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Title: How do you handle the first attempt at oxygen? Post by jmc1106 on Sep 2nd, 2005, 4:19pm Ugh, last night DH had his worst cluster yet. Took 15 minutes for an Imitrex injection to kick in, and it was just awful! He went back to the doctor we met last weekend at an urgent care center. She put him on Prednisone, and prescribed oxygen. My question: since we don't know if the oxygen will work, how do we do this? Wait for a headache that's not so bad? Or give it 10 minutes and then do an injection? We've got four injections to last the long weekend (splitting them in half, but I am still having nightmares about running out if he has 2-3 a night), and I am feeling very nervous! Thanks! Jan |
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Title: Re: How do you handle the first attempt at oxygen? Post by SteCo on Sep 2nd, 2005, 5:09pm Quote:
First be sure the set up you have is correct IE: high flow regulator and non-rebreather mask as both of these items are important to have this work well (look at bars on left of this page and hit the oxygen info. bar) Cut the elastic piece off of the mask.....as the O2 has a tendency to make one relax.....and even sleepy. You do not want to fall asleep with the mask on.....too much O2 intake is not good. I think most can beat a CH in about 10-20 minutes w/it. I use the O2 at FIRST sign of CH...set the regulator anywhere from 10-15 (you'll eventually figure out what setting works for you). The sooner you catch them the better and may not even need the trex. Good luck!! SteCo |
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Title: Re: How do you handle the first attempt at oxygen? Post by jcmquix on Sep 2nd, 2005, 11:48pm I can tell you that you are going to have to practice the O2, I have only had it about 2 months. But you have to give it a chance to work for you, it was really hard at first, but I learned to abort 80% of the CH's with just the O2. I usually give it about 15 minutes to start aborting, then I will do a TREX inj and go back to the O2. Just be Patient... Don't give up on the O2 if it fails once or twice, I had a few that it didn't work on, but thats what all the others tricks are good for..... Learn as many as you can and use them.... Wishing & Praying for some PF Time !! Charlie |
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Title: Re: How do you handle the first attempt at oxygen? Post by E-Double on Sep 2nd, 2005, 11:55pm hit the tank early. @ first twinge!!! Everyone has subtle variations on technique. Some slow and easy while others try to almost hyperventilate. He'll learn. Stick with it! Good luck to you both :) |
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Title: Re: How do you handle the first attempt at oxygen? Post by lionsound on Sep 3rd, 2005, 7:03am Here are some very good tips from Chuck :) Go here: http://www.clusterheadaches.com/cgi-bin/yabb/YaBB.cgi?board=meds;action=display;num=1123513751 wishing you well and PF! -lionsound |
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Title: Re: How do you handle the first attempt at oxygen? Post by jmc1106 on Sep 3rd, 2005, 8:37am Hm, he got the non-rebreather mask, but the doctor only prescribed 5-6 liters, wanting to use the least amount possible and says some of her other patients get by on this. Does anyone else use this setting? He did get a cluster (not a horrible one) at 5:00 this morning, and got relief after 20 minutes on 5 liters. It didn't completely go away though, and he got hit with another one at 7:30. So he took a small Imitrex injection to try and knock it down all the way. I am also wondering if the added moisturizer is beneficial or if some people just like it. We didn't get that, but I am willing to try the mayonnaise jar trick. I was very glad to get a full night's sleep, since he can use the oxygen on his own (I have no idea how he could do that Imitrex injection trick with the statdose system...I have a hard enough time with it, when I'm woke out of a deep sleep). Do any of you break these open in advance to peel that damn label off? That's what really slows things down, but I hate to think that I will end up wasting an injection if it isn't needed and the cycle ends or improves. That's $55 worth of goodies we could save for the next time. Thanks so much for all the good advice. This board is a real life saver! Jan |
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Title: Re: How do you handle the first attempt at oxygen? Post by E-Double on Sep 3rd, 2005, 9:31am Some do get relief at lower flow rates but I think they refer to lower as 8. I blast mine up to 15 and will gradually decrease. You nailed the imitrex tip idea. Do it ahead of time and have it ready to go. I'm glad you got sleep and remember that part of being a great supporter is taking care of yourself!!! Eric |
