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        New Message Board Archives >> Medications, Treatments, Therapies 2003 >> Abortive Med/Dosage
        
(Message started by: LasVegas on Sep 30^th, 2003, 1:03pm)

Title: Abortive Med/Dosage
Post by LasVegas on Sep 30^th, 2003, 1:03pm

Reviewed the statistics of the medication survey area regarding medications to abort CH. Looks like it has not been updated in a couple years. Imitrex injections, sprays and pills seem to best followed by oxygen. But then there is a category of narcotics. What type of narcotics and what MINIMAL dosages are recommended? I have self diagnosed my CH thanks to this website back in Nov 2000. Have been undiagnosed suffering, being treated like a test rat with no relief nor diagnosis for 25 years of Fall season episodic CH's. My imitrex prescription can not be refilled, insurance only allows two refills per month. I don't have the cash to pay for the quantities I require. At the same time, I make too much $ for welfare or financial assistance from a medical program for the needy. My Dr (primary care physician) is not knowledgeable about CH's and am waiting to be referred by my HMO to a neuro which "could take up to 30 days" and am trying everything I can to prevent my life (every aspect) from falling apart, which it is, by the hour. I realize there will be a better day, hopefully CH free and that suicide is out of the ? but it has recently crossed my mind. I am desperate and really am in need of some good advice and support from others who are able. My pharmacist says that when HMO's limit refills, she recommends patients to ask their Dr for alternative medications that hopefully the HMO will cover until the preferred meds (Imitrex) can be refilled the foillowing month. What other abortive medications and dosages (minimal levels preferred to function in life) seem to work? From your appreciated feedback, I could request my Dr to "tide me over" with an "alternative" abortive drug of choice. Please list a med and dosage that has worked for you. Thanks in advance, Gregg in Las Vegas.

Title: Re: Abortive Med/Dosage
Post by jminmilwaukee on Sep 30^th, 2003, 1:34pm

If you do not already have it, get the O2. Only abortive that has ever worked for me.

You may want to take a look at www.clusterbusters.com for a long term solution.

Good luck, hope this helps.

Jmin

Title: Re: Abortive Med/Dosage
Post by Prense on Sep 30^th, 2003, 5:05pm

At your doc's request, your insurance company may be willing to increase your monthly prescription. Trex is mainly used for migraines and thus that limitation is made based on such. Your doc needs to contact your insurance company. Additionally, use imitrex injections and use the "imitrex tip" located on the left of this page. It can tripple your trex usage if it works for you.

Other than that, your only other option is O2.

Chris

Title: Re: Abortive Med/Dosage
Post by Bob P on Sep 30^th, 2003, 5:50pm

Agree with Prense. Your doc can give your insurance a letter of medical necessity and get your allotment of Trex increased.

Another trick I used was to get my allowed amount of each triptan. I'd get prescriptions for 6 shots of trex, 6 nasal trex, 12 pills of trex, 12 pills of amerge, 12 of maxalt, etc. I'd get my max of each and then I would back up the rest of the month with cafergot and O2. Worked pretty well.

Title: Re: Abortive Med/Dosage
Post by LasVegas on Sep 30^th, 2003, 6:56pm

Thanks for the replies/leads. I will try this. As for the "Imitrex tip" my concern is 1. will it work for me? and 2. the entailed process of hopefully doing it right while excruciating pain. Since starting this post earlier today, I have had a shadow since 9:15am this morning, then around 4pm went through a full blown attack. Had 1 Imitrex shot I was saving for night time emergency and had to use it. Worked within a mattter of a few minutes as always. After it subsided and left my head feeling full and numb, I called my Dr's office to see if they could prescribe something for me consifdering I have used all of my Imitrex injections and the HMO will not allow anymore dispensed at the pharmacy. I told the nurse that I will either be dead from overdosing on other pain medication in my house (will try anything for relief at any expense) or in the ER if I make it that far. She called me back after speaking with my Dr and told me to go to ER or an urgent care clinic and get a shot of Toradol and then come in tomorrow morning at 11:15am. The nurse said go there ASAP to get the shot, but I am not presently experiencing a full blown attack (Thank God) and concerned of wasting the shot that may be needed later tonight when the Beast comes to Dance w/ me in the moonlight. What the hell is Toradol and will it last all night?, all morning tomorrow till 11:15am appt?, should I still be afraid to sleep? (haven't slept much out of fear and pain in the last two weeks). I am drained, feel helpless and scared. Will post update later tonight/tomorrow to let others know how this worked. Wish me luck. Gregg in Las Vegas

