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        Cluster Headache Help and Support >> Medications, Treatments, Therapies >> Vet trying to get O2
        
(Message started by: NJRik on Dec 5^th, 2007, 12:51pm)

Title: Vet trying to get O2
Post by NJRik on Dec 5^th, 2007, 12:51pm

I'm retired from the Navy and on Tricare Prime. I just got a script for O2 but now Tricare says there not sure if it is covered. Does anyone know if they cover it?

Title: Re: Vet trying to get O2
Post by Bob_Johnson on Dec 5^th, 2007, 2:55pm

Can't respond to you question but offering an article in case you're told is not an acceptable treatment. Just print and hold it.
==========
Headache. 2005 Jan;45(1):98. Related Articles, Links

CLUSTER.

[No authors listed]

Rozen TD. High oxygen-flow rates for cluster headache. Neurology. 2004;63:593 The two most effective cluster abortive agents are injectable sumatriptan and inhaled oxygen. Because most cluster headache sufferers are cigarette smokers and at high risk of coronary artery disease, many develop contraindications to triptans. Oxygen, the safest of all cluster therapies, is not effective for every patient. In Kudrow's landmark study, 75% of patients responded to 100% oxygen at 7 L/min, although only 57% of older chronic cluster headache patients had relief. A recent study documented a gender difference in response to oxygen because only 59% of female cluster patients responded to oxygen, whereas 87% of men did. In most textbooks and articles on cluster headache treatment, patients are instructed to use 100% oxygen via a nonrebreather face mask at 7 to 10 L/min. The rationale behind this prescribed oxygen-flow rate is unknown but has become doctrine since the Kudrow study. Prescribing higher flow rates of oxygen up to 12 L/min has recently been suggested, but there is no documentation that this may improve efficacy. Higher oxygen-flow rates (up to 15 L/min) are not known to benefit cluster headache patients refractory to standard oxygen therapy. Three cluster headache patients who demonstrated no response to standard oxygen therapy were exposed to higher flow rates of oxygen (14 to 15 L/min) to assess response. Comments: Once again, Dr. Todd Rozen's observations will change my clinical practice!-Stewart J. Tepper, MD I have questions: Were these empirical observations or do Drs. Kudrow and Rozen know how rate of flow affects oxygen delivery? Is oxygen uptake higher with higher flows? After all, 100% oxygen is 100% oxygen unless under hyperbaric pressure! Perhaps higher flow rates dry the nasopharyx to a greater extent. If patients perceive a higher flow rate, might this be an enhanced placebo effect? It seems like an interesting study to be conducted, and it would be useful to test if using nasal cannulae is just as good. Pulse oximetry and arterialized capillary blood gases could be used to monitor oxygen saturation and CO(2) retention/carboxyhaemoglobin levels in smokers.-David S. Millson, MD.

PMID: 15663630 [PubMed - as supplied by publisher]

Title: Re: Vet trying to get O2
Post by Gator on Dec 5^th, 2007, 7:56pm

Insurance companies never cease to amaze me. Supposedly, they have staff doctors they consult about treatments. Apparently, either they don't or the doctors they use are out of touch with cluster reality.

More than 35 years of research has proven 100% oxygen to be a safe and effective abortive for more than 70% of cluster headache sufferers. It is also the least expensive abortive available. Your insurance company should love that one. Try having your doctor write a letter of medical necessity, explaining the need for oxygen.

Here are some links that may help as well:

The National Library of Medicine and National Institutes of Health's Medline Plus Website:

http://www.nlm.nih.gov/medlineplus/ency/article/000786.htm

The National Headache Foundation:

http://www.headaches.org/consumer/topicsheets/oxygen.html

The Mayo Clinic:

http://www.mayoclinic.com/health/cluster-headache/DS00487/DSECTION=7

Dr. Todd Rozen:

http://www.mhni.com/faqs_high_oxygen.aspx

http://www.mhni.com/articles/Articles.aspx?DocID=4255

Dr. Lee Kudrow:

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1526-4610.1981.hed2101001.x?journalCode=hed

Dr. L. Fogan:

http://archneur.ama-assn.org/cgi/content/abstract/42/4/362

On 02-15-05, the American Family Physician published the article "Management of Cluster Headache" by Dr. Ellen Beck, Dr William Sieber and Dr. Raul Trejo. In the Acute or Abortive Treatments section, it states that oxygen and sumatriptan are the "treatments of choice for acute cluster headache."

http://www.aafp.org/afp/20050215/717.html

The European Federation of Neurological Societies guidelines state that oxygen and sumatriptan are the "drugs of first choice" for the acute treatment of cluster headaches.

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1468-1331.2006.01566.x

There are tons more examples out there.

The fact is, oxygen works well for most cluster headache sufferers. Considering its efficacy, lack of harmful side effects and low cost, I am dumbfounded that anyone should have to justify using oxygen as a cluster headache abortive.

Hope this helps you and anyone else in the same boat.

Good luck!

Title: Re: Vet trying to get O2
Post by NJRik on Dec 6^th, 2007, 8:56am

Thanks for the help printed all the stuff. Going to my Neuro today then to the base and will bring what I have to the insurance people. I can't help but to think that it will work.

Again Thank You Guys,
Rik

Title: Re: Vet trying to get O2
Post by Grinner62 on Dec 6^th, 2007, 9:40am

Re-Tired Air Force here.

Yes, Tricare Prime does cover O2. Find a med equipment supply company and they should be able to do the paperwork. No referral required. Probably need a written script. Co-pay has been $5 a month for me.

Don't accept the standard 8 LPM regulator like I did. O2 has never worked for me because of this. You need a non rebreather mask and whatever flow rate it takes to breathe freely. I need at least 13 lpm, some on this board say they need up to 20.

Title: Re: Vet trying to get O2
Post by NJRik on Dec 6^th, 2007, 9:53am

Best news all day. My GP did not say what size tank or what type of mask on the script so the supplier could not get it past Tricare DUH. Got to luv the Army. Will fix this today Thanks for all the help.

Rik

Title: Re: Vet trying to get O2
Post by Grinner62 on Dec 6^th, 2007, 10:08am

Glad to help, but hope ya don't need it.

PS. Imitrex statdose, they'll only fill 5 boxes (10 shots) every 90 daze. It takes a while to build up a stockpile. The base pharmacy has it.

Title: Re: Vet trying to get O2
Post by kcopelin on Dec 6^th, 2007, 11:04pm

Another retired AF...TriCare Prime did cover O2....the VA will also dispense it-though its difficult. Highly recommend the article on justifying high flow rates...had some snags there. And you might want to just get your own clustermask.

PFDAN y'all
kathy

Title: Re: Vet trying to get O2
Post by NJRik on Dec 10^th, 2007, 8:33am

Yea I have my air Big tank for home and two for the road. Thanks everyone for your help.

Rik

Title: Re: Vet trying to get O2
Post by Gator on Dec 10^th, 2007, 12:35pm

Really good news, Rik. Congratulations and may you never have to use it.