Missed a 2nd day of work today due to CH's.

I've been in cycle 8 weeks now and although my hits are average KIP 2-3 each time, the frequency has been more than past cycles.  I've been getting these small hits 5+ x daily. 

This past several days has been a bit rainy and cooler temps here in Las Vegas and believe the weather has something to do with my hits becoming incredibly painful.  As mentioned above, i've averaged KIP 2-3 for past 7 weeks and this week has been KIP 7 - 8. 

Many have reported they get worse at a "peak" before end of cycle. 

My cycles usually last 8 to 12 weeks, so hope this is what is happening.

Yesterday and today I have called in sick from work.  I am a one man show in a small company as their only salesman.  This is obviously not good that I am not available to produce sales due to my absence.  My boss has been given the "letter to employer" and is empathetic and has been taking it easy on me this past month of September.  But I fear he will not remain patient. 

I have no patience for any BS right now and honestly could not see myself dealing with clients and work while experiencing fatigue from CH's, let alone a shadow or an attack.  This sucks!

Perhaps, time to review your treatment program to see if some changes are needed.

See, under "Medications", message-"Frova-advantages".
The longer effective life may be useful when you are having a string of mild attacks.

That's good advice from Bob.  Frova is a long acting triptan that can give you a good break - for a day anyway.  All you can do is rest up as best you can and get back in there. 

You've been around here a while now.  You know what options there are.  Have you tried Batch's regime?

-Dennis-

I hope that you get some relief soon. I've had to miss a few days of work due to my last episode and it was rough. My boss is also understanding, but even an understanding boss can only take so much. (((hugs)))

My boss is getting very frustrated with me missing so mu h work and being very unproductive.  I have only been putting in mornings and leaving work in the early afternoon and not returning.  I fear being away from my home as that is where the o2 is located.  I bring Imitrex to work with me, but fear taking more than 2x/day, so feel more comfortable at home next to the o2 as I get attacked btw 2pm and 3pm, middle of my 9am to 5pm workday.  Think I am going to get fired because of these fucking CH's! :(

If your job is on the line it's time to become more assertve about your treatmen program. Working with your doc--now?

Might be time to look at alternatives.

Clusterbusters.com

Given new life to many here. Either way you go, wishing you a break soon, good luck with the job.

Joe

I often abort 4-6 times a day with Imitrex injections. 
They are gone before they become a work issue. 

Use your Imitrex injections at work.
At home debate whether to go with additional Imitrex injections or alternative methods. 

Why are you only doing 2x Imitrex per day?  Are you doing half-injections?  You should be clear for at least 4x half-vials per day. 

I do 2.0ml on my average abort... under half a vial, so technically I am good for around 5x aborts per day.  I tend not to sweat #6 if it comes around.   

what about another O2 tank at work, my boss is very understanding and lets me have one here if a hit happens at work right to the O2 and then back to work. I haven't had to use it for weeks as Batchs D3 regime has had me PF except when I stopped it thinking my cycle was done - it wasn't and right back on it and back to PF

Have no doctor = no health insurance, so this cycle i'm on my own.

Still getting hit 3x/day after almost 3 weeks of anti=inflammatory regimen and 11th day of Prednisone.

Why fear 2+/xday of Imitrex?  I fear heart attack!  Plenty of info i've read over the years about this subject that scares me.  Never was clear how to understand using less than 6 mg dose of trex inj.  Maybe somebody would be willing to talk w/ me on the phone about how to do this?  If so, PM me and I will give you my phone #.

Alterbatives may be only consideration in near future, we'll see how things go over next week of tapering off Pred completely and if cycle breaks and/or if anti-inflammatory regimen finally works.

No o2 at work as option due to outside sales going door to door all day to businesses.

Using o2 at home w/ Redbull that seems to help SOMETIMES, but that's the problem, can't be working while stuck at home in middle of workday.

