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   Just got back from the doctor's...
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MidnightObsidian
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Just got back from the doctor's...
« on: Feb 18th, 2003, 9:16pm »
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He gave me a prescription for 100mg pills of Verelan PM (a slow release form of Verapamil) and a bunch of 10mg samples of Maxalt and Maxalt-MLT, a rizatriptan abortive.
 
He accepts the fact that I have all of the symptoms of a cluster headache, but isn't sure whether to believe the severity of the attacks that I'm experiencing.  I suppose that I need to stop maintaining such a calm and lucid demeanor in such situations.  I was on a K7 when I was in there, but I wouldn't let him know.  I suppose that you all can relate to how hard it is to keep something like that concealed and to speak in a low, calm tone while all you're really thinking of is how great it would feel to beat the living crap out of your head with your favorite textbook or phone or whatever.  He didn't want to be too invasive in the beginning, even though I'd personally love to be put on everything that I can regardless of the side effects.  To be honest, I don't think that any side effects could be worse than these things.  In fact, he didn't even feel that there was any reason to give me a prescription for an oxygen tank.  
 
I am so sick of this already, and it's been less than four years.  I don't know how I could put up with this for the rest of my life.  Bah.
 
Anyway, I'm hoping to see some results from these things.  Do any of you think that what he gave me will be enough to touch the headaches, though?  I've only taken the Maxalt-MLT once (he said not to take more than a single 10mg tablet in a day), but seeing as how it's an abortive, I'd think that it would do something for me.  It didn't seem to touch them.  I've never heard rizatriptan mentioned on these boards before; have any of you used it?  Finally, will 100mg of the Verelan PM stuff even begin to help me?
 
Thanks again for all of your help.  This has got to be one of the best online communities out there, and I'm proud to be a part of it.
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Marc
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Re: Just got back from the doctor's...
« Reply #1 on: Feb 18th, 2003, 10:12pm »
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Edward,
 
Generally speaking, 100mg of Verapamil (Calan, Verelan) is considered too low to help most of us. As we have discussed before, do some serious research here and on the OUCH site and you will find more info than you can believe!
 
Some people need 240+ mg to work
Many people need 450+ mg to work
Some people need 720+ mg to work
 
Start slow and work your way up until it works. MOST people report effectiveness kicks in after 4-8 days.   Some CH savvy Doctors prescribe the instant release variety because it appears to work better.  
 
Maxalt (also can be found using the search feature) is another Triptan, related to Imitrex, Amerege, Axert, Zomig and Frova. Maxalt MLT is the fast dissolving version – melts in your mouth…..  
 
You found us - now USE the resources made available  - take a more proactive approach to getting armed with info to take to your Doctor.
 
Marc  
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MidnightObsidian
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Re: Just got back from the doctor's...
« Reply #2 on: Feb 18th, 2003, 10:26pm »
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Yeah, I told the doctor that the 100mg probably wouldn't begin to touch my cluster headaches, but he said that I needed to start slow.
 
I went to him with pages of information, excerpts from the forums, medical information, stuff from OUCH, the results from the survey, medicine information, and so on.  He has two other CH sufferers that go to him, though, so he seems to know what he's talking about.
 
Some of the stuff that he said, however, went against what I've heard many people here say.  He said, for one, that the Imitrex pills worked just as quickly as the injections and that there's no reason to use injections or the nasal spray unless you're feeling nauseated from the headaches.  He also said that the slow-release calcium channel blockers were better than the instant-release ones; he actually said that those were completely ineffective against cluster headaches and migraines.  
 
In the end, he sent me out of there with all of my printouts in hand.  I'm hoping that he's the best guy to go to about these things, because he's a really nice guy.  Still, the contradictions have got me wondering...
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Re: Just got back from the doctor's...
« Reply #3 on: Feb 18th, 2003, 10:48pm »
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I'm betting if this if this Dr was getting hit with a k-10 whether he was nauseated or not, he'd jam that needle in his thigh in a second.  
Don't know about the Imitrex pills but I do think the injections are a lot faster acting and more effective than the nasal spray.
pfdan's to you
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Re: Just got back from the doctor's...
« Reply #4 on: Feb 19th, 2003, 12:08am »
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midnight, i can't add much of a tech nature, at least right now but i will tell you to keep lookin for docs that are a bit more in tune with what you might be feelin""
 
don't get me wrong, i just had so many mis-diagnosed conditions that i am gun shy of any doc that seems to know yet refutes what scanty knowledge is out there...
 
check out the ouch site and see if you are in the area of any reccommended docs.  i apologize for the typo's i am being slammed right now. guess thats why we are up!!!
 
best of luck.     tim
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Ann
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Re: Just got back from the doctor's...
« Reply #5 on: Feb 22nd, 2003, 9:56am »
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Midnight,
 
It seems like you are comfortable with your doc and that maybe all you really need to do is be more forceful with him.  I agree with everyone here...your verapamil dose is low.  I'm taking 360 mgs of immediate release.  Last year, the drugstore screwed up and gave me the slow release.  It took me over a month to figure it out.  Acutally I clued in while I was posting here!   ;D  I had them change it and saw a big change within a few days.  However, if you choose to  change to immediate release, be very very careful.  Some people have had very bad experiences.  I felt so bad...felt like passing out, I ended up calling my sister and chatting with her until I started feeling better. (I was alone at hone at the time)  As far as imitrex injections versus the pills, the injections work for me within 5 minutes.  The pills can take up to 30 minutes to take effect and that's long considering the pain! DUH! LOL
 
Good luck and next time you're having a Kip 7 at the doc's let him know for God's sake.  Hiding your pain will not let you get the help you need!
 
hugs
Ann
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Re: Just got back from the doctor's...
« Reply #6 on: Feb 22nd, 2003, 10:15am »
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The fact that Verapamil takes about a week to become effective tells me that it needs to build up in one's system. Therefore, the immediate vs. slow release debate becomes moot. However, never having taken anything but the immediate release form, I can't say for sure.
 
As to the Maxalt, both my neuro and my primary care guy have both prescribed it, and they both agree that a second dose can be taken 2 hours after the first, but I shouldn't exceed 2 doses in a 24-hour period. Perhaps you have a previously diagnosed heart condition that would preclude you from taking more?
 
One piece of advice - dramatically increase the amount of fiber you consume while ramping up on the Verapamil. You'll thank me for it later.
 
Bill Cheesy
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Re: Just got back from the doctor's...
« Reply #7 on: Feb 22nd, 2003, 7:20pm »
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'night, I have seen a number of adverse reactions to the slow release Vera. If after 5 days it does not get better, TELL THE DOC TO GET NORMAL VERA!!!
And get MORE of it.
 
Also go for O2. If you can't get it prescribed, try the industrial type. As Jonny for info about valves.
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