Title: Re: Abortive Med/Dosage
Post by mobmom on Sep 30^th, 2003, 10:45pm

I have an appointment with my doc in vegas on Thursday. I tired 100 mg of imitrex tablets and they didn't seem to kill the beast. He gave me Fiorcet as something to hold me over till all my blood work and CT scan results are in. Don't know what he'll put me on after that. I do however know that from my own post that everyone here frowns on the narcs. I do too, but if it takes the beast away so that I can function in the meantime, then so be it. Good luck with your appointment and hopefully you and I both will be in better shape next time around.

Title: Re: Abortive Med/Dosage
Post by Mastifflvr28 on Sep 30^th, 2003, 11:23pm

LasVegas,
I hope your nite wasn't too bad.
The 1/2 to 1/3rd shot usually works really well for most clusterheads. A lot of times clusterheads don't NEED a whole 6mg. Taking 2 or 3mg's seems to abort in almost the same amount of time with a LOT less side effects.
When you go to the docs, see if maybe you can get VIALS of trex, and that way you can self administer 2mg with an insulin syringe.
The trex tip does take some concentration and can be hard to do when in pain. Maybe if you don't have kids around you can leave the little vial out with the sticker already scraped off so you can grab it and jab...then take a qtip and push down till half the liquid is gone?

PF vibes going up to you!!!
Take care and let us know how it goes.
Sorry can't answer any of your questions about toradol etc.
Mast

Title: Re: Abortive Med/Dosage
Post by UnsolvedEquation on Sep 30^th, 2003, 11:24pm

There are NO narcotics that work for me. And the reason that most of us here 'frown' at narcotic use is simply because we feel that they do nothing for CH pain. If it did work for us ... we'd all be taking it (believe that !) I feel like if someone were to say to me that they had a cluster attack and took a pain pill and it took away the pain ~ Then they really didn't have a cluster attack ! (my own opinion)
Listen to the advice about the Imitrex tip. It's good advice. You may be able to use 2 or 4 mg instead of a full 6 mg dose and get relief.
Goodluck & Hang in there ... You're not alone !
~ Unsolved ~

Title: Re: Abortive Med/Dosage
Post by Bob_Johnson on Oct 1^st, 2003, 4:32am

www.headachedrugs.com, then search for meds. Site run by a headache doc in the Chicago area; two of his books listed; suggest you get one of them to get a organized presentation of your options. This is especially important if you have to educate your doc on how to care for you. If you can afford it, get the $50 title which is aimed at M.D.s; you doc more likely to accept the information.

There are many combinations of meds which can be tried; that's why you need an organized guide.

I've had good success with Zyprexa, 5mg, to abort attacks. Works consistently in 20-minutes.

Title: Re: Abortive Med/Dosage
Post by Prense on Oct 1^st, 2003, 5:42pm

on 09/30/03 at 18:56:37, LasVegas wrote:

As for the "Imitrex tip" my concern is 1. will it work for me? and 2. the entailed process of hopefully doing it right while excruciating pain.

Only one way to find out... Try 1/3 first, wait 20 minutes and if you are still staring at the beast, go for another 1/3. If you find that 1/3 is not cutting it, then go with 1/2 on future attacks. Some people require the full dose no matter what. Be prepared for the partial dose not to work until you know for a fact that it does.

Also, you don't have to peel the entire label off, just enough to see what you are doing. You will get the hang of it after a few tries. Pull the cotton off the q-tip and it stashes neatly in the lid of your injector case. You may have to cut 1/2 inch or so off of it.