Title: Triptan safety--latest statement
Post by Bob_Johnson on Jun 1st, 2004, 9:47am
--------------------------------------------------------------------------------
Since this is a report on medications and not on the condition being treated, I believe it would be O.K. to apply these findings to folks with Cluster. NOTE: there are no comments about using triptans at the high/multiple dosing which is often done by cluster patients. (Treat everything below the line as a quotation. These are selected para. from the total report.)
--------------------------------------------------------------------------------
Consensus Statement: Cardiovascular Safety Profile of Triptans (5-HT1B/1D Agonists) in the Acute Treatment of Migraine

Headache 44(5):414-425, 2004.

Posted 05/25/2004
Abstract
Background: Health care providers frequently cite concerns about cardiovascular safety of the triptans as a barrier to their use. In 2002, the American Headache Society convened the Triptan Cardiovascular Safety Expert Panel to evaluate the evidence on triptan-associated cardiovascular risk and to formulate consensus recommendations for making informed decisions for their use in patients with migraine.
Objective: To summarize the evidence reviewed by the Triptan Cardiovascular Safety Expert Panel and their recommendations for the use of triptans in clinical practice.
Participants: The Triptan Cardiovascular Safety Expert Panel was composed of a multidisciplinary group of experts in neurology, primary care, cardiology, pharmacology, women's health, and epidemiology.
Evidence and Consensus Process: An exhaustive search of the relevant published literature was reviewed by each panel member in preparation for an open roundtable meeting. Pertinent issues (eg, cardiovascular pharmacology of triptans, epidemiology of cardiovascular disease, cardiovascular risk assessment, migraine) were presented as a prelude to group discussion and formulation of consensus conclusions and recommendations. Follow-up meetings were held by telephone.
Conclusions: (1) Most of the data on triptans are derived from patients without known coronary artery disease. (2) Chest symptoms occurring during use of triptans are generally nonserious and are not explained by ischemia. (3) The incidence of serious cardiovascular events with triptans in both clinical trials and clinical practice appears to be extremely low. (4) The cardiovascular risk-benefit profile of triptans favors their use in the absence of contraindications.

----------
These data should be interpreted in view of characteristics of the patient population in migraine clinical trials. Generally, controlled clinical trials with triptans excluded patients with cardiovascular risk factors including known ischemic heart disease, symptoms or signs consistent with ischemic heart disease, cardiac arrhythmias requiring medication, and supine diastolic blood pressure >95 mm Hg and/or systolic blood pressure >160 mm Hg. Thus, the clinical trials data cannot be generalized to migraine sufferers with cardiovascular risk factors.

Triptans are associated with a modestly elevated incidence of chest symptoms (ie, triptan sensations) relative to placebo in well-controlled clinical trials that excluded patients with significant cardiac risk factors or known ischemic heart disease. The chest symptoms in clinical trials were generally transient, mild, and nonserious.

Given the widespread use of triptans, the risk of serious cardiovascular adverse events during postmarketing surveillance appears to be very low. While the risk of a serious cardiovascular event during triptan use appears to be very small, it cannot be dismissed. Serious cardiovascular events, some of which resulted in death, have been reported in association with triptans during postmarketing surveillance. The causal association of triptan use with serious cardiovascular adverse events is difficult to determine based on the postmarketing surveillance data alone.
===========
Expert Opin Pharmacother. 2010 Nov;11(16):2727-37.
Sumatriptan therapy for headache and acute myocardial infarction.
Barra S, Lanero S, Madrid A, Materazzi C, Vitagliano G, Ames PR, Gaeta G.
SourceAntonio Cardarelli Hospital, Cardiology Unit, Via Antonio Cardarelli, 9, 80131 Naples, Italy. giovanni.gaeta@tin.it

Abstract
IMPORTANCE OF THE FIELD: Migraine is a common, debilitating, chronic neurovascular disorder. Triptans are considered the drugs of choice to treat migraine attacks; however, their use is limited owing to concerns about cardiovascular safety.

AREAS COVERED IN THIS REVIEW: The aim of this review is to describe: the mechanisms of action of triptans; the case-reports of acute myocardial infarction (AMI) associated with sumatriptan use; and the results of studies evaluating its tolerability and safety.

