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Cluster Headache Help and Support >> Medications,  Treatments,  Therapies >> Too much oxygen?
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Message started by candid on Jan 19th, 2010 at 4:57am

Title: Too much oxygen?
Post by candid on Jan 19th, 2010 at 4:57am
Hi
I've been having a really tough time for the last 2 and a half weeks.  I'm a chronic and my patern became pretty consistent but all of a sudden im terrified.
The oxygen hasnt been workig nearly as well.  I can go through an entire E cylinder and the pain hasnt receeded.  Even when I'm on the oxygen the pain isnt receeding like it used to.  The oxygen is still helping but only in the way that its keeping the pain somewhat tolerable but even afer sitting on the o2 for 45 minutes - 5 mins after i get off tge pain ramps right up again.
Anyway my question is if its possible to suck down too much oxygen and suffer adverse side effects.
I went through 5 E cylinders yesterday and 7 the 2 days before that.  What is too much? How do I know if im overdoing it?
My doctor has told me I need all the help I can get and told me to use zomig on a daily basis.  but with o2 not working as effectively im so scared the pain will comeback tenfold- magnified by the zomig and then i have nothing to treat that pain with.
I've been using oxygen to abort my clusters for over 3 years and it was amazingly effective until 2 and a half weeks ago when i started to taper from my beta blocker-inderal.  For the last 2 weeks its been pain to the point of imprisonment.
I'm sorry for bitching im just reallly struggling

Title: Re: Too much oxygen?
Post by Chad on Jan 19th, 2010 at 6:57am
Hang in there bud.  I know the the pros on here will have suggestions on this.  BTW, what is your flow rate?

I'm wishing you PF days ASAP!

Title: Re: Too much oxygen?
Post by candid on Jan 19th, 2010 at 7:11am
Thanks chad,
I use 25/lpm or 15/lpm

Title: Re: Too much oxygen?
Post by Iddy on Jan 19th, 2010 at 7:49am
Sorry that you are in such a bad way Candid :(

Have you read the o2 link? There is updated info available.

Do you have a specialist in Toronto? If not send me a PM and I will pass on my MD who is a Headache Specialist as well as a Headache Researcher. He accepts new patients and is very well versed in CH.

Hope you find some relief soon :)

Iddy

Title: Re: Too much oxygen?
Post by Batch on Jan 19th, 2010 at 2:43pm
Candid,

Hang in there...  What you appear to be experiencing is a "High Cycle" where the hits come fast, furious, hang on like a klingon, and resist preventative and abortive medications including oxygen therapy. 

There are solutions for this condition and it is NOT the result of too much oxygen, but it can be an indication of a low arterial pH and that oxygen therapy is not being used effectively..

We've anecdotal proof that high cycles like this correspond to a low arterial pH...  If this is the case, your arterial blood is likely too acidic.  The normal blood pH should be 7.4 (7.35 to 7.45).  If your arterial pH is in the low end of this range or below, your vascular system reacts to this condition by dilating.  Arteries react like this in response to a higher than normal CO2 level so dilation takes place to increase blood flow from the body to the lungs to release the excess CO2. 

This condition also appears to make the cluster headache triggering mechanism more effective and that results in an increase in the frequency, intensity, and duration of cluster headache attacks.  A low arterial pH also tends to make oxygen therapy less effective.  In other words, it takes longer than normal to abort the cluster headache pain with oxygen therapy even if used correctly. 

The simple solution I use when a high cycle starts is to take 4 to 6 calcium citrate tablets with vitamin D, magnesium and zinc a day.  A mineral supplement blend like this acts as a chemical buffer to bring a low pH condition back up to neutral.

During my high cycles, I average 3 to 4 attacks a day and during low cycles, I average is 3 to 4 attacks a week.  If I dose on the mineral supplements, the frequency of my cluster headaches drops to one attack in ten days...  I use the Kirkland brand Calcium Citrate tablets from Costco.  Citracal® Plus Bone Density Builder has a similar formula but at slightly lower concentration per tablet.

