Ok - so it is bad enough I am up most of the night but now I am having them during the day and I need some advice on how to keep them at bay during the day.  I am guzzling coffee, but I have a big meeting to go to on Friday and I am very scared of an attack during the meeting.  so much is going on in my life right now, I really can't let people see me like this.  I am up for a promotion and I am afraid I will not get it if people know about this problem and if I don't go to the meeting, it will not be acceptable.  Why now??????  Any suggestions to help with the meeting?  I will be a passenger and not driving to the meeting so I can take something but so far nothing has worked I will ask my doctor for anything you can recommend. 

Imitrex injection would be the fastest abortive and you can discreetly keep it in your pocket.  Excuse yourself if you feel shadow then go to the bathroom and pain should hopefully diminish before you return to meeting.  Just make sure you know how to use it before you need to.  Good luck on your promotion :)

Frovatriptan is also another option.  I have used it when I have had to fly.  It should keep the beast at bay for hours.

I don't recall if you mentioned so forgive an old guys brain....but does your doctor have you on any kind of a preventative medication? One you take daily while on cycle to limit the number and intensity of your hits? Verapamil is popular, I use lithium, topomax is also mentioned a lot.

Joe

tammy1 wrote on Feb 3^rd, 2010 at 3:33pm:

I have a big meeting to go to on Friday and I am very scared of an attack during the meeting.

Call your doctor to report the results of his first suggestions.

(from your intro thread)


Quote:

The doctor gave me Cafergot pills, but I am either taking them too late or they don’t work.  He also gave me some pain meds.

I don't know how to use Cafergot, some here will, but pain meds before a meeting don't sound resultful or impressionable.

For the short fix until an adequate treatment regimen can be adopted, request if he has any Imitrex samples, or can prescribe for you.  Starting a prednisone taper can help while ramping up a preventative and adding oxygen soon. 

Call or he will not know.  I'd expect a response, or, seeing a doctor perhaps more acquainted with clusters on an immediate basis may be a more rigorous option.

I'm with Beth on this one. There are pill form triptans that are longer lasting than imitrex. Frova and Amerge are two of them. See if your doc has any samples.

Brew wrote on Feb 3^rd, 2010 at 5:20pm:

I'm with Beth on this one. There are pill form triptans that are longer lasting than imitrex. Frova and Amerge are two of them. See if your doc has any samples.

Agreeably.  I haven't tried these others but because also, recalling my first use of trex left a flushed feeling, which can be distracting. 

I get daytime CH every cycle, I have found that while at work if I can catch them in time I can just take an imitrex pill( I can feel a slight change in my shadows before a true ch hits most times) but for the ones that come on fast and are the most painful only the injection seems to work.  I am now having to take O2 to work after today. 
I am at a new job for just over a yr and haven't had a cycle until last week.  My supervisor saw me today and I had to leave work as I didn't take the injection in time and it wouldn't go away.  Either I had by DH come get me or she was calling 911.  I opted for hubby to take me home to my O2. He knows more about CH than the paramedics here do.

My boss let me take oxygen to work to take as needed.  You may be suprised how understanding or accomodating they may be.  You can try to educate them.  It worked for me.

I wouldn't recommend this on a regular basis but I have taken Imitrex essentially as a preventative.  During a cycle, it will usually get me 8 to 10 hours of relief before my headache comes back.  I have taken a dose of Imitrex before my headache actaully came back and prolonged the relief period.  Could have been coincidence that the headache didn't spring back that particular time but it might buy you the time you need to get through your meeting.

Medrol dose pack.

A 6 day course of pred that will stop your attacks on the first day.  They will probable return on day 4 or 5 but at least you get a few days attack free.

tammy1 wrote on Feb 3^rd, 2010 at 3:33pm:

Ok - so it is bad enough I am up most of the night but now I am having them during the day and I need some advice on how to keep them at bay during the day.  I am guzzling coffee, but I have a big meeting to go to on Friday and I am very scared of an attack during the meeting.  so much is going on in my life right now, I really can't let people see me like this.  I am up for a promotion and I am afraid I will not get it if people know about this problem and if I don't go to the meeting, it will not be acceptable.  Why now??????  Any suggestions to help with the meeting?  I will be a passenger and not driving to the meeting so I can take something but so far nothing has worked I will ask my doctor for anything you can recommend.

This is one time I would seriously consider using the Imitrex tablet (50 mg).  Take it when you're driving to the meeting.  This should cover you throughout the meeting.  I use to get at least 4 hours relief from that in the past.  I use injections now, but you'd obviously have to excuse yourself if you need to do that and then wait it out till the pain subsides which could be 3-5 minutes.