WHAT THE READER WILL GAIN: Sumatriptan administration can be followed, in close temporal relationship, by AMI in young or adult migraine patients. Some of these cases have developed in subjects taking their first dose. Based on the results of prospective studies,

THE RISK OF SEVERE CARDIOVASCULAR ADVERSE EVENTS AFTER THE USE OF A TRIPTAN IS ESTIMATED AT 1:100,000 TREATED ATTACKS. THESE ADVERSE EVENTS, ALBEIT VERY INFREQUENT, HIGHLIGHT THE IMPORTANCE OF CAREFUL ADHERENCE TO THE SUMATRIPTAN PRESCRIBING INFORMATION.

TAKE HOME MESSAGE: Inherent in its mechanism of action, sumatriptan could produce (coronary) vasospasm sometimes followed by AMI. The drug should not be prescribed to patients with history, symptoms or signs of ischemic vascular disease; an in-depth evaluation should be carried out in subjects at intermediate cardiovascular risk.

PMID:20977405[PubMed

very challenging night, exhausted, depressed, called into work a few minutes ago advising I will be taking today and tomorrow off, hoping my cycle breaks over the weekend and hoping I still have a job on Monday

OUUUUUCH!!!

Good thing I stayed home today, much easier to scream loudly and pace frantically when all alone   :'(

Hello,

This is what normally happens to me... (well when I was in cycle) i would get my morning wake up, jump to the 02 tank, and after 10 mins or so i would lay back down and my loving wife would say "are you OK Hun"?? and after a nod of yes she would softly say to me " Then get up and go to work"

Hope that helps.
Protect the plate...
Coach Bill

coach_bill wrote on Oct 21^st, 2011 at 9:33pm:

Hello, This is what normally happens to me... (well when I was in cycle) i would get my morning wake up, jump to the 02 tank, and after 10 mins or so i would lay back down and my loving wife would say "are you OK Hun"?? and after a nod of yes she would softly say to me " Then get up and go to work" Hope that helps. Protect the plate... Coach Bill

I've never had a worthy supporter in 32 yrs of suffering, except you guys and now my 11 yr old son, thanks to all of you in Clusterville for continued support.

If somebody could please PM me who is familiar with how to properly do the "Imitrex Tip", I really need to learn and try it.  Will gladly give my phone number to be coached.

START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE

I've never done this, but these are the details of how to take the stat pen apart, and using a q-tip for the plunger, metering a standard dose into up to 3 doses. Hang in there Vegas, high cycles are a rough road. We've all ben there and it sucks. :(

Joe

Vegas,

The trex trick is not at all tricky,  there is a great video to help ya along with that on youtube, but i gotta ask... If your willing to take the chance of running the trex trix, Tell me you have at least looked at clusterbusters????

Protect the Plate...
Coach Bill

Joe, thanks!  Read that a million times and didn;t make sense until I re-read it after I had a phone conversation with another sufferer.  Thank you to both of you! 

I've tried it 4x and it worked, but took much longer than a regular 6mg inj.  Additionally, my shoulder is swollen from the inj site and lots of dripping blood each time.  Maybe my favorite shoulder is not the best place?<<<sarcasm!

Coach Bill,
I'm getting there, just have HOPE 123 regimen will terminate cycle and/or after 11 weeks and 1 day that tonight is the "grand finale".

My Pred is down to 30mg and haven't slept more than 2 hrs in past 24 hrs.  Been hit viciously every 45 minutes to 3 hours.  Downed at least 8 cans of RedBull, 1,000 psi of o2, 18ng of Trex inj, 40mg of Trex sprays...all in the past 24 hrs!  I am emotionally drained, yet wired probably from the RedBulls and adrenaline.  Taking these few PF minutes to check emails and post here...then try to be as productive as possible while away from the DEMON and his little f--kin sidekick gremlins >:(

Needless to say, I am officially on a leave of absence from work!

Sub-q injection hurts the least in belly fat.

Thank you Brew!  This helped w/ less pain and no blood! ;)

You're welcome, LV. I inject myself subcutaneously with a different med twice a week, and I've developed a circular pattern around my tummy so I won't hit the same spot but every three weeks.

Of course, it's not Imitrex, so I'm not in the throes of pain when deciding where to stick either.

Brew wrote on Oct 24^th, 2011 at 7:17am:

You're welcome, LV. I inject myself subcutaneously with a different med twice a week, and I've developed a circular pattern around my tummy so I won't hit the same spot but every three weeks.