I also drink 2 to 3 glasses of lemonade a day during high cycles.  One 8 ounce glass with lunch and two with dinner.  Strange as it may sound, the citric acid in lemonade actually elevates the arterial pH and this helps to further lower the frequency, intensity, and duration of my attacks.

Arteries sense a high pH condition as being caused by not enough CO2 so they constrict to slow the flow of blood from the body to the lungs to allow CO2 levels to build.

Check the pH balance chart at the following link:

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Cutting down on red meat and maxing out on green veggies can also help elevate arterial pH.

As you indicated you've an oxygen regulator capable of 25 liters/minute, the first thing you need to do is keep it at that setting and breathe as deeply as possible.  25 liters/minute is superior to 15 liters/minute and it's the minimum flow rate that supports hyperventilation... 

Higher oxygen flow rates work even better and faster as they support a greater level of hyperventilation...

What kind of non-rebreathing mask are you using?  If you've got one of the disposable masks with the 1-liter reservoir bag, order an O2PTIMASK™ kit from DJ here on CH.com. 

The breathing technique used during oxygen therapy is very important.   I stand while doing the following to give my diaphragm full range of motion in order to ventilate the lungs to the maximum extent possible to cast off CO2.

Exhale as completely as possible... and when it feels like your lungs are empty... their not, so do an abdominal crunch like in doing sit ups along with a coughing maneuver only hold the squeeze you feel in your chest muscles until you hear a wheezing sound for at least a second... then inhale as deeply as possible and repeat. 

If you're doing this breathing technique correctly, you should start feeling the symptoms of paresthesia, a slight tingling of the fingertips and the back of your neck along with a slight feeling of dizziness in less than a minute.  Paresthesia is the best indication you've hyperventilated long enough and cast off enough CO2 to push your system into respiratory alkalosis (an elevated arterial pH).

The arteries in and around your trigeminal nerve will react to an elevated pH by constricting (as they would from an imitrex injection) and this will help abort the attack.

Take care,

V/R, Batch


Title: Re: Too much oxygen?
Post by candid on Jan 19th, 2010 at 3:58pm
that's very interesting..i'm using an o2ptimask..
I guess i gotta get me some supplements.
Still...is there something that can happen regarding the clusters or general health if you're sucking down 6 E's a day?

Title: Re: Too much oxygen?
Post by Brew on Jan 19th, 2010 at 4:03pm

candid wrote on Jan 19th, 2010 at 3:58pm:
that's very interesting..i'm using an o2ptimask..
I guess i gotta get me some supplements.
Still...is there something that can happen regarding the clusters or general health if you're sucking down 6 E's a day?

You'd have to be breathing 100% O2 for almost 24 hours straight to even start to have an effect on your body. I'm not quite sure, but I think the first signs you've had too much pure oxygen is pulmonary edema.

At 25 lpm, 6 E's would last you about 2.5 hours.

ETA: You can find lots to read here:

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Title: Re: Too much oxygen?
Post by Batch on Jan 19th, 2010 at 7:47pm
Candid,

The average abort at a flow rate of 25 liters/minute should take 8 to 10 minutes and consume 200 to 250 liters if you're breathing properly and not having complications like a low pH.  As the average E-size oxygen cylinder holds 708 liters...  you get a max of 3 aborts...

If on the other hand, you're not breathing properly, the pain is in the Kip-7 to Kip-9 range, and your pH is low, the aborts can take as long as 25 to to 35 minutes and aborts taking up to as much as 50 minutes are not uncommon as you've already figured out. 

At that rate, it's easy to burn through an E-size cylinder in one abort.  See the following link:

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It shows a fully charged E-size cylinder will deliver 35 minutes of oxygen at a flow rate of 25 liters/minute.

If we factor out the low pH condition there's a logical reason for the longer abort time when not breathing properly.  When the tidal volume (the volume of oxygen inhaled with each breath) is on the order of 4.0 to 4.5 liters (a very deep breath made possible with forced exhalation... i.e., squeeze till you wheeze,) we'll have a residual volume of 1.5 to 2.0 liters remaining in our lungs.  This is based on the average adult male having a total lung capacity of 6.0 liters. 

