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superhawk2300
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Opinions: Oxygen and tripans
« on: Feb 13th, 2008, 8:31am »
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What are your personal feelings as to how much oxygen is too much oxygen?
 
How many triptan doses do you feel comfortable taking and how many days in a row do you feel comfortable taking that dose?
 
Does your response to the treatments effect what you do? For example if you do not responde to the oxygen after a certain time do you keep sucking away even though it isn't working or do you quit it for that time?
 
I know what is "offically" recommended but as CH people, what do you personally feel / do regarding these items?
 
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Re: Opinions: Oxygen and tripans
« Reply #1 on: Feb 13th, 2008, 8:44am »
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Hello SuperHawk:
 
I use the O2 whenever I feel a CH coming on.  It usually works for me within 5-7 minutes.  I hang in there for at least 10 minutes, sometimes 15, before I grab for the Imitrex.
 
I divide the doses of Imitrex in half, allowing me to use up to 4 shots within 24 hours.  I have even pushed that envelope a little bit.  Sometimes for days at a time.
 
That's when I try to get a little more creative with energy drinks, avoiding naps, forcing myself to try to get on with life and not letting the CH rule my life.
 
That's my 2 cents.
 
Wishing you well,
 
Ray
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Re: Opinions: Oxygen and tripans
« Reply #2 on: Feb 13th, 2008, 9:19am »
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Here is my experience.  Your mileage will vary  Wink  
 
For me, it depends on how early I catch it.  If I get on the O2 early I'm close to 100% successful within 10 minutes.  I stay on another 5 to reduce the liklihood of reattack.  If it does sneak back I pound an energy drink and get back on the O2.  That'll usually do the trick.
 
If I wake up with a barn burner going I give the O2 two 15 minute attempts before reaching for the Imitrex.  Before the first attempt with O2 I suck down an energy drink.  That way the Taurine has a chance to get into my system while the O2 knocks the bastard down.
 
If those two attempts fail then I reach for old faithful, Imitrex.
 
With this strategy I averaged one Imitrex injection a  week during my last cycle.
 
If I use Imitrex on consecuitive days I risk rebounds.  So my goal is to rely heavily on O2 and keep the triptan usage to an absolute minimum even if it means some 45 minute fights with the beast.  My hits always last 1-3 hours so I'm still ahead of the game.
 
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Re: Opinions: Oxygen and tripans
« Reply #3 on: Feb 13th, 2008, 10:33am »
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I felt like I was sucking a lot of O2 also, but then I got a clustermasx and my consumption was cut way, way down (in addition to the amount of time spent huffing away).
 
I know currently there isn't a way to receive one, but check out the website http://www.clustermasx.com to get the gist of how this mask works and then go to http://www.mushys.com/O2/mymask.html to build your own buy buying the parts seperately.
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Re: Opinions: Oxygen and tripans
« Reply #4 on: Feb 13th, 2008, 10:41am »
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If you're an otherwise healthy person, you'd have to breathe 100% O2 for over 20 hours before there would be even the possibility of long-term damage.
 
Ask any fighter pilot. They are on 100% O2 whenever they are at the contols.
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Re: Opinions: Oxygen and tripans
« Reply #5 on: Feb 13th, 2008, 11:12am »
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I go 15 minutes max on the oxygen before giving up. Mine build fairly fast and if they aren't in full retreat after 15 minutes I'm in for a butt whooping. At 15 minutes or so I'll give up and go with trex injectable. I'm fortunate in that lithium is still a highly effective preventative and the 02 works for the majority of my attacks.
 
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Re: Opinions: Oxygen and tripans
« Reply #6 on: Feb 13th, 2008, 2:21pm »
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Oxygen (with clustermasx) usually works in 5 minutes. If not I shoot 1/3 Trex.
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Re: Opinions: Oxygen and tripans of
« Reply #7 on: Feb 13th, 2008, 9:11pm »
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According to www.pdrhealth.com and other reliable sources, the maximum dosing limits for Imitrex follow:
 
IMITREX INJECTION
 
The maximum single recommended adult dose is 6 milligrams injected under the skin.
 
The maximum recommended dose that may be given within 24 hours is two 6 milligram injections taken at least 1 hour apart.
 
IMITREX TABLETS
 
The usual adult dose is one 25-, 50-, or 100-milligram tablet taken with water or other liquid. The most you should take at one time is 100 milligrams, and the most you should take in 1 day is 200 milligrams. Doses should be spaced at least 2 hours apart.
 
If you have liver disease, you should not take more than 50 milligrams of Imitrex Tablets at one time.
 
IMITREX NASAL SPRAY
 
The recommended adult dose ranges from 5 to 20 milligrams taken when the attack begins and repeated once, if necessary, 2 hours later. Doses are usually taken as a single spray in one nostril, but if a 10-milligram dose works best for you, you can take it as a 5-milligram spray in each nostril. Do not use more than 20 milligrams at a time, or take more than 40 milligrams a day.
 
OXYGEN THERAPY
 
As far as how much is too much when it comes to oxygen therapy goes, Brewcrew has already pointed out that aviators breathe 100% oxygen on every flight.  Navy and Marine Corps pilots routinely breathe 100% oxygen for two or more hours on every flight and I would further point out that they've been doing this for over 60 years and there's been no reported problems...  I've over 3000 hours flight time with all of it on 100% oxygen and I'm still here...
 
