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First Timer (Read 1369 times)
Tanker Yanker
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First Timer
Mar 24th, 2012 at 7:26am
 
Good morning. Brand new to this World of Hurt and am hoping to get a few answers.

A little background... 53y/o married WM living in the Asheville, NC area. USAF Veteran with VA medical. HIV+ for 14 yrs (pulled someone out of car wreck who had it) with viral load at undetectable levels for many years. Long haul liquid chemical big rig driver.

Just over two weeks ago while at home recovering from a kidney stone procedure (another first), I came down with the worst headache I'd ever had and I'm sure everyone here can fill in the rest. Roared back again the next day, starting for several hours beforehand with a very sore neck (right side) which made me initially believe I needed a chiropractor despite freedom of movement. Yet that same place, same time of day thing had me stumped. After about 10 days or so (and being scared to death that something was BAD wrong), I hit the internet in search of answers and discovered cluster headaches. Never even heard of them before. Saw the doctor at the two week mark (this past Thursday). He seemed to know quite a bit about them, asking alot of questions, and then agreed with my self-diagnosis ("you have all the classic symptoms") yet thankfully sent me for a battery of tests to rule out anything else (brain scan was negative, most of the lab work has come back with everything thus far within normal ranges although hormone levels (testosterone, etc.) will take a few more days). Kind of a relief there, so to speak, but not too crazy about what that leaves as the alternative. 'Nuf said.

Okay, couple of questions...
1) Attacks initially started at around 4:30 to 5pm and stayed that way for several days. Then they moved to the 7-8pm range for a while, then to 11pm. Finally got through a pain free night this past Thursday (shadowing around 8pm or so which I hit with a Red Bull -- something I learned in my research). Friday, however, had one at 9:30am and then again at noon. Pain free again last night, but at 5am this morning got hit kinda bad (the Red Bull rides again). So here's the question: during my research I failed to read anyone writing about them changing times. Is this a common theme, a precursor of bigger and better things yet to come, or perhaps even a symptom of something else?
2) As a regional haul trucker (all points east including Canada but only rarely west of Texas), I routinely put in long days for weeks at a time with hours that change daily and am definitely concerned how this may affect my career. Drove through a rather bad one last Monday night for about an hour (with no self-medication; hadn't discovered the Red Bull trick yet) and managed to keep it to together. It quit just about the same time I hit my yard and I was ever so grateful I was through for the day (14 hrs) as I feel pretty drained and as though the whole side of my head has been battered for quite a long while afterwards. So, any other truckers on here? If so, how do you deal with them?

Awlright, all for now; daylight is breaking through. Home for the weekend thank goodness. Sorry to be here but looking forward to learning all I can from your experiences ("Ask the man who owns one"). Thanks...
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« Last Edit: Mar 25th, 2012 at 12:26am by Tanker Yanker »  
 
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wimsey1
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Re: First Timer
Reply #1 - Mar 24th, 2012 at 8:32am
 
Greetings and welcome to the board! It sounds like you're just beginning your battle with the beast...not the symptoms but the actual combat. You need several weapons in your arsenal, and those include a good preventative (like topamax, verapamil, lithium, that kind of thing) and good abortives. You've hit on the Red Bull and that's good, but you need to explore adding O2, especially in E tanks. And sumatriptan injectables are a great abortive especially used when all else fails.

As to the changing times, that's pretty typical in the beginning. And "the beginning" can be several years long. Eventually they will either go away (if you're really lucky) or just settle into a painful routine. There's a lot to learn so read, read more and take notes. A really informed and good headache specialist who has experience with CHs is also a must. Best of luck, keep your dirty side down and your clean side up. Blessings. lance
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Tanker Yanker
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Re: First Timer
Reply #2 - Mar 24th, 2012 at 8:46am
 
Thanks, Lance. Need all the advice I can get right now. My doctor asked me right off if I wanted an O2 tank but I told him to hold off a bit until all the test results come back. Not sure if I can play with it and drive either...