Keep pursuing your doc/insurance to get your allocation of trex increased, and refill it as soon as you can always! Everytime I talk to my doc "I am out of trex" That's my story, and I'm stickin to it! ;D

Title: Re: Abortive Med/Dosage
Post by LasVegas on Oct 1^st, 2003, 9:54pm

Well, i'm still alive. Absolutely drained, but here. Did not go to the ER last night due to no attack. I actually slept the whole night straight through for the 1st time oin 2 weeks of this cycle. However, about 30 minutes after waking up, it started with the shadows, then it hit full force. I went to a quick care to get treatment and by the time (10 minutes) came around when the nurse brought a syringe and oxygen tank, my CH was gone. Not even a shadow, so I told them they took too long and there's no need to get treatment and walked out on them. The nurse actually had the nerve to tell me that Imitrex is for migraines, not clusters and that Imitrex would not work for me. I then shared, while in pain with this Triage Nurse, an education lesson to her that shut her up from that point on. Well, I left the quick care and started shadpows about 20 minutes later. Went to my Dr (primary care physician) and he gave me a shot of Torodal. All that did was m,ake my butt sore and gave my shadow a bit of relief, but it was still there, hidden behind this Toradol "bandaid". He had me get 5 vials of blood taken, don't know what he's checking for. Told him about the 17 Excedrin Migraines and he said that will kill my liver and give me rebound headaches in the meantime. Told me he was not willing to work with me if I was going to self administer. I agreed to follow his orders. He gave me a script for Loratab, which I took this morning and only took the pain away for 10 minutes. He was still persistent about prescribing me this. I discussed all of the meds you guys were kind enough to post and share and he wrote me a script of Prednisone on a "tapered" level. 3 per day for the 1st 3 days, 2 daily for 3 days and 1 tablet daily for 3 days. 20 mg each, no refills. Said every individual has a tolerance level and the dosages of others on this site, may not be right for me. He also said that the Imitrex is harmful to the heart. Says that it's not the insurance company being cheap, it's the medication itself that is not supposed to be taken more than 3 or 4 times per month. He said my blood pressure was 108 which was a concern of his considering I am a health nut/former bodybuilder with an excellent health history. Says the o2 will take some time to get approval on from the insurance company, but would work on that. Not sure what i'm going to do here, but pray, and with all this pain and praying, i'm starting to become an atheist considering the pain is not going away. I'm grateful for this site, it's the only place I have found knowledge and an escape with those who understand, because NOBODY else understands or is knowledgeable as us!!! Has anybody here tried breaking into or bribing the pharmacy? Bad joke/will keep my cool. Wish all a PF good night.

Title: Re: Abortive Med/Dosage
Post by UnsolvedEquation on Oct 1^st, 2003, 10:54pm

Bob ~ Did you know that there is a class action lawsuit against Zyprexa ? Zyprxa has been identified as the cause of diabetes and other blood sugar problems.
http://www.yourlawyer.com/practice/overview.htm?topic=Zyprexa
http://www.injuryboard.com/view.cfm/Topic=791

Title: Re: Abortive Med/Dosage
Post by Mastifflvr28 on Oct 1^st, 2003, 11:53pm

LasVegas...
I'm wishing you luck, but I'm also concerned about your doc. He is not willing to work with you or listen to you.
trex 2 or 3 times a month is rediculous for clusterheads...most of us would be dead by now if that were true.
Consider finding a new doc if you can.
Also you can print off meds info from here and ouch and see if he'll look at or listen to that?
Sorry your not getting much help.
Mast

Title: Re: Abortive Med/Dosage
Post by J.ten_Dam on Oct 2^nd, 2003, 4:30am

;D Hi there I have a solution to the trex tip. All you need to do is file the end of achopstick so that it is wide at the top and measure the length as aplunger so it will onle releas half or eaven a third. thisway you dont nead to pealback the stikker. I am trying to make a better deskription with photos of how to do it. if you like I can send you what i have made sofaar.

Title: Re: Abortive Med/Dosage
Post by Prense on Oct 2^nd, 2003, 6:43pm

Goto this link and print...

http://www.rxlist.com/cgi/generic/sumitr_pi.htm

It clearly shows that trex has a two injection per day limit...nothing more. It also states that it is used for meegraine and cluster attacks.