Now this could be a good use of a tatoo, with a suitable pattern to guide you around your three week loop!

Mike NZ wrote on Oct 24^th, 2011 at 2:23pm:

Now this could be a good use of a tatoo, with a suitable pattern to guide you around your three week loop!

That's pretty funny.

Vegas,

Hang in there.. It will be gone soon and you will be  back to a normal boring life (never sounded so good huh).

Protect the Plate
Coach Bill

Does anybody remember at the end of Total Recall movie when Arnold and his lady sidekick were gasping for air and their eyes started bulging out of their skulls?  This is how i've felt several times today, yesterday, everyday is running together as one continuous long living nightmare.

I sure hope this is the "grand finale" and about to end my cycle, as this is truly unbearable but will not quit as I recognize this is temporary and must live to the fullest btw hits. 

The o2 is only helpful if started at onset of attack and to hyperventilate need to be at 40lpm, sometimes 60lpm.  25 lpm is for slow deep breaths only and 15lpm is used for 5 or 10 minutes after successful o2 abort.  But even with Redbull, o2 does not always work, especially if KIP level is high. 

Imitrex inj works best and am using half doses manually with qtip in stomach, but probably getting rebounds as the frequency is countless times per day now, my guess is up to 8x/day and running out of trex. 

So leaving in a few hours after I get my 11 yr old off to school and take advantage of my leave of absence and make a full day drive roadtrip down to Mexico.  Did this 6 yrs ago and no prescription required, unlimited supply (despite limited cash) and change of scenery w/ a lonely desert drive should do me good. 

Thanks again to all of you for your encouraging words, wisdom and support.  We are all unique, yet each of us here are so very much alike sharing this rare disorder that nobody else understands.

Will post upon my return tomorrow night. 

Long day jabbing stomach 4x while driving 80mph w/ my knees on lonely desert highway :'(  but this blonde/blue eyed Viking made it in/out of an unsafe, poverty stricken war zone safely with a bag of Imigran Solucion and a full stomach...awesome food!  ;)

Wow...that's truly going the extra mile...and mile...and mile. Glad you're safe and away from the border wars. How often do you have to make that trip? Blessings. lance

wimsey1 wrote on Oct 26^th, 2011 at 8:04am:

Wow...that's truly going the extra mile...and mile...and mile. Glad you're safe and away from the border wars. How often do you have to make that trip? Blessings. lance

That was my 2nd time.  Last time was my last cycle, Aug/Sep 2005.  Tragic accident/Coma resulted in a 6 yr remission of CH's, but the Demon and his little f--kin gremlins are all making up for time missed with me, that's for damn sure!

Tortured w/ 11 attacks in past 24 hours since i've returned from south of the border.  Maybe got 4 hours sleep total in last 48 hours, absolutely drained.  This is a living nightmare!!!  Used most of my free time last night and today on this site researching archives, pdf files, etc.

Am starting another Pred taper and this time adding the Verapamilo.  Did not start Verap 18 days ago at start of 1st Pred taper cuz I was...

A-hoping the anti-inflammatory regimen would have helped, but after 4 & 1/2 weeks absolutely no benefit whatsoever, however I will still take it nightly just in case it all of a sudden helps.

B-didn't want to take the chance of my sex life being destroyed by Verapamil possible male side effects, but after 4 yrs she dumped me last week, so might as well take what worked for me in past cycles.

Let my boss know I will try to return to work on Monday-Halloween, but I doubt I will get there as i'm too afraid to be away from my o2 tank.  Hoping for the best of course!

Sure miss the days of having a decent paying job that offered medical benefits and short term disability!!!

I'd be surprised if I were the only 1 in cycle right now that is not able to work.  Anybody else going through something similar?

I'm one of the guilty ones that stays off the boards until I'm suffering again...must be something in the back of my brain telling me if I don't think about it, it will go away...heh.

Back to reality.