As for the time change saga, I was kind of hoping you wouldn't say that but at least now I know. Better to have all the info I can gather at my disposal I guess.
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Guiseppi
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Re: First Timer
Reply #3 - Mar 24th, 2012 at 9:26am
 
Reconsider the oxygen route. I pulled off a 30 year law enforcement career by keeping an E-Tank in my trunk when I was on cycle. An attack starts with that familiar bunching up of neck muscles, that full feeling in the ear and that "oh crap here it comes feeling." I fire off the 02, 6-8 minutes later I'm pain free.

The fact your doc suggested oxygen, and insisted on a battery of tests to rule out anything more sinister, tells me you REALLY lucked out and found a doc who knows his stuff.

You need an organized approach to managing them so they don’t manage your life. I use a 3 pronged approach, many use a similar approach:

1: A good prevent med. A med I take daily, while on cycle, to reduce the number and intensity of my attacks. I use lithium, it blocks 60-70% of my attack. Verapamil is the most common first line prevent, topomax also has a loyal following. Some have to combine lithium and verapamil together to get relief. The biggest problem with lithium is if the DMV finds out you're using it they want a battery of reports from your doc that say you're not mentally unable to operate a vehicle.

2: A transitional med. Most prevents will take up to 2 weeks to become effective. I go on a prednisone taper, from 80 mg to zero over a two week period to give me a break while my prevent builds up. Prednisone will provide up to 100% relief for many CH’ers but is harsh on the system and should only be used for short periods of time.

3: An abortive therapy, the attack starts, now what? Oxygen should be your first line abortive. Breathing pure 02 will abort an attack for me in less then 10 minutes, that’s completely pain free. Read this link as it must be used correctly or it will not work

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Imitrex nasal spray and injectables are very effective abortives. I use the injectables, they’re expensive, and I rarely use them, mostly just when I get caught away from the oxygen. The pill form generally works too slow to be effective for CH’ers.

Go to the medications section of this board and read the post "123 pain free days and i think I know why." It’s a vitamin/mineral/fish oil supplement, all over the counter stuff, that’s providing a lot of relief for people who have tried it, it’s a long read, worth the time.

Glad you already discovered the energy drinks.  Chugging it down as fast as you can when you feel an attack starting  willabort or at least really reduce an attack using these.

Finally, visit our sister board for “alternative” treatment methods outside of mainstream medicine. As you’ll see from all the success stories on this board, there is something to it.

clusterbusters.com


Read everything you can on this board, if you are a CH’er, knowledge is your best ally. We’ll help you all we can.

Joe
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"Somebody had to say it" is usually a piss poor excuse to be mean.
 
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Bob Johnson
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Re: First Timer
Reply #4 - Mar 24th, 2012 at 9:46am
 
First question to hit me: does being on the road impose any regs/potential problems about meds you may be using?

That you have a good doc is super. Suggest you print out the PDF file, below, and use it as a tool to discuss your options with him.

Using a preventive is essential, SOP. Verapamil has an excellent track record for effectiveness and safety (the PDF file). The goal is to reduce #of attacks/intensity of them.

Abortives: Issue with oxygen is how to use while on the road (plus regulations??) Imitrex injection is the fast and effective. But can you carry needles while driving?

If injection is a problem, the nasal spray formis second best but less consistent response, for some.

Second choice to Imitrex injection, in my judgment, is the following. Print out and discuss with the doc; see if he is willing to do a trial for effectiveness with you. The advantage is pill form which, when driving, has a clear advantage.
===
Headache 2001 Sep;41(8):813-6 

Olanzapine as an Abortive Agent for Cluster Headache.

Rozen TD.
Department of Neurology, Jefferson Headache Center/Thomas Jefferson University Hospital, Philadelphia, Pa.

