Hi, thanks to everyone on this site I found a nuero and he has me on verap, and O2. I have been on verap since Jan. I tried to taper off last week, I made it down to 40mg from 240mg and got slammed with ch. While on the 240 I have been doing well.
My question is if I remain on it and get on a plane in Aug. should that trigger an attack.?
I read some people say flying triggers a ch. If so I may opt for a cruise. I would hate to spend a week on the beach dealing with the beast.
Thanks!!
Frank

It has for me, but then I am very susceptible to Barometric pressure as a trigger. 

Keep your abortive Handy!

Only one way to find out. Everyone is different.

Two tips:

1. Take a reliable abortive with you, like a trex jab or nasal spray.

2. Arrange with your O2 company to have a tank or two delivered to wherever you're staying when you get there.

JustNotRight wrote on Jun 23^rd, 2010 at 10:25pm:

It has for me, but then I am very susceptible to Barometric pressure as a trigger.  Keep your abortive Handy!

Ditto.....but don't let the beast make your choices...abortives on hand...O2 at your destination!

Very good question.  I know it can trigger an attack but have wondered if it can trigger a full cycle.  In other words, is it only a trigger when in cycle?  That seems to be the case for me.  Curious how to arrange 02 at destination  My provider is only local.  Shop desitnation providers and get some tanks?

birdman wrote on Jun 23^rd, 2010 at 10:35pm:

Very good question.  I know it can trigger an attack but have wondered if it can trigger a full cycle.  In other words, is it only a trigger when in cycle?  That seems to be the case for me.  Curious how to arrange 02 at destination  My provider is only local.  Shop destination providers and get some tanks?

Hit(s) yes...cycle, nope.

Definitely a problem. I'd open an account with a "national". I use Lincare and have picked up or had delivered e-tanks in CA, NV and OK. Worked well and I only had to deal with knuckleheads who didn't "know" me and complicated things way more than necessary. Patience, perseverance, and a few deep breaths got me through...."illlegetimi carborundum".

Best,

Jon

Thanks for all the input. I will be traveling to Punta Cana and doubt I will be able to get O2 there. As far as imitrex, I will definitely be packing those.
I spoke to my nuero today and he said I should go and just bring a higher dose of vermap with me just in case.
I will let everyone know the results if I decide to go.
Thanks for the help!!

Yes flying is a trigger for me. The cabin is pressurized  to about 8,000 ft. That and the poor oxygen content due to recirculation cause me a problem if I am in a cycle.
Airplanes have oxygen on board but are really afraid to administer anything to a person for fear of something going wrong and they get blamed.
To solve that problem, I have a medic alert bracelet that says my name, Cluster HA Oxygen 15 LPM.
I get O2 quick with very few questions until the attack is over. The flight crew figures no one ever got in trouble by complying with instructions on a medic alert bracelet. Works like a charm!
I fly almost every week for work and having the bracelet has allowed me to keep this job.

Never has for me.

A few years ago I made believers of the flight crew on an American Airlines flight.

Had a Kip 8 in the middle of the flight. 

They gave me an oxygen tank and mask, and the pilot was alerted, etc.  Not good.

Make sure you have a note from the doc that you need to carry on your imitrex statdose pack.

Nowadays they might balk at having sharp objects on the plane without a good reason. 

I strongly agree with everyone who said not to let this condition dictate what you do.

Good luck.

Dennis

NovellRed,

Where did you get the Medic Alert bracelet and what were the procedures for obtaining it?  I carry a medic alert ER card signed by my doctor for oxygen therapy at 25 liters/minute, but a medic alert bracelet might be even better.   

The last time I checked, there were at least three organizations that make medic alert bracelets and necklaces, but the cluster headache disorder was not on their "list" unless it could be covered under their rare disorder provision.

I'm sure there are others that would like this information.

BTW, as you correctly pointed out, at cruising altitude, the cabin pressure in a commercial airliner is around 8,000 feet.  At that cabin altitude, the available partial pressure of oxygen is 30% less than at sea level.  A drop in oxygen concentration tends to result in vasodilation that favors the cluster headache triggering mechanism.

The other part of the problem is CO2...  At that same cabin pressure, the partial pressure of CO2 only drops by 7.5% and that shifts the oxygen-CO2 ratio heavily towards CO2.  As an increase in CO2 levels also acts as a vasodilator, the combination of low arterial oxygen levels and high CO2 levels can easily result in vasodilation.

As a side note, supplemental oxygen is required at a cabin altitude of 10,000 feet to prevent loss of consciousness due to hypoxia as the available partial pressure of oxygen is 40% less than at sea level.

From my experience as an episodic for 10 years and 6 more as a chronic, whenever I'm in cycle, I've found the reduced pressure experienced during airline travel favors the cluster headache triggering mechanism and on a few occasions at level-off, trigger an attack all on it's own. 

Like Brew suggests, I always order up oxygen at my destination and carry imitrex nasal spray during airline travel.

Take care,

V/R, Batch

I have always been afraid to fly when in cycle, because of the inability to have O2 present. My last flight to Germany was particularly problematic. I had abortives for the flight and for my 14 day stay, but I got hit every day with Kip 8's, and after a few days, the abortives became pretty ineffective. The only O2 I could get there was sold in a little can (15euros) and lasted about 2 minutes. So expensive and so little effect. That was probably my last trip to see my wife's family. Sigh. lance

I was concerned about out-of-cycle flying, but it turned out to be no problem.