In this case, a tidal volume of 4.0 to 4.5 liters will ventilate the lungs to the maximum extent possible and wash out the most of the CO2.

If on the other hand, the tidal volume too low, say on the order of 2.0 to 2.5 liters on the inhale cycle, we're breathing too shallow. This leaves a larger volume of residual breath (3.5 to 4.0 liters) left in the lungs.

As the residual breath contains the highest CO2 concentration,  we've set up a tug-of-war between elevated oxygen concentrations and elevated CO2 concentrations.

An elevated oxygen concentration supports vasoconstriction that aborts the cluster headache attack, and an elevated CO2 concentration supports vasodilation that prolongs the attack.  That makes oxygen your friend and CO2 your enemy...

Hope this helps...

Take care,

V/R, Batch

Title: Re: Too much oxygen?
Post by anthony g on Jan 19th, 2010 at 8:40pm
batch all the way the man knows his stuff!!1

Title: Re: Too much oxygen?
Post by candid on Jan 20th, 2010 at 9:40pm
thanks batch, a lot of interesting info..
i brought up the ph thing with my doctor but he didnt seem to think i was talking about anything.
So I guess I gotta get supplements and hyperventilate..
whats so frustrating is that it worked so well for so long and then it decides to stop working...God definitely knows how to test the limits of ones sanity.
Thanks for putting my mind at ease about sucking too much oxygen...i guess now my worry is paying for all these cylinders.
Thanks again, feel free to add i love the info

Title: Re: Too much oxygen?
Post by Fox on Jan 21st, 2010 at 9:37am
Candid,

Just to toss in another POV -  My HA specialist emphasized, and writes on the O2 prescription:
"Breathe normally for 15-20 minutes, seated, facing floor".  He demo'd the position, sitting, bent over, facing the floor.  Supposed to help the blood flow & O2 reach the head faster.

"Seated" can be a challenge if it's a hard hit and you're "dancing".

I see others "huff" the O2, and I suspect their attacks are worse than mine.  15 LPM in the facing floor position has been working for me.  Usually abort in 6 minutes, but always doing minimum 15 minutes O2 to ensure.  12 LPM worked before, but 15 seems to be necessary for me this cycle.

Your mileage may vary.  Just sharing 2 cents here, FWIW.

Hoping you can knock the Beast down...

Fox

Title: Re: Too much oxygen?
Post by Brew on Jan 21st, 2010 at 10:07am
First time I've ever heard the "facing floor" thing. Sounds kind of "wives' tale"-ish to me.

Title: Re: Too much oxygen?
Post by seasonalboomer on Jan 21st, 2010 at 10:46am
The "seated facing floor" thing just kind of came to me naturally. Although I add my own twist of rocking back and forth ;)

Title: Re: Too much oxygen?
Post by vietvet2tours on Jan 21st, 2010 at 11:04am
I have a fancy plastic five gallon bucket to sit on.

                 Potter

Title: Re: Too much oxygen?
Post by Fox on Jan 21st, 2010 at 11:24am

Brew wrote on Jan 21st, 2010 at 10:07am:
First time I've ever heard the "facing floor" thing. Sounds kind of "wives' tale"-ish to me.


This was a recommendation from New England Center for Headache.  Take it FWIW, not straight to the bank.  Whatever works best for each of us, doesn't work for all of us.

Fox

Title: Re: Too much oxygen?
Post by Mr. Happy on Jan 21st, 2010 at 9:10pm

candid wrote on Jan 19th, 2010 at 4:57am:
I've been using oxygen to abort my clusters for over 3 years and it was amazingly effective until 2 and a half weeks ago when i started to taper from my beta blocker-inderal.  For the last 2 weeks its been pain to the point of imprisonment.
I'm sorry for bitching im just reallly struggling

See: Inderal

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