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MattJ
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Painkillers? Any Suggestions?
« on: Dec 22nd, 2002, 7:17pm »
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Recently I've gotten a very bad CHA attack. I was prescribed Lorcet 10/600 and after using 30 over a few weeks, they lost effectiveness.  
 
I now have a limited supply of Imitrex injections that do work well. I must make the Imitrex last as long as possible (I cut the dose) and need to know if anyone has used a painkiller that is strong enough to "take the edge off" only. If I can reduce some of the pain, I might be able to muscle through a few of them. I will be going back to the doc soon and need to know if anything he can prescribe may work.
 
Thanks!
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Re: Painkillers? Any Suggestions?
« Reply #1 on: Dec 22nd, 2002, 7:25pm »
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Hi Matt.  I can't make any recommendations about painkillers, but it may be a good idea to get on a preventative med if you can.  Verapamil seems to work good for many here and has relatively few side effects.
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Re: Painkillers? Any Suggestions?
« Reply #2 on: Dec 22nd, 2002, 7:32pm »
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Thanks, Verapamil worked well my last cycle but is useless this time. I have gone back on Prednosone (which has helped in the past) on Friday and I'm hoping it will "kick in". So far...nada.
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Re: Painkillers? Any Suggestions?
« Reply #3 on: Dec 23rd, 2002, 7:12am »
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Hiya Matt,
 
What works for me is a triptan, Maxalt MLT 10mg. or Zomig ZMT 5mg. (fast acting, under the tongue dissolving tablets, NOT the regular tablets) combined with oxygen therapy. You can’t get many Maxalt tabs from insurance (6 per month max. for me) so you have to save those for the Big One and you can’t take more than 2 in any 24 hour period, so the oxygen is absolutely necessary for all the other times you feel the shadows creeping in. Go to the search button in the top right corner and type in “oxygen” and read up. This site is your one stop information resource, so start reading all the categories on the left hand side of the page, read it all, the more knowledge you have the better you can communicate with the medical community. Be sure to read about and do a search for “triggers”, these are catalysts that can really set us off. My triggers are alcohol (even the smallest amount, like a non-alcoholic beer) and bright light in my right (cluster side) eye. When I feel the shadows creeping in I hit the Oxygen and that pushes them back. However, when I’m asleep I can’t feel the shadows increasing and I wake up with the Big One. Jonny clued me in that if you take abortive triptans (I use Maxalt MLT 10mg. or Zomig ZMT 5mg., both are quick dissolving tabs) before going to bed, they can prevent that night time attack, especially if you get hit, like I do, within 2 hours of going to sleep. The half-life of both of these tabs is in the 2-3 hour range. This has enabled me to get quality sleep these last 2 weeks. Avoiding triggers during your cycle can dramatically affect the intensity, duration and number of attacks.
 
 
Good luck,
 
David J.
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Re: Painkillers? Any Suggestions?
« Reply #4 on: Dec 23rd, 2002, 8:33am »
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I just wont to add my medications for breaking out of cycle.But remember that i`m not a doc,just another clusterhead from Norway  
   
Verapamil Retard 120mgX5-7/daily during cycle    
Oxygene alone at 10ltm for 15 minutes or combined with imitrex-shots does miracles.The shots should start working in 6-9minutes.a few secons after that you are almost painfree    
Prednisolone in high doze for 10 days 80mg    
then over a 3 weeks periode step down like 60-40-30-20-10-5mg /daily    
     
This is the miraclecure for me,but i`m not a doc.just another clusterhead from Norway    
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Re: Painkillers? Any Suggestions?
« Reply #5 on: Dec 23rd, 2002, 8:40am »
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percacet is another medicine that will take the edge off the ha.  I am on methadone and have not had a ha since I started taking it.  May want to consider that.
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Re: Painkillers? Any Suggestions?
« Reply #6 on: Dec 23rd, 2002, 10:25am »
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Thanks, everyone for the replies. I am familiar with most of the standard helpers from this great website. Last night I did not have to take the Imitrex injection. Although I woke several times with pressure and shadow, I can handle this. (I'm at work right now with the Shadow and I'm doing well.) If the Prednosone is kicking in finally, I won't need the painkillers! (Verapamil isn't doing well this time).
 