In-cycle is another story.  A hit on a plane is most unpleasant for me and whomever is next to me.  I got pretty messed up on a long trip, but it had significant time-zone changes and nicotine upsets thrown into the mix as well as flying.  And no meds - this was prior to finding a worthy doctor.

You've got a doc and some meds, and I hope that all goes well for you.  Enjoy!

I booked the trip!!! I leave on Aug 7-14. I bought the insuranse..just in case. I have been in a cycle since Jan. My cycle would only last about 8-12weeks. I never used prevents. I would use trex inj and ride out the cycle. This is the first time I tried prevents...vermap.  I cant believe I'm still in a cycle. I hope I'm not going chronic!! Oh well wish me luck!! And thanks again to all.

Cappu,

have a wonderful trip! :)

I know we all are different, but flying has not been a problem for me. It's been a while since my last flight, but during my early ch years I flew quite often between Finland and UK. Those 3 hours were ok, I recall occasional shadows, but no hits.

Wishing for a PF journey to you,

Sanna

Hi everyone.  I spent many years flying as a professional aviator and I never was able to correlate flying with cluster attacks.  Yes, what everyone has said is true about reduced oxygen at cruising altitude but it never induced one for me.

The cabin altitude of a 737 at cruising altitude is between 5,000 and 8,000 feet.  So on a normal flight you could be breathing the same amount of oxygen as people in Denver, Albuquerque, Salt Lake (almost) etc.  While us sea-level folks will surely notice the difference, it isn't that bad. 

So maybe it does trigger for some??, never for me.  I am currently on my first airplane trip in 6 years.  Since I will be gone for 1 month and away from my meds, I took a maintenance dose before I left and haven't had any problems or shadows since I have been gone (2 1/2 weeks, currently out of cycle).  I use the clusterbusters protocals and caffeine as needed.

Some plant smells (not bay laurel) will trigger if I am in my cycle but not out.  I bet flying could be the same.  :P

--Shaggy ;)

Just got back from a trip to LA from Iowa.  4ish hour flight with a mid way plane change each way.  Did ok - no problems on the plane (thank god). 
Currently am on Verapamil, Magnesium, touch of Lamictal.  Daily moderate shadow at about 10:30 CST but that's all.  Ongoing cycle for almost 3mths now.   >:(

I have not had many problems while flying. Crazy though god help me when the seasons change.

Hello to all that read this post. I'm back from my vacation to the Dominic Republic. The 4 hour flight there went great. No attack. I am on verap. I had plenty of trex with me. No problem carrying trex on plane. I took about 20 inject. on my carryon. (I never had to use any). I also had a letter from my Nuero.
I had mixed drinks all week, no attacks. One night I tried a glass of wine, that triggered an attack..kip3. Wine and beer are my worst triggers. I do ok with vodka and rum..thats what I drank all week with no attacks. I do not drink while at home. I was on vacation felt great so I figured why not try to enjoy myself, after all it was all inclusive and I paid big$$ for the week. It was my 20th anniv. and my wife and I wanted to treat ourselves.
Having said that...flying home was a different story. On decent, I felt the pressure in my temple and behind my eye. I DID NOT NEED TO USE MY TREX BUT WHEN i RETURNED HOME i USED MY o2 and that worked fine. The next day I had a kip2 all day. I been home four days now and have been doing fine.
I do feel the verap. keeps the attack from getting worse than it could. My Nuero told me to up the dose before I went on vacation but the last time I went up I got dizzy and lightheaded. I stay on 240mg which is all I can tolerate. The constipation I deal with ,but the dizziness  can't.
I think If I was not on verap. I would have got slammed while flying.
I will try to vacation in the US in the future. My O2 provider can provide me with O2 at anyplace I travel in the States. I would be more comfortable knowing I had O2 in my hotel room if I needed it.

Great news, good to hear beasty wasn't able to screw up the anniversary plans. And congrat on 20 years! [smiley=thumbsup.gif]

Joe

I'm glad to hear the trip went well Frank.  Welcome home and congrats on the 20 years.

There should be a medal for something like that ;)

-Dennis-

Thanks for all the people who posted to this thread. Yesterday I did my first flight since starting with CHs. It was a 7 hour flight, so I was a bit apprehensive about how it would affect me until I read the replies here. But it was totally uneventful. I just hope the return trip is a similar non-event.

Crossing my fingers for ya Mike!

Joe

Totally uneventful return trip, although it did feel a bit odd as I dropped my oxygen cylinder back off at BOC in Perth knowing it'd be about 12 hours before I was back home to my home supply. Especially as Friday evening about 8pm is a near certain time for the beast to arrive when I'd be airborne but he didn't turn up.

Perth BOC (at Welshpool Road) were great. Since I'd not used any oxygen and the cylinder seal was intact I only ended up paying for the cylinder rental which worked out at under AU$5 (about US$5) for the two weeks. When the value to me of having it was near priceless.

And I get to try the flying again on Tuesday, but I've no fear at all.

Damn, great news all the way round! :)

Joe