Hi All,
 It seems like there are many of us that have almost constant shadows so hopefully this thread will be helpful to others.

  In short, can constant low level(kip 1-6) be considered chronic CH?

 For me, a historically episodial sufferer, since my last episode about a year ago, I have had almost constant shadows on my cluster side.  My doc and I are trying to figure out if it is a different type of headache, without any success.  Low dose of Gabapentin worked pretty well for about 9 months but is not helping much anymore.  I just ruled out Chronic Paroxysmal Hemicrania by trying indomethacin.

  I am now thinking that I may be chronic and am experiencing a high off cycle.  Any thoughts?

Thanks,
Bill

I'd not consider shadows as anything more than a possible signal of an impending full blown attack.

Personally, shadows have come for as long as 2-months before full bore attacks but always episodic. But it doesn't follow that shadows will always lead to an active period and so it's  useful to consider these as discrete experiences.

==============

Curr Pain Headache Rep. 2001 Feb;5(1):55-9.  


Premonitory symptoms in cluster headache.

Raimondi E.

Catedra de Neurologia, Facultad de Medicina, Universidad Nacional de Rosario, 9 de Julio 3826, Rosario 2002 PKP, Argentina. raimondi@cablenet.com.ar

Cluster headache is one of the most excruciating headaches affecting human beings--especially the male sex. Most of the cluster headache cases are of episodic nature, with active cluster periods lasting generally between a few weeks and 2 or 3 months. A still undetermined percentage of patients report nonpainful sensations preceding the onset of the pain attack for a variable period of time. If occurring only a few minutes or a few hours before the onset of pain, such symptoms are called prodromal. When occurring for several days, weeks, or months before the pain, they are termed premonitory symptoms. The author believes that premonitory symptoms have not been properly diagnosed and emphasizes the need to investigate their presence, because by knowing them advances can be made in the understanding of the physiopathology of this particular cephalalgia. Furthermore, it can also allow the physician to be ahead, by giving preventive treatment and stopping or diminishing the intensity and duration of the pain attacks.

Publication Types:
Review

PMID: 11252138  

Not saying for sure but check the medications side effects if you havent allready.
Many drugs can create the constant headaches including gabapentin and Indomethacin.

There is chronic pain and then chronic CH. My "personal" belief is they are different animals, if not experiencing CH attacks at the same time, and should be addressed accordingly.

I have almost constant shadows all the time - I consider a shadow to be on a 2-5 scale. I use energy drinks and coffee to shoo them away so I can think and function. Anything over a 5, I consider to be a hit. Because of the daily pain, I'd consider myself chronic, but there will be others here who wouldn't think so because I'm not having full beast attacks everyday.

I also find after a hit, I don't notice my shadows so much for a little while, but then the nagging comes back.

I don't take any meds other than melatonin and o2, so unless it's rebound from the caffeine... I assumed it was shadows. I had it before I was dx as well.

Em
x

Em, how do you know when to use the 02 so that it works to abort?  I didn't make the connection until CH-Hell pointed it out, but the 02 stopped working for Gary as an abortive.... around the same time he started to constantly shadow at pretty high levels.  He does the same - only considers 5 and above attacks, the rest are "shadows."  But it seems the shadows mask the actual onset of the attack, so that by the time he tries the 02, it doesn't work to abort - or if it does, it only works while he's on it, and even if he slowly reduces the flow rate, the beast comes slamming back, no matter the length of time on the 02 (though usually it just doesn't help anymore).

Gary gets the droopy eye and the congested nose and goes "Oh no...." - but apparently these aren't "early enough" warning signs for him.  

Is it that they are early enough warning signs for you?  Or do your attacks come regularly enough you know when to expect them?  Or is there something else? (Hoping we can learn something from your experience)!

Thanks,

Laurie

Hi Laurie,

I'll send you a pm now!

Em

hey now billyjoe.

my neuros still refuse to call me chronic. tho they can't break my cycle no matter what they throw at me. my CH started april 08. was diagnosed june 09 (yes i'm lucky). ever since it started i've had a constant shadow/low level of pain on my cluster side  (b4 it spread to my whole frickin head). i had these constant shadows b4 during and after i was diagnosed and started with drugs and O2....etc. it seems for some the shadows r a warning for an impending attack. i've never had the luxury.
BLAM. no warning. my attacks always last a long time at least an hour mostly more...

*shrugs*
sorry not a helpful post...MKD

I get shadows often.  Most are no big deal, and I had probably just shrugged similar ones off before my first real cycle.  On occasion, I'll get a harder hit, but very very brief (minutes).  It seems that my body is doing something to keep the beast at bay.  That was as bad as it got last year.

I started getting more serious shadows last week.  My cycles usually run April-June.  I'm scared half to death that these are "a possible signal of an impending full blown attack", and hoping (please, please, not again!) that I can "consider these as discrete experiences."

im no dr but thats what i would be thinking. but again i am no expert , i have been chronic going on 7 years, but i still get definate hits at least six times a day. but i also have almost constant shadows

 I get alot of shadows too but nothing ever over a 4. The CH is so much differnt than the shadows, It even takes me a minute or two to relieze its even happening with a shadow, but That ole Ch feeling is instant. Great Post.


                           Challening, More assertive.. Coach Bill

MkeithD wrote on Feb 12^th, 2009 at 2:56pm:

my neuros still refuse to call me chronic. tho they can't break my cycle no matter what they throw at me. my CH started april 08. was diagnosed june 09

WTF does that mean?

Anyone?

wrote on Feb 12^th, 2009 at 9:04pm:

MkeithD wrote on Feb 12th, 2009 at 2:56pm: my neuros still refuse to call me chronic. tho they can't break my cycle no matter what they throw at me. my CH started april 08. was diagnosed june 09 WTF does that mean? Anyone?

It means that he's a time traveler or he fat finger types like me  ;)