I'm not a doctor, but the information I've collected from some very credible sources says in short, the only time limit on oxygen therapy at 15 liters/minutes or higher is the number of oxygen cylinders you have on hand.   There are any number of studies that will tell you that six (6) hours is a conservative time limit for continuous exposure to 100% oxygen at sea level pressure if you're otherwise healthy.  Your lungs will tell you when you've had enough...  I'm told the symptoms of pulmonary oxygen toxicity are a lot like pneumonia...  It gets progressively more difficult and painful to inhale...  This condition and the symptoms are reversible and clear rapidly by breathing normal air.  
 
If you want to be super conservative, the Navy Hyperbaric Oxygen Therapy (HBOT) safe exposure tables set a limit of 60 minutes on 100% O2 with a 15 minute break breathing normal air before starting back on O2 therapy...  but that is at 2 ATM pressure equal to 30 feet under water...  not at sea level pressure of 1 ATM.
 
Accordingly, stopping O2 therapy at 15 minutes may be stopping you from an abort a few minutes later...  I've also found that abort times start dropping with flow rates above 15 liters/minute.  
 
We all need our sleep and that can be hard to get when you're getting nailed by an attack every two hours around the clock.  Prior to using higher flow rates, I found that oxygen therapy at 15 liters/minute combined with a 25 mg. imitrex tablet aborted the attack and prevented one or more of the regularly scheduled two-hour attacks giving me at least 4 and some times 6 hours of sleep at night.  
 
Again, we're all wired differently so whatever works best for you is usually the best course of action...  Having said that, I wouldn't sell oxygen therapy at 15 liters/minute short and cheat myself our of an abort by stopping it after 15 minutes. Oxygen therapy is still the least invasive and most cost effective abortive available to us as cluster headache sufferers.
 
So...  If you're looking for opinions on the pros and cons of imitrex or oxygen therapy... you've come to the right place.  There's plenty of them here...  Having said that, there's no replacement for good critical thinking and research on your own.  The Internet provides us ready access to far more information than was available in the past.  Just remember to get a balanced sample and not settle on the first article you find as gospel.  
 
Take care,
 
V/R, Batch
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Re: Opinions: Oxygen and tripans
« Reply #8 on: Feb 13th, 2008, 10:27pm »
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Triptans suck! O2 rocks!  
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Re: Opinions: Oxygen and tripans
« Reply #9 on: Feb 14th, 2008, 8:01pm »
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Thanks for the info guys! It is mucho appreciated!
 
It is so interesting how this varys for each of us. Well except for the part that sucks - that seems to be a constant!
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Re: Opinions: Oxygen and tripans
« Reply #10 on: Feb 18th, 2008, 1:08pm »
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Similar to others, I reach for O2 first, but if it hasn't kicked it within 15 minutes, it means the oxygen isn't going to do it.  Then I reach for imitrex.  I'm pleased that my dr. inadvertantly prescribed the vials this go 'round.  I've been dividing the doses and find that a half dose works quite well, allowing me to administer more frequently if needed.  The injections are a breeze to administer and sting less than the stat dose injectors.
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Re: Opinions: Oxygen and tripans
« Reply #11 on: Feb 18th, 2008, 1:44pm »
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I always dive for the O2 first if available. I give it 15 minutes. If it is severe, then I'll got for a trex injection -- but I avoid doing that at all costs. I get severe rebounds from using it more then once / twice a week.  Caffeine, ice, and screaming at a higher power help me fill in the gaps.
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Re: Opinions: Oxygen and tripans
« Reply #12 on: Feb 18th, 2008, 9:38pm »
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Oral triptans didn't do anything for me, except kick in about 20 minutes after my hit was over.  I don't have any experience with the injects (yet).
 
O2 has been very very good to me.  I knocks most of the hits out completely, if I start quickly enough.  The initial ramp-up quits sooner (and easier) and the hit quits way sooner.  Even if I don't get there early enough, O2 makes things quite a bit more tolerable.  I went through the last cycle about halfway before I got hooked up with a clustermasx and O2.
 
Melissa, an interesting observation.  I found about 15 lpm with the clustermasx filled the bag as fast as I used it.  Using more would be pointless, it just leaks out when the bag overfills.  I didn't realize that other masks took more; perhaps they are leakier.  Gosh, am I the lucky dude who got the last clustermasx?
 
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Re: Opinions: Oxygen and tripans
« Reply #13 on: Feb 18th, 2008, 10:43pm »
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I started using oxygen 15 years ago. It worked well for about 10 of those years and got to where it wasn't working as much and I stopped using it altogether and I was then introduced to Imitrex, which worked almost every time. I am now in a cluster and decided to try oxygen again. I can only go 10 minutes as the headache comes on fast and furious. I have Imitrex vials and use about 2 mg. It takes longer to kick in and have gotten some nearly full blown attacks because of that. I am 7 days into my cluster and find I am feeling crappy,weak and out of breath when doing mild activities, Are others having those symptoms from injecting?
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