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Jaime
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Doctors - Arrrgh!
« on: Sep 16th, 2004, 1:59am »
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Finally got to talk to my doctor about how the Vioxx and Maxalt did not work.  I had printed out some info from this site and the OUCH site to share with him, but he hasn't read it yet.  He did give me  one sample pill of Imitrex, 100 mg. Oh joy. I'll probably end up using it tonight,  when the 11 p.m. beast shows up.  He also went on and on about Prozac as a preventative.  He seems reluctant to use Verapmil with me because my regular blood pressure tend toward the low side of normal. I notice a distinct absence of any mention of Prozac on this site or orther headache sites, so I wonder where he is getting this push for Prozac.
 
I keep mentioning that Oxygen and injectable Imitrex are the preferred abortives, but it is like I am talking to a wall.  He just blinks at me and then talks about Prozac some more.  
 
The headache log I have been keeping helped. He does seem willing to learn,  and acknowledged that I probably knew more about cluster headaches than he did because of all my recent reading.  He also insists on speaking of my headaches  = or any headache - as migraine. Maybe he went to a migraine seminar this summer or something, so he has migraine on the mind.
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    nailinmyeye
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Re: Doctors - Arrrgh!
« Reply #1 on: Sep 16th, 2004, 5:08am »
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Jaime,
 
I don't know about the research or anything, but from my experience, Prozac does nothing for my Clusters.  I am on Prozac for depression, and I have been for probably 10 years.  I have had Clusters for 4.  Prozac does nothing for my Clusters, unless it does something I don't know about because I have always taken it...
 
Also, I would be VERY adamant that the doctor not speak about your headaches as migraines (presuming you have been diagnosed with Clusters - I can't remember from your previous posts).  There are a couple of reasons for this, in my opinion:
 
1) While Clusters and Migraines might be similar in some ways, they are different conditions.  Clusters are incredibly more painful than Migraines.  For the doctor to refer to Clusters as Migraines means that he is understinding your condition wrongly, and treating the wrong condition.  You do not want to be treated for Migraine, you want to be treated for Cluster.
 
2) It is insulting, at least to would be to me.  I am not belittling Migraine as a serious condition, but to call Clusters Migraines would piss me off.  The pharmiscist did that to me the other day, I politely told her that I did not have Migraines, I had Cluster Headache, which is a different condition.  It really sucks when people don't understand, but it seems to me that it becomes serious when your doctor doesn't, and refuses to, understand.
 
I would suggest that you print off the articles you find on or through this site about the Imitrex Injections as the abortive of choice, and Oxygen as another effective abortive., as well as the info about preventatives.  If he is willing to learn, as you say, he will listen to you, and will stop treating you for Migraines.  If he will not, then you need to find a new doc, imho.  Better yet, can you get to the Neurologist, one with experience in treating headaches?
 
I am having trouble getting my doctor to prescribe the right prevents, and am actually glad I will be moving to Canada in two months.
 
That's just my opinion. I am sure someone will be along shortly with more experience and information than me.  But I do hope you find some relief, and soon.
 
Casey
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Re: Doctors - Arrrgh!
« Reply #2 on: Sep 16th, 2004, 6:32am »
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Go to www.headachedrugs.com and search for Prozac and/or SSRI. Print out the reports about relative ineffectiveness for cluster and give to your doc.  
 
With doc who are closed to new information your best leverage is, at least, to give him medical information from a source which he might recognize as legit and informed.
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Re: Doctors - Arrrgh!
« Reply #3 on: Sep 16th, 2004, 10:26am »
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I second the headachedrugs.com site.  Just saw the Doc's over at Robbins.  Great people, well eductated in our condition.  I'd split that 100mg if you can.  I have never taken anything over 25mg in the tabs.  They work after about 30-45 mins.  At the time it was wonderful.  If you have tried other abortives, it will seem like a lifetime.  Go with the lowest doesage you can and by all means find a new neuro!
 
