Any doc who uses morphine in relation to ch is either uneducated or is desparate to find you relief and is assuming morphine will ease the pain, which it won't.
Cheers
Sean.......................................
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Bob_Johnson
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Re: Please Help!
« Reply #6 on: Mar 6th, 2007, 12:44pm » |
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Not an easy question. Possible to have cluster-like symptoms and not have CH; can arise from injury or other disorders.
And then we have:
Curr Pain Headache Rep. 2006 Apr;10(2):130-6. Links
Head trauma and cluster headache.Manzoni GC, Lambru G, Torelli P.
Headache Centre, Department of Neurology, University of Parma and University Centre for Adaptive Disorders and Headache, Via Gramsci, 14, 43100 Parma, Italy. giancamillo.manzoni@unipr.it
Post-traumatic cluster headache (CH) is a very rare occurrence. Only one such case has been verified in the literature thus far. On the other hand, a non-casual association is almost certain to exist between previous head trauma and future CH onset. Considering the generally long interval of time separating the two events, it is not easy to accurately explain the nature of the head trauma/CH relationship. Head trauma may damage extra- or intracranial peripheral or central nervous structures, hence predisposing to the future development of CH. However, there also is the possibility that previous head injuries may be more frequent among CH patients because of their lifestyle, which may leave them more exposed to the risk of traumatic events.
PMID: 16539866 [PubMed
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Skyhawk5
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Re: Please Help!
« Reply #8 on: Mar 6th, 2007, 3:05pm » |
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My last cycle I had to have eye tubes put on my cluster side. Told the Doc that codine was bad for CH. He gave me Darvacet and it worked well for me. Hope this helps.
Vibes your way, Don
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Sean_C
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on Mar 6th, 2007, 1:44pm, BB wrote:| Overuse of acute medications for headaches including tryptans and pain killers are widely known to cause rebound headaches. The more rebound headaches you have the more the vicious cycle you can get into. More headaches, more medications, more rebound headaches, more medications still ... The result is a prolonged cycle and the increased risk of becoming chronic. |
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It mentions daily/migraine headache, nothing regarding cluster heads becoming chronic due to prescribed medications. There's no hard evidence that I can see Annette.
" Like with CTTH, the overuse of acute treatments for migraine (including analgesics, ergot derivatives and triptans) can be responsible for transforming migraine into a chronic condition. However, the transformation may also occur as part of the natural history of the condition."
Where's Flo 
Sean.....................................
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| « Last Edit: Mar 6th, 2007, 7:13pm by Sean_C » |
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nani
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Re: Please Help!
« Reply #10 on: Mar 6th, 2007, 8:18pm » |
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Annette, the second and third links refer to MOH (medication overuse headache) which, you know, is not a cluster.
http://headaches.about.com/od/allheadpaintype1/a/med_overuse_ha.htm
I've seen studies that suggest overuse of Imitrex can cause additional CH attacks, but never anything on morphine or other pain meds doing that. Nor have I seen anything that suggests that morphine will turn episodic CH into chronic CH.
OK, Skyhawk ...
on Mar 6th, 2007, 3:05pm, Skyhawk5 wrote:| My last cycle I had to have eye tubes put on my cluster side. |
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Wot?
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BB
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Re: Please Help!
« Reply #11 on: Mar 6th, 2007, 8:56pm » |
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Nani and Sean
If you are looking for an article that uses the word CH specifically and narcotic links to the transformation of episodic to chronic then thats true, there isnt.
The articles I have read talked generally about chronic headaches including chronic migraine and chronic daily headaches. The basic pathophysiolopgy of them are similar to cluster headaches, they all involve the same trigeminal pathways and serotonin. The medications used for them are the same as for cluster headaches. The mechanism explained for the transformation of episodic migraines to chronic migraines that involves narcotic use is by the causation of rebound headaches. It is well known that overuse of pain killers cause rebound in all types of headaches, including CH. The more rebound headaches you have, the longer the cycle is going to be. The longer the cycle going to be , the less time in remission. The lesser the remission period, the more likely you are going to become chronic, or at least fulfil the criteria of being chronic. The transformation may not be permanent as withdrawing the meds may see the reverse back to episodic, ot may not.
Articles implications can be understood and evaluated in several ways, not just the face values of the words. Thats how results of researches are debated.
However, if one wants to be picky about specific word, then I stand corrected. I should say there is evidence linking narcotic (over)use to the transformation of episodic neurovascular headaches to chronic, and not use the word CH.
I wish Flo is still around, I would have a ball debating things with him. I do miss that.
