Posted by gary g (209.187.112.145) on July 20, 1999 at 12:18:13:
In Reply to: Cafergot taken off market???? posted by David Chalfant on July 20, 1999 at 01:07:57:
mornin' headbangers
hmm..problem looming here?
cafegot has always been one of my staples for managing these buggers
tried the generic ercaf a couple times, got the impression it didn't do it for me as well as the branded version
never used the combination forms - my doc & I like to use single action meds & combine them when and as needed, instead of trying to get it all in one shot - just personal preference
before I found o2, my strategy was to use cafegot until I neared the danger level, switch to heavy duty painkiller (percoset, generic=oxycodone,etc) for a bit, then back to cafegot when I (rapidly)built up a tolerance/resistance to the narcs...
ping-pong - a balance between being stoned or risking stroke, actually - but such is life with CH
thru it all using LOTS of generic benadryl (diphenhydramine)which I am convinced helps moderate both the depth/length of the cluster, and the severity of individual attacks
OTC acetaminophen, ibuprofen, etc might as well be water, for my case
if using the narcs, gotta watch constipation REAL close - senna based laxatives help - I got so I took one with each oxycodone & seemed to come out "even" - -
plus if I use the narcs too much, I get what amount to withdrawal headaches when I stop, & have to deal with that for as much as a couple weeks, using tylenol to back THAT off
the ergat form I use is the basic ergatomine tartrate + caffeine, basic formula - - as I understand it, the ergot physically constricts the blood vessels to help reduce the painful pressure in the affected area, and the caffeine then increases the blood pressure to keep enough o2 flowing - so it IS a very touchy balance - really screwing around with Ma Nature's design
frankly I have often gone WAY WAY over the limits without ( YET ) any detected serious side effects, but doc has told me to watch VERY VERY carefully for signs of circulatory impaction (cold extremities, blurred vision, etc) and stop IMMEDIATELY if they show up
it IS a potentially dangerous compound, and could rapidly be a problem for anyone with other afflictions, and possibility even without
my pharmacy told me years ago that its shelflife is questionable, and they don't keep much around to be sure their supply is fresh
fun fact:
ergatomine is based on a wheat fungus (ergot)which is among other things a potent hallucinogenic, there are medieval accounts in Europe of whole villages being possessed by demons etc,for periods of days, that are believed to be the result of ergatomine poisoning from inhalation of "mildewed" grain dust
ALTERNATIVE:
for me, high flow pure oxygen, as often discussed on this board, is a MIRACLE
I first tried it midway thru my last cluster: it did NOT shorten the cluster, compared to recent previous episodes but it DID stop fully 90% of my attacks within a very few minutes, and before they got to serious levels if - AND ONLY IF - I got on the tank at the VERY FIRST hint of an impending attack; a couple times I procrastinated & paid dearly for it
the key appears to be the high flow (8-10 liters / minute inhalation rate - the max on most medical regulators) taken PURE (NOT mixed with outside air as you breath) this requires a nonrebreather mask - which means you only get the pure oxygen straight from the tank, and no environmental air, and none of your exhalation
it can be dangerous if overused, apparently, but it's GOTTA be a hell of a lot safer than narcotics or cafegot stroke
suggestion - hold the mask to face with hand, don't use the headstrap strap
then if you doze off, you won't end up breathing pure o2 for an indefintite period
also - if your insurance co has shot you down on o2 in the past - try again - they are rapidly coming onboard because it saves them BIG BUCKS compared to imitrex, ERoom visits, etc