OBJECTIVE: To evaluate olanzapine as a cluster headache abortive agent in an open-label trial. BACKGROUND: Cluster headache is the most painful headache syndrome known. There are very few recognized abortive therapies for cluster headache and fewer for patients who have contraindications to vasoconstrictive drugs. METHODS: Olanzapine was given as an abortive agent to five patients with cluster headache in an open-label trial. THE INITIAL OLANZAPINE DOSE WAS 5 MG, AND THE DOSE WAS INCREASED TO 10 MG IF THERE WAS NO PAIN RELIEF. THE DOSAGE WAS DECREASED TO 2.5 MG IF THE 5-MG DOSE WAS EFFECTIVE BUT CAUSED ADVERSE EFFECTS. To be included in the study, each patient had to treat at least two attacks with either an effective dose or the highest tolerated dose. RESULTS: Five patients completed the investigation (four men, one woman; four with chronic cluster, one with episodic cluster). Olanzapine reduced cluster pain by at least 80% in four of five patients, and TWO PATIENTS BECAME HEADACHE-FREE AFTER TAKING THE DRUG. Olanzapine typically alleviated pain within 20 minutes after oral dosing and treatment response was consistent across multiple treated attacks. The only adverse event was sleepiness. CONCLUSIONS: Olanzapine appears to be a good abortive agent for cluster headache. IT ALLEVIATES PAIN QUICKLY AND HAS A CONSISTENT RESPONSE ACROSS MULTIPLE TREATED ATTACKS. IT APPEARS TO WORK IN BOTH EPISODIC AND CHRONIC CLUSTER HEADACHE.

PMID 11576207 PubMed

--------------------------------------------------------------------------------


Olanzapine has a brand name of "Zyprexa" and is a antipsychotic. Don't be put off by this primary usage. Several of the drugs used to treat CH are cross over applications, that is, drugs approved by the FDA for one purpose which are found to be effective with unrelated conditions--BJ.
=====
Since this abstract was first posted Zyprexa has appeared in some lists of recommended meds for CH. [BJ]
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Tanker Yanker
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Re: First Timer
Reply #5 - Mar 24th, 2012 at 10:34am
 
Thanks guys for your quick responses. You do raise some good questions I'm going to have to get some definitive answers to.

My first guess regarding rules and regs (without consulting the Federal Motor Carriers Safety Regulations Handbook) would be that carrying an O2 tank in my cab could possibly place me under Hazmat restrictions (mainly no tunnels, etc.) forcing me to alter my routes sometimes several hundred miles out of the way depending on the state. Just off the top of my head, Pennsylvania and Maryland are particularly restrictive and I'm a regular customer in that area. Further research needed here on my part.

As far as preventative drugs go, most certainly nothing that could cause drowsiness or other possible distraction from the road. Safety ALWAYS comes first, no exceptions. Period. And as moderator Guiseppi pointed out, there may be an entire mountain range of paperwork to be completed in order to confirm I am still competent to perform the task to satisfy the DOT -- and those regs can vary from state-to-state. Yet another research question.

Taking many notes, will definitely be armed with some good options to discuss with my doc when we speak again next week.

Off again.
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« Last Edit: Mar 24th, 2012 at 11:05am by Tanker Yanker »  
 
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RichardN
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Re: First Timer
Reply #6 - Mar 27th, 2012 at 5:30am
 
Hi Tanker Yanker

  So glad you found us.

  Do you have any heart/artery issues or high cholesterol?  If so, you won't be able to take the imitrex (a MAJOR vaso-constrictor) which can be dangerous if you have the above conditions.  I have some artery blockage and high cholesterol, so I can't use.   02 has been my abortive for ten years.  I also used Rock Star orange (tastes like Orange Crush) . . . hate the taste of Red Bull. 

  After coming here and getting the info to take to my doc, I got a script for Verapamil and 02 . . . within 3 weeks I had my first PF day in over a year (had three attacks that night, but had 02 to kill them before reaching the "dance" stage.

  For the last 4 1/2 months have been PAIN FREE . . . passed the "beer test" . . . other known triggers NOT producing attacks.  I'm giving the credit for this to Batch's D3 regimen . . . . and there's nothing in it that should give you any state reg problems.

  Welcome to the board . . . keep reading . . . keep asking.

   Keep the rubber side down,

      Be Safe,   PFDANs


         Richard
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I can live with the beast as long as I don't have to "dance" with the bastard.
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Tanker Yanker
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Re: First Timer
Reply #7 - Mar 27th, 2012 at 4:19pm
 
Thanks Richard, glad I found my way here too. Seems like with the lack of definitive medical solutions the "ask the man owns one" approach is by far the best game in town. And perhaps the only one.

