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nanbibb
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Dr. tomorrow
« on: Oct 11th, 2007, 8:41pm »
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Luckily, my husband has coerced the dr. (family practice) to see me tomorrow. I am on 7 days of pain and ready to go insane.  Cry
 
Any suggestions on what I need to ask or find out about?  
 
I have my journal that I have kept track of headaches to take with me.
 
I have a couple of questions also
Has anyone here had clusters and then been diagnosed with MS? My dr. mentioned it to my husband today.
He also mentioned trigeminal neuralgia.  
 
Any thoughts or ideas?
 
Thank you in advance.  
 
Nancy
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Guiseppi
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Re: Dr. tomorrow
« Reply #1 on: Oct 11th, 2007, 11:06pm »
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Well the accurate diagnosis is critical, I don't know of any MS/CH people on the board yet. Print out the oxygen info on the left and try and talk him into prescribing it. If he's not open to it, sorry to say it's time to shop for a new doc.
 
The sad fact is doctors get about 4 hours total education on headaches, I suspect 26 seconds of that is on CH. You're a woman, so first he'll probably try and convince you it's a migraine....(another warning bell!!!)  
 
The trick is finding either a doc who knows something about CH...(long shot)....or a doc who is open to learning!!! Educate yourself as much as you can, it will most likely be up to you to manage your care. Good luck!!!
 
Guiseppi
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Re: Dr. tomorrow
« Reply #2 on: Oct 12th, 2007, 5:47am »
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You being a woman, don't be too suprised if you are diagnosed as being hysterical (unless your doc knows his CH stuff).  Good luck!
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Bob_Johnson
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Re: Dr. tomorrow
« Reply #3 on: Oct 12th, 2007, 7:07am »
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Print two copies: one for you, one to leave with the doctor.
 
It's a tool to influence his thinking if you have a doc without much headache experience and a way of guiding your discussion with him.
--------------
http://www.plainboard.com/ch/chtherapy.pdf
 
Here is a link to read and print and take to your doctor.  It describes preventive, transitional, abortive and surgical treatments for CH. Written by one of the better headache docs in the U.S.  (2002)
   
 
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Bob Johnson
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Re: Dr. tomorrow
« Reply #4 on: Oct 12th, 2007, 9:26am »
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Have you taken the cluster quiz on the left side here?  Do you have most of the symptoms?  I also have never heard of anyone having MS regarding CH.  But I did go misdiagnosed for many years....told I had migraines and have tried most every med you can name to no avail....CH are quite specific and like the others have said if he knows his stuff he will know right away and not dilly dally around with other crap.  Lots of us have had to go to dozens of Docs to get the help we need...ie....O2..Best of luck
 
Alicia
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nanbibb
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Re: Dr. tomorrow
« Reply #5 on: Oct 12th, 2007, 9:36am »
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I hav taken the quiz and have most of the symptoms. I also tend to have background headaches as well. I have been having a lot of nerve problmes as well, feeling like I have an electric current going through my arms, etc. any time I get started and unexplained sharp pains. I have been on a B complex to help with that lately. I am not sure what is going on. I was dianosed several years ago with ch but choose to eliminate medical treatment to have my daughter. Since then theyhave not been as severe and I could deal with them. It has just been awful this time though. Not sure will wait and see what he says today I guess.  
 
Thanks for the info.  Smiley
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Bob_Johnson
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Re: Dr. tomorrow
« Reply #6 on: Oct 12th, 2007, 11:28am »
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J Headache Pain. 2007 Sep 24;  
 
 
Cluster headache attacks and multiple sclerosis.
 
Gentile S, Ferrero M, Vaula G, Rainero I, Pinessi L.
 
Neurology II — Headache Centre, Department of Neuroscience, University of Turin, Via Cherasco 15, I-10126, Torino, Italy, sgentile@molinette.piemonte.it.
 
We report the case of a patient who developed typical cluster headache attacks and was diagnosed as having multiple sclerosis (MS) at the same time. The headache attacks resolved after i.v. treatment with methylprednisolone. MR imaging showed a pontine demyelinating lesion involving the trigeminal nerve root inlet area, on the same side as the pain. The association between cluster headache and MS has been rarely described before. This case suggests that in patients with cluster headache neuroimaging is often useful in order to exclude structural lesions.
 
PMID: 17901919 [PubMed]
 
------------------------------------------------------------------------ --------
 
2: Cephalalgia. 2004 Nov;24(11):980-4.  
 
 
Prevalence of primary headaches in people with multiple sclerosis.
 
D'Amico D, La Mantia L, Rigamonti A, Usai S, Mascoli N, Milanese C, Bussone G.
 
C. Besta National Neurological Institute, Milan, Italy. damicodo@tiscali.it
 
The aim was to investigate the lifetime prevalence of headache and primary headache (diagnoses according to International Headache Society criteria) in multiple sclerosis (MS). The relationships between headache and clinical features of MS and MS therapy were also investigated. We studied 137 patients with clinically definite MS; 88 reported headache, 21 of whom developed headache after the initiation of interferon. The prevalence of all headaches in the remaining 116 patients was 57.7%. Migraine was found in 25.0%, tension-type headache in 31.9%, and cluster headache in one patient. A significant correlation (P = 0.007, Fisher's exact test) between migraine and relapsing-remitting MS was found. Primary headaches are common in MS patients. Further studies are needed to clarify the mechanisms underlying this association, particularly the association between migraine and relapsing-remitting MS, and the role of interferon in the development of new headache.
 
PMID: 15482362 [PubMed]
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Bob Johnson
nanbibb
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Re: Dr. tomorrow
« Reply #7 on: Oct 12th, 2007, 8:09pm »
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Diagnosis - Severe CH with paresthesias this is from my family practice doctor. No run around or anything he was very good. He has set me up to going to the Ryan Headache clinic in 3 weeks. He prescribed Indocin and percocet to keep the pain under control. He did not want to start me on something he prefered that the specialist do that.  Smiley
 
I was so happy, he did not say I couldn't have it because I was female or anything. I am his second patient that he has ever seen with ch symptoms.  
 
Thank you for all the help and info. Time for me to do more research.  
 
Nancy
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Re: Dr. tomorrow
« Reply #8 on: Oct 12th, 2007, 8:29pm »
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nancy, I certainly understand a GP not wanting to start prescribing a bunch of stuff till you see a Neurologist.
 
 But if you are in a lot of pain and have no relief, I'd try to go rent an 02 tank and get a regulator.
 
 Historically Percocet will not help.
 
 At least with 02 you can have a safe & effective way to keep things under control.
 
 Get ready for an MRI and a huge bill....even with insurance. Mine cost a total of over 4 grand !!!
But the Neuro will likely find it necessary.  
 
 
    If you are like I was when I first got CH, you are likely out of your mind with fear & pain.
 
  If it is possible to get some 02, trust me...it is safe & may be a life saver "stop-gap" measure.
Hope it works out well for you.
 
 Cheers, Dave
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