Can't spend your life on abortives only. Getting a preventive med going is essential.

Do you have a good headache doc--NOT just any neurologist?
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LOCATING HEADACHE SPECIALIST

1. Search the OUCH site (button on left) for a list of recommended M.D.s.

2. Yellow Pages phone book: look for "Headache Clinics" in the M.D. section and look under "neurologist" where some docs will list speciality areas of practice.

3.  Call your hospital/medical center. They often have an office to assist in finding a physician. You may have to ask for the social worker/patient advocate.

4. Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or On-line screen to find a physician.

5. Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or Look for "Physician Finder" search box. They will send a list of M.D.s for your state.I suggest using this source for several reasons: first, we have read several messages from people who, even seeing neurologists, are unhappy with the quality of care and ATTITUDES they have encountered; second, the clinical director of the Jefferson (Philadelphia) Headache Clinic said, in late 1999, that upwards of 40%+ of U.S. doctors have poor training in treating headache and/or hold attitudes about headache ("hysterical female disorder") which block them from sympathetic and effective work with the patient; third, it's necessary to find a doctor who has experience, skill, and a set of attitudes which give hope of success. This is the best method I know of to find such a physician.

6. Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or NEW certification program for "Headache Medicine" by the United Council for Neurologic Subspecialties, an independent, non-profit, professional medical organization.
        Since this is a new program, the initial listing is limited and so it should be checked each time you have an interest in locating a headache doctor.
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Get up to date on treatments. See PDF file, below.
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Read the whole article:




 
Cluster headache.
From: Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or (Orphanet Journal of Rare Diseases)
[Easy to read; one of the better overview articles I've seen. Suggest printing the full length article--link, line above--if you are serious about keeping a good medical library on the subject.]

Leroux E, Ducros A.

ABSTRACT: Cluster headache (CH) is a primary headache disease characterized by recurrent short-lasting attacks (15 to 180 minutes) of excruciating unilateral periorbital pain accompanied by ipsilateral autonomic signs (lacrimation, nasal congestion, ptosis, miosis, lid edema, redness of the eye). It affects young adults, predominantly males. Prevalence is estimated at 0.5-1.0/1,000. CH has a circannual and circadian periodicity, attacks being clustered (hence the name) in bouts that can occur during specific months of the year. ALCOHOL IS THE ONLY DIETARY TRIGGER OF CH, STRONG ODORS (MAINLY SOLVENTS AND CIGARETTE SMOKE) AND NAPPING MAY ALSO TRIGGER CH ATTACKS. During bouts, attacks may happen at precise hours, especially during the night. During the attacks, patients tend to be restless. CH may be episodic or chronic, depending on the presence of remission periods. CH IS ASSOCIATED WITH TRIGEMINOVASCULAR ACTIVATION AND NEUROENDOCRINE AND VEGETATIVE DISTURBANCES, HOWEVER, THE PRECISE CAUSATIVE MECHANISMS REMAIN UNKNOWN. Involvement of the hypothalamus (a structure regulating endocrine function and sleep-wake rhythms) has been confirmed, explaining, at least in part, the cyclic aspects of CH. The disease is familial in about 10% of cases. Genetic factors play a role in CH susceptibility, and a causative role has been suggested for the hypocretin receptor gene. Diagnosis is clinical. Differential diagnoses include other primary headache diseases such as migraine, paroxysmal hemicrania and SUNCT syndrome. At present, there is no curative treatment. There are efficient treatments to shorten the painful attacks (acute treatments) and to reduce the number of daily attacks (prophylactic treatments). Acute treatment is based on subcutaneous administration of sumatriptan and high-flow oxygen. Verapamil, lithium, methysergide, prednisone, greater occipital nerve blocks and topiramate may be used for prophylaxis. In refractory cases, deep-brain stimulation of the hypothalamus and greater occipital nerve stimulators have been tried in experimental settings.THE DISEASE COURSE OVER A LIFETIME IS UNPREDICTABLE. Some patients have only one period of attacks, while in others the disease evolves from episodic to chronic form.

PMID: 18651939 [PubMed]
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As you have time, explore the buttons (left) starting with the OUCH site.

But the primary encouragement is to get moving on a preventive med....

Good morning.  After calming the last attack I was able sleep until 10:30.  I knew at that 5:30 alarm there was no way I could function at work today.  Not necessarily refreshed but relieved. 

I've been taking a mix of prednisone and verapamil for two weeks now with apparently little result.  Maybe this cycle is peaking and this stuff will start working; in past cycles, after a week and a half or so and it would start to work.  I start the prednisone at 60 mg/day, stepping down 10 mgs after 5 days (currently down to 40).  I started the verapamil at 120 mg twice/day, but that was stepped up to 180 after a week.  On Monday my blood pressure was up to 140/98 (usually a nice even 120/70) so he upped it to 240 mgs twice a day.  For some reason my bp was up to 160/98 yesterday.  I guess I've got to ride this out for a day or so and see what happens.  Other than not getting any perceivable relief from this cocktail, the dizziness, forgetfulness, occassional slurry speech, excess urination, and intestinal traffic jam they cause are a blast.  Gotta remember to stand up slowly, too; I've blacked out for a few seconds standing up too quickly (including last Saturday while proctoring SATs; thank God I didn't fall down).

I've used the same doctor for some time, but maybe it's time to change.  I was supposed to have a nerve block injection in my spine yesterday to calm down a nerve pinched by a bulging disc (which actually feels pretty good, I assume from the anit-inflammatory effects of the steroid), but cancelled that for fear of triggering a headache.  There's  a guy in this other doctor's group who is a specialist in cerebrvascular disorders.  I wonder if I shouldn't contact him? 

Thanks for the suggestions.  I'll be sure to try the dietary suppliments.  I started taking 5 mgs melatonin last night and will continue to do so for a few days, then up it to 10.

Sadly, probably of no real significance. The beasts ability to morph is legendary. I went the first 20 years without ever having a wake up hit. Once I got to sleep I was safe. The night time terrors didn't start for me until I hit my 40's. He do like to keep mixing it up on you.

Joe

I wish I could get the Imitrex injections;t pills at the moment.  They don't kick in for some time but do seem to help stave off the rebound.  I didn't take anything but O2 and a Red Bull last night until the third hit.  I'd had enough at that point.  The injections work well when I can get the damn insurance company to pay for them.  The side effects are creepy, but I can put up with that.

I had read some of the mushroom info and am intrigued.  I'll have to investigate a bit more.  I'm guessing there aren't any legal means of distribution available around here.  Do they grow wild in northern climates I wonder?  I know a guy with a natural beef farm and I'd bet he'd let me wander the fields to investigate (I'm in CT).  I spend 3 weeks in VT during August and there are dairy farms galore.  If the stuff grows up there, I'd have plenty of areas to investigate.  I'm going to have to look into this further.  Thanks for the suggestions.

you can also find information at Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or on Rivea Corymbosa and Hawaiian Baby Wood-rose seeds as an alternative to the fungi. Good Luck.

David