I've been online here for the last few hours hoping that some miracle cure happened since 2009 (my last cycle). I have been in the non-working mode for two days now with one of the most unpredictable cycles my mind can remember in the 22+ years I have been living with this...thing. I can't honestly say I've tried all possible treatments but I've tried a lot. I had to place a call today to get my O2 script renewed as that is pretty much all I do anymore. I had become a pincushion for a few Neuro's in the past and finally, around 2001, decided, with the help of a close friend and family, to detox myself. I'll be straight with you. It was hell. After that cycle stopped, NOTHING happened for the better part of 3 years.

I don't even remember what I was taking at the time but I know a ton of the different varieties/cocktails I had been taking over the years is still in use today. After an almost 3 year period, it came back....first in the Spring, then in the Fall. It went away for almost 2 years...then repeated the same schedule. The last couple cycles have been more erratic but then again, I think I may have broken one with some clusterbuster treatments back in 2006. Ever since then, I'd have better luck winning the Powerball jackpot than trying to predict my next cycle.

I guess my whole point of this rambling is to say; "I'm back" and that you're not alone.

I'm taking tomorrow off work as well and also going to give the Batch method a shot as it's not to far from the stuff I'm already taking...just in larger quantities. There's quite a bit of stuff to go over since I've been out of the loop for so long...and, it's a good excuse to not sleep   :/

Uncontrollable,
Many only come here when in cycle, I am also guilty of this, welcome back. 

We are all "David Banner" on the same drowning battle ship trying to stay afloat. 

Sounds like you know quite a bit about CH's and have taken proactive steps in your treatment over the years.

Thanks for sharing I a not the only 1 missing work as a result of CH's.

Stick around, PFDAN to you  ;)

Hey Uncontrollable, and welcome back. No cure since 2009, but as you're finding, we have learned a lot about how to tweak the prevents and aborts. I came here looking for a way to deal with the Beast and I found several. I would encourage you to make an exhaustive list of everything that someone has said has helped, whether or not you have already tried that, noting specifically doses and frequencies. Then, compare that list exhaustive list against your own experience, again noting anything different from when you tried it. Pay particular attention to the O2 links. Many of us are finding that we started with 8-15lpm and a general nonrebreather mask, and found that flows up to 40lpm with a specialized clustermask helped tremendously. And coupled with an energy drink, brought my abort times down to 3-5 minutes. Same with verapamil. On it forever, but at the label max of 240mg/day. Now, at 640mg/day I have some control over the hits. Let us know how you are doing and don't hesitate to ask questions. God bless. lance

Uncontrollable,
Was thinking about what you and I both wrote here...we don't come around often enough when out of cycle.  I do check in here and there, but not like during a cycle that's for sure.  PF time we don't want to think about CH's so we focus on being productive, right?  At least that was my logic, until a few minutes ago I realized that this cycle my PF time is spent researching and trying to better understand everything new and what I never learned before and what I once knew but forgot.

I think it would be wise of sufferers to read when not in cycle, as I for one certainly would rather my PF (while in cycle) time to be shared w/ my 11 yr old son.

Also, I feel good when I help others, just my kind nature.  So to post encouragement and/or recommendation to somebody suffering, even when out of cycle, makes me feel good knowing I helped somebody possibly feel better.

Does this logic of mine make any sense? Maybe not, lol, cuz i've had barely any sleep in I don't know how long now.

To Lance and others taking Verapamil...
I've read a few "dont's" while taking Verap:

1. avoid grapefruit & grapefruit juice
2. no melatonin
3. avoid energy drinks

#1 is from drugs.com and heard it from pharmacists.

Is there any validity to #2 or #3 ?

I'm planning on starting Verapamil on Friday am and taking advantage of Redbull and 02 today/Thursday.  Redbull w/ o2 helps m much better than 02 alone, so would prefer to wait a day on Verapamil to hopefully get a few things done.

Hit 4x KIP 8-8-9-9 in past 6 hours.  Very minimal PF time so have tried sleeping.  No more than 45 minutes PF. 

Hit 1 & 2...Trex nasal spray abort less than 10 min and 2nd attack aborted w/ spray in less than 5 min.

