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(Message started by: dynogyno on Sep 11th, 2006, 9:18pm)

Title: old guy with new diagnosis
Post by dynogyno on Sep 11th, 2006, 9:18pm
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... ::)

Title: Re:  old guy with new diagnosis
Post by georgej on Sep 12th, 2006, 12:00am
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  


Title: Re:  old guy with new diagnosis
Post by BB on Sep 12th, 2006, 12:35am
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

Title: Re:  old guy with new diagnosis
Post by MJ on Sep 12th, 2006, 12:52am

Hi dynogynodoc.

Heres a site you may find informative. check all the links therein.

http://www.clusterbusters.com/index.html


Title: Re:  old guy with new diagnosis
Post by Bob_Johnson on Sep 12th, 2006, 8:56am
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....")
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Title: Re:  old guy with new diagnosis
Post by RichardN on Sep 12th, 2006, 1:47pm
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

Title: Re:  old guy with new diagnosis
Post by mcf69 on Sep 13th, 2006, 4:08pm
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.

Title: Re:  old guy with new diagnosis
Post by E-Double on Sep 13th, 2006, 7:09pm
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=medsarchive2005;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


Title: Re:  old guy with new diagnosis
Post by dynogyno on Sep 13th, 2006, 8:30pm
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

Title: Re:  old guy with new diagnosis
Post by Barry_T_Coles on Sep 13th, 2006, 9:18pm
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 09/11/06 at 21:18:08, dynogyno wrote:
I'm a physician (can you guess what kind?) ::)

YEP ;)

Kind Regards
Barry

Title: Re:  old guy with new diagnosis
Post by Jonny on Sep 13th, 2006, 9:28pm

on 09/13/06 at 20:30:16, dynogyno wrote:
Took a peek at my chart and Neuro. thinks I might have SUNCT-sudden onset unilateral something something with tearing.


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?

Title: Re:  old guy with new diagnosis
Post by nani on Sep 13th, 2006, 11:10pm
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?  ;;D   Just kidding (kinda).
pain free wishes, nani

Title: Re:  old guy with new diagnosis
Post by Charlotte on Sep 13th, 2006, 11:29pm
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

Title: Re:  old guy with new diagnosis
Post by E-Double on Sep 14th, 2006, 7:08pm
Actually SuNCT is responsive to Neurontin and.......
http://www.ninds.nih.gov/disorders/sunct/sunct.htm#Is_there_any_treatment

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

Title: Re:  old guy with new diagnosis
Post by chopmyheadoff on Sep 15th, 2006, 7:16am
welcome dynogyno - how i would love your job !!




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