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chefjohn
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Rebound headaches
« on: May 12th, 2008, 9:01am »
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I have a question about Rebound headaches and Imitrex inhalers.  I started this cluster about 3 weeks ago and they would come once every 2 to 4 days which was not too bad but they would last 3 plus hours.  I had an episode Friday night and went to the ER for O2.  On Saturday I got my prescription for Imitrex and was having an attrack Sat night so I took my first dose.  it worked fine but I had another attack last night ( and took another dose) and am having one right now.  I am wondering if I am just peaking, if that happens or if it has anytrhing to do with the Imitrex.  Your thoughts would be helpful.  Thanks   John
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Paige_H.
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Re: Rebound headaches
« Reply #1 on: May 12th, 2008, 9:12am »
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Hey John.  When I got into that ignorant, dreaded, cycle (yes, I'm bitter about it) I start off with a HA every other or every 2 nights.  Then after about 2 weeks, it amps up to every night, sometimes 2-3 times per night and they get worse and worse.  Then after 2-3 weeks (sometimes more) of that, it will go back to once every other night and then just disappear.  The thing is, CH is weird in that the pain is the same, but everyone seems somewhat different in the way cycles begin and end.  But everyone seems to have that stupid, stinkin peak.
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DennisM1045
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Re: Rebound headaches
« Reply #2 on: May 12th, 2008, 9:50am »
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So you are saying the O2 worked?  If so that's great news!  Take this info to your Neuro and get some tanks for home / work / anywhere use.  The perscription should look like this:
 
100% O2 at 12-15lpm w/NRB as required for treatment of accute cluster headache attack.
 
I've heard some folks say that Imitrex increases the frequency of attacks.  However I haven't found this to be true myself.  I only use Imitrex once O2 has failed and I'm riding a Kip 8-10.  Otherwise I just keep hitting the O2 till it's over.  I'll only use 1 to 2 injections a week max.
 
If you're not on Verapamil you can use energy drinks too.  The Taurine can help keep the hits from returning too quickly.  If you are on Verapamil you just need to be careful not to use more than one or two a day.
 
Cycles do ramp and fade.  For me it happens multiple times within a single cycle.  You just never know what the beast is going to do.
 
Try not to read too much into it.  One hit at a time and live in between them.
 
-Dennis-
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MJ
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Re: Rebound headaches
« Reply #3 on: May 12th, 2008, 10:00am »
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Hi John
 
The only way to determine if you are having rebound headaches is to stop using the medication.
 
Imitrex does have that ability to prolong a cycle, increase the frequency of hits and cause rebounds.  
 
Some find continual relief with it every time and it is a godsend. Others find momentary relief and unknowingly extended suffering. A few find no relief at all with it.
 
 
Not everyone has peaks in their cycles. I would venture to say its a 50/50 thing, even the pain is quite different for many.
« Last Edit: May 12th, 2008, 10:08am by MJ » IP Logged

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Re: Rebound headaches
« Reply #4 on: May 12th, 2008, 10:11am »
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I have been luck in not having rebounds from the zomig or maxalt.  Of course at this point, I'm so sick of this bullcrap that I want to be put away or something.  I hate it, I don't care what anyone says.  Thirty years of this stupid crap is enough.  
 
Just try everything you can.  Some cycles it will work, others it won't.   You just never know.  It is just a constant trial and error to see what will help.
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BMoneeTheMoneeMan
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Re: Rebound headaches
« Reply #5 on: May 12th, 2008, 10:29am »
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I know some people have said the use of triptans seems to increase the need for more.  
For me, definately, I need to take a small dose.  If i take 1/2 of a dose or more, it is likely I will have a bad, bad time.  I generally take a very small shot and it helps me.
That is the problem with triptans.  The docs say not to use more than 2 doses in a week.......but we get 5+ headaches per day.  It is very important you do not take more than your doctor's recommended max intake.
 
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Re: Rebound headaches
« Reply #6 on: May 12th, 2008, 10:55am »
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Another question I have is what would one consider to be the time span of a rebound headache from the original headache as opposed to the next headache just being the next headache.  For instance if in my case the frequency was 2 to 4 days for the first two weeks and now has increased to 1 to 2 a day could that just be a result of the natural course of my attacks.  For it to be a rebound does it necessarily need to happen 2 hours later, 4 hours later, is their a timeframe?  Another aspect is that in the beginning the attacks seemed to be alcohol triggered and happened while I was awake.  Some were late at night because I work nights but they didn't wake me from a sleep until now.  I have been on Prednisone for 6 days now and Melatonin for just 2 days and have taken 3 doses of the Imitrex nasal in the past 2 days.  ( I can't take another one until after midnight tonight and its only 10:30 am now).  I am waiting for my next doctor's appointment so I can get a prescription for O2.  Anyway I am rambling here but this being my first real episode with CH I am trying to figure out the difference between rebounds and the natural progression of these attacks.  Any advice would be greatly appreciated.  Thanks   John
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Re: Rebound headaches
« Reply #7 on: May 12th, 2008, 11:04am »
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I've always considered rebound HAs as the ones that come within 2 hours.  If they stay at bay for at least 12, I just consider it the next freakin' hit.  But I'm not really sure.  I haven't slept in so long, that I'm not sure what my name is at this point.
 