Annette
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Sean_C
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on Mar 6th, 2007, 8:56pm, BB wrote:| The more rebound headaches you have, the longer the cycle is going to be. The longer the cycle going to be , the less time in remission. The lesser the remission period, the more likely you are going to become chronic, or at least fulfil the criteria of being chronic. The transformation may not be permanent as withdrawing the meds may see the reverse back to episodic, ot may not. |
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Annette, I am a prick, get over it 
I'm going to give you my explanation of experience here, it doesn't work that way.
Taking medication for "clusters" IMHO, and I am undisputedly not a doc, give you the risk of becoming chronic because you are doing so.
Give me real facts showing otherwise, and I'll recant my opinion.
Other than that, medications for some, especially me, have been a god send, I absolutely love Trex. I never leave home without it 
Cheers,
Sean..........................................
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UN solved
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Regarding the use of Morphine...the more you take, the more you'll need to take to achieve the same relief. The line has to be drawn somewhere or you'd risk overdosing. Maybe better to seek a less dangerous drug (if there is such a thing). Addiction comes quick and often without warning.
UNsolved
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BB
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Re: Please Help!
« Reply #14 on: Mar 6th, 2007, 9:34pm » |
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on Mar 6th, 2007, 9:10pm, Sean_C wrote:
Annette, I am a prick, get over it
I'm going to give you my explanation of experience here, it doesn't work that way.
Taking medication for "clusters" IMHO, and I am undisputedly not a doc, give you the risk of becoming chronic because you are doing so.
Give me real facts showing otherwise, and I'll recant my opinion.
Other than that, medications for some, especially me, have been a god send, I absolutely love Trex. I never leave home without it
Cheers,
Sean..........................................
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You are definitely NOT a prick 
I am all for medication for CH, they do help to control the condition, they just need to be used with caution.
I do want to raise the awareness regarding the use of narcotics specifically, its generally not appropriate for CH as it doesnt really work that well for CH pain and it has so many risk factors.
I just need to watch each single word that I use here so that I wont cause a controversy.
Love you Sean.
Annette
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Sean_C
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I have a trendency to over anal-yse as my wife would say
I love you too Annette
Cheers
Sean...........................................
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Skyhawk5
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Re: Please Help!
« Reply #16 on: Mar 6th, 2007, 11:10pm » |
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Sorry! Posted right after a hit. I had a blocked tearduct and would have lost sight in that eye unless I had the surgery to put in tubes to drain that eye. It was no fun.
SKyhawk
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nani
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Re: Please Help!
« Reply #17 on: Mar 6th, 2007, 11:14pm » |
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on Mar 6th, 2007, 9:34pm, BB wrote:
I just need to watch each single word that I use here so that I wont cause a controversy.
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It's not about controversy, Annette. It's about giving advice in broad generalizations that don't really apply to us at all. CH is not migraine, or MOH, or anything but CH. If I had a nickel for everytime someone gave me advice that was meant for migraine and not for CH...well, you know the rest. There are still docs out there who think CH is strictly a male issue... Anyway, I could go on and on. I hope you get my drift.
Pfunk, I'm sorry we hijacked your thread. I hope you are getting some relief. hugs, nani
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nani
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Re: Please Help!
« Reply #18 on: Mar 6th, 2007, 11:16pm » |
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Thank you, skyhawk. I can't say I've heard of that before.
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BB
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Re: Please Help!
« Reply #19 on: Mar 6th, 2007, 11:30pm » |
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Nani, why does everything I say get taken as "advices" ? they are meant as an opinion, as sharing of information and knowledge.
Personally I believe that a caution on ( excessive ) use of narcotics for any type of headaches, especially CH where it doesnt work very well, and the risk of rebound headaches with its use, plus the likelyhood that rebound attacks can prolong a cycle and reduce remission time is very relevant to CH, but thats just me.
We can agree to disagree and still be friends, cant we ?
Annette
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nani
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Re: Please Help!
« Reply #20 on: Mar 6th, 2007, 11:37pm » |
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Folks can always disagree and still be friends. I do it with people here all the time. When we make a comment on a med thread that asks for it, it is looked at as advice. Period.
I still am not seeing your logic, Annette. True, opiates and painkillers do not usually work on CH. True, they have a high addiction potential.
Please give me your explanation of "rebound" HA. Do you mean MOH, or additional CH attacks? Because having chronic MOH has absolutely nothing to do with making anyone's CH cycles last longer, or increase CH activity. And, as I've already stated... there is no evidence that I know of that suggests that morphine will either A) cause CH rebounds (as in additional attacks) or B) extend a cycle or C) turn episodic CH chronic.