Don't give up so easily...

Additionally, if what the doc is giving you is not working, tell him he had his chance to do his job. Then, don't suggest, demand scripts for meds that are more universally known to work. If BP is an issue for taking a calcium channel blocker, then perhaps you could try Topamax or something else that doesn't affect BP.

Unless you have some high risk cardio issues, you should be fine with trex injections and O2 should not be a problem either. Get something that handles the attacks then focus on preventing them. On the bright side, the pred should work well for you in short duration.

Or, just get to another doc and start all over. Either way, best of luck to ya! ;D

Chris

Title: Re: Abortive Med/Dosage
Post by UnsolvedEquation on Oct 3^rd, 2003, 4:23am

2 injections per day .... 3 or 4 per month ....
BAAA HUMBUG
I use anywhere from 2 to 8 injections per day at 4 mg apiece and have for YEARS. It's not gonna kill ya to get what you need as long as your BP isn't sky high already. I'm still alive and never had a bad reaction or ill side effect from the amount of Imitrex I use. If you must have 3 or 4 shots a day ... I'd say take it and forget about all the suffering you'd do without it !

Title: Re: Abortive Med/Dosage
Post by LasVegas on Oct 3^rd, 2003, 1:23pm

For those of you who have been following this thread, here's an interesting update. Don't know if my timing from the Beast is up or coincidentally a few things worked in my favor, but...I have slept 2 nights in a row without waking with a CH. Furthermore, I have not had any attacks, a bit of lingering (scale of 1 to 3 with no treatments required) for over two days since that Torodal shot in the butt and 2 nights of Prednisone. Would the Torodal work instantly? Would the Prednisone work instantly? Does it only take a week for the Verapamil to kick in? A combo of all and some serious prayers and all I have is fear that this is all temporary and a stiff neck. Actually had the motivation and successful effort working yesterday and today for the 1st time in two weeks. Even got some housework, landscaping and pool cleaning out of the way. Does anybody remember the Beast/Demon in the movie the Twilight Zone? He was seen by a guy on drugs in an airplane. For those of you who remember that scene, I had a dream about this Monster two nights ago. I was in an airplane, as if I were the guy in the movie, and looked out the window at this Demon on the wing during a lightning storm. He reached his claw into the plane window and I awoke feeling his touch on three areas of my left temple and neck where I get my CH pain. He waved goodbye, gave me an eery smile and flew away into the storm. Interesting is always a safe word. Even if this CH episode is over (2 and a half weeks), I will stay on the board to help others with encouragement and continue to learn as much as I can from all of you experienced wonderful individuals. Wishing all a PF day/night! Gregg in Las Vegas.

Title: Re: Abortive Med/Dosage
Post by Pinkfloyd on Oct 3^rd, 2003, 3:56pm

on 10/03/03 at 13:23:59, LasVegas wrote:

Would the Prednisone work instantly?

Yes. 60mg of prednisone will work immediately...so to speak. If you are at a dose that is high enough to stop the attacks, it will be almost immediate. You might still be good at the 40mg dose...20mg will possibly still give you relief, everyone is different. Hopefully the tapered dose will cool off the cycle for you.

PF

Title: Re: Abortive Med/Dosage
Post by Prense on Oct 3^rd, 2003, 6:14pm

on 10/03/03 at 13:23:59, LasVegas wrote:

Does it only take a week for the Verapamil to kick in?

6-8 weeks...different people have different experiences.

Title: Re: Abortive Med/Dosage
Post by Karla on Oct 3^rd, 2003, 7:09pm

Try other abortives such as axert, maxalt, amerge, frova, zomig, imitrix etc. Find the abortives that work for you the best. Then have your dr write you scripts for imitrix pills, imitrix ns 5mg, 10mg, 20mg, imitrix shots, oxygen, axert, and zomig. Then one week take imitrix, the next week take zomig, the next week take axert, the next week try a different one. You get the point? Use oxygen first for all these and then if the oxygen doesn't work you have medicines waiting to back you up on. Good luck.