Hi, I have been lurking for a while and never posted, so thought I would.  A little about my history.  I am 35 have had clusters (I think) since menstrual cycle started at 14.  Use to get an unbearable headache everyday after lunch at school and gone within an hour. Years later had them in college.  Then had them very badly after each of children were born (2 children).  I am an avid exerciser and always have been.  I trained and ran a marathon which brought on incredible clusters in my 20's.  I have cycles in the late summer early fall.  I have been cycle free for 4 years up until 2 weeks ago.  I thought I had killed the beast and he is back in full force!  I get these 10 minutes after exercise and if I drink any alcohol at all (even just 1 beer), and every once in a while without cause I will get one.  I mountain bike and love it and it really makes me angry when I have to decide between the two!  I am in great shape and read that so many of you are helped by exertion which really confuses me.  Anyway, just wanted to see if there were any others like me as far as exercise is concerned.  I deal with them with caffeine, excedrin migraine, and imitrex (very sparingly).  Had a monster of one last night for 2 hours after 1 hour of mountain biking.  Thanks to anyone with any advice!

Candy

Lancet. 1999 Sep 18;354(9183):1001-2.
Comment in:
Lancet. 2000 Jan 8;355(9198):147.

A new cluster headache precipitant: increased body heat.

Blau JN, Engel HO.

Exercise, a hot bath, or elevated environmental temperature provoked cluster headaches, within 1 h, in 75 out of 200 patients. This new observation accords with recognised precipitants--alcohol, histamine, and gyceryl trinitrate--perhaps via generalised vasodilatation or hypothalamic activation.

Publication Types:
Letter

PMID: 10501368 [PubMed]

Thank you for the responses.  I have been looking into using O2.  As I do think there is a connection in my case.  I do tend to get them as I start to cool down from exercise.  If I exercise over 1 hour I get them during the exercise which make me bail completely and head home.  Anyway, I was prescribed Verapamil 4 years ago as a preventative and never started it as I have been pain free for 4 years (my longest span ever).  Thinking of maybe trying the Verapamil as I cannot give up my bike.  Anyway thanks for all the positive feedback, hoping this will be short lived!

Just wanted to update everyone on what happened tonite.  I did not work out as still tired from last nights 2 hour episode of CH.  At 8:30 pm one came out of the blue with not much warning with no exertion at all (was watching tv relaxing).  My husband is a do it yourselfer and has all kinds of tools etc. in the garage.  I had talked to him about the o2 success others had had and the minute I started with it he went to the garage and came back with an o2 tank with a tube connected.  I  breathed in the tube while clamping my nose and felt immediate relief.  Did this for about 5-7 minutes took a 3 min break and repeated.  After 2nd session headache was tolerable.  After about 30 min headache was gone!  Shortest lived one ever  but also my first for no reason (exercise or alcohol).  So far I am psyched on the outcome of the o2!  Thanks for the advice!

Joe- thanks for the pointers on the O2.  It is amazing how fast I found relief after just a couple deep breaths of the O2.  My hubby said I looked like I had just inhaled some good drugs, hard to believe you can become eurphoric off O2, guess it's the relief that the beast is getting a beating! 

I wish I could find something to take just prior to mountain biking that would hold the cluster off at least until I got home from the trail.  I have not rode much at all this week beacause for some reason the exercise is what gives me a doozy of a cluster.  I seriously can hardly make it home from the trail and it is only 2.5 miles away from my home.  I thought maybe an energy drink, may try that next time.  I have premedicated myself with 2 excedrin migraine and also one time with straight aspirin hoping that would keep my vessels constricted but still got the cluster about 5-10 min post exertion.  I am just determined not to let the beast take my singletrack away from me!!! Thanks again, loving this community and everything I have learned so far!

Hi Candy and welcome. Verapamil is what I take as a prevent (480mg daily is my magic number) and o2 at 25 lpm with a o2ptimask  as my abort! Great combo for me, so far!
By the way, my wife and best supporter ever Angie and I mountain bike also!
So proud of your hubby setting up a quick o2 set-up!!
Verapamil will constipate you for sure, I use Fiber1 cereal daily, works for me.
Nice to meet you.
  Barry, I am 51 years young 

Ask your phamacist if this is available: Ergotamine, 2mgSL.

This old timer will often prevent attack if used before exercise begins; also used to prevent niight time attacks.

I am also new to this board and love it.  I am female, 41, and started having CH about the same time you did, early teens.  I just about fainted when I read your first post just now as I too would have them just after lunch when I was in high school and remember one time the school secretary was taking me home bc I was in such pain (small town, small school!) and I threw up in the parking lot on the way to her car!  Poor lady was probably very worried about her car...! 

After several trips to the ER, family doc, dentist, eye doc, and chiropractor, I finally ended up at a neurologist who diagnosed CH and put me on fiorinal for pain and prednisone which successfully halted the cycle.  The CH have returned every 6 months to 2 years throughout my life, fiorinal lost it's effectiveness for me (when I was young it just made me sleep), prednisone also eventually lost effectiveness.  I have been put on antihistamines, ergot-amines, and I can't remember what all else. 

Exercise and excessive heat are my WORST triggers!  Anything that dilates that blood vessel in my head will send me into orbit!  Diesel exhaust fumes will also trigger me.  Bright sunlight is just painful too me during a cycle - does not trigger a full blown attack but a low grade throbbing pain.

I've had two children and was headache free during both pregnancies and while breastfeeding which makes me think there's a definite hormonal component.  I've been on a cluster for almost three months now which is the worst I've had in probably 8 years. I'm on 240 mg verapamil as a preventative and using treximet for pain.  The fact that I'm going on three months says that the verapamil is not as effective as it used to be, I'm also getting breakthrough headaches at night, 11 pm to 1 am.

I started melatonin 6 days ago, 3 mg 30 min before bed and it's helped greatly with the nighttime attacks, but I did have some breakthrough last night so plan to go up to 6 mg tonight. 

After reading about the possible link with low testosterone in the treatments section of this board, I'm in the process of having my OBGYN order hormone tests, or he may be sending me to a headache specialist in St. Louis.  I've been so frustrated because my local neurologist who would listen to my suggestions and research and would work with me moved to Utah, so I've been trying to get help from my family doc and it's not going very well!!  I'm so tired of breaking in doctors.

This site has been SO helpful and has given me hope!  Sorry for the long post, it's just so comforting to talk to people who understand.