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Title: Re: How do you handle the first attempt at oxygen? Post by hwm54112 on Sep 3rd, 2005, 10:49am I used O2 many years ago, but it stopped working ) Back then, I found that, if I went untreated, the HA would last about 45 minutes, on O2 it would last 4-5 hours at a tolerable level. I eventually had to have surgery (pre=imitrex days). If you think about it, when you use a rebreather mask, you are getting 100% pure oxygen, no air is mixing with it, regardless of the flow. If the flow is too low, the mask will collapse when you breathe in all the O2 contained in the mask if it doesn't fill your lungs (try breathing into a baggy). Therefore the rate of flow can't control the amount of oxygen. You would not be able to breathe. Flow rate is only a factor in amount of oxygen used when using a nasal canalis or a breather type mask. Therefore, you should set the flow rate at a level which allows a comfortable breathing rate without collapsing the mask. As far as how you do it, it does not matter if you breathe fast or slow. Remember, you are breathing 100% O2 all the time. Your breathing rate does not control the amount of O2 you are getting. If my explanation is understandable, I'm sure you will see that your doc is wrong in prescribing a flow rate unless he knows your lung capacity and breathing rate which he can't because both change constantly. Your scrip should be 100% O2 as needed. Didn't like the moisturizer. things got clammy. Imitrex- I use 1/3 the dose. Full dose knocks out HA in 3-4 minutes, 1/3 dose takes 7-10 very long minutes. I pry syringe out of holder with my thumb nail (sometimes it hurts, you can also use a popsicle stick DON'T USE METAL TO PRY WITH). I then use my thumb nail to rip a slit of the label off, mark vial with a sharpie and stick it back in holder gently. I carry it around for weeks that way/ Then I use !/2 of a cuetip as a plunger (I give them to me in the shoulder. Anything longer tends to drop out if I fumble a bit. Imitrex- Check out Canadian pharmacies. They may have pre-filled syringes that are great. Glaxo quit distributing them in the states several years ago, but they were available in canada. You can also get it in vials (here in the states) that you draw up into a seperate syringe. Prednisone is a great cluster buster. 80mg for 3 days, then 60 for 3, 40-3, 20 -3. Hopefully give you tempoary relief until meds can kink in. My savior - 360 mg of verapamil 3 times a day. This is a massive dose (some docs don't believe it) but it does work with no apparent side effects. At times I can reduce it to 240 3 times a day. Hope this helps. I've dealt with these things for 25 years and tried everything. All kinds of drugs, surgery 3 times. I guess I'm a pro. It's important that DH learn to do the injections. It's really hard the first time but it does get better. I used the stat-dose one time and threw the gun away in favor of self injection. I always had a needle phobia until my daughter had a crises and I got an HA at the same time. I was forced into it. It's also important that he learn what his tells are. For me, I have a blood vessel in my temple that begins to protrude about 5 minutes before I have an attack. I become aware, touch my temple and can see and feel the vessel throbbing. It was 100% reliable. |
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Title: Re: How do you handle the first attempt at oxygen? Post by brewcrew on Sep 5th, 2005, 12:27pm Also, I would say use it for at least 5 minutes beyond the point you're sure the h/a is gone. I've had too many come back because I didn't go long enough. |
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Title: Re: How do you handle the first attempt at oxygen? Post by BMoneeTheMoneeMan on Sep 5th, 2005, 12:38pm Yes, make sure you have a non rebreather, and make sure you have a regulator that goes up to 15lpm. At the first sign of a CH, start the O2. Huff that for at least 10 minutes.....nice deep breaths from the bag. Like its been said, take the O2 first, if that isnt helping after 10 minutes or so, you might wanna try the trex. One thing i have noticed is that when a CH has come and fully taken hold and is a bad one, the O2 has a hard time getting the upper hand. Try to catch it early and it should stop the beast from increasing in intensity. PF wishes BMonee |
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Title: Re: How do you handle the first attempt at oxygen? Post by Gator on Sep 5th, 2005, 2:35pm Oxygen is a miracle if used properly. I don't see how he can breathe at all at 5 - 6 lpm. During the beginnings of an attack I have a hard time with 15lpm. Sometimes you have to fight to get what you need as most docs are not familiar with CH. Many are hung up on O2 saturation levels and won't prescribe high flow rates. Here is an article from a leading reseacher in the field that justifies high flow rates. Print it and take it to your doctor. http://www.chhelp.org/mhni.html |
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Title: Re: How do you handle the first attempt at oxygen? Post by jcmquix on Sep 5th, 2005, 7:44pm This is a link explaing how I divide the TREX inj... If you have any question, please send me an IM.... http://www.clusterheadaches.com/cgi-bin/yabb/YaBB.cgi?board=meds;action=display;num=1124329956 God Bless Charlie |
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