Hey all, I'm a little bit shaken up and I thought someone on here might have some insight or could at least assuage me for the next 24 hours before I put in a much needed emergency phone call with doctor man.

I literally had the worst headache I've ever had in my entire life last night, and you know for us that's saying something. It began around 3:00 AM. I was still up with my partner as he's visiting from quite far away so I wasn't asleep for any part of it. So it began around 3:00 but wasn't bad for a while... 3-4 on the kip. I didn't want to treat it because I've been in a really bad spot the last few days and have needed more Zomig than I like to take fearing rebounds. That 3-4 lasted until about 3:30, and all of a sudden it went from about that level of pain to an imaginary "27" on the kip scale in about 2 minutes. It ramped up so quickly and so intensely that I almost passed out from how fast the pain was overwhelming me. It was so awful that my partner and I couldn't even get the cap off my Zomig when I decided I absolutely needed it (approx 3:31, or less than minute after whenever it started to get Really bad) because we were both freaking out and I had to bite it and pull it off with my teeth because I couldn't wait another second. He's usually very calm and very good about this, but I think he was getting very frightened as well because he's never seen me collapse that fast.

So, I took the Zomig around then but was already getting totally slammed in a way I never even thought possible. The pain was so intense it spread much past where it normally goes; it is usually centered in my left temple and upper cheek and jaw... this time the pain traveled past the imaginary halfway point between the left and right sides of my face, but not over my whole head... could still feel pain over my right eye. It also traveled all the way down my nose, which was the weirdest sensation. The whole bridge of my nose was on fire. The pain was so, so bad that while I wasn't suicidal I actually thought to myself "you know what? There's always a chance I am truly having an aneurysm or something this time and am going to die."

It persisted at that kip "27" until about 4:45 and then began to subside, but until about 6am it kept retreating to a kip 3 or 4 for 5 minutes and rising again to a full 9 or 10 for about 5 minutes... up and down for that whole time. That also rarely happens to me. The Zomig usually either totally aborts an attack or doesn't touch it, not that weird in between thing. By 6 it was a kip 2 or so and then continued to gradually completely subside (by 6:30).

Now, it's getting cold here in Wisconsin and there's a chance my normal headache also aggravated a sinus infection I have and don't know about that made my whole face hurt. I don't want to worry unnecessarily, but I'm sure you'll all understand why I am a little terrified because this is very unusual. I've always read that in terms of emotional stress especially, chronic pain patients should try not to worry too much unless things change and... this was a big change. I don't really need advice on the best path to take with my meds after this because none of them are really working anymore. I just thought maybe someone could share either a similar story or just tell me I'm not dying even though I know I'm not. And frankly, I also know that no one here can actually promise me I'm not going to die for certain.

I know it may sound like I'm being way too dramatic about this, but words cannot fully express the severity of my pain or the depth of my concern in light of this situation. I'll be calling my doctor first thing in the morning, but need to get through till then emotional (and physical) without totally losing my sanity. Don't worry, I'm pretty sure myself I'm not REALLY going to die but man, am I scared in general after this.

Thanks...

Zac

EDIT: For everyone asking about my cycles, I am chronic.  :'(

That sucks Zac. Obviously, a call to your doc is warranted to confirm it was just an A$$ kicker CH and nohting else. I don't recall if you have tried the oxygen route or not? The best thing for me with 02, is you never have to gamble with whether or not "this" hit is worthing using your med to abort. Every attack, from a shadow, to a K-10, you nail with 02 as soon as it starts.

Hoping the doc has some answers for ya. Hang in there.

Joe

Guiseppi, I have done the O2 thing. It just doesn't work for me. Doc is very informed about oxygen therapy and wrote script for 15-45 LPM so I have tried pretty high flow and have followed all of the tips on the oxygen page here including the demand valve. I know it's unusual and just sucks, but O2 does not work for me.  :-/

It's the crappy nature of CH. There doesn't seem to be much of anything that works for everybody. >:(

Joe

Zac, that was quite a dramatic literary masterpiece, thanks for sharing.  We read because we care and understand and offer advice but are not doctors and you know that.

I'm in the worst cycle I recall of 32 years of surviving this living nightmare and also have felt as if my head was going to explode with aneurism or whatever on many occasions, last night and the night before and the night before that and for the past 15 weeks, so I understand and empathize.

In fact, I refuse to bend my head down for any reason while being attacked in fear the TORTURE by the DRAGON will worsen!  That's just me though, probably would be just fine.

O2 does not work with me every time either.  One of my lungs is only 70% due to a past injury, so the o2 takes me longer than most to abort and sometimes does not abort. 

Have you tried slamming a can of Redbull or energy drink at the onset of an attack? 

