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findjoshua
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    findjoshua
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After the Neuro
« on: Jan 29th, 2008, 8:50am »
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All,
 
As the hits have kept on coming... worse and worse...
 
I went to see the neurologist last night.  He (hesitantly) upped the Verapamil to 360mg from 240mg.  My resting pulse was borderline but he said we'd try it and if I felt any ill effects to go to call him a lower dose.  He also prescribed Zomig 5mg nasal spray and a pred taper that I could start while the higher dose ramps up.
 
I started taking a very small dose of Melatonin before bed and I have not been hit the past two nights that I've taken it.  i don't *think* it could work that fast, but I'm not complaining.
 
thanks to all who helped and responded to my posts these past few days.
 
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thomas
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Re: After the Neuro
« Reply #1 on: Jan 29th, 2008, 9:08am »
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on Jan 29th, 2008, 8:50am, findjoshua wrote:
.
 
I started taking a very small dose of Melatonin before bed and I have not been hit the past two nights that I've taken it.  i don't *think* it could work that fast, but I'm not complaining.

Yes it most certainly can work the first time you try it.
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Religion and sex are powerplays. Manipulate the people for the money they pay. Selling skin, selling God, the numbers look the same on their credit cards. Triptans cause rebounds. Learn it, believe it, live it. I use triptans as the absolute LAST RESORT when treating my CH.
Guiseppi
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Re: After the Neuro
« Reply #2 on: Jan 29th, 2008, 10:11am »
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Hopefully the higher dose of verapamil will back down the hits for you. Glad the melatonin is helping, getting that full nights sleep really makes a difference in my attitude towards fighting the beast. I haven't tried the zomig sprays but several people have posted success with them.
 
Remember, if NONE OF THIS WORKS....don't panic. There are still many treatments left to try, some of us had to run through a lot of failures before finding our "silver bullet" regimen. We'll run with you every step of the way.
 
Wishing you peace and some pain free time.
 
Guiseppi
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Why are all sensors, seeking intelligent life, pointed AWAY from earth?
Bob_Johnson
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Re: After the Neuro
« Reply #3 on: Jan 29th, 2008, 10:23am »
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Melatonin does work rather quickly.
 
Print this article and give to your doc. He should recognize the author as one of the big wheels in headache work.
 
 
Headache. 2004 Nov;44(10):1013-8.    
 
Individualizing treatment with verapamil for cluster headache patients.  
 
Blau JN, Engel HO.  
 
    Background.-Verapamil is currently the best available prophylactic drug for patients experiencing cluster headaches (CHs). Published papers usually state 240 to 480 mg taken in three divided doses give good results, ranging from 50% to 80%; others mention higher doses-720, even 1200 mg per day. In clinical practice we found we needed to adapt dosage to individual's time of attacks, in particular giving higher doses before going to bed to suppress severe nocturnal episodes. A few only required 120 mg daily. We therefore evolved a scheme for steady and progressive drug increase until satisfactory control had been achieved. Objective.-To find the minimum dose of verapamil required to prevent episodic and chronic cluster headaches by supervising each individual and adjusting the dosage accordingly. Methods.-Consecutive patients with episodic or chronic CH (satisfying International Headache Society (IHS) criteria) were started on verapamil 40 mg in the morning, 80 mg early afternoon, and 80 mg before going to bed. Patients kept a diary of all attacks, recording times of onset, duration, and severity. They were advised, verbally and in writing, to add 40 mg verapamil on alternate days, depending on their attack timing: with nocturnal episodes the first increase was the evening dose and next the afternoon one; when attacks occurred on or soon after waking, we advised setting an alarm clock 2 hours before the usual waking time and then taking the medication. Patients were followed-up at weekly intervals until attacks were controlled. They were also reviewed when a cluster period had ended, and advised to continue on the same dose for a further 2 weeks before starting systematic reduction. Chronic cluster patients were reviewed as often as necessary. Results.-Seventy consecutive patients, 52 with episodic CH during cluster periods and 18 with chronic CH, were all treated with verapamil as above. Complete relief from headaches was obtained in 49 (94%) of 52 with episodic, and 10 (55%) of 18 with chronic CH; the majority needed 200 to 480 mg, but 9 in the episodic, and 3 in the chronic group, needed 520 to 960 mg for control. Ten, 2 in the episodic and 8 in the chronic group, with incomplete relief, required additional therapy-lithium, sumatriptan, or sodium valproate. One patient withdrew because verapamil made her too tired, another developed Stevens-Johnson syndrome, and the drug was withdrawn. Conclusions.-Providing the dosage for each individual is adequate, preventing CH with verapamil is highly effective, taken three (occasionally with higher doses, four) times a day. In the majority (94%) with episodic CH steady dose increase under supervision, totally suppressed attacks. However in the chronic variety only 55% were completely relieved, 69% men, but only 20% women. In both groups, for those with partial attack suppression, additional prophylactic drugs or acute treatment was necessary. (Headache 2004;44:1013-101Cool.
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thomas
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Re: After the Neuro
« Reply #4 on: Jan 29th, 2008, 10:27am »
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on Jan 29th, 2008, 10:11am, Guiseppi wrote:

 
Remember, if NONE OF THIS WORKS....don't panic. There are still many treatments left to try, some of us had to run through a lot of failures before finding our "silver bullet" regimen. We'll run with you every step of the way.
 

Indeed!  It took me about 12 years to find mine.  But like anything else it doesn't always work.  Just stay after it.
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Religion and sex are powerplays. Manipulate the people for the money they pay. Selling skin, selling God, the numbers look the same on their credit cards. 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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