BTW Tammy, if you do get a promotion, you really need to talk to your boss about this condition we all have.  Let he/she watch videos, read the "employer letter" and such.  The more they know, the better your relationship will be with your employer and they won't be wondering why your absent due to this pain.  Once they accept it, see about keeping O2 in your office and if not that, get that script for injections.

I hate to say this but I think I am going to find a good excuse not to go to the meeting, uh staffing issues or something not reflecting my health.  I have not been sleeping well either and quite frankly it shows. I am scared of an attack and I also dont want people talking about how terrible I look (ego). I have made a list of the meds you guys recommend and will ask my doctor if he has any samples or what he thinks I should try. He was out of the office yesterday.  He is a very kind doctor and I know he would like to help me, but he did have to get a book out to look up what to give me when he gave me the cafergot.  I have Naproxen he gave me too, 2 a day and I think that is suppose to help something too. 

In the meantime, I found coffee helps so I make a pot and keep it in a carafe on the counter so I can drink some at night right away, I then go outside in the cold and pace around the house (the cold air helps distract me from my head pain) - then I go in the house exhausted and sleep for an hour and then do it all again -this is the night time ritual,  the day problem is new and I am noticeably affected (as you all know there is no smiling through a cluster).  Thanks for all your advice.

Still hoping they just go away!!!!!!!!!!!!!!

Maybe you should actually see a neuro and get a real diagnosis. Just a thought.

            Potter

Quote:

Still hoping they just go away!!!!!!!!!!!!!!

You can wish in one hand and shit in the other - see which one fills up first.

Treat it or be a victim.

Unprepared and as yet unmanaged might persist in curtailing necessary functions more than hoped for also until drawing a line.

We're here to help.     :)

An Imitrex injection has me feeling as though I can pretty go on with my day in less than 5 minutes. Have your doctor get you a prescription if you're going to deal with daytime hits and have limited options. Mind you, I don't know if I'd like to be presenting in front of a group on minute 6 but I can easily sit in a room with others and fade into the group.

Thank you all for your advice and help.  .

Thank you all for your advice and help. 

I saw my GP yesterday ( went much better than I thought) and she gave me some samples of Maxalt -Mlt (rizatriptan benzoate ) . Had a ch start at about 8 last night and it wasn't responding to O2 so I gave it a try. Took about 5 minutes and the ache was gone. I was at a kip5 and rising fast and it was completely gone in 5. You might want to try it cause it's a pill that desolves on your tongue. If you can get it open ( this might be a prob.) easily, it will look just like your eating a mint. Desolves almost instantly too. Only tried it the one time, but it was the best nights sleep I've had in weeks.

Maxalt is absorbed in the gut, not through the lining of the mouth, and it takes about 25 or 30 minutes to get enough into your system to start having a positive effect. The fact that you were feeling much better in 5 minutes was not due to the rizatriptan.

I tell you this only so that you're expectations aren't quite as high next time. It works well for many people, but dissolving tab is designed more for convenience than quick delivery. You can take one anywhere, and without a glass of water.

That is disappointing. Hoped I'd have something to use in a pinch- sigh.

Zomig nasal.....

NancyB wrote on Feb 5^th, 2010 at 1:21pm:

That is disappointing. Hoped I'd have something to use in a pinch- sigh.

  You said it worked?

         Potter

I thought it did. Was getting a real humdinger. I was  trying to think what I was going to try next since the O2 was not working- even after the second time I tried. Then I thought what the heck. Didn't even get that weird feeling I used to get with trex where it felt like part of my brain was missing. I'm going to try it again the next time I get a bad one and let you know.

Being a daytimer myself, I believe in the judicious use of caffeine.  Doesn't work for everyone and some people say it is their trigger.  I was on my way to a meeting the other morning and was just getting a light pressure in the usual spot.  Stopped into a convenience store for a coke, had a cup of coffee in the waiting area and went into the meeting and no one knew a thing (except I talked a lot).

If I absolutely couldn't get a CH for an hour or 2 I would pop a nodoz(caffeine pill) and that would cover me.  I know some people can't do caffeine, but lots of us can.

Also treating with 'alternative treatments' (clusterbusters.com) having very good results.  Pretty much negated this cycle.

There is life with our clusters.  Hang in there!

--Shaggy

Had another one last night just before bed took the maxalt again- same results. Also slept through the night for the first time in nearlt a month. That might be the benadryl though. I have found that with 2 of those I can sleep through just about anything.

Ya'll might try starting melatonin at night before bedtime. I've been doing it for years and I sleep thru the night. It gets me the rest I need to fight the day hits.

And ya might try keeping a Red Bull (or another energy drink) handy for the first sign of  a hit. It will sometimes abort a hit in its tracks.

Of course O2 is my mainstay for aborts. I keep Red Bull handy for those "stubborn" hits, but usually the O2 does the trick. (I use the demand valve and it's great).

Hugs BD :-*