How about slamming a Redbull or energy drink at the onset of an attack followed by O2 hyperventilating while sitting up (not in a fetal position) with a NRB mask at 40 lpm?

If Zomig is a problem for you, get a script for Imitrex injections and use the Imitrex Tip to conserve and help eliminate TORTURE by the DRAGON.

What preventative meds are you taking and at what dosages and for how log at those dosages?

How long have you been in cycle?

Don't be a stranger Zac, we are here to offer our support to you.

Call your doctor!!!

As effective as is Zomig, it's a bit "soft" on the initial impact compared to Sumatriptan injection. Suma hits hard and fast but it's not as long lasting as other in this family--but worth a try.

If Suma. doesn't do the job, ask your doc for a sample of this one. Number of us have had excellent results and it's almost as fast acting as Suma.
--
Headache 2001 Sep;41(8):813-6 

Olanzapine as an Abortive Agent for Cluster Headache.

Rozen TD.

Department of Neurology, Jefferson Headache Center/Thomas Jefferson University Hospital, Philadelphia, Pa.

OBJECTIVE: To evaluate olanzapine as a cluster headache abortive agent in an open-label trial. BACKGROUND: Cluster headache is the most painful headache syndrome known. There are very few recognized abortive therapies for cluster headache and fewer for patients who have contraindications to vasoconstrictive drugs. METHODS: Olanzapine was given as an abortive agent to five patients with cluster headache in an open-label trial. THE INITIAL OLANZAPINE DOSE WAS 5 MG, AND THE DOSE WAS INCREASED TO 10 MG IF THERE WAS NO PAIN RELIEF. THE DOSAGE WAS DECREASED TO 2.5 MG IF THE 5-MG DOSE WAS EFFECTIVE BUT CAUSED ADVERSE EFFECTS. To be included in the study, each patient had to treat at least two attacks with either an effective dose or the highest tolerated dose. RESULTS: Five patients completed the investigation (four men, one woman; four with chronic cluster, one with episodic cluster). Olanzapine reduced cluster pain by at least 80% in four of five patients, and TWO PATIENTS BECAME HEADACHE-FREE AFTER TAKING THE DRUG. Olanzapine typically alleviated pain within 20 minutes after oral dosing and treatment response was consistent across multiple treated attacks. The only adverse event was sleepiness. CONCLUSIONS: Olanzapine appears to be a good abortive agent for cluster headache. IT ALLEVIATES PAIN QUICKLY AND HAS A CONSISTENT RESPONSE ACROSS MULTIPLE TREATED ATTACKS. IT APPEARS TO WORK IN BOTH EPISODIC AND CHRONIC CLUSTER HEADACHE.

PMID 11576207 PubMed

--------------------------------------------------------------------------------

Olanzapine has a brand name of "Zyprexa" and is a antipsychotic. Don't be put off by this primary usage. Several of the drugs used to treat CH are cross over applications, that is, drugs approved by the FDA for one purpose which are found to be effective with unrelated conditions--BJ.
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Since this abstract was first posted Zyprexa has appeared in some lists of recommended meds for CH. [BJ]
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Also time to look at your preventive med--both type and dosing.

Just an update... put in e-mail to doctor so he knows kind of what happened and will talk to him some time tomorrow. I've been feeling okay today, I only had one minor attack... a 5 on the kip but compared to last night that was still so much more bearable. I didn't treat it since as of right now, I do (as Guiseppi said) have to kind of pick and choose which attacks I treat since I always have to worry about rebounds with no luck on the O2. Considering I am chronic, I am at least lucky in the sense that most days I don't get a huge number of attacks; usually 2 or 3 but sometimes only one so the first few headaches of the day are a little easier not to treat since I know they may be the only ones I have to struggle through. I do, however, get into week or 2 long periods where I will get upwards of 5 a day... so I'm just grateful for any times I can avoid even one attack. And of course, I have to treat them more often when I'm having so many because after I struggle untreated through 3 or 4 all day long I just can't handle anymore physically or psychologically.

That's about all, and at least I'm happy to report there was only one today. Sometimes little news is good news  :-/

Zac, please forgive me if you have already discussed this on site, but I am wondering since O2 does not work, and your primary abortive (zomig) is letting you down, what is your plan? How will you abort future hits? If you do not have a plan, then you are leaving yourself to the mercy of your doc, which in my opinion, is never the best route. If you haven't made an exhaustive list of everything someone here uses an abortive and preventive, I would highly encourage you to do so. It's extra work but it does give you a possible roadmap toward effective and personally tailored treatment. It beats just sitting around waiting for the next attack. I know. At my worst chronic cycle i was getting hit 6-8 times around the clock, non-stop, for two years. Now, about once a day. Cake walk, right? Good luck, and God bless. lance