Hit 3 & 4...Trex inj (3mg) abort less than 15 min.  and 4th Trex inj (3mg) no abort/just reduced to low KIP 3 which I have now.

o2 is out and will get refill in less than 2 hrs when welders supply opens for the morning.  Too much Imitrex I know, but am out on a limb :'(

Welcome back uncontrollable. Don't sweat the staying away while out of cycle, everyone deals with their cycles differently. The Batch regimen has been working wonders for many, hope it gives you the edge you're looking for.

Joe

Hey guys!

Thanks for the warm welcome back! Though, this isn't how I would like to spend my time in a perfect world (no offense), it is nice to know I'm not on that deserted island completely alone.

I agree with Vegas that we should be more proactive in staying current with the boards. For all I know, something could have been discovered and I could be taking something in my PF time to keep the beast at bay. So far, I have gathered a ton of info that could possibly help. I WILL keep you guys up to date.

Wimsey, when I dropped everything but the O2, it was a rocky start but I finally found my groove by modifying an old non-rebreather from an ER trip and messing with the regulator I was renting...since then, I have purchased the Clustermask and bought my own regulator that bumps up to 25 lpm. No easy task, mind you. Most of these max at 10-15. It took a little digging and reopening my ebay account but it was worth it.

If I can keep myself calm and slowly exhale, 15 lpm will fill the bag quick enough. When that doesn't apply, 25 does the trick. Usually not on it more than 15min and I'm keeping Red Bull stocked in the fridge. A friend had mentioned Bronkaid when i told them about the effects of Red Bull and even gave me a few tablets but I have been too scared to give it a try. I have seen mention of it here on the boards but I guess I'm just weird like that.

Guiseppi, I'm on Day 1 of the Batch method...MAN that's a lot of pills to swallow! I will keep you guys in the loop as far as progress goes. I still plan on taking no prescriptions (besides O2, of course) this cycle so my results should be pretty un-tainted one way or the other.

Thanks again for being out there...all of you!

UN

Quote:

To Lance and others taking Verapamil... I've read a few "dont's" while taking Verap: 1. avoid grapefruit & grapefruit juice 2. no melatonin 3. avoid energy drinks #1 is from drugs.com and heard it from pharmacists. Is there any validity to #2 or #3 ?

Gregg, thanks for the reminders that we need to check drug interactions even when using OTC products. I have to say I have not heard of, or experienced, any interactions between verapamil and melatonin that would scare me off. My neurologists (I have two!) both are aware of what I take, and have not had a problem. Nor have I. The energy drinks are another matter. I limit myself to one a day, at most 2 but almost always 1 works fine. Too much could be worrisome with the level of verapamil I take daily. We have issued warnings about this from time to time, so it's good to be cautious. God bless. lance

How about keeping some tanks in your car while you work?  I'm guessing that, if you are walking door to door, you park your car somewhere near? If you feel a hit coming, make your next stop your car.  For those times you can't make it there, use your Trex. 

I no longer go anywhere without a way to abort a hit.  Whether it is a shot or a tank, I've learned that they are a part of my life.  I won't let my CH determine what I do or where I go OR whether I am able to work. 

Jeannie wrote on Oct 28^th, 2011 at 2:05pm:

How about keeping some tanks in your car while you work?  I'm guessing that, if you are walking door to door, you park your car somewhere near? If you feel a hit coming, make your next stop your car.  For those times you can't make it there, use your Trex.  I no longer go anywhere without a way to abort a hit.  Whether it is a shot or a tank, I've learned that they are a part of my life.  I won't let my CH determine what I do or where I go OR whether I am able to work.

O2 in car and Imitrex sounds good in theory, but the reality is...

I could purchase a small tank and another mask and another high flow regulator and a 670 connection customized to fit the smaller o2 tank, etc., etc but O2 only works 1/2 the time for me and those 50% times when I can abort with o2 requires 20 to 30 minutes to completely abort.  Reason being is one of my lungs is only 70% at best due to past injury (hemopneumothorax) so requires me to be on o2 longer than "ideal studies of abort times". 

Just had a 2 hour phone call with Batch who says my o2 therapy is spot on, so I know I am doing everything I properly can.

So my work productivity level would be minimal as much of my workday would be attached to an o2 tank and mentally preparing for the next appointment while being exhausted from my last attack.  Using o2 while out and about on sales calls to 30+ businesses daily would be an exhausting, time consuming and very painful challenge.