Please, when you get your O2, talk to some people here that know alot about it.  I have trouble with the O2, because I have rebound HAs with it.  But talk to these guys and they will help you out.
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Re: Rebound headaches
« Reply #8 on: May 12th, 2008, 11:32am »
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Hi John,
 
For me it is really hard to tell what is rebound and what is just the nature of the beast.  My cycles differ so much from year to year.  For the longest time, my HAs were ALL during the day.  Occasionally I would wake up in the morning with one but for the most part, they hit during the day or in the evening.   Last year, they were ALL during the night. They hit just after I fell asleep.  This year, I have only had shadows.  (it's a great year)   One year, I got hit in the Fall which is really out of character cause I am a Spring sufferer.  The Fall hits were really weird.  I had only severe tooth pain.  No pain in the eye or cheek.  I even went to the dentist but he said my teeth were fine.  My Mom was still living at the time and  she suggested that it might be a HA.  Used my Imitrex shot and, What do ya know, toothache gone in 5-7 mins.   That cycle lasted only about three weeks.
 
Anyway, that's how it is for me.  
 
I sure hope you get through this soon.
 
Jeannie
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thomas
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Re: Rebound headaches
« Reply #9 on: May 12th, 2008, 3:51pm »
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Triptans cause rebounds.  Learn it, believe it, live it.  I use triptans as the absolute LAST RESORT when treating my CH.
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Re: Rebound headaches
« Reply #10 on: May 12th, 2008, 6:59pm »
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Hi chefjohn
 
everyone is different-  my belief about myself regarding imitrex is this-  
1. i could never get enough while in full cycle- even with insurance overrride
 
2.  I believe i had rebounds from them and my rebounds were characterized as stronger shadows ( kip 5's and 6's)  between  full on attacks
 
3.  When i got a break from the trex, my doc prescribed me frova - lasted about 12-14 hours of PF time, thereby limiting the rebounds and the amount i took
 
Now with all this said, this is my belief about my headaches-  Could it be when i was taking frova that my cycle started to become milder anyway ?  I don't know-  
 
Kelly
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BarbaraD
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Re: Rebound headaches
« Reply #11 on: May 13th, 2008, 8:14am »
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If the trex is bothering you (and it did me) you might ask your doc about ergotomine. It's an old drug but works good for me. I've never had any side effects from it -- seems to work longer than the trex without the side efffects.
 
The O2 is the first choice for me and the Red Bull -- ergotomine is the last resort (I hate meds). A good prevent is worth the price (verap, lithium, topamax...)
 
I've been chronic for about 11 years so I can't really remember how the episodic cycyles went... I just remember they were bad the second month...Then right before I died - they quit.  
 
Hope this is a short cycle for you..
 
Hugs BD
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Re: Rebound headaches
« Reply #12 on: May 13th, 2008, 11:14am »
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Dear Barb,
 
  As of now I don't mind the Imitrex and it is working.  I use the inhaler and it takes about 20 minutes.  I have gotten O2 at the ER and they gave me a script for Prednisone which hasn't really helped.  I also have been taking 6mg of Melatonin at bedtime.  They didn't give me any Verapamil but I need to go to another doctor first.  I don't have a PCP and the Neuro is booked for 3 weeks out.  I am going back to a walk-in clinic today to see if I can get that and a script for O2. i guess this is a welcome to the US healthcare system.
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Brew
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Re: Rebound headaches
« Reply #13 on: May 13th, 2008, 11:23am »
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John - How do they have you taking the prednisone? You're supposed to start BIG (60-80mg per day, usually all at once in the morning), then taper down over the next 10-14 days. All at the same time you're taking another preventative (like verapamil or lithium) and giving it enough time to build up to theraputic levels in your body.
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Re: Rebound headaches
« Reply #14 on: May 13th, 2008, 1:43pm »
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Dear Brew,
 
  They started me at 40mg for 5 days and then 20 mg for 5 days.  I realize now what you are saying after reading info on prednisone.  I have 4 pills left but I think with the last 2 I will split in half nand take 10 mg for 4 days rather than 20 for the last two and just stop.  They didn't give me any Verapermil at all which kinda of seems to me that it makes taking the prednisone useless.  If it is a transitional preventitive then it should transition into something  (ie: verapermil).  These guys take a minimum of 8 years to become a doctor and my ER doctors have probably been at it for 20 years as I learned all this in less than a week.  i read many reports which says Ch affects 1 in a 1000 which would still be over a quarter million people in the US alone.  Another paper I just read said "over one million Americans may be affected by CH"  which may be a little high but still, its not like there are only 50 of us out here.  If there were only 50 they probably would know more because it seems the rarer the more interesting.  Anyway went off track a little there.  Thats my ranting for today.  I'm am off to the doctor and the pharmacy.  Check in later.
 
John
 
PS  My typing sucks on CH.  Doe this happen to anyone else?
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