After finally getting a night's sleep (the 11pm train didn't come through last night for the first time in 10 days) and clearing my head a bit, I've definitely decided on heading down the vitamin route at first. Came to that conclusion rather easily too: During my reading when it became so readily apparent that there was no sure-fire-magic-bullet I figured I might as well try to keep it as natural as possible until it proves otherwise. It'll get a golden opportunity at least; I've long been well aware that sheer stubbornness and persistence are most certainly two of my more endearing qualities. Oh, and yes, my cholesterol level is being treated and has been for a number of years. Side effect of the HIV med I take. Under control now (192) but pretty sure it would just regulate itself again if I ever switch as it was never a prior issue. But as my HIV med is so highly effective (and has been for a very long time now), I'm certainly in no hurry to find out either.

Have my boss checking into the O2 in the truck question. Federals regs state no "while driving" but fail to elaborate on whether or not pulling over to the side for some quick hits falls under that category. Never been much of fan of energy drinks either. Have tried 'em here and there in drowsy desperation, but I'm usually a one cup a day coffee guy followed by a Vitamin Water ("Energy" or "Power") if I need it later. Yet since The Beast has found its way into my life, the subsequent increase in caffeine intake is definitely causing some sleeping issues (and that's being quite kind about it) -- not to mention some hangovers far too highly reminiscent of the reckless abandonment of my youth. Hoping I can get an answer soon, but in the meantime there's a 4-pak of Red Bull waiting to tag a long with me when I hit the road again tomorrow morning just in case.

Thanks for sharing your support and knowledge. Your recent success offers great hope and inspiration. May you find peace.

And yes, I'll keep the rubber side down. Now just be sure to keep your *&%! four-wheeler outta my way. Wink 
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« Last Edit: Mar 27th, 2012 at 5:50pm by Tanker Yanker »  
 
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Batch
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Re: First Timer
Reply #8 - Mar 27th, 2012 at 9:05pm
 
Hey Tanker Yanker,

Welcome aboard the Crazy Caravan...  Go for the O2 and the vitamin D3 regimen...  You won't be sorry on either count.  As far as taking your O2 out on a haul...  I've worked with a couple long haulers who kept oxygen cylinders strapped in their sleeper cab.  It's legal, but not while operating your rig.  You need to be safely off the road and stopped. 

You're money ahead with welder's O2 and one of the $35 O2 regulators from Harbor Freight Tools shown below:

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These puppies put out enough flow rate to blow a rear seal...  This method of oxygen therapy isn't passive either.  If you're hyperventilating properly, you'll get tired about the time the pain stops...  on average 7 minutes...  Less if you can catch it early with this method of oxygen therapy.

See the following link Reply #4 to Lobster for an explanation of the breathing technique to use during oxygen therapy.

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Pick up one of the $37.50 O2PTIMASK™ kits at the CH.com Store yellow tab at the left.  They're worth the cost.  I've had one since 2008 and it's still in great shape.

If you have a prescription for oxygen therapy for your CH, keep it with you in the cab.  There's bound to be a nosy county mounty or a smoky bear wondering what the heck you're doing and likely thinking you're working off a drug trip...  Having the prescription handy saves a lot of hand waving...

Swing by a Costco for the three items shown below and take two of each every day.  If you don't shop at Costco, most supermarkets carry the same or similar brands.

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When you have the time, swing by your doc's office for a 25(OH)D lab test.  Knowing your serum concentration of this metabolite of vitamin D3 will help to figure how long before it takes effect.

70 out of 100 CH'ers who try this regimen have a favorable response with a significant drop in the frequency and severity of their CH...  or they go pain free.  Most respond in the first ten days to two weeks and most of them are PF before the end of the third week...  It all depends on your serum concentration of 25(OH)D.

Once you get control of your CH with this regimen...  Keep taking it...  This stuff is good for you health wise and you not be bothered by CH again...

Take care and please keep us posted on the flip side.

V/R, Batch
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You love lots of things if you live around them. But there isn't any woman and there isn't any horse, that’s as lovely as a great airplane. If it's a beautiful fighter, your heart will be ever there
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