Hey all!

I've got an outpatient surgery for an unrelated condition coming up.  This will be a tympanoplasty and possibly ossicular chain reconstruction in my left ear, same side as the clusters.  I am in an active, way longer than usual, cycle.  I get 1-2 Kip 9's every morning (surgery is in the AM as well).

I would love to hear any input from the cool folks on this site.  What should I look out for?  How should I inform my ear surgeon, who presumably doesn't know much about CH?  What happens if I wake out of surgery having one?

I have had this surgery before, and I woke out of surgery to some bad ear pain (not CH) and the recovery nurses couldn't even get a handle on that because they were too busy giving Narcan to the person next to me.   ::)

Oh, and the surgery will be performed under general anesthesia, if that matters.  Appreciate the insights!

Were it me, I'd talk to my headache doctor, who should consult with your surgeon, and explore the possibility of putting you on a 10-14 day prednisone taper. For many, myself included, this will give an almost guaranteed 10-14 day pain free period.

It's the only med I've used that guarantees me a headache free period. What I don't know is if the prednisone will have any effect on the surgery?????

Joe

My thought were similar to Joe's thoughts.

Get your doctors talking, try the prednisione taper to overlap and also see if surgery can be in the afternoon.

Clearly, you tell your surgeon just what you have written here. With a pattern of regular morning attacks I'd raise the question of having your abortive with you and the nurses on order to provide it, should that be necessary.

On the flip side, we have discussed this question any number of times and my memory says that folks have not reported a pattern of attacks being associated with surgery. I've never seen anything reported in the medical literature either.

The whole issue is in your surgeon's court, in any case.

Okay, so I posted a nice, long, thoughtful response to all three of you gentleman, then clicked "Post Message" and... POOF!  Disappeared.  (Twice, dangit!)

At work now, but I wanted to apologize I hadn't gotten back to you all sooner.  More later, but I did want to say thanks.   :)

Thanks for the replies.  Joe, Mike, and Bob, I will definitely be talking (a lot more) to my doctors.  My PCP is no problem, he understands the issue and will no doubt have ideas.  The neuro I just fired has never been helpful, and as for my ear surgeon, he's the unknown.  A nice guy, but I'm not sure how to make him understand best.

Joe and Mike, I'm not sure how pred will affect surgical healing, so I will do some research.  I do know my PCP has always been wary of pred due to its side effects and so has been reluctant to prescribe a high enough dose to stop them.  I think for surgery he might make an exception.  I will ask.

Unfortunately, changing the time of my surgery is a no-go.  This guy is the best in town for my issue and only does them in the AM.  I can't really put it off either, as it's for a deaf ear and I've put it off so long that it's affecting my job--which, in turn, provides me with the insurance to cover 18 boxes of 'trex per month.  Bless them.    :-*

Thanks for the help guys!

I have been through this a couple of times.  Have a talk with the anesthesiologist before the surgery.  They will understand the problem and have oxygen for you to use if needed. 

I have been through this a couple of times.  Have a talk with the anesthesiologist before the surgery.  They will understand the problem and have oxygen for you to use if needed. 

Ooh, of course!  I totally forgot about the anesthesiologist.  Thanks clavers!

One thing that worries me about the O2 though, is how hard I have to huff it.  That tends to create a lot of pressure in the ear, which could rupture the whole surgical repair.  May have to go the Imitrex route to avoid accidental Valsalva maneuvers. Hm...  :-?