Thanks for the suggestions.
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Re: Painkillers? Any Suggestions?
« Reply #7 on: Dec 23rd, 2002, 11:32am »
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I just wanted to add, Matt. Please be careful with the Lorcet, as it has a very large amount of acetaminophen in it. 650 mgs...which means you can only take max of 6 in one day. Any more especially with any kind of alcohol, can cause liver damage.
 
There are other choices with less acetaminophen, ask your doctor.
 
Jim
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Re: Painkillers? Any Suggestions?
« Reply #8 on: Dec 23rd, 2002, 11:58am »
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Thanks, Jim. Never took more than 4 in a day. Alcohol? What's that? No more beer drinking for me until this cycle ends. If I have a drink, I will be in great pain a few minutes later. Guaranteed.
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Re: Painkillers? Any Suggestions?
« Reply #9 on: Dec 26th, 2002, 12:27pm »
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Lorcets made my chs worse...started getting rebounds then...After years of antiseizures, etc, my neuro/pain management doc put me on a regime that is working for me...i do not recommend it for episodics and recommend it only for those who have had no luck with other meds...i am on duragesic patch 25mg..gabitril (antiseizure) and verapamil...This was a last resort for me , I am chronic, and it has worked since august for me..I have been hesitant to post it until i saw i would get thru Christmas as this is the worse time of year for me..and as i said, i do not think this is a treatment for episodics only chronics that have had no luck with other meds...i am not an advocate of narcotics as i am a nurse at a drug and alcohol center...and if you do go on a regime like this...NO ALCOHOL at all....I am just grateful that i am finally pf....praying for all of you still suffering...smiles, nancyc
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Re: Painkillers? Any Suggestions?
« Reply #10 on: Dec 27th, 2002, 1:30pm »
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Good luck to you Nancy, glad you found something that is working for you.  
 
The heavy doseing of Prednosone (80mg a day) that I have been on since last Friday is working well. Very few CHA's. No need for pain killers at this point. The Imitrex is holding up for the time being. Will have to see what happens when I slowly start to taper down on the Pred today.
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Re: Painkillers? Any Suggestions?
« Reply #11 on: Dec 27th, 2002, 4:13pm »
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Matt, I too am one of the unlucky ones that can't use triptans.  I rely heavily on O2 and they give me narcotics to take the edge off.  Be warned, narcotics DO NOT abort CH's and by the time they take effect the CH is already fading.  It becomes a scenario of guessing when it's gonna be a little kipper or a big one, so you know whether to take it or not.  You have to take it at the first signs if you think it's going full blown, and even at that it will only slightly take the edge off.  The downside of course is it IS a narcotic and therefore addictive, and it causes rebound headaches.
 
What I do to help avoid the rebounds, is I take the narcs when I know I need them, but I also take aleve before and after to help reduce any rebounds.
 
That's my take on things anyway.  Narcotics are not a CH'ers friend, but they can sometimes help when you are waiting to find the magic combination of preventatives and abortives.
 
Cat
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Re: Painkillers? Any Suggestions?
« Reply #12 on: Jan 2nd, 2003, 7:14pm »
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Thanks, Catlind. I am hanging tough. No pain killers now. I still have 2 half shots of Imitrex left. I can probably get a new Imitrex prescription if need be soon. I was afraid the Imitrex would be gone and I'd be left with nothing.
 
I have used Alieve before for lower back trouble. Never thought of using it for clusters. I know it's an anti-inflamatory.
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Re: Painkillers? Any Suggestions?
« Reply #13 on: Jan 9th, 2003, 2:57pm »
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I have suffered for over 12 years now. Tried and did it ALL. From lidocane inj to imitrex to diet, meditation, chiro, message, zomig, maxalt, and on and on.
The only TWO that work for me are:
VERAPIMIL (as a preventative)
FIORINAL WITH CODIENE  (during an attack) A cup of strong coffee with ice pack to accompany the fight!
 
