Clusterheadaches.com Message Board


    
      
        Clusterheadaches.com Message Board
        (http://www.clusterheadaches.com/cgi-bin/yabb/YaBB.cgi)
      

        New Message Board Archives >> Medications, Treatments, Therapies 2004 >> MY FIRST NEURO VISIT
        
(Message started by: Carolann on Jun 3^rd, 2004, 2:14pm)

Title: MY FIRST NEURO VISIT
Post by Carolann on Jun 3^rd, 2004, 2:14pm

I just came back from the neuro. I have CH (duh). After an hour of questions and a few physical tests (kinda like taking a DUI test) , I was prescribed the following:

Indocin (anti-inflamatory)
Midrin (abortive)
Migranal (abortive)

I was glad to find out I don't have Horner's syndrome, just a droopy eyelid.

I HAVE to taper off the Vicodin and Excedrin migraine because she said I was probably having rebound headaches.

If the above don't work, then it's on to oxygen.

Here goes nothin,
Carolann

Title: Re: MY FIRST NEURO VISIT
Post by Prense on Jun 3^rd, 2004, 7:47pm

on 06/03/04 at 14:14:37, Carolann wrote:

f the above don't work, then it's on to oxygen.

That is very backwards. When O2 is used correctly as an abortive, the results tend to be phenomenal...especially when you consider side effects, etc. The problem with O2 is portability. A tank large enough to handle more than 5 attacks would be too big to tote around with you.

Indocin did absolutely nothing for me. I have no direct experience with the other meds you mentioned. Verapamil (calcium channel blocker) is typically considered to be the preventative of choice, but not everyone can take it.

Normally triptans are used for abortives...

Excellent advice to taper off the vicodin and the excedrin.
I hope you find some relief soon.

Regards!
Chris

Title: Re: MY FIRST NEURO VISIT
Post by Bob_Johnson on Jun 4^th, 2004, 8:14am

With a diagnosis of Cluster, the meds given you are not appropriate--they are simply not recognized as effective to abort cluster and there is nothing here to prevent them. Makes me seriously wonder if you have a doc who is up to date on this condition.

If you have to, or want to, stay with this doc, then strongly suggest that you do some reading and be able to take to the office suggestions for more effective medications.

Suggest either the second or third titles:

HANDBOOK OF HEADACHE MANAGEMENT, 2nd ed., Au. Joel Saper, MD, 1999, Lippincott Williams & Wilkins. A highly condensed volume for doctors but good for "advanced" clusterheads who have a grasp of medical terminology and medications. Covers all types of headache with the section on cluster being brief. Sections on general considerations in treatment and on medications are important.

MANAGEMENT OF HEADACHE AND HEADACHE MEDICATIONS, 2nd ed. Lawrence D. Robbins, M.D.; pub. by Springer. $49 at Amazon.Com. This volume is better organized and easier to read for nonprofessionals compared to Saper's book. 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....")

HEADACHE HELP, Revised edition, 2000; Lawrence Robbins, M.D., Houghton Mifflin, $15. Written for a nonprofessional audience, it contains almost all the material in the preceding volume but it's much easier reading. Highly recommended.

Also, look at: www.headachedrugs.com. Put "Cluster headache" in the search box. This site run by a doc who operates a good headache clinic. The material is not orgnized as well as it could be but searching is worth the effort.

Title: Re: MY FIRST NEURO VISIT
Post by Rock_Lobster on Jun 4^th, 2004, 8:31am

Agreed with Bob.

Here is a fairly decent online summary of Cluster treatments:

http://www.future-drugs.com/admin/articlefile/ERN020304.pdf

Good luck,
Lobstah

Title: Re: MY FIRST NEURO VISIT
Post by Superpain on Jun 11^th, 2004, 5:11pm

I agree as well. Your doc is giving you meds from the 80's.
O2 should be first.

And "horner's syndrome" is really no big deal....
It's not a disease. Just a set of symptoms brought about by something else. In this case ch... So if the ch is causing the drooping eyelid that sort of means that you DO have Horner's...

Or maybe you just have a droopy eyelid for some other reason. [smiley=huh.gif]

Title: Re: MY FIRST NEURO VISIT
Post by don on Jun 11^th, 2004, 7:44pm

Quote:

Indocin (anti-inflamatory)
Midrin (abortive)
Migranal (abortive)

That should work just fine.

For Migraines.

Title: Re: MY FIRST NEURO VISIT
Post by Gator on Jun 12^th, 2004, 12:00am

What kind of neuro who knows anything holds off on the O2 until other things don't work? O2 should have been the first thing he prescribed. It's cheap, it has no side effects, an "E" size tank (about 3' tall) with a little wheelie cart is relatively portable.

The place where I get my O2 will give me as many of any size tank I want and as many refills as I need and it doesn't cost anything extra, just costs $45 per month which the insurance company has been paying up until now. Smaller that the E size just doesn't make sense and bigger than E you couldn't be mobile.

I'd print out some of the stuff here including the pdf file Rock suggested and take it to him. If he continues to treat your CH like a migraine, then you may need to go elsewhere.