This is a detailed post about the bucket of medications I took today and what led to it.

It's been very tough the last two months. 

Dec 12: Cluster starts and has me at about a 2 - 4 on the Kip's scale all day long with periodic escalations to squirming around.

Dec 28: ENT gives me an intranasal nerve block using a syringe, long needle and an endoscope.  This is an actual injection through the mucosa targeting the sphenopalantine ganglion. 

Jan 12: I went to pick up my usual refill of buprenorphine but the pharmacist refused.  My pain doc switched to Sutter and his DEA number was different and there was no way the script could be filled.  I called Sutter and they said it would require a new patient visit and the soonest would be in two months.  I called my GP and neurologist but they don't have the special designation required to prescribe buprenorphine.  I called around and the soonest I could see a pain doctor was January 26th. So there I was, staring down the barrel of horrid opiate withdrawals.  I had 24 hours before withdrawals start. I scoured the web for a solution and the best I could find was overnight delivery of 10 pounds of poppy seeds and make tea.  Desperate times, desperate measures.

Poppy seed tea tastes horrid but it worked.  Probably too well.  I was careful and started slowly just to stave off withdrawals. I was so happy I had done the nerve block becuase I could not have handled chronic clusters while in withdrawals.  Soon enough though, the clusters started back up so I had to increase my dose of tea.

Jan 26: I saw the new pain doc. It was a quick appointment, mostly him confirming I actually had a pain condition.  Then he gave me a script for the buprenorphine and off I went to fill it. I skipped the tea for 24 hours before taking the buprenorphine.  But that was nowhere near long enough.  All the different alkaloyds in poppy seed tea seem to bind for a long time, and then there's "stacking" when your GI system slows down.  So even though I had waited 24 hours there was still plently of codiene and morphine in my system.

30 minutes after taking the buprenorphine it hit me like a truck.  Imagine the sensation of falling, with your skin bubbling off, and your insides trying to turn themselves inside out and a horrid sense of doom.  Precipitated withdrawals.  It went on for about 36 hours.  I called 911 and it was very difficult to work the phone.  Things sorted themselves out after a few days and I was back to normal, or normal for me, which is a 3 - 4 on the Kip's scale all day long, with the occasional dance with the devel.

Jan 29:  I went back to the ENT for another nerve block.  For some reason this block did nothing.

Feb 2:  still in cluster, so for the past 7 weeks I had been chronic with a brief vacation due to the December nerve block.  It was a Tuesday and I decided to try some edible medical marijuana.  I had tried some a couple years ago and it didn't seem to help but I thought maybe I'd give it another shot.  I got a peppermint patty and ate half.  One hour later I was completely out of my mind, in pain, and it was horrific.  I was vomiting and freaking out and time was just not moving.  In my stupor I somehow thought that I was holding reality together in my mind, and if I failed the universe would disappear, along with time and space.  The most intense part lasted about 8 hours and 36 hours later I was back to reality, although it took about a week to feel fully normal again.

Feb 15 - Today:  I'm losing it.  I can't deal with this pain any more.  Suicide is not an option as I have a family.  Since this cluster started I've been seen by a top neurologist at Stanford, my local neuro, psychiatrist, GP, new pain doc, ER doc - my point is that I'm trying the conventional channels and not just winging it.

I keep a prescription of prednisone on hand for cases like this.  I really hate taking pred as I feel like hell afterwards and usually get all kinds of colds.  I also had some Hawaiian Baby Woodrose seeds (HBWS) that I though I might experiment with at some time.  And that time was now.  I decided to go nuclear.  Here is my chronical of today.  Please do not take this as advice. 

7:00am  Wake with a 6 on Kip's scale.  Take the usual: 240mg Verapamil, 2 tylenol, 2mg buprenorphine, 15mg Remeron
8:30am  No improvement.  Sitting on edge of bed and squirming.  Decision to go nuclear discussed with wife and we agree. Start with 2 HBWS
10:00am  Pain fades to a 4, laying down now. Take 3 more HBWS
Noon     No improvement.  Start prednisone 60mg
2:00pm  Pain still at 4, feeling agitated.  Apply intranasal lidocaine
3:00pm  No improvement.  Mix up a potent batch of PST.
4:00pm  Pain gone.
5:00pm  Mow the lawns, take down the Christmas lights.

Again, please do not try this yourself.  I'm posting this because I need to vent.  I didn't notice anything peculiar about the seeds.  At one point I felt a bit loopy but that was probably the PST.

Yes, I take it for the CH. after failing all the conventional meds plus a failed RFA there was no option other than opioids. I've been prescribed various opiates and decided buprenorphine was the best fit.  It does a good job of dealing with the irritability and despair of being in pain, and takes the edge off it. It also has less of a high than the other opiates and has a safer profile than full agonists.