Nothing else works for me.
Good Luck
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Re: Painkillers? Any Suggestions?
« Reply #14 on: Jan 13th, 2003, 4:13pm »
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Matt, you asked the question I have been wanting to ask. I'm already using the Duragesic patch for this round, which helps for the shadows, but it does nothing for the really awful kind, particularly those that arrive in the middle of the night. I'm taking Topomax as a preventative and haven't had much luck with Zomig this time, I don't know why. With what I'm already on, I hate to ask for more, but is there anything that can be taken in addition to the patch for acute pain?  
 
Karla, is the Methadone addictive? How much, how often? Did the pain go away all at once or was it  gradual? I hate to ask my Doc, unless there is something specific I can ask for, and provide a dosage and tell her that it worked well for someone out here. Maybe instead of in addition to, instead of.
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Re: Painkillers? Any Suggestions?
« Reply #15 on: Jan 13th, 2003, 8:05pm »
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I got one tiny bottle of Stadol nasal spray prescribed so I could make the Imitrex last longer. It helped for mild pain only. Clusters can cut right through painkillers if it's up there on the kip scale. I think they are going away now. less and less frequent. I can only hope....
 
Good luck. Use the painkillers sparingly and carefully.
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Re: Painkillers? Any Suggestions?
« Reply #16 on: Feb 2nd, 2003, 12:06am »
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This is my first time here on this site, so I hope this goes where it's supposed to.
 
Since I get clusters infrequently now--I'm having my first attack in over four years, used to be every 1 year and 4 months (weird, yes, but I could set a calendar by them).
 
I find two vicadin take most of the pain away. There's still the shadow, but at least I don't feel like going to the ER. Imitrex did nothing for me.
 
Be careful with vicadin, though. During my last cluster, I did go through physical withdrawal. Only lasted about 36 hours but it wasn't pleasant.
 
Better than a CH, though.
 
Good luck
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Re: Painkillers? Any Suggestions?
« Reply #17 on: Feb 2nd, 2003, 10:32pm »
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"Only about one quarter of patients with debilitating headaches that are not migraines benefit from treatment with narcotics such as morphine and oxycodone, a Michigan researcher reported here Thursday"
 
http://www.clusterheadaches.org/library/medications/narcotics.htm

 
http://www.clusterheadaches.org/library/general/management_of_ch.htm

 
I hope this helps.....PFDAN's
Mark
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Re: Painkillers? Any Suggestions?
« Reply #18 on: Feb 3rd, 2003, 12:41pm »
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I guess since I'm in the middle of a cluster now, I must be in that 25% that vicadin helps. (I'm not even sure that vicadin is a technical "narcotic"; I think it's a bit weaker.)
 
I'm seeing a doctor here in Washington tomorrow morning. I just moved here from NYC so I hope I don't run into the problems of potential substance abuse because of these clusters. Many physicians are very reluctant to prescribe anything stonger than Tylenol 3 if they don't know you.
 
And, as we all know, Tylenol 3 is a crude marketing device rather than a true cluster-relief medicine.
 
Dean
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Re: Painkillers? Any Suggestions?
« Reply #19 on: Feb 4th, 2003, 3:48pm »
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I recommend Oxygen or see my post Mother Nature vs Meds....
 
 
Good luck.
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Re: Painkillers? Any Suggestions?
« Reply #20 on: Feb 12th, 2003, 9:33am »
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i had some luck with this stack:
500mg asprin,
500mg paracetamol (useless...)  
30mg pseudoephedrine,
1 very strong coffee,
and sometimes a bit of codine.
 
(wont work if caffeine makes your CH worse.)
 
i feel as though the pseudoephedrine and caffeine stimulates the brain to release serotonin. Caffeine also constricts the blood vessels, while asprin thins the blood (stops the platelets clumping together) similar to the effect of serotonin.
And if you try this remember to drink lots of water. The reason perhaps that people who find that caffeine and alcohol causes CH is because these both cause dehydration. So drink lots of water, it may shorten the cycle.  
 
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