T
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Jaime
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Re: Doctors - Arrrgh!
« Reply #4 on: Sep 16th, 2004, 11:14am »
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Well - it is too late now to split the pill.  I took the 100 mg pill at 2:00 a.m.  I didn't get any relief until 4:45 a.m.,  and even then there was a Kip 4 shadow hanging in the background. Even worse,  I couldn't sleep,  and have been awake since 2:00 a.m.  I didn't start sleeping until after midnight, so I think I only got about 1.5 hours of sleep last night.  I got about 3 hours the night before and maybe 4 hours the night before that.   Maybe 8 or 9 hours of sleep ouyt of the last 72 hours.  At what point does sleep deprivation drive a person insane? It is now 7:15 a.m. and I am supposed to be at work in 15 minutes.  Hah!
 
I work for the doctor who is treating me.  I am a temporary fill-in receptionist while his other employees take vacations.  I'm getting free treatment.  This is the only way I can get health care at all.  I don't have the option of finding another doctor or a new neuro. I don't think I have it in me to work for him today. My Imitrex pill experiment last night did not go well.
 
I did spend quite a bit of time at the headachedrugs.com site last night.  I printed off a few things.
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Re: Doctors - Arrrgh!
« Reply #5 on: Sep 16th, 2004, 11:20am »
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I feel for your situation, truely.  Keep dropping off the stuff from OUCH and Robbins, they should peak his intrest at least.  Try the melatonin at night.  I started on 3mg, and planned for 9 hours of sleep that night, that way if I only got 8 I could take my time getting ready the next day.  At least you will get some sleep.  Most people have said that they use 9mg a night and I am well on my way to using that much over the next night or so.  Hope you get some relief soon!
 
T
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    nailinmyeye
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Re: Doctors - Arrrgh!
« Reply #6 on: Sep 16th, 2004, 11:34am »
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Jaime,
 
I suppose if you are getting the care for free, and it is your only option, then it is better than nothing.  I hope you get some help from him soon.  I agree with the others about taking the info in to him.  I guess if you can't go to work for him, he will know directly that 1) this is painful for you and serious enough for you to miss work, 2) that his last treatment didn't work, and 3) it is in his interest to treat you properly.  Please keep us updated.
 
Casey
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Jaime
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Re: Doctors - Arrrgh!
« Reply #7 on: Sep 16th, 2004, 12:15pm »
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I went in to work this morning with a few printouts.  I put them in his box to read later, and told him I didn't have it in me to work today.  Today's patients deserve someone who can be professional, and I don't need to collapse with a nervous breakdown in public. His office is only open Monday -Thursday. He made a bit of a wise-crack that the stress of working full-time was getting to me. I felt insulted, and wanted to cold cock him with an uppercut. Instead, I told him I wish it was stress, that I know the difference, and that I plan to be at work on Monday, sleep and the beast permitting.
 
I've got to say, I didn't like the way the Imitrex made me feel, either. Cotton mouth,  and my stomach felt odd. Not nauseous, but unsettled.
 
I've been taking 9 mg of melatonin every night for about 2 weeks. I got very decent sleep the first week,  and it hasn't seemed to have much effect this week. I take the melatonin between 9 and 10 p.m.  I've been falling asleep around midnight. The beast has been waking me at 2:00 a.m. and at 5:00 a.m. like clockwork.
 
I'm thinking that Remeron might be a better option than Prozac for me as an SSRI to try. Remeron taken at night can have a profound sedative effect because of it's histamine antagonist effects.  I've taken most of the SSRI's as anti-depressants in the past.  At least the Remeron might help me sleep,   and with Remeron - I don't lose my orgasms the way I do with the other SSRI's.
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FZfan
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Re: Doctors - Arrrgh!
« Reply #8 on: Sep 16th, 2004, 1:11pm »
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on Sep 16th, 2004, 12:15pm, Jaime wrote:
I don't lose my orgasms the way I do with the other SSRI's.

 
Holy shit! Talk about horrible side effects!  
 
I know your treatment is free, but your doctor sounds like an ass to me.Bad free treatment ain't much different from no treatment.
 
One thing you can try besides the melatonin when you have no med insurance is oxygen. I can't recommend it highly enough. Without med insurance you can still get welder's o2. I'm no expert at this, but there are folks on this board who are. It's relatively cheap and there are no side effects. It won't prevent the attacks, but it can be very effective at completely aborting them.
 
Get yourself hooked up with some welder's o2 pronto.
 
Oh, and tell your smart-ass doctor to go fuck himself.
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