Without a doctor, health insurance nor prescription...Imitrex is extremely limited supply, but does exist thanks to donations and minimal cash purchases in Mexico.  Even if I had an unlimited supply of Imitrex, we all know the rebounds are common and the side effects of too much trex is harmful. 

So with an avg of 3x/day attacks btw 8am to 5pm "work hours", I am truly restricted from a productive work day.  Bottom line is until I am out of high cycle, I am limited on my productivity with any aspect of my life, specifically my job.

I am in a very high cycle getting hit every hour of the night and absolutely exhausted during the day while enduring addtl 3x/day hits.  Feel like I am going out on a limb on the rare occasion that I am able to leave the house for a quick grocery run or get my son to school, so have minimal confidence I could survive 1 full work day without consequences.  I am sincerely not well.

Just got off the phone w/ my boss who told me I need to make a decision if I can return to work next week and go full force or if I need to part ways and get healthy.  Once healthy enough to work to call him and ask for my job back but no guarantees.  I am no where near ready to go back to work in the same capacity and have no idea if my cycle is ending, if I am going chronic, or when my high cycle will end.

I don't want to quit and my boss says he doesn't want to can me.  But my boss says I have to make a decision on Monday if I am well enough to work without more time taken off or he will have to hire somebody else and can not afford a replacement and me.

Unfortunately this is not my decision if I am able to get out of cycle by Monday, it is the Beasts decision, as I truly have no control over when I am going to be attacked, how long I am to remain in cycle, etc.

Feeling much pain physically, emotionally and financially.  I am truly stuck btw a rock and a hard place w/ decision to give my boss on Monday. 

Well, I was scheduled to go back to work this past Monday-Halloween.  However, my cycle is still high and unable to be away from o2 for long periods of time as i'm still being attacked an average of 3x/day and 4x/nightly.

Paid cash for a neurologist appointment yesterday and it went very well.

Got doctors note to stay away from work til the 21st.  This should give enough time for blood levels to titrate and become effective with Verapamil prescription.

My boss told me he has a business to run and will need to find a replacement if I can not return to work this week.  He asked me to resign and after i'm healthy enough to work to call him and IF an opening is still available, then I am welcome back.  Key word is IF.  No thanks! 

I let him know I am not resigning and will return on the 21st and if he can not be patient to wait, then I guess he would just have to terminate me.  He is the cheapest, most frugal man i've ever worked with and his only concern is his company, not his sole breadwinner salesman (me) welfare.  Only him and his wife and me are full-time employees and he nor she has even called me once to ask how i'm doing.  I've been away from the office since the 20th.  This clearly shows they are only out for themselves and don't care about me.  No benefits, just low hourly pay and horrible pay plan on commissions.

After 4 days of emailing back n forth between my boss and I, he advised he is not terminating me.  Probably because he realizes A-few salespeople will match my loyalty and efforts and B-the time it would take to train a replacement, I would've returned to work. 

It's too bad he didn't fire me because after the back n forth stressful emails with him over these past several days I believe there is much hostility built up and am not looking forward to working for this jerk anymore.  Not to mention all of these emails were triggers to attacks!!!

FMLA not available due to the 50/75 rule and EEOC is not available either, as the company I work with has only 3 full time employees.

Suppose the good news is at least I still have a job with time off (not paid) to hopefully get my cycle under control.

I don't feel so isolated now that i've read this new report...

"Cluster Headache Personal Burden.—In the USA, 17% of the surveyed population had lost a full-time job due to their cluster headaches. A total of 8% were currently out of work or were on work-related dis- ability secondary too their headaches. Full lost days of work per year secondary to cluster headache were 1 to 10 days in 47%, 11 or more days in 21%, while 32% had never lost a single day of work. A total of 38% were unable to leave their homes between 1 and 12 days per year because of their cluster headaches, while 11% stated they were literally bed-bound for 31 days or more per year because of headaches, while 28% had never lost a single day because of head pain."

---

Only 7 weeks away from work, with neurologist notes submitted stating "temporarily disabled" and received notification from employer that my position has been replaced. :-[