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Just been diagnosed (Read 678 times)
aimee25
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Just been diagnosed
Apr 12th, 2012 at 9:52am
 
Hi,

I came home from hospital last night after having spent two days there. I was diagnosed with cluster headaches in A and E the doctors knew straight away. When they tried to tell me, I had no idea what the illness was the word headache just didn't truly describe the pain. I spent the following two days in a ward where the doctors gave me various drugs to try and ease the pain nothing would work. I told them if they can't help I am going home they tried everything and the attacks just kept coming. The only pain relief that worked (and only for a very little while) was morphine but it turns out the continued use of morphine can aggravate CH's. So now I am on steroids and Verapamil oh and paracetamol which does absolutely nothing.

I was so happy to get home last night that I almost forgot the dread of the next attack then it came bang on time 11:30. No words describe. 35 mins later the pain was easing. I have been doing some research on this condition today and I'm not gonna lie, I have bummed myself right out.
The doctors didn't really know enough about CH's to go into detail and now I know. It's sinking in, this is something I will constantly be dreading and the dread of the pain is 2nd only to the pain.
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Bob Johnson
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Re: Just been diagnosed
Reply #1 - Apr 12th, 2012 at 10:21am
 
FIRST STEP!
Please tell us where you live. Follow the next line to a message which explains why knowing your location and your medical history will help us to help you.

Cluster Headache Help and Support › Getting to Know Ya › Newbies, Help us...help you

You can add your location by editing your profile. CP Member --> profile
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Your msg suggests that you are not in the U.S., hence the preceding.....

If a stay in the hospital didn't result in some effective treatment and a good sense of the diagnosis...!

You need to start over again, first locating a headache specialist/clinic. But how/where/when depends on your location.
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IF you have Cluster (and I don't accept that Dx yet), some introductory material for you:




Cluster headache.
From: Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to Login or Register (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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Print out the PDF file, below. This is the latest list of standards treatments for Cluster along with evaluations of effectiveness.

WHEN you locate with a headache doc, this list is a good tool to use in discussing treatment options--and as a mechanism to gain some idea of whether you have a skilled doc, i.e., be cautious if some mix of these meds are not prescribed.

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« Last Edit: Apr 12th, 2012 at 10:22am by Bob Johnson »  
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aimee25
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Re: Just been diagnosed
Reply #2 - Apr 12th, 2012 at 10:31am
 
My doctor in the hospital was very good don't get me wrong. Its just his knowledge on the subject wasn't great. After having done my own research as well I do believe I have been diagnosed correctly. I have been referred to a neurologist which I should see in about 2 weeks. I did use oxygen in hospital which did ease the attack but it depended on how far in to an attack I was.
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Bob Johnson
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Kennett Square, PA (USA)
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Re: Just been diagnosed
Reply #3 - Apr 12th, 2012 at 10:39am
 
Medical literature shows that neurologists receiving strikingly little education in complex headache disorders. I would not assume that any neuro has the skills which you need. Suggest you ask, directly, about this docs training/experience.

This issue is so common that many of us have had to move between several docs before we learned how to find the well trained person.

If oxygen was the only treatment you received in the hospital--that's good evidence of a lack of skill.
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As I was closing this msg, caught your location. Confirms my comments. We have a unfortunate # of UK folks who report the same experience you have had. It's clear that so many of the local docs simply lack basic training in complex headache disorders.

Good news! You have an excellent support group which you must contact. They will guide you thru your health care system to good treatment. By law, you have the right for direct referral to a headache clinic, by-passing your local docs

Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to Login or Register


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« Last Edit: Apr 12th, 2012 at 10:44am by Bob Johnson »  

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aimee25
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Re: Just been diagnosed
Reply #4 - Apr 12th, 2012 at 10:41am
 
Dx? is that diagnosis? if so why would you not accept it?
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aimee25
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Re: Just been diagnosed
Reply #5 - Apr 12th, 2012 at 10:44am
 
As i said Oxygen is not the only treatment I received, I also got morphine and Verapamil and steroids. I also had the injection although I am not entirely sure what it was called it bagan with S I was in way too much pain at the time to take notice of what they were putting into me
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Bob Johnson
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"Only the educated are
free." -Epictetus


Posts: 5965
Kennett Square, PA (USA)
Gender: male
Re: Just been diagnosed
Reply #6 - Apr 12th, 2012 at 11:00am
 
Your concluding comment in the first message: docs didn't know enough...

That's the key point I'm trying to convey. This is a complex area of medicine and Cluster is found in about 1% of the population, i.e., many docs never gain the skill they need to treat us.

The meds you were given is one element of the treatment. Questions dosing, timing, combinations of meds, etc. are ones which require experience/skill.

One of the world's leading headache neurologists (former in London) has published studies of how many years & # of docs many people experience before finding knowledge/skill. Our membership has encouraged folks to seek skilled docs at once, if at all possible, to avoid this issue.

Yes, Dx means diagnosis.

Should have suggested that you explore the buttons, left of this page, starting with the OUCH site. Good basic information which will benefit you.
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Bob Johnson
 
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