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BB
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Re: Please Help!
« Reply #21 on: Mar 7th, 2007, 12:37am » |
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http://neurology.health-cares.net/analgesic-rebound-headache.php
Rebound headache is a headache that was caused by the effects of some medication, it can be ANY type of headaches. MOH is not a special type of headache, not a diagnosis, its just a general term such as headache itseld.
If you are suffering from tension headaches and you take too much analgesics you will get rebound tension headaches. If you have migraines and you take too much narcotics you get rebound migraines. If you have cluster headache, you will have extra CH attacks that wouldnt have been there otherwise.
If you have extra headaches when you shouldnt have, then you run the risk of extending the time that you have these headaches. If you have more headaches more frequently then you will reduce remission time. More headaches for longer, reduced remission means increased risk in fulfilling the chronic criteria. Stopping the offending medication can reverse the pattern though.
This is my understansding and logic. You are welcome to agree or disagree.
The bottom line is narcotics are not a good choice for the management of CH.
Annette
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| « Last Edit: Mar 7th, 2007, 12:53am by BB » |
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Pfunk
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Re: Please Help!
« Reply #22 on: Mar 7th, 2007, 12:52am » |
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Thank you all for all the info. Today was actually not too bad of a day. I had one 10 and one 4-5, which I can definitely deal with. I am only taking 900mg of verap, kudzu, feverfew, elavil for sleep(along with melatonin). Of course I have the O2 close by at all times and remain stocked with trex('old faithful- ys know. The last couple of days, I actually slept through the night which is quite an accomplishment since I had been waking up every 2-3 hours no matter what I took. I have been going to PT twice a week(traction, Estem, accupincture,etc. The doc also adjusts my neck twice a week, which seems to alleiviate some of the neck pain. The worst thing for me is the length of this year's cycle. Last year they started Dec. 13 and went to Feb 13. This year, they started on Thanksgiving and have not stopped yet. I seemd to have caught them early enough adn they were only hitting me once every other day. Then, the accident reaggrevated something and I started getting hit evry couple of hours.
I have decided not to take any pain killers as I know it usaully causes rebounds for me. And, since I have the coorrect amount of kudzu running through me, the attacks seem to be coming less often and with lower levels of intensity. My doc does not like to give pain killers anyway unless we have done everything possible.. Just treating the neck pain with ice and/or heat and it works fairly well. Thank you again and PF wishes going out to all.
Pfunk
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Pinkfloyd
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Re: Please Help!
« Reply #23 on: Mar 7th, 2007, 1:21am » |
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on Mar 7th, 2007, 12:37am, BB wrote:http://neurology.health-cares.net/analgesic-rebound-headache.php
Rebound headache is a headache that was caused by the effects of some medication, it can be ANY type of headaches. MOH is not a special type of headache, not a diagnosis, its just a general term such as headache itseld.
If you are suffering from tension headaches and you take too much analgesics you will get rebound tension headaches. If you have migraines and you take too much narcotics you get rebound migraines. If you have cluster headache, you will have extra CH attacks that wouldnt have been there otherwise.
Annette |
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Why do you need Flo to debate you when Nani and Sean have already shown you to be incorrect? Because he isn't here? You'd rather debate someone not here I guess. Isn't that special.
I guess I'm not worthy either but here goes..
MOH IS A HEADACHE DIAGNOSIS.
Rebound headaches are NOT migraines, clusters or tension.
They even hurt in different places. A rebound headache in a migrainer is NOT a migraine. It is triggered by the absense of the offending medication....You have NO CLUE.
What is a rebound headache called when someone without migraines, clusters or tension headaches gets one?
Why is what you write taken as advise????? Because you put yourself out there (up there) as a doctor, thats why.
If what you write is just your opinion, and not based in fact...you should tell people, just like everyone else does, when they say things like....."this is just my opinion"
Do you tell your patients the same thing. When you tell them something, is it your opinion or do you tell them facts? Do you tell them the difference?
Narcotics (whether they are appropriate for any one particular cluster patient or not) do not make someone go chronic.
I give up
Bobw
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Re: Please Help!
« Reply #24 on: Mar 7th, 2007, 1:20pm » |
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on Mar 6th, 2007, 3:05pm, Skyhawk5 wrote:My last cycle I had to have eye tubes put on my cluster side. Told the Doc that codine was bad for CH. He gave me Darvacet and it worked well for me. Hope this helps.
Vibes your way, Don |
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WTF are eye tubes?
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Kill em all let God sort em out
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