"Shadows" is a term coined by a member of this group and isn't a part of the diagnostic criteria for Cluster. The closest medical description is touched by this abstract:

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 
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That you can use alcohol is one of those indiviual variations which does set you apart from most! But--a pure guess--I wonder whether your chronic shadows would disappear if you stopped all alcohol for several weeks.

I have previously gone through a similar period myself, during which I would, while on Verapamil, have daily shadows but no attacks and be able to drink alcohol without being hit.

Since CH morphs all the time its difficult to tell if this is because you are outside of a cycle or if it is because of the prevent or whether you are episodic or chronic, in my opinion.

I was too worried and stayed on Verapamil, but if I was in the same situation again, I would carefully taper down Verapamil and see if the shadows don't get worse.

There is sufficient variation in our experience of CH plus changes over time <sigh> that:

a few folks stay on Verap 100% of the time because their cycles are so unstable.

For most people, there is no medical objection to using 100% any more than if you were using it, or another med, to control blood pressure.

Hi Jay,

My shadows didn't stop and I entered a full cycle again thereafter. This is not to say of course that this will happen to you or Anthony, for every pattern and cycle is very individual and changeable.

Although there are many here who report seemingly very distinct episodic on/off cycles and many chronic sufferers who simply do not get the slightest break whatsoever, there also appear to be a number of people in between who are in a continuous cycle but with on and off peaks.

I personally have given up trying to define my condition as either episodic or chronic. I have not had complete remission for years, but equally have had periods of relatively pain free time that qualifies as attack free while on little to no prevents. Knowing that this pattern will morph one day too, I will just have to ride along till it does!

My personal rule of thumb is to bring down the prevents whenever I feel that I can and to ramp it back up if its too early. It's a trial and error approach but shadows can also be dealt with with redbull, ground dissolved ginger and strong coffee and I personally prefer to keep prevents for hot periods, which for me can last 6-9 months.

Anthony, as far as a 4-month stint for the second time in 11 years is concerned, why martyr yourself with a word like "chronic"? I don't think there is any reason to believe that you are on the path of becoming chronic. A 4 month episode is not unusual at all and I would keep trying to gently test your tolerance on tapering down the prevents over the coming weeks until you are done. Just don't forget coming back here every now and then in the coming 11 years!

Bob Johnson wrote on Apr 6^th, 2010 at 11:56am:

Bob,

Interesting!

I did not know that someone on here originated the term, but long before I ever saw CH.com, and before I'd had any formal diagnosis at all, I was trying to explain to my wife how I knew I was about to go into a cycle.  I described it to her as "...a shadow creeping up on me - not really a headache, but just a funny uncomfortable feeling and the certainty that they were going to start soon..."

Guess the term fits pretty well!

Regards,
Jim

  I was thinking that maybe I'd gone cronic too, because this year I had a 6 month cycle...never had more than 4 month one before...so Don't be too quick to worry about becoming cronic.

  Also...be careful with drinking alcohol while on Verapamil...It is Very hard on your liver.    
   Also it took me 2-3 months to be totaly shadow free, so   anything can happen eh!
   PFDs to ya

This is just my opinion - based upon my own experience.  Verapamil causes constant shadowing!  My last couple of episodes I have been lucky enough not to have any hits at all (YEAH!!) but shadowing everyday sometimes really badly.  I have just sent back the 02 and starting to taper off the verap.  In the past when tapering off the verap the shadowing has been worse - BUT I call its bluff.  For me, no hits, just more shadowing and evenutally this wears off.  I am sure (for me) that if I stayed on the verap I would experience shadowing ever day.  My 2c worth - may well be different for others, but I thought worth a mention.

Kate

I had the same experience than Kate, hence the recommendation to come off Verapamil as soon as is possible. I have found Kudzu helpful while coming off Verapamil.